Managing mental illness and recovery

In the past, people with serious mental health problems were often expected not to recover. Attitudes are changing, and many charities and health services now promote the idea that ‘recovery’ is possible, no matter what problems people are facing, and regardless of whether others believe in the approach or not. Today, people with mental health problems have different ideas about what recovery means to them, and if recovery can be achieved. This summary is about what recovery meant to people we interviewed and how they managed their mental illness.

For those who have experienced severe mental health problems, recovery can be long and complex. Some people we spoke to who had been unwell for a long time, still did not feel they were getting any better. Others did notice improvements, but the word ‘recovery’ was not always favoured, some liked the idea of ‘journey’ better. When some people talked about recovery they meant no longer having symptoms – such as suicidal thoughts, or no longer hearing voices or having unusual beliefs that others do not hold. However, for other people it meant being able to live a full and meaningful life whilst still experiencing mental health difficulties.

David Y thinks recovery is different for everybody and it isn’t just about going back to work but it is about being able to live a useful life.

Age at interview 52

Gender Male

View profile

ECT and medication often played a part in people’s recovery. ECT played an important part for some and you can read more about that here: ‘How Effective did people find ECT’. Although some of the people we talked to no longer took any medication at all, many people spoke about how medication played a role in their recovery (see ‘Medication: effectiveness and side effects‘). Although ECT had helped get him better, Sunil felt that it was his mood stabiliser – carbamazepine – that helped him stay well for 18 years. People often wanted to lessen the amount of medication they were taking over time as part of their recovery. The advice here was to do so with support and to ensure you put other things in place (see ‘Support networks‘).

Catherine Y gradually improved on medication, although she gained weight. With help from a charity she started running. She took a course with the Open University and now works as a support worker.

Age at interview 41

Gender Female

View profile

What people meant by recovery

When talking about recovery, the people we spoke to mentioned the importance of managing their health and wellbeing. People talked about becoming more confident and being kinder to themselves; doing things they enjoyed such as walking in parks and holidaying. Living a life as independently from mental health services as possible; returning to work, education or volunteering to keep active and give back to others; finding a nice place to live; being able to participate in family life and/or other social activities.

Tania felt that, as a family, they were no longer lurching from crisis to crisis. She worked hard at maintaining her health.

Age at interview 41

Gender Female

View profile

People said there wasn’t a single moment when recovery occurred: real change is always slow and gradual. Steve described his wife initially having fewer suicidal thoughts and a ‘calm light-headedness’ and then as her memory came back she returned to her normal self without the depression. Nevertheless, looking back, some did notice a turning point. A few people mentioned a specific moment after leaving hospital when they felt they began to recover.

Matt tells the story of how his wife suddenly relaxed at the end of the course of ECT and it was the beginning of a slow recovery.

Age at interview 36

Gender Male

View profile

Recovery often didn’t happen in a straight line and people experienced highs and lows along the way. Some people hadn’t been acutely unwell for some time, but had what Suzanne called ‘blips’, where they saw familiar warning signs that they might be at risk of becoming unwell, such as not sleeping or starting to feel low.

Although at first recovery might just mean getting through a bout of severe depression or suicidal feelings, over time it took on new meanings. Sometime after a crisis was over, people found themselves faced with new challenges, like anxiety over managing serious money issues, or coming to terms with a difficult past. Helen found she could only move on when she wasn’t haunted by the past. Some people, like Sue, who had not had a good experience of either ECT or the mental health system, felt that they actually needed to recover from the effects of being in mental health services.

Until she began maintenance ECT Tania describes being very depleted and having a low immune system because of the drugs and lack of sleep. An illness like flu could trigger another episode of mental illness.

Age at interview 41

Gender Female

View profile

Techniques for stress reduction and self-help

The people we spoke to had often learnt techniques to help them feel well and keep them on an ‘even keel’. For some this meant pacing themselves better, spending time on hobbies and with friends, going for walks, exercising more, and just managing their lives in a different way. Others spoke about practicing mindfulness, eating a special diet, trying to challenge negative thoughts (through meditation, hypnosis and talking therapies) or having treatments such as Reiki or massage. Yvonne said she didn’t like the word recovery but said ‘if you can [have] total insight into your illness, I think you’re going to get on a lot better and certainly move forward in a positive way’. Cathy said recovery for her was ‘being happy with the way things are, even if they may not be perfect’. Enid tried to make the most of everyday and not worry about the future: ‘just live in the moment’. She went to church, went out with friends, enjoyed music and found that her dog was great company. Many people spoke about the importance of being able to sleep well. Dafydd thought that establishing a regular sleeping pattern was key to his wife’s recovery.

Yvonne says she can still become quite ill quite quickly if she gets very stressed. Having a support network who tell her when shes doing too much, helps her manage her illness.

Gender Female

View profile

Suzannes friend have her a healing treatment, like Reiki, which she felt kept her well at times where she was teetering on the edge of becoming ill again.

Some people found their religious beliefs or spirituality played a special role in their recovery. Tracy said her faith gives her self-worth. Suzanne describes waking up after her last ECT treatment and hearing her late grandfather’s voice. She calls it the ‘lovely spiritual aspect to [her] recovery’. Albert feels he was able to give up drugs 14 years ago because of an experience he had doing yoga which changed his outlook on life: he said ‘it was as if I had woken up to the fact that I was only a tiny grain of sand on a rock hurtling through space’.

Helen found the church and her faith taught her how to balance things out.

Age at interview 60

Gender Female

View profile

Support networks

Getting support was vital for many of the people we spoke to. People who had had ECT, and those who cared for them, could easily...

Deciding whether to have ECT

Most of the people we spoke to were very unwell when they were offered ECT. Some were 'catatonic' (unresponsive) at the time, and others had...