Can people with serious mental illnesses recover? That’s the question. It depends on your definition of “recovery” of course, but we’ll get to that in a minute. “Recovery” is now the goal when it comes to mental illnesses and, if your doctor is anything like the one I had when I was diagnosed, he will have told you that you will recover. But I’m not sure that recovery isn’t a myth for those with serious mental illness. Read one for more about not recovering from serious mental illness.
What Is Recovery in Mental Illness?
This elusive concept of “recovery” is defined in many ways. According to the National Association of Mental Illness (NAMI), mental health recovery is:
“. . . a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her potential.”
That sounds ridiculous in its non-specificity. “Healing and transformation?” What does that mean? What is “healing?” Do I get 100% better? 50% better? And “transformation.” Do I turn into a butterfly? It all seems so wish-washy to me. (By the way, NAMI further confuses the matter by introducing the 10 “concepts of mental health recovery” here.)
The Canadian Mental Health Association (CMHA) does slightly better and says:
“Recovery is the personal process that people with mental illness go through in gaining control, meaning and purpose in their lives. Recovery involves different things for different people. For some, recovery means the complete absence of the symptoms of mental illness. For others, recovery means living a full life in the community while learning to live with ongoing symptoms.”
At least the CMHA mentions “mental illness.” At least they’re including us in that statement overtly (as I would argue that “mental health recovery” and “mental illness recovery” are quite different).
What Is Recovery in Serious Mental Illness?
To the best of my knowledge, no one specifies any difference between general mental illness (or health) recovery and serious mental illness recovery. I would suggest that recovery for those with serious mental illness (that’s illnesses like bipolar disorder and schizophrenia; about four percent of the population) is different. For example, “healing and transformation” is just a silly notion for me when it comes to recovery. I haven’t healed and the only thing I’ve transformed into is a writer — and that’s not because of the diagnosis.
I’ll give NAMI the concept of living a “meaningful life” as that’s a personal thing and, I think, achievable thing for most, but living in the community isn’t always possible and neither is this whole concept of striving to achieve “potential.” People with serious mental illness have, if anything, blunted potential (“Mental Illness and Crazy Blocks Goals“). Do you have any idea what I could do if I wasn’t sick every day?
As I said, the CMHA is a little more reasonable as it acknowledges that recovery is different levels of wellness for different people. “Healing” is too lofty a goal for too many.
The Myth of Serious Mental Illness Recovery
Please see my message to those with serious mental illness who are striving for this myth of recovery, here:
I’m a little bitter about the pressure to “recover” in serious mental illness. I’m a little bitter about it because I don’t believe it is possible for many people. You can define it however you like, but part of that definition has to be about wellness and functionality. Can you be considered recovered without some level of wellness and some level of functionality? Those things have to be there otherwise what is recovery for? Why would anyone want it without those things?
And the thing is, my level of wellness and functionality sucks. It’s better than some people’s, of course, but it’s not what I want and it’s far from my potential. In fact, it’s far from what my functionality was 15 years ago. In other words, I’m getting worse. (That’s not actually surprising, though. Prolonged lack of treatment success does tend to increase dysfunction. It harms your brain more and more.) And there’s no definition of recovery that allows for that.
But the thing is, we’re all supposed to recover. There’s no place in these organizations for people for whom that is not a reality. There is no place for people who can’t achieve that goal.
Now, I’m not saying I’ll never get there. I’m not saying you’ll never get there. I believe in treatment, and I believe in getting better. But when massive periods of your life are spent sick, recovery is really pipe dream most of the time. It’s possible that a new treatment will help me. I know that. That’s why I keep going. But even then recovery feels impossible for my serious mental illness. And there should be a place in the mental illness (mental health, if you prefer) world, in the “recovery model,” that accounts for people like me. I know no one wants to think about us, but we matter, and we’re important, and our experience is valid.
You may not “recover” from your mental illness, but that doesn’t mean there’s anything wrong with you. That means there’s something wrong with treatment.
Wow. I couldn’t agree more. I get so tired of reading magazine articles that seem to focus on lame solutions for dealing with the illness. The endless articles on diet and exercise as if the illness can be alleviated by lifestyle choices. It’s frustrating. It’s so refreshing to hear a real take on how messy and awful the illness can be. I have bipolar 1. I cannot work and that’s been hard for me. People often say, “You will work again.” to me. They don’t realize that my version of Bipolar is severe and chronic and it sucks and it is incurable. These types of comments just rub salt in the wound and make me feel worse. Thank you for sharing a dose of reality about bipolar disorder with your readers.
Hi Natasha
Im in an AA for biplars struggling with addiction and we were talking about this same topic.. Do we who struggle with mental illness really recover. We all came to the same conclusion. We are in recovery. We are not cured. I guess miracles still happen today, but It is more important to focus on our self care, which includes managing our illness.
Thank you for providing this clarity to the Recovery issue Natasha.There are so many different levels and intensities of Bipolar that it is at hard to generalise. As someone who has had the condition for over 40 years one thing that is hugely undeveloped is treatment refractory bipolar depression: there are only three treatments recommended by the FDA. Contrast this with the scores of drugs used for mania and hypomania. And the depression phase is much more personally destructive i.e. involves much more suffering.
Thank you for this Natasha. This is very well said and very important. I’m one of the lucky ones. Although I have been very, very crazy numerous times in my life, I’ve been mostly symptom free more than 30 year now. I’m 73 and have lived a fairly normal and fairly successful life. Still I have to wonder what I might have been and what I might have done with out schizophrenia or bipolar with psychotic features. (I’ve been given both diagnoses. Also I don’t consider myself recovered. I consider myself in recovery. There are things I have to do to stay in recovery and I will neve be free of the fear that psychosis might return at any time.
Thank you for sharing your views on “recovery” in serious mental illness. Recovery’s a tough one isn’t it and it means different things to different people. But yes, I agree, everyone’s expected to “recover” these days.
I don’t have what’s classed as a serious mental illness, I experience anxiety and depression and also now have a physical neurological disability, from which I’ll never recover fully. So I now have both physical and mental health disorders so I can never function as I did almost ten years ago, and I miss that. I really miss the life I had before.
Since I started blogging some 8-9 months ago, I’m starting to feel a bit more useful but I don’t think I’ll be “living a full life in the community……..” anytime soon.
Thanks for this. I have talked about this lots. It’s one of the reasons why Bell Let’s Talk upsets me – all the people are almost fully recovered there is no room for people like me.