In the world of mental illness we talk about “response” and “remission” and not cure for mental illness. The reason is very simple – we don’t know of a cure for mental illness. One may exist, but we don’t know of any such cure for bipolar disorder, depression, schizophrenia and other mental illness.
What are Treatment, Response, Remission and Relapse?
The words we use most often are treatment, as in I’m in treatment for bipolar disorder; response, as in I’m responding to treatment for schizophrenia; and remission, as in I’m in remission from depression.
- Treatment – treatment is whatever is applied to make an illness better such as therapy, medication, mindfulness and so on.
- Response – response is generally positive or negative and indicates whether a treatment is working. A positive response means you have shown improvement on a given course of treatment, it does not necessarily mean that all your symptoms have disappeared, only that there has been positive movement in some way.
- Remission – remission is the state in which all or most of your symptoms have “remitted” or gone away. People have remissions from cancer, and many other illnesses as well as mental illness.
- Relapse – relapse is a state in which the symptoms reassert themselves after a period of successful treatment or remission.
What is a Cure for Mental Illness?
A cure for bipolar, depression, schizophrenia or other mental illness would be a state of recovery where no more symptoms were present and you were returned to health permanently. This is the one that is contentious in mental illness. Most doctors believe that even once a mental illness goes into remission, relapse is possible, and in some cases, even likely. It is thought that the mental illness – the fundamental neurobiological causes – never go away, but they may be successfully treated for a period of time. This amount of time could be forever, but it most often is not.
So if a disease goes into remission forever, isn’t that a cure?
I guess that depends on who you ask. If you have to be treated for the rest of your life, even if you’re in remission I’d say it’s hard to argue that you’re “cured.” On the other hand, if you get better, taper off treatment, and remain better, then maybe you would consider that a cure. I’d be hesitant to use the word “cure,” personally, but that’s me.
Who Goes Into Long-Term Remission? Who’s Cured of Mental Illness?
That’s a toughie. I’d start out by saying that it’s impossible to know who will go into long-term remission or get “cured” of mental illness, but that isn’t exactly true. We know that people with milder forms of the disease have a much better chance of full remission. We know that you have a better chance at a mental illness “cure” if:
- You don’t have a family history of mental illness
- You have a more mild form of mental illness
- You have a good support system
- You have access to quality medical (including mental health) care
- You have had fewer episodes of mental illness in the past
Unfortunately, most of us reading this right now do not fit into this category. It doesn’t mean that you won’t find long-term remission; it just means that you’re not in the most likely group.
Is a Cure for Mental Illness Possible?
Mental illness is not one thing and all mental illnesses are not created equal. Depression isn’t the same as bipolar disorder which isn’t the same as schizophrenia. And with different severity levels, these diseases become, yet again, different.
But in the case of severe mental illness, is there a cure?
No.
Not if you ask me.
[push]I think suggesting there is a cure for mental illness overall just isn’t true. We don’t yet have a cure for mental illness. [/push]
I have no doubt that some people with a mental illness can experience long-term remission and some may even consider themselves “cured.” But I have yet to see a person with schizophrenia make that claim. I have yet to see anyone who suffers from psychosis make that claim. I have yet to see anyone with severe, long-standing symptoms make that claim. So it is possible? Maybe. In some cases. But maybe in those cases the disease just isn’t like the other cases. Maybe they are in a category by themselves. Maybe (undoubtedly) we just can’t recognize who is in that category.
So I wouldn’t want anyone to think that a cure absolutely is or absolutely is not possible for any given person, because I don’t know. But I think suggesting there is a cure for mental illness overall just isn’t true. We don’t yet have a cure for mental illness. We’re just going to have to live with that fact. But that’s OK. It puts us in good company with epileptics, Parkinsonians, diabetics and many, many others.
A Sidenote
As an aside, the closest thing we currently have to a cure seems to be deep brain stimulation. For those who get it, and for whom it works, it seems to “cure” depression. But this treatment is still in its very early research stages.
Serious motorcycle accident at age 18 , numerous broken bones and serious head injury sustained.
Hit a car head on flew 30 feet in the air (saw my life flash before my eyes) landed on the bonnet of a parked car and rolled in the gutter.
Further head injury sustained aged 21 when jaw fractured in 3 places by a coward punch king hit.
Diagnosed with Schizophrenia , then later even diagnosed bi-polar.
Hospitalised 3 consecutive times in Intensive Care Psychiatric Unit (ICPU) locked ward 3 months duration each time and further duration open wards thereafter release from ICPU.
20 years on Haloperidol injections.
