One in five people will experience some kind of mental illness in their life (Mentalhealth.gov, 2014). For some, this may be a one-time episode depression or anxiety, or other symptoms. Others may struggle with reoccurring bouts of mild to severe, or even debilitating, symptoms of mental health or substance use disorders. Recently, the world learned of the tragic death of comedian Robin Williams. Many were stunned to learn of his struggles with substance abuse and depression. These are both very serious diseases, but they are also treatable. The death of Robin Williams sadly illustrates the worst possible outcome for a person with mental illness. However, this loss can also serve to remind us that we must understand what recovery is, how individuals can achieve recovery, and how individuals with mental health and substance use disorders can live full, happy, and productive lives.
The History of Recovery
The concept of recovery from behavioral health disorders goes back to the mid-1800’s, in England. In fact, the son of an English prime minister wrote a book about his experience of recovering from psychosis in the 1830’s. He shared that he recovered in spite of the type of “treatment” he was given at the “lunatic” asylum. In the United States, recovery has been connected with substance abuse, and Alcoholics Anonymous, which began in the 1930’s (History of the Recovery Movement, 2014).
From the 1940’s to the 1960’s, society and treatment professionals believed that people with mental illness should be confined to hospitals to get well. Many were locked up in State Hospitals and other facilities. However, beginning in the 1970’s, there was a movement toward de-institutionalization and work began to maintain people with behavioral health disorders in their communities. Eventually, in the 1980’s and 1990’s the recovery model we have today started becoming more widely accepted in the mental health treatment system (History, 2014).
For 25 years, the Substance Abuse Mental Health Administration (SAMHSA) in the United States has promoted National Recovery Month every September. Recovery Month is a time to increase awareness about prevention, treatment, and recovery from mental health and substance use disorders. Additionally, activities around the country help to encourage people with behavioral health disorders to speak up and share their own personal experiences of recovery, and remind us that recovery is possible (Recovery Month, 2014).
In 2011, SAMHSA updated their working definition of what recovery means (SAMHSA, 2012). While this is just one definition, and recovery means different things to different people, it does give us a framework within which to understand some of the concepts of recovery. The journey to recovery varies a great deal from person to person, and each would tell a different story about what has been most important, and most challenging, on their path. However, in general terms, SAMHSA has defined recovery from mental health and substance use disorders in this way:
“A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential” (SAMHSA, 2012).
This is a brief, and seemingly simple, definition of a process that is often continuous and life-long. Recovery is about being emotionally and physically healthy, being able to make decisions about life and treatment, and achieving personal goals aspirations. As part of their definition, SAMHSA has also identified four major areas of focus of a life in recovery.
- Health: This means making informed and healthy choices that support physical and emotional well-being. This includes overcoming or managing disease(s) or symptoms. For example, this may mean abstaining from use of alcohol, illicit drugs, and non-prescribed medications if one has a problem with addition. It may also mean taking medications and consistently practicing healthy coping skills for someone with bipolar disorder
- Home: Having a stable and safe place to live is crucial for a life in recovery.
- Purpose: Having meaningful and purposeful daily activities, such as a job, school, volunteering, family caretaking, or creative activities, and the independence, and resources to participate in society.
- Community: This includes having relationships and social networks that provide support, friendship, love, and hope (SAMHSA, 2012).
- Consciously attending to each of these areas can help people achieve and maintain recovery. Deficits or challenges in any of these areas of life create stresses for anyone, not just those with behavioral health disorders. In addition to a focus on these areas, there are some other principles that can help guide and support recovery efforts. These guidelines were developed by SAMHSA (2012), with input from consumers, family members, and behavioral health professionals.
- Hope: Hope is essential and means that there is a belief that recovery is possible. It provides motivation to overcome challenges and obstacles as they arise
- Self-Determination: Self- determination and self-direction are essential foundations for recovery. People must be able to define their own life goals and create their unique pathways to these goals (SAMHSA, 2012). Individuals must experience autonomy and independence, as much as possible, enabling them to exercise control and make choices about the services and supports they choose to access. This increases feelings of empowerment and the ability to make informed decisions, and build on strengths to achieve, or regain, control over life.
- Many Paths: Everyone is unique, with their own strengths, inherent value, needs, preferences, trauma experiences, culture, and goals. All of these factors combine to determine individual paths to recovery, and no two paths are identical. Journeys to recovery, and maintenance of recovery, may include professional clinical treatment, medications, and support from families, faith-based organizations, schools, peers, and others.
- Non-linear: Recovery does not always occur in a linear way. On the path to recovery, there may be set-backs along with growth along the way. Set-backs can be a natural part of the process, making it essential for the development of resilience for individuals and their loved ones.
- Abstinence: For those with addictions, abstinence from the use of alcohol, illicit drugs, and non-prescribed medications is the goal. This goal is supported by access to safe and stable living situations and healthy support networks (SAMHSA, 2012).
- Holistic: Recovery is about a person’s whole life—including body, mind, spirit, and their community. Services and supports related to all of these areas should be accessible and delivered in an integrated and coordinated way.
