Predicting how much impact mental illness has in a person’s life

Why is it that some people have a psychiatric disorder and they bounce back and it’s not a big deal, while others struggle terribly? For the unlucky ones, mental illness defines them.

Here are some factors that affect how much impact psychiatric illness has in a person’s life.

  • The severity of the symptoms. Any way you dice it, mild-to-moderate anxiety can often be hidden and isn’t as disruptive as an episode of psychosis with hallucinations and paranoid delusions.
  • The duration of the episodes. So a chronic depression or severe obsessive compulsive disorder may be more disabling than a brief episode of psychosis.
  • The form of the symptoms. Some symptoms are intrinsically more public than others, or more difficult to bounce back from. In terms of “Can I be a doctor if I have bipolar disorder?,” one episode of walking around the hospital naked may be all it takes to get sent home. Form and severity of symptoms, and the duration of the episodes, are likely to be intrinsic to the disease and not something the individual controls.
  • How responsive the illness is to treatments. Some people have very severe symptoms that are very responsive to treatment.
  • External support systems: access to good care, chicken soup, and TLC. Job flexibility may enable some people to quietly take time off when the going gets rough. Understanding friends and family — these are all good things.
  • Individual personality features that support good coping. This is vague and I just made it up, but it’s the best I can do — maybe “resilience” is another term for it.
  • Individual special features which help a person compensate. So being extremely intelligent, or extremely efficient and diligent, or very charming and charismatic, may make everything else a bit easier.
  • Stress load. This is hard to say for all people — many people really struggle when things go wrong, and not all people with psychiatric illnesses relapse under severe stress, but all things being equal, it’s probably better to not have a lot of loss and stress in life if one is trying to cope well with mental illness.
  • Co-morbid substance abuse. People with psychiatric disorders and drug or alcohol addictions just don’t do as well. Often, it’s a toxic combination.
  • Co-morbid medical disorders.
  • A willingness to devote time, energy, money and resources to a healthy lifestyle. It can’t hurt.

Dinah Miller is a psychiatrist who blogs at Shrink Rap and co-author of Shrink Rap: Three Psychiatrists Explain Their Work.

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  • http://www.askthisdoctor.com Dave Hunter M.D

    I found your article very interesting.
    Once I was talking to a psychiatrist and he explained to me what a normal mind was: The mind that no one possesses. He went on to explain how everyone has a flaw in their psyche. Whether it is a personality disorder or a full blown mental disorder, everyone has them. The key is how you cope with these things.

  • http://drsamgirgis.com Dr Sam Girgis

    Mental illness can be devastating to some patients. The factors that you point out above are all very relevant. One factor that I would like to add is the reaction to psychiatric medications. If the side effects or the reaction to the psychiatric medications is not tolerable, then the patient will not take the medication and would rather function with the psychiatric illness.

    Dr Sam Girgis
    http://drsamgirgis.com

  • http://www.ZingLiving.com Melanie Lane MD

    The question of why some people recover from mental illness and others don’t has plagued me for a long time. I struggled for ten years with dysthymia punctuated by bouts of suicidal depression. I suffered from extreme social anxiety, abused alcohol and drugs and entertained an eating disorder for many years too.

    Finally, I experienced an epiphany – either keep thinking and doing the same things and die, or open up my mind to the possibility that I couldn’t know with absolute certainty that the whole world was an awful place, and that there might be answers to my suffering that I hadn’t yet found. I had to accept full responsibility for my own wellbeing and let go of my victim mentality, and I had to be willing to challenge my arrogant ego, which believed it knew everything.

    Today I am alcohol and drug free, have a healthy relationship with food, and am very physically fit. I am generally content with my lot in life most days and cope with traumatic events reasonably well. I am still looking for ways to translate my personal experience into something useful for others. One way I do this is with life coaching, which can be an empowering adjunct to a person’s overall wellness plan. I wish I could bottle up what I have learned and experienced and share it with everyone who suffers.

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