Everyday will be a fight. Everything a weapon in your arsenal against your illness.
People with a mental health diagnosis are almost in constant fear of relapsing. Whether you have a long-standing condition or are suffering from a new diagnosis, the fear of symptoms re-activating, or worsening, is a real problem for those of us that have a mental illness. Most of us want to know: 1) will I always have this problem?, 2) what if these symptoms persist?, or even, 3) how do I know when I am truly recovered? These are all questions to ask ourselves.
Investigate the nature of your diagnosis and prognosis. With this information in hand, you can now devise a plan to manage your situation. The best way to ensure your worst fears about relapse never become a reality means having a stance about recovery. Folks with a chronic condition, co-morbidities, and other factors complicating the road to better health and wellness should be even more realistic with the stance they hold towards healing.
Here is the irony but also the pragmatic black and white of it all. Let’s say you are having a problem. The fastest and least risky route to fixing the issue is finding a solution. So, when you’ve got several problems happening at one time, finding multiple solutions takes more savvy, skill, and also more energy. If we are to pursue this logic, as the sheer volume of issues increases, so do all the ‘inputs’ into recovery. By inputs or ‘protective factors’ as some call them, I mean the amount of energy, self-awareness, skill, and savvy around navigating every avenue of your journey healing.
The capacity for people to maintain their mental health and recognize new symptoms activating is usually very much our own to self-manage. With the exception of some mental health symptoms, like anosognosia (commonly associated with schizophrenia) which might complicate a person’s ability to understand his or her own illness. Most of us notice we are either feeling or thinking differently. The truth is though, we are in just about complete control over our mental health. Despite what some people believe, our mental health is in our own hands.
What I am saying is sure, there are some environmental, biological, genetic, and parental contributing factors to how we feel, and what we think. Do these markers only serve as indicators in how we measure our health? The answer is, probably not. These contributing factors are just that. So, in the event, your life circumstances are particularly limited and you feel restricted your capacity to maintain good mental health, think again!
Let’s take a look at our power to control and self-manage our own mental health landscape. Self-determination: the inner drive. The very mobility needed to move work on our selves forward. Self-awareness: realizing our strengths, as well as limitations. Sure, some of us are put in impossible situations, born into poverty, victimized, abused, and maltreated, but even in these circumstances, some discover resilience. They make it, despite the seemingly disparate nature of their problems.
So, why do we fear relapsing so much if it is in our means to stay or get healthy? The answer is, because people, regardless of the successes they experience. Often lose sight of the bigger picture. For people in recovery, the road ahead can seem long, especially with more seemingly chronic diagnoses. Often people just give up when they hit a rough spot. Maybe the road ahead seemed too long and difficult. But the most tragic way people shoot themselves in the foot. Continuously make the same mistakes without gaining insight into your behavior.
Well, chronic can very well mean your symptoms persist for the long-haul or in some cases, life-span. The rest of our lives for a lot of us, especially young, and even middle-aged people, can seem like a lot of work. For many people sustaining this much effort for the long-term across the life span is just too much to wrap their heads around.
The fact of the matter is maintaining good health, especially our mental health, will only make living easier in the long term. Creating and allowing for more solutions to manifest during difficult times can create a more manageable living situation. Aside from these (un)reasonable explanations for why people lose sight of their recovery plan are folks who rationalize away their lives and in turn, defer recovery and any chances at better health in their future.
Rationalizing away or worse, discontinuing vital behaviors and habits interfering with healthy decision-making will halt our recovery in its tracks even during the tenure of our road to healing. This can be due to several reasons. Sometimes we deem ourselves cured. Other times, we encounter a seemingly insurmountable situation created by our negative behaviors as a result of playing out symptoms of a disorder.
Whatever the reason, because there are just so many, almost infinite self-rationalizations we can manifest to discontinue our self-care practices. Be especially mindful of this train of thought before it leaves the station. These are merely negative self-messages we create, which become cognitive distortions, seemingly real and true, but at the root of it, are untruths and outright lies our minds manifest to justify maladaptive behaviors. They are unhelpful, at times frightening, and if we follow these negative thoughts to their horrific conclusion, are disturbing to most of us experience them.
I recommend self CBT (Cognitive Behavioral Therapy), being active in your mental health treatment, and disputing and challenging these rationalizations every day. Don’t wait, discontinue this thinking when it first occurs. This abrupt but necessary discontinuation of maladaptive thinking will go a long way in terms of sustaining our positive behaviors and persisting towards our goals for ourselves, and good mental health.
There is no question that these negative, maladaptive, and self-defeating behaviors can and need to be stopped when they first trigger us or stop us from doing what we all need to do for our recovery. Like most thoughts surrounding fear, paranoia, and anxious thinking, all snowball, combine and multiply our worst thoughts. Following your self-care plan across the lifespan will mean living a life free of this fear or at least, regulated as best as possible so negative thinking does not multiply and disable us.
