The Art (and Science) of Living with Mental Illness.
Learning to live well with serious mental illness is possible through a concerted effort to learn and adopt new ways of relating to your environment, yourself and others, an approach I call aggressive holistic self-care. Aggressive holistic self-care is a simple concept (approach your illness with an all-or-nothing’ fight mentality) but will mean something different to everyone. The ten facets of my self-care program will be largely the same as any other. That said, it is important to understand that every individual must make the program their own. Another person may drop sleep hygiene and add music because of its central role in their life. The most important task is identifying those life activities which are central to your sense of self. Add to that necessary illness interventions and the program is set, a recipe for success, or at least a plan that can make the difference between life and death when things get really bad.
Illness Education - Become an expert!
Of course acceptance is a prerequisite. Once you've accepted your illness the learning can begin. Read ravenously for a while. In order to manage any illness you must know about it's impact on your body and mind. A particularly difficult aspect can be accepting the limits of human knowledge regarding serious mental illness. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) is an important tool, but it's just that, a tool with limitations, imperfections and real flaws. All sources of information must be taken with their applications and limitations in mind.
It is difficult to overstate the benefits of regular, vigorous exercise. Your mood may be more stable with improved mental clarity following a good workout. High-intensity exercise releases dopamine in the brain, creating a general sense of well-being. There are carry-over benefits including better sleep, reduced anxiety and improved self-esteem. Again, many scientific studies have demonstrated the benefits of regular exercise. For many exercise may be the most impactful strategy for getting and staying well.
The role of religion and a belief in god varies widely from person to person. In the U.S. 90% of people report believing in a force greater than themselves. For those with a strong sense of faith it is important to attend to spiritual needs. For some the intense pain of serious mental illness is eased by spiritual study in a way unlike any medicine. Serious mental illness presents us with so many unanswerable questions that it can be comforting to seek answers to deeper questions in life.
Mindfulness is a way of paying attention that originated in Eastern meditation practices "Paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally" It is sometimes said to be a way of "bringing one's complete attention to the present experience on a moment-to-moment basis" Mindfulness is an excellent way to reduce stress, find joy in our daily lives and maintain a healthy perspective in chaotic and stressful lives. Mindfulness requires training and practice but can become an essential tool in coping with mental illness.
Why don't we just take our pills? The problem of compliance is as complicated as the illnesses. Compliance problems may stem from a lack of insight (anosognosia), avoidance of side-effects, co-occurring substance abuse or simply not trusting the doctor. Sometimes rejection of medicine stems from something deep inside, a strong compulsion to quit and to conceal it from all It doesn't feel like a conscious choice. Anyone who's taken a variety of psychotropic drugs is familiar with the extensive list of troubling, sometimes crippling side-effects. Don't discount the possibility that the side-effects may be causing serious problems. Still, medications often save lives. They bring peace to troubled minds, protect untold numbers from the desperation of suicide. Medications do miracles.
There are a variety of reasons this is so important. First, an income can do wonders for mood, stress level, etc. But work does not have to come with a paycheck. Volunteering in any organization you care about does great things for self-esteem. Work promotes an active lifestyle, provides opportunities to socialize and brings meaning and purpose to a confusing and painful life.
Laughter and Fun
Arguably, among the most important activities in anybody’s life are those things which make you laugh. The health benefits are well documented but anecdotal evidence goes even further. I have made it a point to surround myself with people who, good days or bad, like to laugh and make others laugh. Perhaps nothing else I have done to manage my illness is as important. Unquantifiable, yet profoundly impactful on a person's sense of well-being.
A deep sense of meaning and hopefulness sits atop Maslow's hierarchy of needs. He and others believed that once our other needs are met people strive for a sense of belongingness, love and self-esteem. We seek to find a purpose, to satisfy our desire to help others and make a difference in the world. Self-actualization represents "the full realization of one's potential", and of one's "true self".
Mental Health Counseling
Understanding the source of your suffering, and developing insight and coping skills are the domain of mental health counselors. Having somebody you trust to work through feelings and ideas is an essential part of self-care. Failing to deal with difficult feelings inevitably cascades into other areas of health and well-being. There are many effective approaches to psychotherapy, but all of them depend on having an open, respectful relationship with somebody you trust and who you believe can help. In good times and bad, mental health counseling is the foundation and source of growth and enduring well-being.
Conventional wisdom tells us that a good diet will help maintain wellness in many areas of our life. Omega-3 fatty acids, folic acid and vitamin D are three examples of nutrients which serve as building blocks for important neurotransmitters. Research has shown that diet has powerful effects on overall mood and functioning. One study found that four cups of coffee daily are associated with a 20% lower risk of depression. Our understanding of foods evolves over time but it is undeniable that a healthy, balanced diet is an essential component of a healthy mind.
Developing and maintaining good sleep habits can be difficult. Factors that influence sleep include a patients life style, medications, symptomatic cycles, seasonal influences and stress. Without fully understanding the deeper physiological processes, it is obvious that when someone is very depressed or under stress sleep is much more disrupted. Maintaining regular sleep habits reduces irritability, promotes a more stable mood and contributes to a general sense of wellness.
Once again the primary role of close interpersonal relationships to an individual’s well-being hardly needs restating. And yet, serious mental illness has a tendency to isolate individuals even in the most loving families. It only takes one or two attempts to share experiences with family and friends turning into a storm of fear and emotional turmoil to make even the most sharing people begin to withdraw into isolation and loneliness. Emotional intimacy and meaningful human connections are essential to healthy human experience.