I know, it seems like I'm always mentioning how the symptoms of mental illness come and go over time. That's one way in which mental illness is a little bit predictable, because we know that life with a mental health condition will require more effort on some days than on other days. One thing that I haven't talked about, though, is how those symptoms can change over time.
One common misconception about mental illness is that people experience the same symptoms of their mental health condition over and over again. That's not usually the case. If it was, those of us with a mental health condition wouldn't really need ongoing therapy once we learned how to manage the symptoms for which we went to therapy in the first place.
The reality of living with a mental illness is that symptoms change from time to time. Sure, some symptoms can go away or lessen to the point that we might barely notice them. But...new mental and physical symptoms can also occur at any time. New triggers can emerge. New intrusive thought can suddenly filter into or take the place of old intrusive thoughts. (So far, the content of my intrusive thoughts has changed four times during my wellness journey.) This can happen through no fault of our own. It just happens sometimes, and then we're left trying to figure out how to manage this new piece of the puzzle that appeared after we already thought our puzzle was put together.
The other piece of that misconception is that everything will be fine as long as the person is on their medication, and their mental illness will continuously be "better" with the medication. Medications can stop working. Dosages need adjusting sometimes, or the medications may need to be taken at different times of the day or night if it's helping less than before. Sometimes the medication can cause a new set of symptoms (as it happened in my case), and then a new medication may need to be added to treat the new symptoms. Sometimes medications need to be changed altogether, and then the person experiences a spike in symptoms as they wait the two to eight weeks for the new medication or combination of medications to become effective.
This two-part misconception can add to the idea that I talked about last week, that people that live with a mental illness are "unstable" as a permanent state of existence. It can also make it seem like the person is suddenly getting worse or maybe not trying as hard to stay on top of their mental health. That isn't accurate, though. Just because new symptoms emerge or medications need adjusting or changing doesn't mean someone is getting worse or not trying hard enough. It just means things have changed, and now we have to learn how to cope with these changes that we didn't expect, which can feel like starting the whole journey over again sometimes, depending on how severe the new symptoms are.
Mental illness is extremely unpredictable that way. Every person won't experience the same symptoms or the same symptoms in the same order. The medications for a specific condition won't work for every single person with that condition, and so it's trial and error until the right medications can be figured out by the healthcare team. My point is that mental illness doesn't look or feel the same for everyone. Mental illness may not even look or feel the same week to week for one person. That doesn't mean that one person is "worse" or more "unstable" than the other. It just means their brains are different.
I'll end with this: People don't just keep experiencing the same symptoms of their mental health condition over and over again. Symptoms and triggers can change over time, even though someone is going to weekly therapy and taking their medication(s). Mental illness is unpredictable in that way. Medications won't always cause continuous symptom improvement either, because medications can stop working, or the dosage may need adjusting from time to time. These changes don't necessarily mean that someone is becoming "unstable", getting worse, or not trying as hard as before to be well. It just means they may have been thrown a curve ball, and now they need the time to adjust to this new situation.
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