Stopped taking more than 7 years ago when told by a Psychiatrist ” I’m surprised you are not sitting here dancing in front of me” , in regards to long term side effects of the medications , being Tardive Dyskinesia (TD).
Which is muscle movements a person cannot control , well known to be distinctive to people long term on Haloperidol , a drug which is no longer prescribed to new diagnosed patients. A drug phased out and discontinued which also had a side effect which thankfully I didn’t get , being instant cardiac arrest (heart attack).
After finding out these 2 major side effects (which previously over 20 years had not even been disclosed to me by anyone in the medical profession which is their obligation to do so under medical disclosure ) I stopped seeing Psychiatrists and stopped all medications completely.
It was like waking up after a coma , I started to regain my life back.
One of the major side effects also of the Psychotic drug Haloperidol was get this ” Hallucinations “.
Pays to read those very wordy and long bits of paper that come inside your box of medications.
Now at present 7 years no medication whatsoever , no support groups , no Psychiatrists.
Supporting my wife and two children age 5 and nearly 1.
Being self employed.
Struggling with day to day expenses at times , and times not.
Dealing with threats of evictions from premises , having moved house numerous times due to different circumstances.
Having a car of mine stolen with stock from my business in it and then having to rebuild my business from scratch with nothing and also scrunch and save and get another car.
Dealing with the passing of my auntie , also the passing of a friend , and passing of relatives of my wife overseas.
Numerous other mishaps ,and dilemmas over 7 years.
Most recent just finding out August last year when I took a traffic matter to court in my defence (also had no legal representation had to defend myself due to expensive legal costs of hiring a lawyer) that I have had a driving history of numerous offences recorded against my name for the last 26 years has been on my record due to a perpetrator , or perpetrators using my name as an alias which unless I took the traffic matter to court I would still be unaware , and get this same for a criminal record that has been also case of mistaken identity.
Oh and yes I am also dealing with this myself against roads and traffic , police departments and police commissions , and archived court history documents , ect ect to get it cleared up , as certain departments which I am entitled to free assistance with will not assist.
So remember from Intensive Psychiatric Care
Schizophrenic to Bi-Polar
To medication Free
Dealing with all of life’s ups and downs
Problems and what not.
Myself
In full competence.
So I pose the question or opinion ~
Would I be the only person known cured of a Mental Illness !!!
Or did all those Doctors and Psychiatrists get it wrong !!!
Would I hold a key to a cure !!!
As I have lived as Mentally ill for 2 decades on medications, locked up , drugged up , be it the illness injected into me as Psychotic drugs cause your mind to be altered and cause hallucinations.
And now I can live normal , No Medication
And also cope with more stress and pressure than even the best of them.
Here’s how I would look at the “cure” issue. There are plenty of bright, creative people from the same general gene pool area as we bipolars who didn’t get triggered to have bipolar disorder, and don’t get triggered to have it.
If you looked at a bunch of scans of their brains, you could come up with a pretty good idea of what a non-broken brain of people like us looks like.
Those of us who get bipolar disorder, there’s plenty of evidence that it’s an organic brain disorder. Our brains are actually broken. For a set of formerly bipolar patients to be “cured” they would have to have their brains no longer be broken, and stay no longer broken, without having to continue any kind of ongoing medical intervention to maintain that non-broken state.
If you have to have ongoing medical care to keep it at bay, it’s being treated, it hasn’t been cured.
And I don’t want a definition of a “cure” that would mandate turning all of us into perfect little Stepford clones of neurotyical people from the center of the population.
However, _healthy_ people from our own segment of the population, healthy and functional and non-broken people who are not symptomatic and bear no disease signs but otherwise bear a lot of personality and talent and attribute similarities to us—that’s what it would look like for one of us to be restored to health.
In therapy, when you talk about your goals and aspirations, a therapist frequently will ask, “What would that look like?”
And in the case of bipolar disorder, a cure would look like someone who is still _me_ in terms of my interests and talents and core personality, but without actual _damage_ to my brain and without whatever biological mechanism occurs in the course of the excess anxiety and mood disturbances.
If the doctors can’t do a brain scan on me and get results that are in line with the brain scans of a body of people much like me who do NOT have a major mental illness, then whether I’m symptomatic or not, I’m not cured.
“But I have yet to see a person with schizophrenia make that claim. I have yet to see anyone who suffers from psychosis make that claim. I have yet to see anyone with severe, long-standing symptoms make that claim.”
I guess you are not counting the people that have met online then?
It would have been better wording to say that she had yet to see them be able to make that claim _and substantiate it_.
Duh. We are _all_ familiar with those among us who are bughouse nuts to the point of talking to Psychic Space Bunny Radio in their heads yet simultaneously insist they have either never had a mental illness or have been “cured.”
