When I was going through puberty, I experienced first-hand the emergence of mood or affective disorder. Sure, every teenager gets moody, but my mood imbalance wasn’t exactly subclinical, it was diagnosable and extreme. The diagnosis was bipolar disorder then, long before any psychosis emerged on my clinical picture. I was in high school, not very popular, and very isolated from my peers without a lunch break or a solid clique of friends. As I realised how starved for friendship I was, my mood dysregulation worsened, and I became socially volatile, behaving bizarrely, and agitated.
Without coping skills, a good therapist, or real friends as supports, my behaviour became more extreme. Eventually, the emotional pain I was enduring as an unhappy high school adolescent converted over into numbness. I didn’t want to feel pain anymore. So, my body internalised the emotions until I became so disconnected from them that I felt nothing. At first, this is what needed to happen, I suppose. My body was adapting, albeit, negatively, to the extreme state I was in during that time.
However, like all people with maladaptive coping skills, they collapse on their heads. And, so, eventually, I collapsed, reverting to even more maladaptive coping mechanisms. That was when my behaviour crossed the line from maladaptive coping to self-harm. Like I said, I was numb. I wanted to feel something again. So, walking into my family’s bathroom, I looked in the medicine cabinets and drawers. There, inside the drawers, were my father’s razor blades. I knew about cutting from television and films.
I applied what I knew about cutting and put theory to practice. I took the blade and drew lines across my wrists. First, minor cuts, tracing along my veins. Then, a bit deeper, feeling the force of the blade tear through my skin. ‘Ahh, ouch!’ I thought. Instead of a good feeling, a rush of pain entered into my system. This wasn’t exactly the feelings I had hoped would return.
Instead, physical pain and lots of it began to emerge from cutting myself. Maybe, I surmised, if I cut a little deeper, I would pass through the hurt, and better, more satisfying feelings would manifest. I was wrong again – just more pain. Now, because I cut so deep, the pain was almost as extreme as the emotional pain that preceded my numbness. Now, I was just in shock and poised between two extreme states of physical and emotional pain. I felt out of control at this point.
These are superficial cuts. What we mental health therapists note isn’t very deep. They are done mostly for attention. I was starved of attention from my peers then and really would do just about anything for more. When my parents came home after I had just finished cutting myself, I ran outside for their attention. “look at what you made me do!” yelling at them. I was accusing them or suggesting that their behaviour made me behave this way and that they were the cause of everything.
My decision to self-harm was my own choice. As angry as I was back then at everyone, including my family as most teenagers are from time to time, my decision to behave recklessly and self-harm was entirely my own.
There is a rule or mantra; we professionals have in mental health that rings true always. Nobody controls our behaviour except, ourselves, meaning, nobody is in charge of anyone else’s actions, except for the individual. So, before you blame someone for your behaviour or engage in self-harm, remember my story.
Back then, I feared I would always be in pain. Whether you have a long-standing condition or are suffering from a new diagnosis, the fear of symptoms re-activating or worsening is a real problem for us with a mental illness. Most of us want to know:
- Will I always have this diagnosis?
- What if these symptoms persist? Or even,
- How do I know when I’ve recovered?
Investigate the nature of your diagnosis and prognosis. With this information in hand, you can now devise a plan to manage your situation. The best way to ensure your worst fears about relapse never become a reality means having a stance about recovery. Folks with a chronic condition, co-morbidities, and other factors complicating the road to better health and wellness should be even more realistic with the stance they hold towards healing.
Here is the irony but also the pragmatic black and white of it all. Let’s say you are having a problem. The fastest and least risky route to fixing the issue is finding a solution. So, when you’ve got several issues happening at once, finding multiple solutions takes more savvy, skill, and more energy. If we are to pursue this logic, as the sheer volume of issues increases, so do all the ‘inputs’ into recovery. By inputs or ‘protective factors’ as some call them, I mean the amount of energy, self-awareness, skill, and savvy around navigating every avenue of your journey healing.
The capacity for people to maintain their mental health and recognise new symptoms activating is usually very much our own to self-manage, except for some mental health symptoms, like anosognosia (commonly associated with schizophrenia). These symptoms, and others that have a similar impact on the body, can complicate a person’s ability to understand his or her illness. Most of us notice we are either feeling or thinking differently. The truth is, though, we are in just about complete control over our mental health. Despite what some people believe, our mental health is in our own hands.
What I am saying is sure, there are some environmental, biological, genetic, and parental contributing factors to how we feel, and what we think. Do these markers only serve as indicators in how we measure our health? The answer is, probably not. These contributing factors are just that. So, in the event, your life circumstances are particularly limited, and you feel restricted your capacity to maintain good mental health, think again!
Let’s take a look at our power to control and self-manage our mental health landscape. Self-determination: the inner drive. The very mobility needed to move work on our selves forward. Self-awareness: realising our strengths, as well as limitations. Sure, some of us are put in impossible situations, born into poverty, victimised, abused, and maltreated, but even in these circumstances, some discover resilience. They make it, despite the seemingly disparate nature of their problems.
Why do we fear relapsing so much if it is in our means to stay or get healthy? The answer is, because people, regardless of the successes they experience. Often lose sight of the bigger picture. For people in recovery, the road ahead can seem long, especially with more seemingly chronic diagnoses. Often people just give up when they hit a rough spot. Maybe the road forward seemed too long and challenging. But the most tragic way people shoot themselves in the foot. Continuously make the same mistakes without gaining insight into your behaviour.
Chronic can very well mean your symptoms persist for the long-haul or, in some cases, lifespan. The rest of our lives for a lot of us, especially young and even middle-aged people, can seem like a lot of work. For many people sustaining this much effort long-term across the life span is too much to wrap their heads around.
The fact of the matter is maintaining good health, especially our mental health, will only make a living more manageable in the long term. Creating and allowing for more solutions to manifest during difficult times can create a more manageable living situation. Aside from these (un)reasonable explanations for why people lose sight of their recovery plan are folks who rationalise away their lives and, in turn, defer recovery and any chances at better health in their future.
Rationalising away or worse, discontinuing vital behaviours and habits interfering with healthy decision-making will halt our recovery in its tracks even during the tenure of our road to healing.
There are several reasons. Sometimes we deem ourselves cured. Other times, we encounter a seemingly impossible situation created by our negative behaviours as a result of playing out symptoms of a disorder.
Whatever the reason, because there are just so many, almost infinite self-rationalisations, we can manifest to discontinue our self-care practices. Be especially mindful of this train of thought before it leaves the station. These are merely negative self-messages we create, which become cognitive distortions. They are seemingly real and accurate, but at the root of it, are untruths and outright lies our minds manifest to justify maladaptive behaviours. They are unhelpful, at times frightening, and if we follow these negative thoughts to their horrific conclusion, they are disturbing to most of us experience them.
I said it before. The concern of relapse is real, but the reality is good mental health is truly in our own hands. Ultimately, when left to our own devices, we set its limits and create solutions for disarming paralysing forces before life seems like we are on a ride or a just passenger in our lives. The truth is, we are driving our health forward at a rate and speed and course of our choosing.
Image credit: Freepik
Max E. Guttman, LCSW is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.