Chronic and Incurable

Elisa A. Escalante/ LCSW/ 4-15-2022

“Life works out better when you can see the purpose in your boring day off just as much as you can see the purpose in your purposeful work days.”

      On one end of the spectrum I, as a behavioral health specialist, may get questions like “So what do I do?” “What’s the answer?” Then, on the other end of the spectrum I may get comments or retorts such as “That doesn’t help!” “That’s not going to solve my problems!” Both sets of comments, whether you’re on one end of the spectrum or the other, do end up pointing to the same issue: Expectation reality mismatch. Somewhere along the lines, perhaps you were led to believe that the mental health world has magical ‘cure alls’, or that life in itself, was not meant to have chronic illnesses. That surely, there is a divine intervention that will fix this chronic issue once and for all…. but then… everything falls short. Or rather, most interventions will offer temporary relief, but will not make the physical or mental ailment go away all together.

     When I entered the world of mental health at the inexperienced age of eighteen, I wanted to believe in this obsession we have of ‘finding a cure’. I wanted to save people, I wanted to believe there were concrete answers to the majority of these issues. But what I came to find was the theme of chronic illnesses such as chronic pain conditions, depression, anxiety, PTSD, eating disorders, ADHD, Bipolar disorder, “personality disorders” (Complex PTSD), addiction(s) and more…. Were in fact, very chronic. I saw therapists at workshops and webinars constantly preaching the ‘next big cure’ for specific mental conditions. Only to see colleagues use these ‘promising interventions’, and to their frustration, many of their patients felt better temporarily, but typically had a new flood of symptoms causing them distress anywhere from month’s to years later.

        Curing should NOT be the goal

       Curing should not be the goal, nor should it be promised by any clinician or person. Why? Because most mental illnesses are in fact, CHRONIC. This means that there is a chance the symptoms may go through waves throughout the course of our lifetime. We may have some really great days, weeks, months or years. Followed by some horrendous days, weeks, months and years. Most clients describe these waves, and that their environment, social situations, life circumstances and holistic health often play factors in how they feel too. As a clinician, I’ve had many cases in which people came to get therapy in spurts, often times based on symptom exacerbation. For example, they may get help for months and then disappear for months, then come back for more help. Why? Simply put, when symptoms get better, they see no reason to get help. They may even go on about life hopeful that the symptoms never resurface, only to find out they often do, inevitably, when faced with life triggers, traumas, grievances and other stressful circumstances.

       The Real Goal: Symptom maintenance

        Because most mental conditions are chronic, the goal is symptom maintenance. First, for some clients I just get through the difficult task of explaining the heart wrenching truth: There is no cure all. I don’t have the divine intervention, I have many interventions that can help temporarily alleviate symptoms, but nothing that cures and makes everything go away. And since mental health is not just about biological susceptibility, but in large part, environmental and social factors play a role; how can we ever expect a cure?? Does life stress ever actually go away? No, if anything, hopefully we learn to tailor our lifestyle according to our needs/ desires. The goal of symptom maintenance requires that we get therapy in spurts over time, take what works, and discard the rest. Rinse, wash, repeat. Gain the knowledge, practice interventions, find the tools that work, practice self-care daily if possible, and treat therapy as a marathon vs a sprint. If you try to sprint through therapy, what you are going to find is that you might learn one half assed intervention, and find that it barely scratches the surface of your issues.

       Holistic Health

       Holistic health has to do with the concept that every part of our health and well-being plays a part in how we feel and function day to day: physical, mental, moral, emotional, social, professional, spiritual, financial and more. Most humans will tackle 1-2 of these components heavily in ‘pursuit of happiness’ only to find that there’s a lot missing, there are many voids, and many symptoms that sometimes go unexplained. A balanced individual strives to contribute little by little to all of their life realms, without working to burnout in any category. These individuals, tend to feel better day to day, vs someone that is imbalanced and abstaining from a focus on holistic health. What does focusing on holistic health and balance look like?

         Holistic Checklist:

• Hydrate, rest, nourish, nurture body
• Therapy and/ or medication compliance (talk/ nature/ pet/ writing etc)
• Self Help books/ audios/ documentaries
• Solitude Activities
• Social activities
• Physical activities
• Intimacy/ Love
• Spiritual Outlets
• Budgeting time and money
• Professional development (school/ work formal and/ or non-formal)
• Behaviorally activated hobbies (gardening/ crafts/ woodwork etc)
• Exploring new things/ new adventures
• Building a comfortable/ sustainable routine

Conclusion:

Here’s what they don’t tell us: Being healthy takes a lot of work, especially as we age. Maybe you have a healthy baseline and the above list simply needs to be maintained. However, many people walk around with an imbalanced baseline. Maybe your baseline is depressed, or anxious, or angry. Therefore, the holistic list needs to be modified and some areas may need more focus than others for a while. Sometimes the priorities must change on our holistic list. I mentioned recently to a patient that was struggling with a traumatic loss that it is absolutely okay and acceptable to switch her priorities for the time being, the situation warrants it. This is never a one size fits all. This is a never ending practice, learning to balance our life and self care routine. But absolutely, never under estimate the importance of it. Also, never let someone make you feel like your holistic care MUST be sacrificed. This is your life, after all.