Saturday, December 27, 2014

Is RECOVERY From Schizophrenia Really Possible?

I have been giving "recovery" a lot of thought lately. I read about and hear about people talk about how they "recovered" from schizophrenia and I want to scream because I just don't see how that's truly possible. The definition of recovery is:

"A return to a normal state of health, strength or mind."

That definition begs the question, do we ever "return to normal"?

Certainly, lately, Thomas has been doing better than he has in the past. He holds down a job, he participates in the family, he writes a blog and he stays on his meds. Based on those things, one might say he has reached "recovery" but I would argue that. Has he really "recovered"--returned to a NORMAL state of mind--or is he just doing better for now? Going even further, I would argue that he still fights many demons even though he's holding down a job etc.

His schizophrenia is still alive and well working it's "magic" in his mind. Sure he gave up believing, for the most part, that the government is watching him, as he says in his most recent blog post, though I have had many talks with him where he's told me he still feels watched. Sure, he doesn't believe he is a world leader that will lead thousands of people into a revolution in an effort to change the government. However, he still believes there is something evil inside of him, he wears a talisman to ward it off, and he still feels terrified in a crowd of people so much so that he can't stay at work on the days that it's busy. Is all of that "recovery"?

I don't mean to be a pessimist here but I just don't believe recovery is possible. While I am THRILLED that he is doing better, I still see remnants of this illness in him. I guess, then, you start to put "recovery" on a continuum. Your son doesn't take his meds. He is hospitalized and actively hallucinating. He sees you as his enemy, he (sometimes in some cases) drinks or does drugs in an attempt to self-medicate his illness. He may even be living on the streets. Certainly he is not "recovered" and certainly he has a long way to go to reach the place that Thomas now occupies. So, on this continuum where "normal state of mind" is on the right side and "unrecovered" is on the left, Thomas falls further to the right than many others. His position there is tenuous, at best, though. Just the other day in therapy he talked about the possibility of lashing out physically on someone who upsets him. He argued that while he worries that he might hurt someone's feelings by standing up for himself, he still feels in danger of hurting someone. That, to me, is not "recovery" in the sense that he is residing in a "normal state of mind".

Then I zero in on the word "normal". I put it in quotes because what exactly is "normal"? Who decides what is normal and what isn't? Certainly the dictionary, a book full of the "right" definitions of things and people and states of being etc., shouldn't be the one that defines normal. Certainly the woman who writes an article stating, that from her point of view, she is recovered, doesn't decide for ALL OF US that her definition of "recovery" and feeling "normal" is the holy grail of what we strive for. Certainly the doctor who only visits with our loved ones for a short period of time once a week or every now and then can't really say for sure that someone is "recovered" or "normal" because they aren't there all the time like the rest of us with our loved ones watching the waxing and waning of this illness that can change in as quick as one hour to the next. So who gets to decide?

Does Thomas?

By some people's definition, he is "recovered". As I said he holds down a job, etc. but if you ask him if he feels normal, he just stated it in one of his blog posts that he does not feel normal and I would venture a guess that if I asked him if he has "recovered" from schizophrenia he would say that he hasn't. He's smart enough to know that he has this illness for the rest of his life. Even the government (Social Security) just stamped his file "disabled" and is funding the rest of his life because based on the nature of his illness, they believe he will never be able to hold down a full time job, which he won't. Is THAT "normal"?

I don't know. I guess I just don't see it. Am I a pessimist mired down in this illness or am I a realist, one who has lived with this illness in her son for the better part of the last few years and has seen marginal changes and certainly changes that didn't stay changed to a steady state of "recovered"? I suppose it's all open to interpretation. Many of you wish desperately that your loved one will be like Thomas someday but there are many of you also in the same place I am that would argue my point for me.

The continuum is a slippery line where our loved ones slide left or right due to life circumstances, medication changes, happenstance (given the right circumstances a delusion can pop up out of seemingly innocent events), stress levels, socioeconomic status, depression, loneliness and any number of other things. At best our loved ones live balancing steadily near the right side of the "normal" or "recovered" side of the continuum but we all know how fragile that can be.

I believe that "recovery" is next to impossible but my seemingly pessimistic attitude is not really pessimistic because I see Thomas doing well, I celebrate it, I DO NOT TAKE IT FOR GRANTED, and I feel some semblance of relief when he wakes in the morning and comes to me and tells me he slept well. Thomas is in a good place, no doubt about it, but good can become not-so-good later today. You just never know.

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