I said it before. The concern of relapse is real but the reality is good mental health is truly in our own hands. Ultimately, when left to our own devices, we set its limits and create solutions for disarming paralyzing forces before life seems like we are on a ride or a just passenger in our lives. The truth is, we are driving our health forward at a rate and speed and course of our choosing.
When everything is moving in the wrong direction I recommend taking on a stance I term total recovery.
The complete mobilization of your resources to maximize the potential for your gains in healing.
To truly make gains when our bodies are pitted against death or risk of serious illness, experiencing improvement in our health condition may truly mean there can no obstacle in your path to recovery. Success and better health outcomes will depend on our capacity to identify problems ahead, problems at hand presently, and produce solutions quickly before other issues become complications in our treatment and ongoing recovery.
Total recovery means taking all the unknowns and revealing them as markers, and meter-sticks to measure our gains and decrease the risk of relapse. Identifying all available resources at your disposal and being creative.
What is holding you back? What can you supplement that is working well to amplify your chances for success. This will be critical in sustaining treatment and maintaining the stamina you need to make those reasonable and lasting changes in your life to experience more success in recovery.
Ask to ask for help when you need it. This may mean reaching out and calling your case or care managers! Daily if necessary. I’ve seen and done this myself. Your point person should be on redial until you are on the road to more stable living. Once you are well on your way to your goals, consider easing up on your supports, but truly think about how to reconfigure them to match your new adjusted goals.
Getting to know and familiarize yourself with the system can be difficult. Make connections, network, and build alliances around you. Get to know entitlements available for your disability and what you need to do to qualify. All this information is available through different government agencies depending on which system your disability or treatment is apart of, and the provider within the system can start the process and get the ball rolling to keep your recovery moving along without incident.
While there are still resources available for you if you connect with key players in the systems that serve your special needs group. There may be qualifying hoops to go through and steps ahead of you so start early and are prepared for delays. By being prepared for systemic delays and red tape to clear will likely reduce gaps in your treatment due to the non-payment of fees associated with treatment.
Commitment to care, adherence, and radical acceptance will be vital to preserving your belief in a positive outcome. It’s easy to disbelieve in recovery if you aren’t sticking to your treatment and completing your objectives in care. Don’t expect results if you aren’t focused on your treatment and adherent with the recommendations of providers. Once you’ve evaluated the risks and benefits of your treatment path, complete the entire journey (your prescribed care) until you’ve reached your goals.
Listen, you can still turn this around, it is just going to take everything you’ve got!
I recommend allying with your therapist, treatment team, and close peers with a vested interest in your mental health. Establishing a deep trust with those who have close personal contact with you every day. In doing so, if these collaterals begin to detect an extreme and toxic abnormality in your health, you can feel safe in taking their advice and concern very seriously. Like I mentioned earlier, staying connected with collaterals in which you can delegate your health needs to is a great plan “B” if your own self-care takes a back seat to the other nonmedical priorities of life (and there many of these)
Sure, no clinician, therapist, or friend can get a perfect read on our health. But for those of us without a great deal of self-awareness or drive to look after ourselves, there are still options and strategies to stay healthy without relying completely on perception which may be off. People need to truly care enough about their health to self-monitor all the time. The priority of the day, when it comes to our own health and wellness must be addressed. Anything otherwise is likely to be disruptive to our mental health and even put our lives in jeopardy regardless of our diagnosis.
A second more short term plan can always be delegating out responsibilities. Family, friends, and those we trust even when we disagree with them (unless it puts us directly or indirectly at risk of harm) are great folks to delegate tasks to if they enlist in your care or agree to help. The reasoning here is regardless of how we feel or think about the validity of our friends’ opinions on certain matters. When it comes to our mental status, for some of us, symptoms can disrupt a person’s capacity to stay connected to reality or even take on complex delusional systems. These not only complicate our interpretive eye to know what is truly happening with our health but may require you to bring in collateral support.
In the end, anyway, you want to manage your mental health, do at least that much. Have a plan, and have another plan when the original road map to better health becomes unworkable. Ultimately, whether you have a chronic condition or an acute diagnosis, relapse is only something to be feared when you aren’t doing what you need to do to work towards better health and healing.
Relapse is real. Relapse is awful. But it isn’t the end of the world. Relapsing and experiencing the renewal of old symptoms can still be a reminder to get back on track with your recovery. Keep going, and don’t stop. When you stop taking care of yourself, be prepared for your worst fears to not just haunt you, but become the grim reality you feared so vehemently instead of investing the same mental energy in health and healing.