Recovery is not only possible but should be expected.
Medication, education, and support are key factors in successful outcomes.
Other factors include but are not limited to regular treatment, good social environment, community involvement and resources, acceptance, hope and self-esteem.
The recovery journey
The recovery journey is different for everyone. It is different in the length of time it takes, it is different in the extent of the recovery. Some people recover to the point they were at before the illness struck, others, unfortunately, are not so blessed. Many factors are involved in the recovery journey, and here I will discuss those factors that I feel were important in my daughter’s recovery.
Before starting it may be useful to look at the definition of recovery that is shown in the “Mental Health Commission of Canada Recovery Guidelines”.
“Recovery means living a satisfying, and meaningful life even when there may be ongoing limitations related to mental-health problems and illnesses. It starts with the fundamental belief that not only is recovery possible, it should be expected regardless of diagnosis or situation."
So, it can be seen from the above statements that recovery is a very individual and personal thing. There is no single level of success and the timeline can be extremely variable. Therefore, it is not just recovery but rather a recovery journey. This journey may wax and wane as the illness lessens or intensifies.
In my daughter’s case, this recovery journey has taken several years, but I am happy to say that she is currently doing very well and I am proud of her. She is now living on her own, is responsible for her finances and self-care. She is also a Peer Support Worker and does a lot of public speaking about her journey.
Following a major psychotic episode, it is difficult to understand that recovery will in fact occur. There can be significant cognitive deficits as well as physical and emotional factors that make recovery look as though it will be impossible. There are also many cases where further episodes or relapses, continue to make the situation look hopeless. I was very fortunate, as my daughter was accepted into the early psychosis intervention program. At my first visit to this program, I was told that recovery was to be expected. This gave me hope. I was also advised, that I was a part of my daughter’s recovery team. Initially, I didn’t really understand what this meant, but I soon found that I had to educate myself about mental illness so that I could understand. I enrolled in psychoeducation programs, researched information on the Internet, and read many books about mental illness. I also joined family support meetings and started taking a much more active role in my daughter’s care. My wife had passed away the year before, so it was all on me. I talk much more about my own education and the growth during this period in other sections, so I will limit myself in this section to focus on my daughter’s recovery journey.
In the first few months, there were very few signs of recovery at all as there were significant cognitive deficits to overcome, and we were still going through medication changes trying to find effective stabilization of symptoms. Most of the time my daughter was either sleeping or extremely lethargic, with little motivation to do anything. When the psychotic symptoms eventually stabilized, there was still a long period where the cognitive deficits were limiting what my daughter could achieve. It also took time for me to understand exactly what was going on, and to learn the best ways that I could support her. Initially, I would try and encourage her by taking her out to the school playground to shoot hoops, or to the tennis court to hit a few balls. This was when I learned that I had to develop patience and not try to push too hard. I eventually realized that my daughter’s recovery was as much me learning and changing, as it was my daughter’s efforts. I began to understand that the lack of progress was not my daughter being lazy or uncaring, but rather was the result of the damage caused by the psychotic episode. There seemed to be little help with the cognitive deficits other than letting time heal the damage.
Gradually over the years my daughter showed signs of recovery in some area’s but was still very much a loner with no social life. I was happy that the crises had abated, but was not happy with the slow progress toward independence and a fulfilling life for her. The problem was exacerbated by the development of obsessive compulsive disorder and extreme anxiety about germs. After several years of isolation and no motivation, my daughter joined a psychosocial rehabilitation clubhouse. This made a huge change in her recovery process. She was now able to make new friends who did not judge her and was guided by caring, empathetic clubhouse staff members. She became involved in club activities and her self-esteem and motivation gradually improved.
The next big step was when she moved out to live on her own. This was an anxious time for both of us but it worked out well and produced another huge leap in self-esteem. I continued to closely support her through this change while encouraging her to become less dependent on just me. Her social life improved and over time her independence became more noticeable. She took recovery support training at the clubhouse followed by the required training to become a peer support worker. She is now fulfilling her dream to help other people who are recovering from mental illness.
The key ingredients for my daughter’s recovery were:
- Medication for Stabilization of psychotic symptoms and anxiety
- Family support in practical ways, e.g. encouragement, financial, transportation, accommodation.
- Psychosocial Rehabilitation for social interaction, self-esteem and skill building
- Subsidized housing to develop independence
- Support of professionals, friends, and family for support, motivation, and availability of training
- A huge amount of determination and hard work on my daughter’s part.
It may have taken a long time but the “expected recovery” prognosis given, has indeed occurred.