Yes. The answer is an unequivocal, irrefutable yes. We can see this in anecdotal personal experiences and in research. Let’s start with an anecdote and then we’ll explore some research and what it might mean for you on your own journey.
In the past, I struggled with a bunch of different mental illness diagnoses. The symptoms included things like believing people were trying to poison my water bottle, standing in front of the stove to make sure it didn’t turn on after I’d checked that it was off, washing my hands repeatedly under scalding hot water until they felt clean, checking the door lock repeatedly, seeing people get run over by cars, seeing myself smash my teeth out or stab sharp objects through my eyeballs, not picking up knives because I was afraid of stabbing somebody, sinking entire days into online compulsions, not touching raw meat, convincing myself I’d contracted a terrible disease, leaving every relationship I got into, taking hours to write a simple email, changing how I acted in my apartment because I believed I was being watched, and so on and so on. It’s a long list. Struggling with my brain consumed every minute of my life.
The great news is, I don’t deal with any of those symptoms any longer or any of the crushing anxiety or depression that went along with them. After some bouncing around the mental health care system, I was lucky enough to find therapy, I learned skills to cut out all of the compulsions I was engaging in and how to relate differently to the stuff in my head. It was gruelling work, I had to make massive changes in my life, but it’s been more than seven years now since I would have classified as having a diagnosable mental illness. I am not mentally ill. My mental health is better than it has ever been and it would be impossible to go back to struggling with mental illness unless I chose to do it. You can learn more about how I define recovery in this video: “How do you define recovery?”
I am not an anomaly. Let’s start with some of the tough ones because when I bring up recovery, I’m usually met with comments like: “Yeah, but not for serious mental illnesses like schizophrenia,” or “Sure, but not for personality disorders…” The thing is, it’s people with lived experience of those diagnoses that have been leading the recovery movement for decades.
We know people recover from Borderline Personality Disorder. In one 10 year study, they found that 83% of participants experienced at least a four-year remission of symptoms during the study, and 50% achieved full recovery: “Time to Attainment of Recovery From Borderline Personality Disorder and Stability of Recovery: A 10-year Prospective Follow-Up Study,” American Journal of Psychiatry.
For an inspiring anecdote, check out the work of Brandon Marshall, who was at risk of losing his career in football to BPD but got help, is back playing with the New York Giants, and started a non-profit to help others get the same chance at recovery he had. He shares more in this article he wrote for The Players’ Tribune: “The Stigma”
With schizophrenia, research shows between 40% to 60% of patients can expect remission of symptoms if they get treatment: “Remission in schizophrenia: validity, frequency, predictors, and patients’ perspective 5 years later,” Dialogues in Clinical Neuroscience. A meta-analysis found around 14% of patients would meet the criteria for full recovery: “A systematic review and meta-analysis of recovery in schizophrenia,” Schizophrenia Bulletin.
A big caveat here is that research studies tend to focus on traditional therapies that generally try to get rid of hallucinations. Recent approaches to recovery emerging from within the schizophrenia community often focus on learning how to experience hallucinations. To learn more about learning how to hear voices, check out the International Hearing Voices Network.
And we could go on through whatever diagnosis you can think up. Eating disorders? 49% of patients recovered during this study: “Recovery and Relapse in Anorexia and Bulimia Nervosa: A 7.5-Year Follow-up Study,” Journal of the American Academy of Child & Adolescent Psychiatry.
And what about Major Depressive Disorder? This meta-analysis of 92 studies encompassing 6937 patients had 62% of participants no longer meeting the criteria for MDD: “The effects of psychotherapies for major depression in adults on remission, recovery and improvement: A meta-analysis,” Journal of Affective Disorders.
Or maybe addiction? A study of 4422 adults with a history of alcoholism found 35.9% in complete recovery and 27.3% in partial recovery. “Recovery from DSM-IV alcohol dependence: United States, 2001–2002”, Addiction.
I’m going to stop things there because it’s weird we even need to have this conversation. Of course recovery from mental illness is possible. The real conversation to have is this: What makes it possible for some and not others? How can we support more people through recovery? How can we make changes in the context surrounding people to help them succeed with recovery? How can we remove systemic barriers and challenges that fuel relapse?
You might look at those recovery numbers and say they’re not very high. For most of those illnesses, less than half of people receiving treatment found recovery. But the most effective treatments for mental illness all involve the patient taking action on their own every day. Any therapist can tell you how to change your relationship with your thoughts or how to cut out a compulsion, but you still have to do it and keep doing it. So what we’re looking at with mental health is more like physical fitness.
Those recovery rates I cited are probably no different than what you’d expect to see with any other behavioral change, like somebody getting into great physical shape. How many people can make the changes to improve their physical fitness level each year? Figures on gym membership drop-outs are tough to come by but by six-months into the year, around 40% of new members have dropped out. That doesn’t mean the remaining 60% all become Olympic athletes. And those are the people who can at least access a gym.If you’re working two jobs and struggling to buy food for your family, how could you have time and money for a gym membership or weekly therapy sessions? Humans struggle with change even when they’re oozing privilege. Throw in socioeconomic barriers and the difficulty swells.
Numerous studies have demonstrated the effectiveness of Exposure and Response Prevention therapy for recovery from OCD. It’s challenging, but it’s worth it. The key though is actually following through on it. A 2005 study on ERP found that 86% of participants improved significantly after a 12 week course of therapy if they stuck with the therapy. Of the group that dropped out before the end of the 12 weeks, only 62% saw improvement. “Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder,” American Journal of Psychiatry.
That study wasn’t about long-term recovery but that gap between the group that completed the study and those who didn’t illustrates the problem we’re dealing with here: your chances of improving your mental health drop significantly if you can’t do the work to improve your mental health. Expecting recovery without the support to make the changes involved with recovery is like expecting to develop the endurance and strength to run a marathon without doing any training. It’s just not possible. We need to look at the contextual factors around a person struggling with mental illness. We need to look at barriers getting in the way of making and sustaining changes. We need to look at support.
If you or somebody you know is dealing with mental illness, expect recovery. Seek out professional help that believes in recovery. But most importantly, take action. What supports need to be in place to succeed with recovery? What barriers do you need to remove? What baggage can you throw out to lighten the journey ahead?