Expectations in Mental Health
BY : SHELBY MILLER
I remember my first doctor’s appointment addressing my daily struggle with anxiety… I was a junior in college and panic attacks were a pretty regular occurrence. Life felt completely out of control. I was in the thick of nursing school, my parents were in another country, my family and boyfriend Logan were in another state. I was not functioning well. I finally opened up and told my parents what was going on, and we made a plan. First step, talk to a doctor. I walked into a family doctor’s office with sweaty palms and a racing heart, completely mortified I was in this situation.
I spoke with a doctor who was very reassuring and normalized what was going on with my body in a way that made me feel slightly less crazy. In her encouragement she said, “This won’t be forever. You probably just need to get through nursing school and then you can come off the medication.”
Two years later I attempted to come off the anti-anxiety medication, and it was a disaster. Much worse than junior year of college. Now I had bills and a big girl job and was taking care of really sick patients. That conversation rolled back through my head and I remembered her saying, “It won’t be like this forever.” I was angry, blaming myself, and feeling like something was wrong with me. I was supposed to be better. I was supposed to be back to normal. I was about to get married and I couldn’t bring all this mess into my marriage. I was involved in my church and loved Jesus, so why was I depressed and anxious about everything? What was wrong with me?
Expectations around mental health are so important. If you have ever been diagnosed with anxiety, depression, or another mental illness, you might be wondering how long it will last. You may be asking how long you will be on the medication and how long your doctor will ask you questions about your mental health. How long, how long, how long?
First of all, there is no timeline on any disease process. Each of our bodies react differently. From diabetes to strep throat to depression, some people recover quickly while others get sicker. Some people slowly progress into heart failure and some people seem to decline over night. Our bodies are incredibly complex, and although scientists and doctors are really smart, they don’t have it all figured out.
The first step in setting expectations for mental health is to actually believe that mental health is a medical condition. You need to acknowledge what your body is going through. Voice the lies from your past that told you you were a negative person or just being crazy. Mental health has both a medical and emotional component, and it can be difficult to have realistic expectations around it, but it’s so important.
Secondly, I want to gently remind you that when we ask how long this problem will be here, we are assuming it is a self limiting disease that will eventually go away. It’s important to realize that’s not always the case. This might be what your doctor tells you to keep you from spiraling at your first appointment, but some of us will be on antidepressants and antipsychotics for the rest of our lives just like some of us will be on blood pressure and cholesterol meds forever. It depends on our unique body and the chemicals inside of us. Most people with high blood pressure do not feel defined by the fact that they remain on BP meds, so we don’t need to feel any different about our medication for mental health. Your medication list does not define you…it is just a tiny part of your story.
There’s another side to all this. Sometimes our expectations are just about our medication and not about OUR part in the process. Research shows that medication works some of the time, counseling works a lot of the time, but medication and counseling together work most of the time. There’s also prayer, meditation, support groups, learning new coping mechanisms, exercise, diet changes, and so much more that you have the power to make choices in. Sometimes our expectation is that the medicine will fix us, when really we have plenty of work to do while the medicine levels out our chemical imbalance. I have friends who have started on medicine for anxiety and quit after a week because it’s not working fast enough. Were they also exercising, journaling, thought mapping, and taking other steps towards health? (A side note here is that most mental health medications take weeks to reach full effect.)
My expectations around my mental health have changed drastically over the last several years. I have come to the conclusion that medicine will likely be part of my life for a long time because I know I am prone to anxiety. Instead of spending my time thinking about the timeline of lowering my dose or being done with counseling, I focus more on the present moment and caring for my mind and emotions. Mental health is a one day at a time kind of battle. It is hard and also freeing to not get caught up in unmet expectations from both ourselves and society. Throw away the timeline and call it what it is. I have anxiety, and I have for a long time. It is a part of my story, but it’s not who I am. I have to make decisions to support my mental health, but my mental health does not control my life anymore.
Spend some time this week evaluating your expectations. Are you expecting too much from yourself? Too little? Are you being realistic about timelines and what you’re capable of in this season? Grab a trusted friend and talk through this with someone who knows and loves you. And most importantly, remember that everyone’s timeline is different and even if this is something you carry forever, it does not define you! You are more than your mental health.
