The fluidity of mental health

Yesterday I was catching up with a therapist and talking about the people she/her organisation support and she must have used the term ‘recovered’ at least 5 times; ‘well we offer x service to those who have recovered’, ‘for those who haven’t there’s this’, ‘yes our recovery rates are x%’ etc. It made me flinch every time. Recovery (in my opinion and experience) in mental health isn’t black or white, yes or no, or finite. You aren’t ‘recovered’; a person isn’t either permanently well or ill, permanently either happy or sad, healthy or unhealthy etc.

This may sound depressing in itself- the idea that recovery is never quite the end result, but I believe it’s more helpful to talk in fluidity, transition and journeys, rather than the absolute of recovery. Our mental health’s are all on a spectrum and each of these will be different to each other’s and at different times. Yesterday, I was happier and healthier than I was the week before, when I felt slightly anxious, but that was much better than 3 weeks before that when I felt low for 4-5 days. You get the idea. Our mindsets, moods, levels of stress, happiness, kindness to ourselves, fluctuate and all vary day to day, week to week. Who can tell me they felt exactly the same stress wise, happiness wise etc, last year, to this year? They’re ever changing, improving, strengthening, worsening and that’s ok; hopefully we’re growing and learning about them all the time.

 The fluidity of mental health

But when you add concepts and labels like ‘recovery,’ it becomes dangerous. It allows institutions, most noticeably the medical profession, and by extension government and policy, to let themselves ‘off.’ There is then no real focus on the long term, thorough and genuine ‘recovery’ (or shall we say our journey or improvement in our mental health’s- we need a new definition and discussion of this!). What long term ‘life’ skills or coping strategies can we be equipping people with if the thought process is ‘great your scores show you’re recovered, let’s discharge you’? What support are we really giving people to feel better long term with the use of this language? It allows people to look back and say ‘but last year, I’d recovered, and now I’m ill again…’ and feel worse about themselves and their mental health as a result. What if we change the definitions in mental health to mean a person could say instead ‘I felt better last year, my mental health was more stable, I had a more positive outlook on life AND (not but) I’m less well now- I’m on my journey which is ever changing and I’m sure I’ll get back to being stable soon (come full circle, not this linear back and forward).’

This also helps people fully accept any diagnosis of their mental health- that it will always be a part of us and so we need to learn as much about it as possible to ensure we keep it at bay and minimal. That it’s ok if we experience it again and not a shock that it wasn’t just a one time thing we’d ‘recovered’ from.

We all need to be curious, not judgemental, about our (and others) mental health’s. We should be constantly working on ourselves, checking in, being aware, instead of wanting to tick boxes of well or unwell. Mental health is becoming more and more prescriptive, using check lists to decide or ‘diagnose,’ instead of recognising its complexity. I understand we need measurables in mental health but the general approach needs to change. We should be talking about fluidity over recovery. Grey areas and discussion over labels. Curiosity over assumptions.