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The Imperative of Accountability in Recovery

Recovery does not happen overnight. Nor does it happen with only one person wanting it.

I do not wish to delve into textbook definitions of recovery, but how I, a diagnosed manic-depressive, experienced it.

Mental illness is disruptive: it interrupts daily functioning and sometimes destroys relationships along the way. To recover is to function again and to have well adjusted relationships with family, friends and the community.

However, it takes a confluence of elements to make recovery happen. As one doctor put it, the patient has to want to recover in order for it to take place. Although the family and the treatment team may do their best to help the patient, it is the patient’s willingness to accept his or her condition and do something about it that always spells the difference between being trapped in a destructive cycle, or breaking the pattern and going back to functioning again.

A supportive environment is likewise an important ingredient in recovery. Without a family that understands the condition of the patient and gives appropriate care, recovery would be akin to a mountain that is hard to climb. The family has to be tolerant of lapses, vigilant during crisis periods, understanding, and generous for treatment and medication is often a costly undertaking.

Doctors who are empathetic and caring could also make a difference in the way a patient recovers. Without a medical supervisor who has a genuine interest in the patient’s welfare, recovery may be an obscure spot in the horizon.

As the patient recovers and regains normal mental, emotional and physical functioning, however, they must remember that they begin to take accountability for their actions.

In my years as a volunteer in this psychiatric facility, I have seen fellow patients backslide and slip in their journey to recovery. Often, I have noted, they blame their condition for their actions. For instance, a reckless spending spree or promiscuity is often said to be caused by a manic spell. Or another instance of drug and alcohol abuse is blamed on an adverse environment or family problems.

I do not subscribe to such excuses.  I have been asymptomatic since 2009, with no major breakdowns after that year and I ascribe my recovery to two things: my education about my condition and my sense of accountability for my actions.

While the two are not mutually exclusive, I believe there is a dynamic about how one’s awareness of mental illness, vigilance and accountability interplay to sustain the momentum of recovery. I once heard a trainee complain that his family treats him like a child. I told him: stop acting like one.

Education is important; one has to understand that there is a biopsychosocial element to mental illness and behavioral problems to know that it is a condition that one should not be ashamed of. Education tells us that the aberrations in our functioning are part of a disease, and that disease can be managed and treated, as with any other medical condition.    

Accountability, has been, I believe, my compass through these years as I stayed asymptomatic and functional. I do my best to watch for warning signs of depression or mania, and go to my doctor as soon as I feel a spell coming on. This, I would not have been able to do without self-awareness, which can only come from education.

I am of the belief that my condition is an opportunity to remain humble and be of service to my community. Humble because I recognize that I, as a patient in recovery, need help as much as the people I try to assist with my knowledge and skills.

Without a sense of accountability, I believe I will not be able to perceive my condition as such. Without this, too, I may have relapsed, conveniently ascribing my maladjustment to my illness.

Patients ask not to be discriminated against because of their condition. But equitable treatment is a double edged sword. Yes, we could be treated like the rest of functioning society, but we must also be prepared to be held to moral norms that dictate we control our maladjusted behavior. We cannot, for the rest of our lives, attribute our misbehavior to our environment, our circumstances, our families, but most of all to our illness. 

And while our families may cut us some slack because of our condition, they should not condone destructive behavior, especially if it affects other people.

We want equal treatment; then we should hold ourselves accountable for our actions. A person who has truly recovered is one who contributes to the welfare of the community and its members and holds themselves responsible for their actions. Mental illness should no longer be considered a causal factor for maladjusted behavior; rather it should be motivation to strive for normalcy and functioning.