‘Recovery’ means a lot of different things to different people. It even has different meanings depending on the ailment or illness to which it refers. Recovery from a bout of the flu, for instance, will leave a person weakened, but ultimately there will be no lasting or long-term effects as a result of their short illness. Recovery from an operation can be a slow process (depending on the severity of the operation), but wellness can be fully restored, especially if it is something routine – in fact at times wellness can be enhanced as a result of the operation itself. Recovery for an alcoholic or drug addict means being able to stay away from the substance that had them addicted in the first place, so is all about personal willpower and overcoming those addictions rather than any lasting ‘recovery’ – hence the phrase a ‘recovering alcoholic/drug addict’. But there is no doubt that their lives are greatly enhanced (excuse the pun here) by the absence of those substances from it. Recovering from cancer means being in “remission” and having your fingers crossed that you won’t get a secondary cancer somewhere else or that the initial cancer won’t reappear five or ten years down the road. Recovery can be complete but most cancer survivors will tell you they never quite lose the fear of re-occurrence, even decades later.
Recovery in terms of mental illness, especially bipolar disorder, is a fallacy. There is no ‘recovery’. There is simply a reduction or decrease in the severity of symptoms from time to time and somewhere along the line, a loss of ourselves piece by piece, episode by episode, whether that be through the illness itself or indeed the ‘cure’. Irrespective of the severity of the symptoms, and that is such a subjective and inflammatory thing to say, because while there are ‘degrees’ of severity and degrees of symptoms, there are not ‘degrees’ of mental illness. No one ever says “Mr Smith down the road is a quarter mental”. You either struggle with mental illness or you don’t. Degrees don’t and shouldn’t come in to it – for any form of mental illness. That is so degrading on a personal level, but it also shows an ignorance for the illness of bipolar and its effects on the individual struggling with it. I can say this because at one time I felt this way. I felt my bipolar disorder wasn’t “as bad” as ‘a.n.others’, so why should I be feeling the way I was. I didn’t need to be hospitalized, therefore I wasn’t ‘as sick’ as someone else. I came to realize the error of my ways and also to realize it was the depressive side of my bipolar disorder making me feel so shitty about feeling depressed – but not depressed enough!
So, it is my belief that ‘recovery’ is never ‘fully’ achieved by someone struggling with bipolar disorder. Please don’t get me wrong, of course those of us struggling with mental illness can lead productive lives, have loving relationships with spouses/partners, family and children, keep and sometimes indeed excel in a fulfilling job, be strong independent proud people; but not with the label ‘recovered’ attached to us, we can’t. “I’m a recovered mental(ist)” is not something one would say at a job interview. If you go online and try to research up recovery + mental illness you will be showered with a plethora of articles some as asinine as espousing that the key factor that determines who recovers and who doesn’t most often is the willingness and ability of the person to engage in his or her own healing, and offering ways to become ‘stronger’ in order to do this. I don’t believe that, mainly because the problem with that hypothesis is when we are struggling, when we are either hypomanic or depressed, we don’t have either the willingness or the ability to engage in our own healing process. When I am well, I feel I don’t need it – I’m stable at that moment!
There are also very dangerous editorials (albeit few and far between thankfully) that say we should be medicine free to be completely recovered. They offer alternative treatments and ways to get ourselves medicine free and therefore ‘well’ and ‘recovered’ using light therapies, psychoanalysis, diet and exercise. This is an extremely irresponsible and reckless position to take for any form of mental illness. There is no doubt, all of these therapies work, but alongside medication, not instead of it.
I can only speak to my experiences. I can only speak to the veracity of what I am about to say as it pertains to my illness. With each ‘attack’, with each swing, with each episode, I feel like a piece of me gets lost. I don’t come back from the mania or depression as strong as before. I don’t come back as confident as I was before. I don’t feel as capable, as independent or as ‘bright’ as before. Somewhere along the line my brain has been enveloped by a fog that never leaves. It’s a fog that thickens when I am struggling badly, it stops me functioning almost completely on any full and real level with the world outside my home. It makes me withdraw further and further into myself because that is where it is safest. My thoughts, when I can form them are not coherent, not fluid; it’s like I have to wade through quicksand to get to what I want to say, to wrap my tongue around the words that at other times flow so freely. I used to be extremely quick witted. My significant other has witnessed and too readily comments on my ‘slowed’ pace these days. When I am balanced or going through a period of ‘wellness’, (lets call it that for want of a better phrase) the fog is simply like a haze, a mist. It is there but it is more indistinct. I suppose the best way to describe it is to say I feel slightly muffled instead of engulfed by it. I know everyone changes with the years. I know that a persons’ personality does not stay as it was when they were in their teens. I know my character has changed, my personality has been weathered by the years, yes it has been altered by my experiences and also damaged by my mental illness.
Depression by its very nature robs me of my abilities to form coherent thoughts, to think in a clear and concise fashion and to function well in society. Simply getting up out of bed is a big deal. Deciding to take a shower can seem a humongous task and actually doing it can take all my reserves for that day alone. My depression can sometimes be measured by my actual smelliness. But when my depression lifts and yet the fog remains, that is very difficult to deal with. I am acutely aware in a way I was not when depressed that my ‘abilities’ are limited, my memory patchy and my clear-headedness isn’t actually quite so clear after all.
Memory deficits as a result of the medication to alleviate the symptoms of bipolar disorder for me are significant. Of course I can form short -term memories. If you ask me what I did yesterday, of course I can recall it. But if you ask me what I did on a particular holiday a month or two or six months ago, and I can give you only generalized answers. I cannot recall specific details of day-to-day events even just a few weeks later. I cannot recall conversations I have had with my children, sometimes on issues of importance. If I don’t write down appointments or events to take place in simply a few weeks time, I will forget them. Learning to cope with this type of memory loss is tricky. Unfortunately because the medication is lifelong, so is the memory problem.
With each ‘episode’ of mania or depression I have survived, I believe a bit more of my mental acuity disappears. My memory becomes a bit worse, my brain becomes just ever so slightly more ‘fogged’. If you didn’t know me, you may not realize anything much is wrong with me; I look normal, I can shake your hand, discuss the weather and pass the time of day with you. But I feel ‘lessened’, I feel slower, I feel pickpocketed. Because this illness is a sly one. As with a thief who has pilfered your pockets, you shrug off the loss and move on, so it is with my bipolar disorder. I shrug off my loss, and learn to live with what is to come…..
Cognitive Impairment in Patients With Bipolar Disorder: Effect on Psychosocial Functioning | Psychiatric Times.