World Mental Health Awareness Week - Thursday - Recovery
/I was first diagnosed with clinical depression in 1995 when I was admitted to a mental health respite care home when living in Wales. At the time I had no idea what depression was let alone understanding the concept of mental health recovery. I remember the term used to describe my long period off work at the time was ‘experiencing a breakdown’. My next admission, this time to a hospital psychiatric ward was in 1998 in Kendal. After a further two admissions over the next year, it wasn’t until 2000 when I started working in the Mental Health field I came to hear of mental health recovery as a particular process.
I don’t think it’s true now, but in those early days, my experience of engaging with the concept of mental health recovery was a political one (with a small p). Service users as we were known were gaining voice with regards to our right for our involvement within our mental health treatment. Up until this period in time, as far as I could make out, treatment for mental illness was administered with medical authority where the expert was the psychiatrist. Through a growing movement for change within service user groups and charities, the model for mental illness treatment was shifting from an authoritative top down approach to one where the patient’s personal experience and awareness was increasingly taken into account and validated as shared expertise. In short, it was becoming accepted that mental health sufferers were very much experts in their own suffering.
In 1993, William A. Anthony Ph.D., then the Executive Director of the Center for Psychiatric Rehabilitation at Boston University wrote a paper titled, “Recovery from Mental Illness: The Guiding Vision of the Mental Health Service System in the 1990s.” (link here). Within this article he explored and outlined his understanding and vision for a recovery-oriented mental health system. Essentially, he describes a treatment oriented approach as one where the symptoms of mental illness were managed and alleviated. He describes a recovery incorporated approach as one where recovery can occur even if the illness is not ‘cured’. Recovery from mental illness involves much more than recovery from the illness itself.
It is that last sentence which hugely impacted me when I first read it in 2000 and for the first time, I began to consider my own mental health recovery process.
Twenty years later and I’m still working through the implications for myself of the recovery philosophy W.A. Anthony so wisely espoused. It is his wisdom which continues to inform me about my mental health journey and my pathway towards recovery. Indeed, this is a journey without a destination but always with achievable horizons. There are many other recovery centred models which are variations of a theme. However, I chose to adhere to this one simply because I like the apolitical nature of it. I have never signed up to the political nature of service user emancipation. Although I am antiauthoritarian, I do trust the expertise of the psychiatric professionals involved in my care. I prefer to work with them within the psychiatric system as it is, rather than ‘against’ the system where I determine my rights for recovery set precedence over anything else. This is not to say I do not disagree with those who follow a different path to me and in fact, I support many who have negative experiences of past mental health treatment and seek change as a result. I accept too there are many aspects of our current mental health system of care which could be enhanced, but I hold the view, we are fortunate to have access to what we have here in Scotland and I’m appreciative of this.
This is how I endeavour to live my recovery from my mental illness, the roots of this process set within the words from W.A. Anthony. I understand my recovery is a deeply personal and unique process where I’m developing my attitudes, feelings, goals and skills based on my mental health at any given time. My recovery is about me fostering new meanings and purpose in my life as a I continue to grow beyond the effects of my depression. I am hopeful this will lead me towards living a satisfying life where I believe I contribute even within the limitations set by my illness.
Helping me along my recovery path are these truths.
Recovery can occur without professional intervention. This is important for me to accept. I hold the key to my recovery, not anyone else. It is down to me when to seek the interventions and support I require. By accepting this personal responsibility, I become responsible for my eventual recovery from a depressive episode. I do not rely on the mental health system to ‘cure’ me and rather view my relationship with them as a partnership.
A common denominator of recovery is the presence of people who believe in and stand by me, the person in need of recovery. Crucial to this statement is the non-judgemental relationship I need with those close enough to be involved in assisting me through my mental illness. Key of course is my marriage with Karen and her unswaying support throughout my distressful episodes and subsequent periods recovery. Without her love I would not be here today. My collaborative relationship with my Community Psychiatric Nurse is another key example of where I am supported in an equitable and empowering manner. Knowing I am not being judged for being depressed is fundamental to my recovery.
A recovery vision is not a function of one’s theory about the causes of mental illness. It is extremely helpful to me in my recovery process for an archaeological exploration for the roots my depression to become a key element in my treatment. The fact I suffer from the illness is enough and there is little to be gained by seeking the causes. Understanding a triggering catalyst may help in terms of increasing awareness for the future.
Recovery can occur even though the symptoms reoccur. This is hugely important awareness for me to embody. By doing so, I accept the possibility of becoming ill again as a reality. This way I will never hold the expectation I will never suffer from depression again. I may hope this may be the case, but this is different to expecting it to be so.
Recovery changes the frequency and duration of symptoms. Essentially, symptom reoccurrence becomes less of a threat to my recovery as I become increasingly accepting of living with depression as an illness.
Recovery does not feel like a linear process. As someone who’s professional life has been involved in facilitating personal development awareness for others, I understand my recovery will involve growth and setbacks. There will be periods of change and times of little change, moments when I experience powerful insights, and times when I feel directionless. It is an acceptance that there is nothing gained from planning my recovery and hoping for systematic outcomes.
Recovery from the consequences of the illness is sometimes more difficult than recovering from the illness itself. As an example of this, I continue to struggle with the awareness because of my last episode of severe depression, I damaged important relationships in my life at the time. Coming to terms with this is just as difficult for me as it is suffering the symptoms of my illness.
Recovery from mental illness does not mean that I was not really mentally ill. Again this is an important truth for me to embody. As I become increasingly lucid after a depressive episode, I have the tendency to become apologetic for ‘being the way I was’. I minimise the illness as a character failing rather than an integral aspect of my overall health.
All of this is of course not the complete story of my recovery process. There are many subtle nuances which contribute, some more helpful than others. The key for me to understand and accept is the fluidity of my recovery and with this to be patient with its developmental path. Key too is trusting the fact I will recover, the truth that periods of depression will pass to be replaced with opportunities for my life to be lived to its fullest extent.