Recovering from Depression: No easy way
Merely Me’s post, Recovery from Depression: What Does it Mean?, poses a question that I've put to myself a lot in the last few years. As she says, the self-help quick fixes don't work because there's no short-cut formula to recovery. It takes a lot of hard work, but getting back the ability to enjoy a full life again can and does occur.
There's no single definition of recovery, just as there is no single route for getting there. The comments on Merely Me's post illustrate the varieties of experience people have had with recovery. Some have reached an uneasy truce with depression, others have been able to get the illness under control through mental discipline and many have had only an occasional remission of symptoms.
After working on my own recovery for many years, as I discussed in this recent post (and much more extensively on Storied Mind, my personal blog), I realized that I could only make progress if I took a lead role in defining the approach that was best for me. I also needed to raise my expectations about what recovery could be and aim for a full well-rounded life, not just lessening the severity of symptoms.
In the past, I could never find much support for a more self-directed approach to recovery from the mental health providers I consulted - or even much discussion of recovery and what it meant. But that has been changing dramatically in the last few years.
There's an emerging consensus in the mental health world that recovery, based on individual needs and preferences, should be the goal of treatment. I was amazed to find that this is something new, but it is.
The 1998 Report of the Surgeon General on mental health declared that recovery should be the goal as a matter of national policy. It also emphasized the role of patients in the process and gave a short history of their role in developing the concept of recovery.
Recovery is a concept introduced in the lay writings of consumers beginning in the 1980s. It was inspired by consumers who had themselves recovered to the extent that they were able to write about their experiences of coping with symptoms, getting better, and gaining an identity (Deegan, 1988; Leete, 1989).
Over the next several years, federal health agencies and mental health professional associations joined with ex-patient/consumer advocacy groups to develop a national consensus statement affirming that recovery was to be the goal of treatment. (You can download it here.)
That was in 2005. I found it hard to believe, but that statement marked the first time an agreement had been reached on a definition of recovery. Until then, it seems, mental health professionals had primarily focused on theories about the causes of depression and the methods of treatment based on each theory.
Studies of outcomes were important, to be sure, but tended to emphasize the success or failure of a particular treatment model. They were - and still are - usually measured by before-and-after participant answers to questions based on uniform technical criteria.
The 2005 statement defined recovery in more human terms that lay people could relate to:
Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.
This statement recognizes that the journey must be self-directed. Each person needs to find their own way and decide on goals for the kind of life they want to lead. Some define recovery as an ongoing process, others as the end result of achieving wellbeing. It should be up to us, rather than the professionals.
It goes on to define other guiding principles that I find just as important as any attempt to specify the nature of recovery itself.
Empowerment: Each person can choose from the available treatment options and participate in all decisions.
Individualized and Strengths-Based: Treatment starts with the strengths, coping skills and resiliences of each person rather than just the symptoms of illness.
Hope: The belief that people can overcome obstacles and find a better future is the essential motivating message.
Responsibility: Each person is responsible for self-care and needs to understand - and have the courage to use - the treatment strategies and healing processes they've chosen.
Peer-support: The mutual support of those with depression is an important part of recovery, both for the value of relationships and for the sharing of experience and learning.
The statement also emphasizes the need for respect and acceptance by family and community, a holistic approach considering all aspects of life, including mind, body and spirit, and recognition of the non-linear nature of the recovery process, with its inevitable setbacks and continuing growth.
This statement is the first of its kind to take into account the realities of recovery that those of us with depression have learned through long and difficult experience.
This is a message of hope for recovery - however you define it.