As I continue to mature and age along with my schizophrenia diagnosis, I think about how the passage of time impacts prognosis, and simultaneously on the successful symptom management of a chronic patient. On a personal level, I cannot help but think of how I got here in life. Today, I am a licensed clinical social worker, author of three books, journal articles, disability rights advocate, and representative of various intersections of the mental health community at various boards and committees in NYC. I also teach social work at the university level at Fordham university and am an avid mental health blogger. So, how did I get here from completely disordered and unable to care for myself. Well, to begin with, a big player in my recovery was getting on the right medication, receiving quality therapy combined with my strength, will power, and most importantly, support from my close family, friends, and peers.
To this day, I continue to believe that I could not have made it this far, so quickly without these folks. I have been so privileged. Without the help of my parents, family, and friends, my clinical picture would look radically different today, than if these natural supports had never been available in my life. Without these critical lasting supports, people like my mother, father, and other long-standing friends prior to my illness and conversely during its tenure were the building blocks of my recovery. My parents ongoing belief in my own willingness and capacity for recovery, fortitude, and ability to carry on when life seemed unmanageable is what must be discussed here so others reading can understand the benefits of unconditional support when it meets radical acceptance and self-actualization.
I truly believe success in the face of a mental health disorder can be measured in support and accessibility of friends and family. Right down to the generosity of our supporters with their time and energy, their very presence and helping hands have been the fulcrum which has launched me higher into the upper limits of healing than if I was doing this on my own and totally independently. The interesting notation on independence is that it is just the goal and not the means to recovery and healing. The mental health systems gestures, and truly emphasizes the importance of living a full and independent life when carrying a mental health disorder. Even when that disorder is chronic and longstanding.
However, the missing element to theories around lasting independence and goal directed philosophies continues to reject and ignore the importance of incorporating active support in our lives and not doing this all on our own. My parents, Frank and Jane Guttman have traveled with me across the globe for my mental health needs.
When the management of my schizophrenia symptoms improved years ago, and I was able to travel again, I was never shamed by my parents over the limitations I faced due to akathisia. So, when it came to acclimate to certain medications, in the early days, I was either too tired or too restless to sit down for extended periods of time. When my family and I traveled to Europe a year after my initial break, in Italy, I was only able to savor pasta and pizza in short micro doses before I would have to get up and walk around. At least I was out there, though, trying to make it all work. From both parents and friends, I was getting encouragement that did not understand my restrictions as permanent, self-imposed, or limiting.
With few exceptions, my supports have only cheered me in my recovery further. Sure, there are times when I mess up. Either due to my own lack of awareness into the impact of these symptoms on my life, or simply because of lousy decision making from my own naivety in terms of my youth and lack of maturity at this age. Regardless, my collateral supports guided me, making gentle and stern recommendations on how to alter my life course without causing more harm than good. Listen, this can be a tricky thing without guideposts and social markers out there informing our decisions and providing us with extra additional insight when our internal barometers are naturally off kilter.
A person with a severe mental health diagnosis having a support system in place is critical to producing a positive prognosis, if I haven’t made the argument abundantly clear already. I cannot stress this enough, that support systems are critical when you have a long-standing mental health condition. The reasons are both clear as day and subtle. Simply stated, when there are people, either friends, family, or relatives, available in a person’s life, the synergy of their influence and very presence is a protective factor. Protective factors are positive contributors to a person’s safety. These contributors are crucial for people with a disorder when the “chips are down” or life takes another unfortunate turn. When social security payments are late, income is short, or even if the bus is running late and it’s difficult to get to work onetime. Whatever the stressor, life’s negative turns can be due to the impact of mental health symptoms, or just tragic extraneous circumstances. Either way, when support is available, these tragic turns can be reduced or avoided completely.
Simply put, as the chronicity, or level of intrusion of the mental health symptom or disease process increases, so is the importance of having a robust and secure support system. Natural/organic contacts (i.e. friends and family) are the most vital, if they are utilized and accessed by the person carrying a diagnosis, with savvy. Let me put all this into more concrete, real life terms. So, think of a person with an acute or short term active mental health symptom. Since the spans of time acute symptoms are active is less than a chronic disorder, the likelihood of chaos or unplanned circumstances is also less with disorders that espouse short lived symptoms.
However, when a person has a chronic disorder, e.g. schizophrenia or most bipolar/affective spectrum disorders, the expanse of time is so much longer so things are bound to go unplanned, wrong, or just mismanaged in terms of the disorder and its impact on people’s lives over time. Again, to be more specific, if a person with schizophrenia is diagnosed at age 21, by his or her mid-thirties, so much time has elapsed that the person with a chronic disorder becomes more vulnerable just by having the disorder longer.