Accepting that "recovery" means learning to live with it

[BiggerOnTheInside]

How?

I think I know what you're getting at, but could you elaborate?

Do you mean that you don't want to accept that you have to live with it?

I have learnt to accept that I get anxious and stressed easily and also have a tendency to obsess. Acceptance has been a massive part of my recovery because I don't have so much of the "fear of fear".

Mindfulness has helped me be much more aware of when I am getting anxious or obsessive and so I can notice and observe it happening to me rather than that getting completely swept away by it if that makes sense.

I don't know - there are times I think that low times are always going to be part of my life but not all of my life and I can deal with them as they come along and they don't mean my life's not worth living, and there are times when I believe I have it sussed and I will never get ill again, but at the moment I'm in a very low spot and I am struggling to deal with the fact I may never be free of this and even if I recover this time it will happen again and again. I don't feel like I have the resilience to do it once more let alone repeatedly.

I'm doing some mindfulness based treatment at the moment but since the depression(?) hit last Saturday concentration is getting harder and harder. The first four or so days I was getting through okay with accepting the tears and the emotions and the intrusive thoughts but it's getting to that point where the tears stop and all I have is the pain and sadness and tiredness and thoughts of death and accepting they're there doesn't convince me that it's worth living a life where these feelings exist. I'm not suicidal but I don't want to live a life where these feelings keep coming back and I don't know how accepting them will prevent these bad weeks from ruining any chance I have at steady education or work. What I mean is that accepting them doesn't make them easier to deal with when they're there or make them go away any faster or make me any more capable of productive existence when I'm low. I know it's likely better and the only other options than acceptance are fruitless fighting or death. I tried the fighting and it didn't help and I'm trying the acceptance and just hoping it will help but not finding hope easy.

I'm a MH professional

It used to cause me some wry amusement that 'recovery' in MH does indeed mean learning to live with symptoms rather than an absence of symptoms

However the use of recovery in this way was originally led by service users it isn't a double speak thing that professionals made up.

And on reflection I think it is a meaningful concept. Striving to be symptom free may not be achievable for everyone but having a good quality of life surely is. Some people I know actually would not ask to be free of their psychotic symptoms because they see them as a unique experience that others don't have and use them in their art.

Sorry OP x-post

I'm sorry that you are feeling so low and I don't think that you should be required to just accept feeling so bad. It seems that you have got better before and that means there is hope that you can get better again.

1234 You're right that losing the fear of fear or in my case the fear of another low is helpful. I think it can help me make the most of my well periods so I'm not wasting them anticipating the bad times. But it's new to me and still fragile and it turns out very hard for me to maintain in the face of sustained lows.

mama I see what you mean and as a service user movement it can be seen as empowering, but when it's co-opted by mental health services I almost feel like it's a different thing a bit. But learning to accept it would be good if I could find a way to consistently do so. It is very hard.

Hi, I will try to reply again properly tomorrow, but just to say I think I have read that mindfulness is not particularly recommended at time of moderate to severe depression. I think it's useful for relapse prevention (amongst other things).

Really sorry you are struggling, I have been in dark places before (3 episodes) and I do know what you mean about not being able to go through it again. Try not to think too much about the long term but just get through each day being kind to yourself. Hugs to you.

Cross post. It IS hard, therefore it's ok to find it difficult (like A level maths )

Thanks so much 1234.

Maybe you're right it's best used preventatively. Bloody depression turning up before I've finished learning how to prevent it eh?

I'm sorry you've had such bad episodes too. It sounds like they made a profound impression on you.

My last two lows have each only lasted a couple of weeks so maybe this one will be short as well.

I think A level maths might be even harder.

And thanks mama as well. Yes I guess I will get better again.

How have you been today OP?

Have you heard of the serenity prayer? If not you could google it, even if you're not religious, the point it makes is fairly sound IMO.

ACT ( Acceptance and Commitment Therapy) is also worth a google. I personally believe it to be more helpful than CBT, though everyone is different.

Let us know how you're getting on if it helps you get through this....

Some people I know actually would not ask to be free of their psychotic symptoms because they see them as a unique experience that others don't have and use them in their art

Yes, I feel like that. Or at least I feel like that when I'm in a reasonably OK phase. I also get the utterly fed up with myself, "OMG this downward spiral is starting again and I'm going to self-medicate" feeling as well.

Speaking of self-medication, the Serenity Prayer is used at the end of every AA meeting. AA didn't work for me but I did like it: "May (insert Higher Power) grant me the serenity to accept the things I cannot change, courage to change the things I can and the wisdom to know the difference." Equally I think you have to be in a semi-rational state (and I'm not always) to be able to process that. When everything tumbles together it's trickier to separate the controllable elements, because it feels as if nothing is.

Sorry, rambling. How are you doing today, OP?

Oh and I found A levels maths easy ..... Physics O level on the other hand I managed to fail twice. I suppose we all have our strong points and OP, you will have plenty of them so don't lose sight of that.

I understand what you're saying. I had my first episode of MI after DD2, with PND. I was diagnosed with bipolar ten months later. I was 34 at the time and I'm 39 now. For a long time, i used to think I could just 'go back' to how I was. I would be able to dump the drugs. I've now more or less accepted that this is here for life and my aim right now is to get really good at spotting the signs of an episode and acting to minimise the damage. I've worked hard at figuring out a relapse plan. I've also stopped myself looking any further ahead than 2 years.

I've not been well the last year--5 episodes of depression and 2 admissions. I have, however, learnt a lot about how to help myself. I managed to head off the most recent depression without dropping into psychosis.

