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My article- 'Why mental illness recovery is partly a choice'

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Hopefully I'm allowed to post an article I submitted for publication, as it was rejected. I thought it might be helpful for some users. Here we go:

Recently, I saw a quote shared by a personality disorders website on Facebook. The quote was ‘Mental illness is not a choice, but recovery is’. I thought it was a good quote, but when I read the comments on Facebook, most people seemed quite angry about it. Some of them made reference to physical illnesses and asked whether someone with cancer or a broken leg would be told that recovery is a choice. I do see their point. However, personally I can identify with the quote.

Much as I’m always saying that mental illnesses should be treated similarly to physical illnesses, there is in fact a difference. I think that people with mental illnesses should be treated kindly, people should realise that we didn’t choose to have these illnesses and that we deserve sympathy as much as someone with epilepsy or cancer does.

But for many people with mental illnesses, recovery does partly have to be a choice. Sometimes, we can take medications which help our symptoms. For some, medication is all that is needed. But for others, a conscious decision does need to be taken in order to start the recovery process, just as the quote says.

Think about someone with OCD. I use an OCD forum, where people will post over and over again about the same thing, looking for reassurance or for someone to give them the magic answer. Of course that doesn’t exist, the person with OCD will never be satisfied, because that is the nature of OCD. The particular forum I use has some very helpful members who give what probably sounds like quite blunt advice. For example, ‘just ignore what your brain is telling you, and don’t try and remember whether you did something terrible.’ Of course for the OCD sufferer it is never that easy, but my point is that at some point the person with OCD needs to make a choice to recover. They need to trust that what they are doing are OCD compulsions and that they will never get better if they keep doing them. They need to go against what their brain is telling them, and fight for recovery. Someone might be terrified that if they stop checking the taps every 5 minutes for hours, their house will flood and everything will be ruined. But they need to make the choice to go against that, to resist the checking. Otherwise they will never recover. It is partly a choice. If they don’t make that choice, nothing will change and they will not recover. Of course there will be people with different severities of OCD, and the most severe will find it harder to recover, but they all need to take that leap of faith. Maybe at first the choice is just to seek therapy, but it’s still a choice. Using my own situation as an example- for over a year I timed every bit of walking I did every day, and if it was less than 5 hours 20 minutes a week, I was convinced I would get fat and no one would like me. It took a conscious choice on my behalf to overcome this. It wasn’t easy, and I’m not fully recovered yet, but I don’t time my walking anymore. I did have therapy, but I couldn’t have got as far as I did in my recovery without making a choice to fight what my brain was telling me.

I also had to make a choice to start the recovery process for my BPD. A strong part of my BPD is the fear to get better because I worry that if I’m not ill, no one will have any reason to be friends with me anymore and I’ll lose everyone. A big part of me wants to stay ill because of this. It would be easy for me to give in to those thoughts and make a choice not to recover. But I know that if I don’t recover, I’ll keep repeating the same patterns over and over again. I’ll keep becoming too attached to people and then bombarding them with my problems in the hope it will keep them connected to me, and they’ll keep leaving, and I will keep feeling the pain of abandonment. I’ll keep hating myself and having suicidal thoughts when I receive any criticism. So I had to make a choice to recover. I had to decide to have therapy, and I had to decide to refer myself to the Complex Needs Service, which is an intensive group therapy programme that is designed for people with personality disorders.

There are many reasons that people might be scared to make that choice, to take that step towards recovery. And the recovery process is difficult. There may well be a lot of self-examination required. You may have to deal with painful memories that you would rather keep buried. But without recovery, you may stay forever stuck. Think of all the things you might be able to do after recovery that you can’t do now. To get there, you need to make the choice to start recovery. That first step might be as small as admitting that you have a problem, talking to a friend, visiting a doctor to see which medications might help you, or making an appointment with a therapist. But all of these require a choice. As the quote says, ‘Mental illness is not a choice, but recovery is’.


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Great article, kaheath.

I do believe that with OCD recovery is a choice and it is one that we have to make every day in order to get better.

We have to choose to continue on the path of challenging our distorted thinking, ERP and mindfulness techniques, and most importantly choose not to act on our intrusive thoughts by doing compulsions. It's so easy to choose not to recover and to decide to do a compulsion to get some temporary relief, but you are right that in doing so we will never get better.

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Very well-written article. :)

Just a thought though. Does one not have to make the same choice for a physical illness, to seek treatment, medication etc.?

For example, with celiac disease you have to make the commitment to stick to a restricted diet and keep away from  all products with gluten in, in order to get better and stay well. Similarly with diabetes, you have to carefully monitor glucose levels and sugar intake, etc.

It's just that with mental illness, that choice is harder to make, because our thinking processes have become distorted.

What do you think? :)

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Thank you :)

Aha, good point! I guess with physical illnesses though it’s sometimes a lot easier- just take pills, no effort required. I get that that doesn’t cover all physical illnesses, though.

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Yes, that's true.

There are differences, but perhaps not so many as people (not you!) generally think?

I think the reason sufferers object to the phrase is because it seems to buy into the prevalent misconception that mental illness isn't as 'real' as physical illness, or that if you haven't recovered then it's somehow your fault.

Nevertheless, it is indeed important to seek help and aim for recovery, which was the main point of your article, which I'm not trying to criticise as it is very good. Just thinking out loud really.

I'll shut up now. :D

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First it's a great piece, kaheath80, beautifully reasoned and written. Well done :thumbup:

And it gets the point over - we have to make thinking and behavioural changes to recover from OCD.

For me, someone who does experience some OCD improvement from a medication must STILL work through CBT therapy. The classic example as to why is in one of kaheath80 's obsessions - 

8 hours ago, kaheath80 said:

for over a year I timed every bit of walking I did every day, and if it was less than 5 hours 20 minutes a week, I was convinced I would get fat and no one would like me

This needs to be seen to be OCD and not factual. For example, a friend of mine wanted to lose weight by swimming 20 pool lengths several times a week, yet still carry on drinking loads of beer :D

I am on a weight reduction programme at the moment and it involves :

smaller portions 

Low carbs choices 

Reasonable exercise. 

It's going well - I have a target weight to lose of 8kg, about 1 stone 5 lbs - and I have reached half the target in 6 weeks - because the programme is realistic factual and achievable as a combination of those three elements. 

OCD's fears and threats are based on falsehood, exaggerations or impractical, magical possibilities. 

Personally I don't compare physical and mental illnesses. I have physical and mental disability, none of which are apparent to others. 

But I have to decide whether to treat them, or suffer, basically. And without orthotics in my shoes, I would be incapable of walking. 

Without using compression gloves it would be impossible to garden as the consequential pain would be intense. 


Edited by taurean

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Thanks both. I agree with your points and thanks very much for the good feedback!

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