Doing all the right things

The vagueness and uncertainty around recovering from mental illness can be unbelievably frustrating. A phrase I hear a lot in relation to the work I do to get better is “doing all the right things”. It’s code for “everything outside of this is wait and see”.

Doing all the right things means not drinking, smoking or taking any kind of recreational substance that might complicate things. It means trying to go to sleep at the same time regularly. Take the medicines I’m prescribed, in the dosages advised. Show up for assessments and therapy, make sure to stay connected with at least a few people socially so I’m having non mental health related interactions, and do my best to go to work. If I’m asked to do something, do it.

One of the things that gets stressed to me a lot in the therapy process I undergo through the outpatient clinic is this wonderful term called “self-care” which is secret code for “lower your expectations”. If you’ve ever rolled your eyes at participation awards, “self-care” is probably not for you.

The idea of self-care is simple. Be kind to yourself. Don’t ask yourself to do more than you think you can. Reframe what you do manage to get done as an accomplishment. Take time to look after yourself when you need it. Don’t go to work if you’re in the middle of a freak out, or when your brain is so scattered it takes you forty minutes to successfully lace a pair of shoes. Basically, if you can’t handle it, then don’t do it. Keep track of what you can do, and make sure you do your best to celebrate those things.

Self-care as a concept is weirdly at odds with the message that usually follows it, a somewhat sanctimonious bit about needing to continue doing your best to live your life, even if it means breaking out the good old fake it until I make it routine. One of the numerous psychiatrists I’ve seen since September wisely suggested that even if I’m feeling like total shit and am on the verge of having a melt-down, I should just push through and go to work anyway, because it would “do me some good”. Basically, be unkind to yourself to keep things normal.

If, by the time I’ve entered the hospital system for mental health problems the best plan we’ve got is to keep up appearances and put on an act, then I think the plan is a dud. More than a dud, it’s even a little condescending to imply that the almost 18 month long deterioration of my mental health hasn’t already involved plenty of faking it until I (sortof) make it.

Being unwell, and for a long period of time is taxing. The only encouragement that anyone can offer when I bring up the extended duration of my illness or the toll that the ongoing nature has on me, is that I’m doing all the right things.

For reference — This is not encouragement when it isn’t accompanied by improvement.

Last week’s discussion at the clinic about this problem went to a slightly darker place. I was asked what I’d think if things aren’t going to get any better, given I am doing “all the right things”. I let them know that my ongoing commitment to trying to get better rather than killing myself is hinged almost entirely on the assurances from many people that if I just keep slamming my head in the door for long enough, things might change.

The clinician didn’t seem happy with my answer. I’m not entirely sure what they expected, but it was honest. I’ve been treading water for quite some time now on the promise that the mental batterings I experience can and will continue until morale improves. If there really wasn’t any prospect for relief, why would I keep struggling?

People often talk about the recovery process for mental illness, and the magic eight word mantra “make sure you do all the right things”. If that’s worked for you, or is working for you, that’s great and I’m pleased for you.

For everyone else, I guess we’ll play “wait and see”.

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