by Andi Daniel, Technology Coordinator
September 10, 2024
How do we define recovery for mental health? Recovery is generally a well understood concept when it relates to physical illnesses or injuries or substance use. The timeline for recovery is definable as the date that an illness was diagnosed, an injury occurred, or a person stops using substances (or reduces use in harm reduction). Some recovery programs, such as 12-step, acknowledge that time with a physical item given at specific intervals (30 days, 60 days, 1 year, etc.). Mental health recovery is a bit more nebulous.
I have struggled with mental health issues as long as I can remember but wasn't diagnosed or treated for them until I was in my 20s. Therapy wasn't common when I was growing up and there was significant stigma attached to seeing a mental health professional. Even adult resources were limited. Many people were prescribed "tranquilizers" or anti-psychotics, given electroconvulsive therapy (ECT), or institutionalized for long periods of time. Recovery could potentially be measured from the time someone started taking medication, received ECT, or was released from institutionalization although the concept of recovery wasn't really promoted at the time. We are often told that this is just the way our lives are going to be and that there is no "cure." While it is true that many mental illnesses are not cured, it is also true that we can live in recovery and manage our symptoms. This is like someone with a physical condition that will be lifelong but the symptoms and negative impacts can be mitigated. One of the most common analogies is that of diabetes. There is no cure but people can control the symptoms and do most things that people without diabetes can do. We can measure recovery in quantitative terms such as when a person maintains a healthy blood sugar level for a certain amount of time.
There is no blood sugar equivalent for mental health. There isn't really a quantitative description for when someone is in recovery in regard to mental health. Does recovery begin at diagnosis? That is difficult because there is no specific measure of mental illness. Diagnosis is based on observations or reported symptoms but there is no definitive test. Also, recovery looks different for everyone and the only way to determine progress is observation and reported symptoms again which may not be reliable. I remember being given the Beck Depression Inventory in college and thinking "how depressed do I want to appear today?" I was a psychology student and had learned about the test but even people without a background in psychology could choose to answer the questions in a way that could make them appear more or less impaired by their illness. If someone is concerned about being institutionalized, they are unlikely to choose answers that will make institutionalization more likely. If I complete the form in one way, it will look like I am recovering when I may not be whereas a person can't fake their blood sugar levels.
In simple terms, recovery can be defined as returning to a "normal" state. Normal looks different for everyone so that isn't a very good description of mental health recovery. How do I know what normal is if I have been struggling for a long time or have had symptoms for as long as I can remember?
I have decided to count my recovery from the time I last purposely injured myself. I could have chosen the day I left an inpatient setting or recovered physically from a suicide attempt but I really wasn't getting better after those events. I was still experiencing symptoms of my mental illness in a way that was disruptive to my life. I still had suicidal thoughts and injured myself. I can't pinpoint the exact day that the symptoms were less disruptive and I still have suicidal thoughts from time to time. I have a plan and I do things that help me control my symptoms. I am in recovery.