The truth about mental illness: how to live with it

I'm Dr. Orion Terriban, and this is Psych Hacks, Better Living Through Psychology. The topic of today's short talk is the truth about mental illness. So there are many things about mental illness that I think a lot of people don't understand. Dispelling all of those misconceptions is a tall order, but today I hope to knock off two of them. So if you're dealing with mental illness or you know someone who is, this is an episode for you. Let's get to it. The first is one of psychiatry's dirty little secrets. If you're dealing with mild mental illness, if you're feeling down or unmotivated, if you're feeling stressed or on edge, if you're feeling less satisfied by your work or your relationships, chances are that your issue will resolve itself without any further intervention. In the literature, they call this spontaneous remission. According to the research, the majority of mild mental illness will spontaneously remit in 6 to 12 months, regardless of whether you talk to a therapist or start psychiatric medication or really do anything at all. And it's actually unclear how much faster, if at all, these problems resolve themselves when you add those interventions into the mix. As to my knowledge, those studies have not been conducted for a number of reasons. So that's misconception number one. Most minor issues tend to go away on their own. On the other hand, that's not necessarily true for moderate to severe mental illness. Not only may these problems not resolve themselves, but they may, in fact, worsen over time if no change is enacted. This may not sound like a very positive message. It gets positive near the end, but at the beginning, not so much, so you'll have to bear with me. But many moderate to severe mental illnesses might not be curable. There might not be some intervention or some combination of interventions that solve the problem once and for all. For better or worse, mental illness isn't like a physical infection, where you can take a course of antibiotics and be done with the problem forever. Rather, mental illness might be more like a chronic disease that must be managed appropriately for the rest of your life. Consider a chronic disease like diabetes. There actually isn't a consensus on this, but many people believe that diabetes never goes away. Like, once people become diabetic, they remain diabetic for the rest of their lives. This can be a lot to process, which is often why folks are assigned counselors when they're first diagnosed. In any case, there is a wide spectrum of response when it comes to dealing with diabetes. Some do nothing. All things being equal, their conditions deteriorate over time, and they suffer the consequences. Others do a complete 180. They change their lifestyles, and alter their diets, and regularly track their blood sugar levels, and educate themselves on the factors that influence their insulin production, etc., etc. Now, people in this group can sometimes manage their diabetes so well that their relevant panels are indistinguishable from those who don't have diabetes. They might remain diabetic their entire lives, but they don't ever really come into contact with the diabetes per se. This is because the disease is managed so well that it becomes functionally invisible. That said, if these folks were to lapse into old behavior patterns, if they were to start binging on sugary foods, or stop managing their stress, or start bungling their insulin maintenance, then the syndrome of diabetes would resurface. Maybe not immediately, but within a few weeks or a few months, they would be dealing with an acute disease process. The bad news is that these folks might not ever be able to take their feet off the gas. They kind of have to keep doing the good things and not doing the bad things forever, or suffer the consequences. However, the good news is that if they find a way to do this, they can functionally live their lives like anyone who doesn't suffer from the same disease. If you're interested in taking your understanding to the next level, I would encourage you to check out The Captain's Quarters, my members-only self-improvement community. Your monthly membership will get you access to a cadre of like-minded, supportive individuals, bi-monthly group consultation sessions hosted by yours truly, and exclusive content that you won't find anywhere else. Click the link in the description for more information. Hope to see you aboard. Now, this isn't just supported by the literature. It's backed up by my own personal experience as well. Like someone might consider himself a diabetic, I consider myself a depressive. I struggled with severe depression for many years, mostly in my teens and 20s, and I'm very happy to report that I haven't been depressed for a very long time. Knock on wood. That said, I don't think I'm out of the woods. In fact, I've come to accept that there is a tendency, a vulnerability to depression that lives inside of me and might not ever go away for as long as I live. Hence, I consider myself a depressive. And on some level, it's this acceptance that helps me stay non-depressed, as believing I was somehow invulnerable to depression might motivate me to do certain things that would make it more likely for the depression to return. However, because I have accepted the reality of my condition, and because I have made a number of changes to my life over the years, I haven't had to deal with depression for quite some time. I manage the depression so well that it has functionally become invisible. But invisible is different from eradicated. If I were to stop doing these things, I am absolutely certain the depression would return. Maybe not immediately, but within a few weeks or a few months, I would be dealing with an acute episode. That's just the way it is. And just what did I do to pull this off? I know some of you might be curious. The things I did were, on the one hand, behavioral, and on the other hand, cognitive. Behavioral change meant that I had to start doing certain things, and I had to stop doing certain other things. First and foremost, I had to stop doing drugs. It's actually very difficult to resolve an acute depression when you're still using mind-altering substances, including weed. These drugs numb you, sapping your motivation and accommodating you to the status quo. If you're used to taking them, things will get worse when you stop. But it's precisely the acuteness of that misery that can help you break free of a situation that no longer serves you. On the other hand, things I had to do included forming healthy relationships with non-using friends, finding a place to belong, identifying an overarching purpose to my life, getting daily exercise, eating nutritious food, and cultivating some material success. Like, as a broke, lonely, addicted, struggling actor, I'd be more surprised if I wasn't depressed. I was adrift, invisible, and near the bottom of nearly every social status hierarchy. Now, changing that didn't happen overnight. But what was the alternative? My life as it was was intolerable, so on some level, I had nothing to lose and everything to gain. Over time, I was able to transform the various vulnerability factors that kept me mired in depression into resilience factors that reduced the likelihood of the depression ever coming back. It wasn't easy, and it wasn't a linear path, but it was worth it. At the same time, to support these behavioral changes, I had to make a number of cognitive changes as well, including silencing my critical inner voice, facing certain fears and self-limiting beliefs, increasing my capacity to withstand certain uncomfortable emotions, developing the courage to be honest with myself and others, adopting a growth mindset, and learning absolutely everything I could about my mind and my heart. By effortfully changing how I thought and consistently changing what I did, I began to feel better. And of course, the better I felt, the easier it was for me to keep doing the things that made me feel better. And that really shouldn't be surprising, as that's like CBT in a nutshell. In any case, that's the second misconception about mental illness. Most moderate to severe cases will need to be indefinitely managed like chronic diseases. However, once you get the hang of this management, the illness becomes functionally invisible, and you can go through life like any other person. What do you think? Does this fit with your own experience? Let me know in the comments below. And please send this episode to someone who you think might benefit from its message, as it's word-of-mouth referrals like this that really help to make the channel grow. Anyone looking to join my free weekly newsletter or book a paid consultation can do so on my website. There's also my book, The Value of Others, and my member community, The Captain's Quarters. The links to everything are in the description below. Check them out. A lot of great resources there. As always, I appreciate your support, and thank you for listening.