- Peers & Allies: A peer is another person in recovery. Mutual support and the sharing of experience, knowledge, and skills play an invaluable role in recovery. Peers encourage and engage each other, creating a sense of belonging, support, value and community. Additionally, the act of giving back help’s oneself. Peer-operated supports and services also provide valuable resources to assist people on their journey to recovery. Additionally, peer supports for families are also very important for children with behavioral health problems, and they can also play a supportive role for youth in recovery (SAMHSA, 2012).
- Professionals: While peers and allies play an important role for much in recovery, their role is slightly different from professionals. Professionals assist in the recovery process by providing clinical treatment and other services that support individuals in their chosen recovery paths.
- Supportive Relationships: A very important factor in the recovery process is the presence and involvement of people who really believe in the person’s ability to recover from behavioral health disorders. These people offer hope, support, and encouragement, while also suggesting strategies and resources for change. These supports may include family members, peers, treatment providers, faith groups, community members, and others. Healthy and supportive relationships can help an individual engage in new roles (e.g., partner, caregiver, friend, student, employee), which can increase a sense of belonging, decrease isolation and create more fulfillment in life (SAMHSA, 2012).
- Cultural Competency: All diverse representations of culture including traditions, beliefs, and values, must be considered in a journey to recovery. Services and supports should be culturally competent and sensitive, as personalized to meet each person’s individual needs.
- Addressing Trauma: Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration (Mentalhealth.gov, 2014). The experience of trauma (such as physical or sexual abuse, domestic violence, war, disaster, and others) is often associated with alcohol and drug use, and mental health problems (SAMHSA, 2012).
- Community Strengths & Personal Responsibility: Individuals, families, and communities all have strengths and resources that can serve as a foundation for recovery. In addition, individuals have a personal responsibility for their own self-care and their individual path to achieving and maintaining recovery. Individuals should be supported and encouraged to speak for themselves, while families and significant others have responsibilities to support their loved ones, especially children and young people (SAMHSA, 2012).
- Respect: The tremendous courage of people taking steps toward recovery, or in recovery, must be acknowledged and respected. This acknowledgement fosters self-acceptance, a positive sense of self-identity, and a belief in one’s self that is essential to recovery. Discrimination must be eliminated, and stigma must be challenged by community systems and society.
Society still has a long way to go toward eliminating stigma, providing services and resources, and effectively supporting people who have behavioral health disorders. While the guidelines developed by SAMHSA help us better understand what recovery means and how individuals can be supported in their journeys, they don’t tell us the real experience and feelings of individuals in recovery.
Stories of Recovery
Achieving and maintaining recovery takes tremendous effort and commitment by the individual and their loved ones, but it is possible. One man describes recovery in this way:
“As a ‘consumer’, recovery means that I stay aware of my personal indicators that help my family members & me to know when I need more help than usual. My recovery includes keeping a daily plan or routine that I follow each day, which keeps me active and moving “forward” with my recovery. For me, "Recovery" means taking my medicine, setting goals and being active. I do realize that these methods are just as important to me as my medications” (Murry, 2014).
Another young women describes her struggles with mental illness and addiction, as well as the satisfaction and fulfillment she feels from her ability to help others.
“By the age of 23, I was already resigned to dying of my alcoholism. I was suffering from multiple mental health diagnoses, including anxiety, depression, and Borderline Personality Disorder. My hair was falling out, I had holes in my stomach, and a third of my pancreas had been destroyed by my drinking. I was given a year and a half to live by my doctor.
Ten years later, I am now a Recovery Coach, an author, a speaker, a workshop facilitator, and an advocate for recovery…Recovery has given me the chance to become who I was always meant to be, and to help others do the same. Back in the dark days, I never believed I could experience such peace of mind as I do now. I never thought it would be possible to be so free.
Recovery has given me choices that I never had access to before. It has given me the gift of gratitude and the ability to put things in perspective”(Burgess, 2014).
Individuals can overcome their individual challenges and barriers and achieve recovery. They must be able to choose their own path, and decide how and when they will access resources, including treatment services. These personal stories about achieving and living in recovery are powerful reminders of what is possible for those living with mental illness and substance use disorders.
Theravive proudly partners with the following organizations to bring help to those who are struggling with addictions:
Burgess, B. (2014). Voices for recovery. Retrieved August 9, 2014, from http://www.recoverymonth.gov/Voices-for-Recovery/Stories/2014/Beth-Burgess.aspx
History of the recovery movement. (2014). Retrieved August 9, 2014, from http://www.recoverywithinreach.org/Recovery/history
Mentalhealth.gov. (2014). Retrieved August 10, 2014, from http://www.mentalhealth.gov/basics/myths-facts/index.html
Murry, D. (2014, January). Voices for Recovery. Retrieved August 9, 2014, from http://www.recoverymonth.gov/Voices-for-Recovery/Stories/2014/Dante-Murry.aspx
Recovery month 2014. (2014). Retrieved August 9, 2014, from http://www.recoverymonth.gov/
SAMHSA's working definition of recovery updated. (2012, March 23). Retrieved August 9, 2014, from http://blog.samhsa.gov/2012/03/23/defintion-of-recovery-updated/