Why Relapse in Mental Health Recovery is Like Slowly Boiling Over Time

One of the most frustrating parts of mental illness is how it fluctuates over time. You can work for months or years to improve your functioning and well-being, only to have things fall apart all over again.

For me, when this happens it happens slowly. It starts with a few more troubling symptoms, a few more bad days, and it builds until I’m drowning and I don’t even notice. Like boiling a frog. You start it out in lukewarm water so it doesn’t hop out, then you slowly raise the temperature until it boils without ever trying to escape.

Last night I realized I’m boiling.

How Did This Sneak Up on Me?

There are so many reasons I didn’t realize my mental health was getting worse again. There’s the slow boiling thing, of course, but another issue is how my bad mental health days look so different than they used to. When I first started dealing with mental illness, a bad day looked like constant crying, no sleep and hours of obsessive overthinking. Now, thanks to therapy and medication, I don’t typically deal with that anymore, but that doesn’t mean I don’t have bad mental health days. It just means they look different. Now, my bad days look like sleeping 13 hours out of 24, a crushing sense of hopelessness and intellectualizing my feelings so that I don’t have to actually feel them. In a lot of ways, that’s a huge improvement because I can function more easily, but it’s still far from healthy.

Part of me knew my mindset was descending into something unhealthy, but another reason it took me so long to really realize it is denial. I’ve spent so long working on my recovery, reducing my symptoms, getting “better,” and it’s hard to admit when that isn’t working. I don’t want to be sad again. I don’t want to find more coping mechanisms. I don’t want to have failed, again, at being healthy and “normal.” Or worse, I don’t want to exaggerate or take myself too seriously. What if I’m really fine? What if I’m just being dramatic? Sometimes, it’s easier to deny that things are getting worse instead of confronting my deepest existential fears.

But last night I realized my denial wasn’t helping me. I realized that, dramatic or not, I am tired of feeling this way, and pretending it isn’t happening isn’t making anything better. So something has to change.

Doctors, Vulnerability and Trauma

I hate that. I wish realizing my problems was enough to fix them, but alas, apparently problems need actual solutions. But with mental health, there’s never a one-size-fits-all solution. Admitting my mental health is declining means looking for money in the budget for more therapy sessions; it means hopping back on the merry-go-round of medications; it means entering into a world of uncertainty. It means I have to open up and be vulnerable with therapists and doctors and trust that they can help me.

I’ve always struggled with that. When I first started struggling with my mental health, I had several doctors completely blow me off, suggest I was just “stressed,” or even go so far as to say that since I hadn’t attempted suicide yet, I was actually doing quite well. Now, I do my own research on conditions and treatments and medications before any appointment so I can have my own suggestions. I don’t trust doctors to believe me, to see me and my pain and take it seriously, so I try to take charge of my treatment myself.

This is a problem for so many reasons. First, if I show up already convinced I know what’s going on, I present a very simplistic version of reality to the doctors, which makes them less able to help me. Not to mention I might be wrong and the doctor would never know because they rely on my explanation of my symptoms to know what’s going on.

Second, I am not a medical professional. I know myself better than any doctor knows me, but I don’t know chemistry or psychology the way a doctor does. I might think I need one medication based on an obsessive Google spiral, but the doctor may think I need a different medication based on their actual medical degree.

And finally, I can’t treat myself when I’m in this headspace. It’s all I can do to keep my head above water, and now I’m expecting myself to be my own doctor too? That’s just not going to work. But for years now I’ve done it anyway because the alternative seemed worse. The alternative is trusting the doctors to hear me.

I do not trust that anyone will truly hear me or see me. This is one of those truths I’ve been in denial about for a long time because it’s so sad, I didn’t want it to be true. But it is. I am terrified of being vulnerable, of being honest, of being seen, because what if they don’t like what they see? I spent so long growing up trying to be myself only to be dismissed and belittled, and now, no matter how many times different people react with kindness and support, I just can’t trust that they mean it. And I spent so long in my early 20s being patronized and misunderstood by doctors that I trust them even less.

But something has to change. I can’t keep living like this. Otherwise, I am going to snap under the pressure, and it will take months to undo the damage that breakdown will inevitably cause.

It’s Time to Get More Help

So, I made an appointment with my psychiatrist. And of course I Googled medications, but I’m not going into my appointment with my own recommendation. I’m just going to tell him how I’ve been feeling. Maybe I’ll even print this out and let him read it.

I have therapy tomorrow. I’m going to ask for help coming up with practical coping mechanisms I can use for my increasing symptoms, but I also hope to address these trust issues I’ve been discussing. After all, no medication can make you less scared of vulnerability. Meds don’t cure trauma. As much as I want a magic pill to take away all the turmoil and angst that rule my mind, I know I have to do that work myself.

A version of this article was previously published on the author’s blog, Megan Writes Everything.