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 wonder how I got ‘here’. So, how did I get here? I was completely disordered and unable to care for myself ten years ago….
A big player in my recovery was getting on the right medication. Another, receiving quality psychotherapy. These, combined with my strength, will power, and most importantly, support from my close family, friends, and peers.
To this day, I believe I would not have made it this far, so quickly without these critical pieces to my recovery. I have been so privileged. Without the help of my parents, family, and friends, my clinical picture would look radically different today. If these natural supports had never been available in my life, who knows where I might have landed?
Without these critical lasting supports, my mother, father, and long standing friends prior to my illness are the building blocks of my recovery. My parents ongoing belief in my own willingness and capacity for recovery, fortitude, and ability to carry on is what must be undersood as the radical acceptance of healing.
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. The very presence and helping hands are truly the fulcrum which has launched me higher into the upper limits of healing. Certainly, higher than if I was doing this on my own and totally independently. 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 ignore how to incorporate active support in our lives. My parents have traveled with me across the globe for my mental health needs. They have also conversely cleaned my bedding when I was so disordered I soiled the sheets due to catatonia and muscle stiffness. Without my parents support, my independence would be built on a swamp of uncertainty, trepidation, and fear of failure. Doing it all, life that is, on our own makes us vulnerable. Simply, it increases the risk of relapse when we are not in the company of those who can intervene. That is, when we cannot see ourselves and how disordered our realities can become, isolation can be a catalyst for self- destruction.
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 acclimating 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 microdoses 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 ontime. 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 (ie. friends and family) are the most vital, if they are utilized and accessed by the person carrying a diagnosis, savvily. 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 spanse 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 bi polar/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.
Now, if a person has a disorder that is chronic, and continues to flare up every so often over the course of a lifetime, the sheer likelihood these episodic symptoms interfere negatively in the person’s life must also be higher or greater. This is as simple as fractions, numbers, and reductive logic, making simple inferences when it comes to a person’s ability to astutely access and understand their own protective factors over time. There is another caveat to all this, no disorder is the same. Sure, symptoms carry with them certain features which can be identified, grouped, and marked, but their impact on the lives of people with a disorder are usually different.
Depending on the person’s resilience, life circumstances, amount of protective factors in place, and self-awareness (the list goes on and on with insight, judgement) and other areas of cognition which complicate how support systems can be best measured in real terms. Support is a very difficult aspect of treatment to measure given the impact of symptoms and people’s behavior is so radically different given the nature of the support system and its function in recovery. Ultimately, access and understanding how to utilize support goes far when it comes to recovery. When we think about healing and long term wellness in the spanse of a lifetime of chronic symptoms, get some support to experience lasting progress into the future.