Yeah, talked to this guy once. Claimed he was cured by God. I asked him how he knew God cured him, and he told me God told him so. Asked him was he sure about that? He said he was, and he could prove it. So he introduced me to God right there and then. And sure enough, I shook God’s hand and God said, “Absolutely, Napoleon, I cured you right after you beat me at checkers in the rec room.”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881943/
here’s one of the large numbers of trials on the beneficial role of maniduflness training on bipolar disorders.!!! Work on this!
another thing:
the discussion about the term “cure” seems like a rethoric game. Not so useful for people with bipolar disorder or depression. I think that “f you get better, taper off treatment, and remain better, then maybe you would consider that a cure” it’s a “cure” sinonimous…
The others concepts (what the author think cure is) are egotics and useless demonstration of rethorics, with an evident touch of perfectionism maybe due to a too much scholastic approach on the issue.;)
Sometimes to work with people with bipolar disorders is better that studying on the issue.
Good work.
The author seems to ignore the beneift of meditation in preventing and manage relapses.
“As an aside, the closest thing we currently have to a cure seems to be deep brain stimulation. For those who get it, and for whom it works, it seems to “cure” depression. But this treatment is still in its very early research stages.”.
mmm… not the only one…. I suggest the work of Professor Thomas Lynch on self control and refractory depression can be a useful point of view on how researches evolve.
Hi Matteo,
I wouldn’t deny that many people find many things _useful_ but that doesn’t mean they broadly apply.
And “cure” isn’t a rhetoric game. It’s what people want to know about. And yes, a maintained state of wellness can be thought of (maybe) as a “cure” and people use many, many ways to achieve this. And some people never can.
– Natasha Tracy
Bipolar is so sneaky. I do resent having to live with it 24/7 but I am one of those people who does not think they have changed for the better since being diagnosed. I am a bipolar 2, so it is a fine line. I really do not want to live with this for the rest of my life.
Great article.
MadamBipolar,
I understand the resentment of having to live with the illness. I feel it too. Unfortunately, there’s not much for it except just to keep living.
Thanks.
– Natasha
Natasha Hello!
Another great post. I have to agree with everything you say, at least when in the circles of people who suffer from mental illness. I would hate to hear from my son that he thinks he is cured, since he might wind up in square one again. On the other hand, as a professional I need to believe that there is some level of “cure” possible, and that permanent remission can be called a cure. While reading through your words, I was wondering if you would discuss transcranial magnetic stimulation. I believe that is what you are referring to in your “side note.” It looks promising, but nobody even knows when and on what type of depression it is good for. And certainly not for any of the other diagnoses. But there is hope.
Hi Ari,
“I would hate to hear from my son that he thinks he is cured, since he might wind up in square one again.”
That is the danger. And unfortunately, it happens all the time.
“On the other hand, as a professional I need to believe that there is some level of “cure” possible, and that permanent remission can be called a cure.”
I can understand that. I think people who work in the field need to maintain a high level of hope in order to keep passing that along to their clients. I have found this in good doctors and therapists.
“I was wondering if you would discuss transcranial magnetic stimulation.”
I can discuss this therapy and hope to have a person who has undergone it share her experience in the near future (she has found it helpful). I will put that on my list of suggested topics.
FYI, no, my sidenote was about deep brain stimulation which is completely different. In deep brain stimulation electrodes are implanted directly into the brain whereas in transcranial magnetic stimulation, magnets are used outside of the skull.
And you’re right, there is hope.
– Natasha Tracy
Hi Mike,
Unfortunately, it’s true, we can’t afford to turn our back on this disease for a minute without it possibly overtaking us.
I know about partial hospitalization programs – they do work well for some people, not to mention they are much more affordable for many.
– Natasha Tracy
~N, This is a great article. A good reminder for those of us who have been dealing with mental health issues for an extended amount of time. I was in a period of remission for about two years. I even started thinking in terms of the “C” word (although I never stopped taking my meds, stayed on my sleep schedule, monitored my stress level – all the tricks we’ve all learned to hold the demon at bay.) The storm came roaring back about two months ago with a massive bout of depression followed by a period of mixed episodes – even a psychotic event (haven’t had one of those in years.)
My Pdoc got me into a partial hospitalization program (if you’re not familiar with those, give me a shout. I’d never heard of it before either – still not sure of the effectiveness) We are now back to weekly sessions and trying to find a new cocktail that will get me back to a functional state.
Once you’ve been diagnosed with a mental illness, it does not pay to get to comfortable and certainly not complacent. the diseases will just break your heart – if not your spirit. Keep writing, be well.