May is Mental Health Awareness Month.

I thought I would tell this simple story from my work at a psychiatric hospital in the mid-1990s and what it taught me about mental health.

Part of my job at the psychiatric hospital was to work in an intensive outpatient program for older adults. The people we worked with were sixty-five years old or older. They came into the program with a variety of issues. Some were depressed, some were wrought with anxiety, some were experiencing hallucinations and/or delusions, some were so discouraged they had become suicidal. Though their symptoms varied, the stories of why they were feeling the way they were was similar. Their aging years had brought about a series of losses. Often friends or family had passed away. The patient’s health was declining. They were no longer working. They may have had to move from their home into a more manageable  living environment. They were no longer able to drive themselves. They had lost many of the things in life that had always given them a sense of meaning and joy. The losses had created a crisis of identity.

What became fascinating to me is that though the individuals in the program all had arrived at the psychiatric hospital with a similar series of losses some of them recovered from their psychiatric symptoms and moved on and others continued to struggle. Over time I began to notice a pattern in the patients who recovered. Those who recovered had three factors in their lives that seemed to give them the ability to bounce back. I want to point out that none of the three factors had anything to do with medication. Actually all of the patients were prescribed similar medications. Antidepressants, antipsychotics, and/or antianxiety medications were common for all the people in the partial hospitalization program.  Psychiatry did not seem to be the cure.

The first factor was that those patients who bounced back had supportive and emotionally intimate relationships with very close friends or family. Often it was a long time coworker, a  neighbor, or their adult children or grandchildren. These relationships mattered for several reasons. These close friendships meant that someone was there everyday or at least called everyday to make sure the patient was doing okay. This allowed the person recovering to believe they mattered. These relationships also allowed the patient to be authentic and real with another human who cared for them. They could be honest about their feelings without being judged. Mostly these relationships were powerful  because when the patient got into a tough time, there was someone they could turn to for help. They did not feel alone.

The second factor was that those patients who recovered had a hobby, an interest or a part time job that gave them a sense of meaning. One guy made stools people could sit on while they gardened. One lady spent several weeks making special holiday candy and cookies. Another gentleman did a tremendous amount of volunteer work for his church. One guy made wooden toys. Another lady was a leader in a weight loss club. It really didn’t matter what it was. The important thing was that it gave a sense of meaning, purpose, and joy to the person.

The final factor that I identified in the patients who recovered was that they had  an active, personal, and strong spiritual faith. Some were Catholic, some were Protestant, some were Pentecostal, and some were much more eclectic. What did a strong personal faith do for the patients who were resilient?  How did it contribute to their recovery? I observed this. It gave them a place to go with their questions that did not have answers. Questions such as why did my husband die before me? Why am I experiencing the difficulties that I am? Why am I sick? Through their their faith they were able to live with the things in life that did not make sense.

When I think about my own mental health I often reflect back on those simple lessons I learned from the many patients I saw at the psychiatric hospital. The importance of emotionally intimate relationships with family and friends. The importance of having meaningful work and leisure activities. And finally the ability to rest in a Creator who loves me and cares about the details of my life.  It is these simple and unsophisticated things that provided stability and hope. These are the buoys that held up the people in the psychiatric hospital when their lives seemed to be caving in. These are anchors we can all develop. We can kindle old friendships and make new ones (“if you want a friend be a friend”). We can pursue our hobbies and interests. We can find ways to enrich others. We can pray and pursue the Creator. Not only can we do this for ourselves but we can reach out and bring others along with us.