Mental Health: What's the Main Reason for So Many Treatment Failures? (2)

"(Rodrigo Contrera)

Before delving deep into the issue, let's first briefly discuss what constitutes "failure".

My father suffered from bipolar disorder. He was formally diagnosed around 1987, I think. My memory is a bit hazy. But signs of abnormal behavior were evident much earlier, perhaps since 1984. From then on, his condition worsened significantly, displaying manic and then depressive delusions. He was hospitalized, became rebellious, took medications intermittently, sometimes improved on his own, then deteriorated, and finally fell into a state of social mutism, encountering numerous problems, and we were clueless about how to assist him. He died of a heart attack, significantly weakened, at home. He couldn't even overcome the psychic aspects of the disease, let alone therapeutic ones. It was a failure.

In the mental health center I attend, many patients seem okay, if we're basing it on them not having outbreaks, eating consistently, performing some work, or socializing without excessive strain. But are they success stories? I'm not sure. They haven't generally resumed the life of a typical person. By this, I mean they aren't economically independent, they aren't socially independent from doctors or therapists, and they clearly appear sedated, drugged, or simply restrained. It's hard to say they exhibit normal behavior. They are individuals still largely dependent on several factors to prevent deterioration. However, on the whole, they're somewhat better off than my father was.

I had an elderly friend, a former bookie involved in illegal gambling, who suddenly started acting strangely. He'd incessantly repeat things, stop his car in the middle of the road, emerge scantily clad amidst passersby, and display perilous behavior, oblivious to cars and people around him. Could we say he's a success? Not necessarily. Maybe he displayed dementia traits.

There's a guy nearby, practically a beggar, who hangs around a bakery where he once worked. He has a quick mind but aggressive tendencies toward himself. He has delusions, one of which tells him he needs to watch people exit the bakery so he can claim it for himself. He doesn't take medications. We can't really label him a success either.

Are "normal" individuals successful? I have a neighbor diagnosed with schizophrenia who wakes up early to pace continuously. She seems medicated and doesn't appear entirely normal, relying on others for support. Would we consider her recovery a success? By our current definition, only if she managed to lead a productive life on her own terms.

From the cases I mentioned, none match this. Perhaps only I do. But given that I still rely on some external assistance, maybe not even me (we need to be strict about this). What would a recovered patient look like? Almost a mirage.

My psychiatrist knows I'm doing well. My therapist, neighbors, family, they all agree. But based on personal experience, I know that talking about genuine recovery for mental patients or alcohol or drug addicts is complex. Why did I mention addicts? Because drawing a parallel between the two situations convinces me that real recovery is almost an unattainable ideal that only the patient or addict can try to understand or approach. Recovery might just mean the patient is alive with relatively normal capabilities.

I'll discuss these in another article.

(Rodrigo Contrera)"