This article is addressed to anyone who is experiencing serious mental health symptoms but is unable or unwilling to get help for any reason, including fear of stigma or being rejected by community/family.
Unaddressed Mental Illness leading to suicide has recently been the focus of increased attention due to the sharp rise in documented tragedies associated with it. Much of the communal response has correctly been on ways to get help more effectively to those who need it, to identify them better and earlier in their illness, and to destigmatize mental illness so people feel more comfortable reaching out for help before their condition becomes overwhelming.
This increased attention and acceptance has normalized mental illness to some degree, meaning that people who are experiencing symptoms (often depression and addiction,) may feel less alone knowing that many others are going through the same thing. People being treated for their condition in a group setting such as attending meetings, group therapy, or an inpatient/outpatient rehabilitation facility have the additional comfort of being part of a group of others going through the same thing, and that feeling of community further increases a sense of support that can increase the likelihood of a successful treatment outcome.
Unfortunately though there are still many people with mental illness who feel isolated. This sense of isolation and facing a huge problem alone can cause a sense of hopelessness, as the person may feel they can’t get help, and sees no way out. So what can a person who needs help but can’t/won’t reach out for treatment do? Is there any way to begin working on reducing their distress alone?
The answer is yes – there are indeed steps a person can take towards recovery even when isolated and unable to be part of active treatment. Mostly these involve cognitive & behavioral (CBT) techniques, which is the type of treatment that focuses on changing a person’s automatic thinking patterns, beliefs, and activities that contribute to the problem.
Let’s use addiction as an example, because it’s so often involved in these cases:
There are always underlying thought patterns driving addiction – the most basic component is the knowledge that performing the addictive behavior will provide relief (from anxiety, depression, withdrawal symptoms, etc.) – CBT focuses on addressing these factors, understanding what specific role the addictive behavior plays in them, and identifying what situations and stimuli are the most frequent contributors. A common and simple example is someone who becomes socially anxious and drinks before and during social events to decrease the feelings of anxiety. Working to understand these thinking patterns and how they contribute to problem behaviors is called “Functional Analysis,” and is the first step towards changing those behaviors.
Once the automatic thinking pattern is recognized, it can then be addressed. In CBT this is done from multiple directions – challenging and potentially changing the beliefs (ex. is alcohol the only way to reduce the social stress? Is the stress truly unbearable without drinking? Are there any positive aspects to socializing while sober? Etc.) identifying and changing harmful behaviors (ex. avoiding social situations where alcohol is served, doing other anxiety-relieving activities prior to attending social situations, changing sleep patterns if they are a contributing factor,) and improving skills that can be helpful with the underlying issue (ex. practicing specific social skills that are deficient, learning relaxation techniques such as meditation or breathing exercises, taking a public speaking class, etc.) This is a simple and general example; any addictive behavior will have a unique dynamic driving and continuing it and the CBT techniques are customized to each person’s unique circumstances.
Obviously CBT and any other psychotherapy treatment is most effective when done with a good therapist who can provide direction, feedback, support, and psychoeducation. However, a person can learn and practice these techniques alone as well. This is important information to disseminate to the many people who wish they could get help with their debilitating mental illness, but feel there is nowhere to turn because of their unwillingness to let anyone know about their problem. In many cases people have completely lost their coping skills for dealing with whatever caused them to start using in the first place or in cases where people start using early in life, they may never have learned any coping skills at all, having relied on drug use as their primary coping strategy for their entire adult life.
Unfortunately reaching out for appropriate treatment is not a realistic and viable option for people who are afraid or unable to do so for a variety of possible reasons. It’s also important for people to realize that not every treatment works for everyone, and that it’s about finding a good match that works best for each individual. Every behavior and activity pattern has a cause, and understanding the automatic thoughts that make us behave the way we do is the first step towards improvement in any area of life. The important thing to keep in mind is that no situation is truly hopeless, and even if a person can’t reach out for treatment at this moment it’s possible to use these techniques to at least decrease the severity of symptoms to some degree, and not give up.