People can be on the best medication targeting a mental health disorder and still experience disruptive symptoms. Breakthrough symptoms can be voices, delusions, paranoia or even depressive features that go unchallenged by medication and persist either chronically or when triggered by something external. This phenomenon usually occurs when a diagnosis goes untreated for a long time without medication or psychotherapy or if person does is extremely traumatized and adjusting to new circumstances (e.g work, living space, interpersonal conflict) around living with their diagnosis.
When these symptoms manifest it can be devastating blow to morale and hope of recovery. Imagine doing everything at your disposal to heal and you continue to experience intrusive and paralyzing symptoms. As a provider, these are the toughest features to deal with teaching and selecting coping skills to offset the wake of the symptom in a persons life. Breakthrough symptoms can start as early as prior to your discharge from then hospital from first onset of your disorder to months and years down the line when a new trauma or negative element is introduced into your world view.
Many teach radical acceptance when things don’t look like they will improve over time. Teach the person to deal with what is and what will always be and they will make it through the darkest hours of their healing unscathed. In my opinion, this is a gamble and not a very good one. The odds of tolerating breakthrough symptoms at every interval and active occurrence are fair but when the symptoms manifest as new expressions of the symptom a person can easily be jarred into a crisis.
I suggest a different approach to managing breakthrough symptoms. It is a combination of trigger identification, knowing your reactivity to events or stimuli, and eliminating possible life circumstances whenever possible to avoid being thrown into a vulnerable space where these symptoms will be the most paralyzing. This means sometimes making more radical course corrections in life but when you are dealing with the potential for breakthrough symptoms you should do everything in your power to avoid being dysregulated or risk of further imbalance.
Staying positive is critical to approaching these symptoms with the right attitude and creating the right space to reduce their harm in your life. Most importantly, approach the treatment of the symptoms like any other. There are no super symptoms in mental health like there are superbugs associated with colds and flus. Treat these symptoms like any other acute or chronic problem and adjust the treatment fit if you continue to not experience relief. Research suggests breakthrough symptoms are just as treatable as those knocked out and eliminated by medication and psychotherapy.
These symptoms will not persist forever. Overtime, the frequency and intensity of breakthrough symptoms should be less chronic and severe as you begin to manage your recovery and experience healing from its trauma. Remembering to be even more vigilant in staying focused in your recovery given the vulnerable aspects of your symptoms will go a lot further than fearing their chronicity and ongoing future occurrences. Some of us are a little more susceptible to set backs, when dealing with breakthrough symptoms, these setbacks can be waiting just around the corner so don’t tempt fate and continue walking the path of healing and recovery at all times.