Recovery from Mental Illness – those first steps – by Marc Jacques

As a person in recovery from schizophrenia my peers and their family members often ask me what I did to recover. My journey of recovery and my age make my experience to some extent appreciated but I continually talk about those first steps since they are the most helpful to anyone newly diagnosed with any mental illness. I have seen a time when psychiatrists told us we’d be forever sick to a time now when the federal government openly recognizes and promotes recovery. Recovery’s history is filled with many folks like me who refused to conform to the societal expectations of our illness and struggled for physical, emotional and mental health which over the years evolved into the expression “wellness.”

Before I was involved in the recovery movement there were others who laid the foundation for the change in thinking about mental health recovery. To them I am thankful and lucky because in the 1980s I was hospitalized in a transitional period. Folks just before me were hospitalized essentially forever and due to the power of the concept of recovery mental health systems changed. Now we are inclined not to use long inpatient stays. Problems back then were that there was not a network of community supports or recovery activities and many of us cycled in and out of institutions with all the troubles that implies. Therefore a comprehensive recovery orientated service system is essential to the heath of the entire community and saves both money and lives. 

Nevertheless, the first steps for recovery are the same now as they were then. First, change your thinking. Saying “Believe you can recover” seems overly simplistic but your mindset actually influences all your future recovery behavior. Quoting complex behavioral science, believing you’ll get better you will invest more in wellness activities. Understandably, it’s a complicated issue because to believe we can recover we must overcome the half-truths we were taught and accept new insights. We need to get around that deep seated self-stigma about being helplessly mentally ill too. Mental illness is a brain disorder and while there is currently no cure with the right supports people get better. Recovery is a process and not an event. After accepting you can get well you’re not automatically recovered, but you have set in motion a series of actions that will achieve a better quality of life. Change your mindset; involve yourself in recovery activities; begin your own journey to wellness.

Once you’ve made the commitment to yourself to get better, the second most helpful recovery tip is wellness education. Try first WRAP, Mary Ellen Copeland’s - Wellness Recovery Action Plan because it teaches ways to intervene in our cycle of illness and apply self-help techniques to not end up in crisis. Check with your local mental health system to find out when Mary Ellen’s WRAP workshop is being offered near you. Don’t just stop at WRAP, move onto the Pathways to Recovery strength-based workbook written at the University of Kansas by a team of both consumers and providers. Participate in NAMI Peer to Peer programs and join a peer support group like NAMI connections. It is a tremendously important step to stop focusing on what you can’t do and go forward with your strengths.

Medications are vital to my recovery, but please understand that the medications given us for mental illness do not cure us. What they do is reduce our symptoms so we can focus on the other stuff in our lives, like taking care of ourselves and learning the coping skills needed to offset our problems. Over-medicated I lost about eight years of my life to that tired feeling that would not allow me do much of anything. Medication is not one size fits all, everyone reacts differently; assertively advocate for the therapeutic dose that works best for you. Make informed choices. Talk openly and candidly with your psychiatrist and ask that they work with you on your recovery.

Finally, use the internet or library and find a role model who has a mental illness like yours and has an outstanding life. John Nash a person with schizophrenia won the 1994 Nobel Peace Prize in economics. We are movie stars, artists, writers, billionaires, astronauts, US Presidents, Executive Directors, Doctors, Psychiatrists, judges and legislators; there are role models for every diagnosis. This will help you recognize that people with mental illness live valued lives; that we are employed in every imaginable job and with treatment people overcome their difficulties. Figure out for yourself that a mental health diagnosis does not smother all your chances for success. 

Statistics show that clinical depression is the leading cause of disability in the United States and Canada, and in a few years, if trends continue; clinical depression will be the second leading cause of disability worldwide, second only to heart disease.

All of us eventually have a depressive episode where sadness interferes with our life’s routines. Sadness in and of itself is not depression. For clinical depression as a mental illness a person must show signs of a behavioral change by “five or more” of the classic nine symptoms for more than two weeks.  Those classic nine symptoms are: Depressed mood most of the day; a marked reduction in pleasure or interest of almost all activities; Significant weight loss or weight gain (5% or more) or loss or increase of appetite; Insomnia or Hypersomnia nearly every day; Daily feelings of restlessness or being slowed down; Loss of energy; Feelings of worthlessness or inappropriate guilt every day; Daily diminished ability to think or concentrate, or indecisiveness; Recurrent thoughts of death and suicide with out a specific plan or a suicide attempt or a specific plan of suicide.

What's more, your troubles are not due to the effects of substance abuse or medications or accounted for by a medical disorder like chronic pain or by bereavement. And your symptoms can not be better accounted for by other mental illnesses like schizophrenia or Schizoaffective Disorder. Also what is happening does not meet criteria of a mixed episode; that is features of both mania and depression. More to the point your symptoms must cause significant impairment in interacting with people, your job, and taking care of yourself.

I have been depressed and if you haven’t been depressed or lived with someone who was depressed, it is very hard to describe in words what depression is. It’s never easy to write about issues like depression or even happiness because we normally rely on common experiences. So you say it’s like being in love and everyone who has been in love knows what you’re talking about. The same with happiness; I was happy and if you have ever been happy you can relate. Since clinical depression is not the same as a depressive episode it’s hard for people to understand. Things seem hopeless but there are a variety of self-help options which work well for many people. I used these techniques in conjunction with my medication. You hear about these tips from both peers and service providers alike and from self-help books but whatever you choose keep your mental health practitioner informed so they can work with you.

Walking is the easiest self-help exercise and can improve body image, confidence and self awareness. Exercise increases the levels of certain neurotransmitters (endorphins) that elevate mood. Walking is a great way to start exercising and may encourage the person to consider other forms of exercise. Yoga and Tai Chi are easy, usually offered locally in the community or on self-help videos or CDs and combine healing exercise with meditation.

Meditation, guided imagery and self-hypnosis have proven helpful for depression by calming the mind and reducing stress. Some therapists offer to teach you techniques and there are many books, CDs and tapes available at your local library or book stores. They were produced in large numbers and now I often find them in thrift stores.

Accomplishing goals is hard enough without the energy depletion that comes with depression. People looking for help for depression may be overwhelmed by daily life and tasks they need to complete.  Goal setting is an excellent self-help technique that will teach you to break tasks down into smaller steps, helping you regain a sense of control over your life.

Relaxation techniques, usually used with therapy, have been proven to ease stress, muscle tension and anxiety. Unlike other methods of dealing with depression, progressive relaxation will teach you to a “relax at will,” helping you to keep grounded and calm.

Solid medical research has shown that laughing regularly helps people heal faster from all illnesses but especially depression. Regular laughing conditions the brain to create endorphins on a regular basic. Have yourself a heaping helping of humor every day by reading and sharing jokes and humor, watching comedians or comedy movies.

When depression hits, climbing into bed is often the easiest thing to do, but won’t help you overcome your depression. Especially during a depressive episode, being in the company of others has been long established to help lift the cloud. NAMI Connections is a group of members and friends that meets regularly Monday nights at Highland United Methodist Church 1901 Ridge Road in Raleigh and offers support from others with a lived experience with depression and other mental illnesses. Stop in and join us in our journey of recovery and support.