Personal recovery

In the past, it was believed that recovery from conditions diagnosed as schizophrenia, psychosis or bipolar disorder was rarely, if ever, possible. Treatment and care was centred on the clinical management of the ‘illness’. There is now an increasing focus on personal recovery that underpins mental health-related policies and laws at a national and state or territory level in Australia. Mental health community support services and clinical services now see supporting people’s personal recovery as an important part of their work.

Clinical recovery is defined as having fewer or no symptoms. In contrast, personal recovery is understood to mean living a meaningful life as defined by the person themselves in the context of their experience of severe mental health problems. Personal recovery promotes the individual’s health and wellbeing, including defining personal recovery goals, building self-esteem, self-confidence, resilience, the ability to maintain relationships, and having a sense of purpose. Personal and clinical recovery are not mutually exclusive, but can go hand in hand.

This Talking Point is about what personal recovery meant for the people we spoke to. You can read elsewhere about the different ways people described living life in the context of a diagnosis of schizophrenia, psychosis and / or bipolar disorder: Self help strategies, Negotiating Daily Life, and Physical health and mental wellbeing.

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What recovery meant
Support and social contact
Medication
Identity and looking to the future
Acceptance


Nicky said recovery is different for everybody. She thinks it is about making social connections, gaining insight and ‘accepting what’s happened’.

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What recovery meant

Most people we talked to considered themselves recovered at the time of the interview, but recovery was described as something personal and unique for each individual. It could mean simply being well at the time of the interview, like Vanessa who said, ‘You would say probably I am pretty well recovered, but it doesn’t take much for me to start to spiral down’. But for most, it meant a longer-term change in their relationship with their illness. According to Chris, ‘Recovery is a journey. Recovery does not have a destination. Recovery is seeing the light at the end of the tunnel and getting through that tunnel towards the light’.

Many of those who spoke about recovery had a strong sense that it meant being able to better manage symptoms or prevent them from becoming worse. This could mean structuring life in such a way as to avoid stress or learning techniques to deal with the symptoms themselves. Maria, who saw recovery as an ‘every day’ thing, described how she takes Monday and Tuesdays off and gives herself time to recharge. She said by doing this, she feels she can do things she couldn’t before.

Ann has trained her voices to treat her more kindly and accepts them.

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Some people we spoke to didn’t have a clear idea of what recovery meant for them. Quite a few struggled with the term itself, or were still discovering what recovery might look like for them personally. Paddy said recovery was ‘trying to focus on what enables you to get back to a bit of stability’, but added that he couldn’t ‘really pin it down’.

It could be hard to reconcile the term ‘recovery’ with the challenges of living with severe mental health problems and some felt the term caused difficulties by creating expectations for them.

Allen said he tries not to compare himself to others, and focuses on the small things he can achieve.

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For Anna, recovery was ‘elusive’. She thought it was better to talk about ‘living with and surviving’ mental health problems.

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For some people the idea of recovery was difficult to think about because they still felt isolated or, like Allen, were dealing with constant change: ‘The ground beneath has been moving all the time’.

When people were still feeling isolated, managing life changes, struggling with symptoms or unable to ask for help, the idea of recovery could seem far away. As Helen said, sometimes it could be ‘just so hard to climb up out of that dark hole again’.

Brendan understood that recovery was about nurturing interests and relationships but wasn’t sure how that worked in reality unless you had someone to support you.

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Support and social contact

For many people having supportive family and friends was critical to recovery (see also Family and friends). Chris felt he was ‘actually able to develop and go to places [he] never thought possible’. He attributed his new outlook on life to having somewhere to live, feeling supported, and taking medication. He said that he enjoyed living with a friend, and knowing his parents were ‘just a phone call away’.

For Simon recovery was about having friends to support you.

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Because mental health problems could lead to breakdowns in relationships and isolation, the development of nurturing relationships and supportive networks were an important sign of personal recovery for the people we talked to. Nicky thought that the development of social connections was very important for recovery generally.

As well as receiving support from friends and family some people spoke about the benefits of belonging to a church community.

Religion was an important part of Evan’s recovery. He said prayer, and connecting with people gave him hope.

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Medication

Quite a few people talked about the role of medication in their recovery. Michelle described medication as ‘definitely a part of [her] recovery’. For many people, medication was seen as one tool among many that helped. Helen, who at the time we met her was taking medication and seeing her psychologist, said ‘life is good’. She acknowledged that ‘no one’s ever 100 per cent’, but thought she was ‘getting close to it’. For Susana, ‘recovery means taking medication’, as well as being with people who understand you, and taking care of yourself. Ann said medication was only 30% of the ‘recovery work’ and that ‘the rest of it has to come from within’.

Maria has taken a mood stabilizer for 25 years and now also takes an antipsychotic. Although she has ups and downs she feels she has ‘more control’ and said medication has helped with her recovery.

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Identity and looking to the future

While feeling unwell for some people meant seeing no future and feeling isolated, personal recovery was often associated with looking forward to the future, making plans and developing social connections. For Tanai, making plans for the future was key to her personal recovery. She said she gave herself a timeframe to try and avoid being unwell and it got longer and bigger ‘because there were more things to do’.

While finding an identity for oneself going forward was considered an important aspect of people’s personal recovery, several acknowledged that it could take time. As Nicky explained, ‘it takes a while to feel yourself again and to feel your own identity’.

Severe mental health problems and the personal recovery process could shape people’s sense of who they were and build resilience. Lisa described how being with other people with mental health problems had shaped her identity. She said, ‘I very strongly identified as someone who is mentally ill’. Some people we spoke to felt that their experience of living with a condition diagnosed as schizophrenia, psychosis or bipolar disorder had made them a stronger person. Although Niall considered his journey to have been a ‘relentless struggle’, he said he’d ‘learnt a lot along the way’. He felt that the journey had given him ‘inner strength as well as resilience in [his] recovery’.

Alice feels different now and thinks maybe her mental health problem was a ‘wake up call’ to make her more resilient.

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Not all the people whom we spoke to wanted to associate their sense of who they were with their struggle with severe mental health problems. Tanai, for example, couldn’t ‘stand’ those people who identified with being recovered. She thought that it was as if their past ‘illness’ was ‘everything’, and that they had lost every other part of their identity ‘save for the sorry one of “I was sick”‘.

Ann described recovery as getting in touch with who you are now, rather than who you were before, and finding things that are meaningful to you.

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Acceptance

Quite a few people described how acceptance had led to a change in their relationship with their mental health problem, though it was acknowledged that this took time. For Taylor it was important ‘to accept what you’ve got’ but she said this took her ‘a while’. Chris, who heard voices, described how he spent five weeks in hospital trying to figure out what was ‘real’. He said it took two years for him to accept that the ‘voices were not a real person, a real entity’ but were just a part of his ‘imagination’.

Acceptance was deeply personal for the people that we spoke to. For some it meant realising that severe mental health problems were going to be part of their life, and that was ‘okay’. For others, it was about gaining a better understanding of their illness. In Tanai’s view, ‘you never get rid of it completely’. She felt recovery was more about accepting that her thoughts and feelings exist and ‘learning how to live around them’.

Carlo mentored others living with mental illness. He said ‘true happiness’ and ‘peace’ came through embracing the ‘difficult stuff’.

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Feeling as though they were not alone in their suffering or that depression and anxiety were ‘normal human emotions’ was helpful for some. Charlie found it comforting to realise that she wasn’t the only one suffering: ‘everybody has issues… and mental illness is just part of my path’.

Evan identified several important aspects of recovery – acceptance, self-responsibility, hope, and being part of the community.

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