Recent discussions about ‘the mentally ill’ have focused attention on the suffering that many people with a mental illness endure. We are told that ‘the mentally ill’ experience high rates of homelessness, unemployment, suicide, substance abuse, and criminal behaviour. We hear much less about those who lead happy and fulfilling lives.
When people are described as ‘the mentally ill’, the label defines the whole person, not just the illness. The label gives the impression that people with a mental illness are destined to a life of madness and suffering. This is simply not true. The so-called ‘mentally ill’ are often just ordinary people living with a manageable illness.
After all, mental illness is not a character flaw, personality trait or sign of personal weakness. It is an illness that can affect all of us, regardless of age, race, sporting ability or social class. It is the illness that is the problem, not the person.
Like all illnesses, there is an enormous spectrum in the way people experience a mental illness and respond to treatment. Some people experience severe episodes of mental illness throughout their entire lives. Others experience less severe symptoms less often.
It is important to recognise that people with a mental illness can get well, especially when diagnosed correctly and treated appropriately. Like people with asthma, diabetes and heart failure, people with a mental illness can develop strategies to stay well. These strategies enable people with a mental illness to identify early symptoms of relapse and take action to prevent an episode of illness. With insight and experience, people can learn to manage a mental illness like a person with diabetes learns to manage sugar levels.
Our recent research explored the diverse range of strategies that people with manic depression (also known as bipolar mood disorder) used to stay well. The findings demonstrate that people can learn to manage their illness and stay well.
For many participants, controlling manic depression involved the same things that help all people to stay well – eating healthy foods, exercising, sleeping well, managing stress, laughing and so on. However, participants also needed to make specific lifestyle changes in order to stay well. The lifestyle changes were based on participants’ individual needs and social contexts.
For many people, staying well is not just about seeing a psychiatrist and taking prescribed medication. It is about so much more. The challenge is to control the illness so that symptoms of mental illness – depression, mania, anxiety and psychosis – do not interfere with everyday life. By learning what works, and what does not work, many people can actively manage their mental illness.
Our research identified the importance of participants remaining mindful of their illness. Degrees of ‘mindfulness’ depended on the circumstances. For example, when participants were feeling well, the illness was in the back of their minds. It did not play a large role in their lives, but they knew it was there. On the other hand, when participants encountered triggers and felt early signs of illness, it was necessary for them to become more vigilant.
In some instances, participants needed to intervene to prevent an episode of illness. Intervention may simply involve a few good sleeps and a long walk along the beach with a dog. Alternatively, intervention may involve making an appointment with a health care professional and altering medication. With experience, participants learnt what worked best to keep them well.
Until now, we have rarely heard positive stories about people with a mental illness. Instead, we predominantly hear about extreme behaviour when people are unwell. It is not surprising that most people in the community remain frightened and misinformed about mental illness. When we realise that people with a mental illness can not only get well, but also stay well, attitudes towards ‘the mentally ill’ may improve.
First published on ABC Radio National’s Perspective on 31 March 2005