Today I want to talk about taking an active role in your mental health treatment.
I’ve dealt with my own mental health issues of depression and anxiety since I was in my early 20s and I’m still in treatment today. I had a lot of misconceptions about my mental health when I was younger. The biggest of which was that medication, therapies and interventions would “cure” my depression, and initially I thought I had data to back this up.
I would start a new medication and begin to feel better. I was cured! But then something stressful would happen and I’d fold again under the weight of my depression. The answer was usually to increase my medication, or maybe change to a different drug. I’d feel hopeful that this time I’d be cured, and I’d begin to feel better for a time, but then those stressors would come back and I’d be knocked back to the beginning. The cycle repeated for decades and I earned the label of “treatment resistant.”
It wasn’t until my mid 40s that I came to understand medication and therapies were not cures, but tools. And what’s a tool? Lots of definitions to be sure, but I like to think of it as something you use to increase your chances of completing a task successfully. If you want to drive a nail into a piece of wood, you probably won’t be successful using your hand. You may be more successful using a rock. But a hammer was designed to be a great tool for the task.
Antidepressants and therapy are tools. Antidepressants help lift some of the heaviness of depression so you can begin to address the issues making you depressed. Therapy can help you come to terms with issues you’ve encountered and understand how to cope with or move past those issues. But, and I believe most importantly, you have to be ready to put in the work to address those issues. You need to decide that improving your situation is important enough for you to take action.
Imagine you’re thirsty. Do you wait around hoping you won’t feel thirsty anymore, or do you get up and get something to drink? I’m willing to bet most will get up and get a drink to remedy the discomfort of feeling thirsty. For almost two decades I was frequently stuck in the discomfort of my depression and I couldn’t see a way out. The medications increased in dosage and potency, therapy appointments felt endless, medical interventions became more severe, and still nothing seemed to work. I eventually came to realize feeling better wasn’t going to just magically happen or come about as a result of the medication alone. If it was important enough to me to feel better, I had to do something about it besides swallowing pills.
There are two sides to decision making – emotional and rational – and people make decisions for emotional reasons first and rational reasons second. This isn’t my idea, this was proven by Daniel Kahneman, a Princeton psychology professor and he was awarded a Nobel Prize for this discovery in 2002. What I found to be true for myself was that my depression kept me stuck in my emotional mind. I had extremely negative emotions and thoughts any they kept me in a stagnant state I liken to water circling a drain. I felt completely trapped in that state of mind and it wasn’t going to take me anywhere positive. I had to decide to switch to my rational mind so I could start taking some actions to improve my thoughts and mind set, or, at the very least, get moving in that direction.
Unlike taking a drink when you’re thirsty, making a mental switch to taking positive actions didn’t immediately change things. But over time I did start having more good days than bad, and for me that was a major improvement. As time went on, what I also found to be true for myself was the better skilled I became at switching from the emotional mind to the rational mind, the happier I was. We can’t escape the emotional mind. We’re GOING to react emotionally. What we don’t want, as I’ve heard eloquently stated, is to unpack and live there. We need a switch to the rational mind to help us say, “Ok, this happened, now what are we going to do about it?”
If antidepressants and therapy are tools, I see the ability to switch from the emotional mind to the rational as a skill. It takes practice – a lot of practice. But life does seem to give us an unending supply of issues to deal with, so chances to practice are plentiful. And me? I’m still practicing and I’m not “cured.” I’m still a mental health patient needing active treatment but my happiness has increased. It’s been about seven years since I had a major depressive episode, which for me is amazing. I’ll take it.