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Mental health_managing the recovery journey

The recovery process following a mental illness is a journey, not a destination. By taking an approach that focuses on the whole person, and not just their symptoms, recovery is possible.

Monday, February 4 2019

If you have a mental illness, recovery is a multi-faceted process, encompassing the biological, psychological and social domains. It means adhering to your treatment regime, gaining hope, understanding your abilities and disabilities, engaging in an active life, having autonomy, and cultivating a positive sense of self.

“It’s necessary to have a good support system throughout the recovery journey,” says Marna Acker, an occupational therapist at Akeso Nelspruit. “Surround yourself with supportive people that you trust and are comfortable with, and avoid isolating yourself.”

If you don’t have a support system in place, then consider joining a support group in your area and find other ways to meet and reach out to others. Loneliness is a risk factor in mental illness.

“If possible, prepare the people who will be supporting you by including them in a session with your therapist, so that you can educate them about your diagnosis and any changes you need to make,” says Acker. “Do not expect people to understand what you are going through – they need to have it explained. Give them time to ask questions and process the information. It’s important to listen to those who support you when they observe changes in your mood or behaviour and point these out to you. Give them contact details for your therapist, psychologist or psychiatrist in case professional help is needed.”

Acker lists the following four key support systems:

Therapeutic support: This includes psychiatrists, psychologists, and other counsellors or therapists like occupational therapists, social workers, and support groups.

Family: They can provide emotional support (listening and showing empathy) and practical support (helping out with responsibilities, financial support, or taking you to your appointments).

Friends: They can give social support (do something fun with you). You need to enjoy life and participate in activities that are fun for you.

Work: Your employer and work colleagues can give support at work. It is also important to disclose to you supervisor or employer if you need any adaptations at work. They can’t provide help if they do not know what is needed.
Remember, you have the right to choose to whom you disclose your mental illness. Consider the pros and the cons about disclosing to each specific person.

It is also important to think about those people whose presence in your life may exacerbate your illness, and how you intend to manage the impact of those relationships by limiting either your exposure to them or their effect on you.

Making the journey more comfortable
Acker offers several tips to help you along the journey to recovery:

  • Have a balanced and structured daily routine. This helps to create predictability which eases stress and anxiety. It also helps to fill your day with constructive and productive activities that may result in a feeling of purpose for that day.
  • Stick to basic but important self-care. Sleep for eight hours. Eat healthily, exercise, spend time with friends and family but also have some time for yourself. Have free time every day to do at least one activity you enjoy. Learn to be fully present in the moment, in a mindful way.
  • Identify small goals. Start with daily goals and then identify weekly goals and build on this. If you can achieve small goals, it makes achieving the bigger ones easier, and the feeling of achievement will help with your confidence. Take it one day at a time and keep moving forward. Don’t expect to get everything right at the first try. Celebrate the small things you achieve.
  • Continue with therapy. Attend therapy regularly, or start attending support groups. These professionals will help you with everyday struggles and will enable you to see things objectively.
  • Take your medication. Do not change or stop your prescribed medication without consulting your psychiatrist. Make sure you know who to contact if anything happens regarding your medication, side effects or what to do when your script runs out. Make sure to know the function of each of your medications.
  • Mind your social media activity. Limit social media engagement to avoid comparisons or expectations of society. Also, beware of big social gatherings that may provoke anxiety.
  • Go back to work. Do not postpone returning to work and other basic responsibilities. The longer you do, the more difficult it will be to return to them. Be aware that you might not be able to cope with all your responsibilities immediately. Be willing to ask for help if needed.
  • Keep it simple. Do not take on big new challenges at first. Keep things simple and enjoy the small wins.
  • Remember what you have learnt. Continue with therapeutic techniques like visualization, progressive muscle relaxation, mindfulness, journaling, breathing exercises, or whatever works for you. Apps and self-help books are available to assist. Use techniques that will help you to grow, move and feel empowered.

“When things improve, it is because you are making changes,” Acker advises. “If you are getting better, do not stop the things you are doing, as you run the risk of repeating the past. Therapy and applying coping techniques in your life will help you make the changes needed to prevent relapses.”

Should you have a relapse, she adds, this may knock your confidence in your abilities to improve the quality of your life. It becomes harder to get up, build courage and try again after each relapse. There’s also a risk that you may lose faith in the treatment process, or begin hopping from one treating method to another. Defaulting on medication can also present many health risks, which is why you should not stop medication without first consulting your doctor about the risks involved.
Tips for overcoming a setback

  • Dialectical behaviour therapy (DBT) teaches people about the triggers that lead to extreme states of mind. The objective is to limit impulsive behaviours that bring undesired consequences. Use your DBT skills – which you will have learnt during therapy – to start identifying and analysing the situations that spiral you into crisis.
  • Do not isolate yourself or beat yourself up because you failed. Rather think about the small things you did well and know you can learn from the situation to improve next time around. Setbacks are a reality and learning how to deal with them is part of becoming successful at managing life.
  • Organize an appointment with your therapist if you can’t manage the situation by yourself. Asking for help is a courageous act and not a weakness.

Some do’s and don’ts for family and friends
“The family and friends of a person recovering from mental illness should not minimise what the individual is going through. Don’t say things like ‘snap out of it’, ‘be grateful for what you’ve got’, ‘it’s just in your head’, or belittle the recovery process they are going through. This is important and life changing for them even if you don’t understand it,” Acker stresses.
“Do not walk on eggshells around them either”, she adds. “Threat them the same as you have always done, albeit with empathy. They should feel that they can ask for help if they need it. Do not encourage your loved one to stop their medication or other treatment even if it goes against you culture or religion. First talk to the professional involved before making such recommendations.”
If you or someone you know is experiencing a mental health problem and you require help, contact Akeso psychiatric hospitals on 0861 435 787.

To help in the recovery process:
  • Give emotional support. Most of the time listening – not advice – is the best way to give support.
  • Make sure your loved one is taking their medication and keeping their appointments.
  • Ask about the process and show interest in the new information they have learned about themselves, the diagnosis and the changes they need to make.
  • Ask questions if you are unsure.
  • Show empathy (try to understand how they feel) and not sympathy (just feeling pity for them).
  • Continue to engage in activities which they enjoyed before the diagnosis. They are still the same person but with some changes.

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About the Akeso Group
Akeso is a group of private in-patient psychiatric hospitals, and is part of the Netcare Group. Akeso provides individual, integrated and family-oriented treatment in specialised in-patient treatment facilities, for a range of psychiatric, psychological and addictive conditions.
Please visit www.akeso.co.za, email info@akeso.co.za, or contact us on 011 301 0369 for further information. In the event of a psychological crisis, please call 0861 435 787 for assistance.

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