Sorry if I'm rambling. I'm trying to think of this is a long-term learning project, where I no longer tell myself 'never again', but I think I can minimise the damage. It is strangely liberating to not put myself under the pressure of wanting to be 'normal' forever and instead accept baby steps are enough.

Hi again 1234. The mindfulness-based treatment I'm doing at the moment is actually an ACT course funnily enough. Maybe that's why it's now I'm trying to accept this concept of recovery. I was thinking how much aspects of it resemble the serenity prayer.

Today has not been great to be honest. Maybe tomorrow will be better.

scissors that sounds tough.

Lobster I would've though it unusual to be so good at maths and yet struggle with physics?

Hi Bigger and sorry to hear that today's not been good. You can almost cross today off the list though, and tomorrow is another day. Don't put too much pressure on yourself (yes, I know, so easy to type words and so difficult sometimes to put them into practice). I try to remember it's progress not perfection - again, very tricky if you're a perfectionist in the first place.

Re: maths and physics - yes! I would have thought so too. I have a maths degree and am a qualified accountant but English is my true passion, so I'm just an oddity all round really. - it's the quirks that make us who we are. I wouldn't change to be a straight-line person, despite the psychotic episodes (that's unrelated to my being an accountant ....)

There must be people who actually recover, as in no more symptoms. I know there are people who have one depressive or psychotic episode and never again, but what about people who have had two or three? Is there no hope of sustained freedom from relapse?

Yes thankfully today will be over soon.

I only need to get through this and be well by 7th September when term starts.

That's a much broader question, Bigger. I suppose I see it that everyone is different and that our own progress can't be charted against other people's. A bit like you're supposed to think of golf - you play against yourself rather than anyone else. I'm sure some people only have one episode and some two or three and that's it. A good friend of mine had one very bad episode, followed by a spell in a rehab centre, and never again but she did experience some "low" times; just never as low at that one.

I am no scientist but from my own experience, the brain is more complex and powerful than I ever realised and I have had a few experiences that, twenty years ago, if anyone had described to me, I would probably have thought "this person is mad" and given them a wide berth.

I fear my brain is not complex nor powerful but just a bit crap. But I take your point about comparing to other people but only hope there are people who show this can stop.

Last time I was ill years ago it took a long time to get better but mental health services were aiming for me to truly get better. They let me try several different kinds of therapy and tried many different drug combinations until we found something that worked and I didn't get depressions any more. But this time I was offered no therapy and told I have to stay on medication combination that doesn't work and that it's a recovery service now and recovery doesn't mean getting better any more so I was discharged. I found an organisation offering ACT and that too is learning to accept being ill.

I assure you that your brain is as complex and powerful as anyone's. Are you feeling any better today? A fairly pointless question I find, but I ask it anyway. My own mood can change within a split second during a "down" phase. I'm no MH professional and wouldn't think of offering "advice" but I do find that recording thoughts and feelings in writing can be helpful. I also have had times when I bore myself so badly that I can't be bothered to do even that. What's always made me keep on keeping on is the thought that my DD has acted as my carer since she was tiny, in honesty. My ex H left when I was pregnant, we were working overseas and I only had six weeks' maternity leave. Not sure if it was PND but I didn't have time to consider as I had to get back to work.

Hope that you are OK. Baby steps are the way forward.

That sounds so hard on both of you, your xh leaving like that.

Today has been as bad, maybe worse. I find on days where I have to go out, to groups or appointments, I can be almost functional for those couple of hours but pay for the effort afterwards. Days like today I just lie in bed.

I tend to see it like the recovery from a multiple leg fracture. You know you will always have a bad limp and if you don't look after it and try to do too much too soon it will hurt and delay the progression of your recovery.

The trouble when you have a new period of depression, is that it is hard to believe you will feel better again and be able to enjoy the small things in life. But you will, hang on in there. Depression can distort your ability to objectively think that this is just blip.

I had a severe depressive period of about 3 years, 17 years ago. I have been in recovery ever since. Yes I still have a bit of a weakness and have to be careful with myself, but I have learned to spot the signs and make changes to my life, see the GP, talk to good friends and head it off. I have managed to avoid any major relapse for the past 12 years. I consider myself no more mentally unhealthy (perhaps sometimes even better about looking after my MH) than the majority of people.

Just to throw in a slightly different thought... Not meaning to dismiss asking the question you have and discussion of it. Indeed, it is very interesting stuff.

BUT, how about saying actually, we don't know whether you will recover with no further symptoms. Just like we don't know whether you will get cancer or be run over by a bus.

What exactly does "no further symptoms mean"? What if you do relapse, does that automatically have to mean you give up and kill yourself??

Sorry, I don't mean to upset or provoke difficult thoughts.

The uncertainty over the future and questioning whether what recovery involves can be anxiety inducing and depressing in itself, but living with the unknown future is a skill that needs to be learnt! Scary though it might be.

I think ACT and mindfulness help with this because they are about living in the present moment rather than fretting about the future.

What do others think?

I agree with you, 1234. I have zero experience of either ACT or CBT (although I wish I had) and have never taken any meds either. I've kind of relied on a set of personal coping strategies to manage my mind when it directs me down the path it's been before. It doesn't always work as well as I would like (which is when I feel a bit fed up with myself) but I do accept the fact that this is a a part of me that isn't always 100% controllable and that sometimes I have to live with it and not fight against it. In fact I'd go so far as to say that I wouldn't change it because I am pretty self aware and have at least a little of what some people lack - empathy.