“I want to get a life,” I answered the adolescent therapist as she asked me what I wanted to get out of the intensive therapy program. She looked confused. “You mean a social life?” “No, it’s a life, my whole life. I feel like a ghost.” She typed something into the “goals” template of the treatment plan the state required for me to receive her services. I wasn’t sure she understood and wondered if she could.

The onset of mental illness and hospitalizations that followed threw my once social adolescent self into hiding. Before all that had happened, I had been odd, no doubt, but I was active in the school band and felt some attachment to the people around me. After the hospital, everything stopped.

For months, my life felt like one long day I spent mostly at home. On the occasion that I made it to the school building, I’d notice all these changes: a broken door, people talking about a dance I knew nothing about. It’s amazing how fast life moves when we are young and how still mine felt at the time.

Yet, slowly, I carved out something new for myself. At first, it was small things like walking up to the gas station down the road or taking my dog to the park. Even as I felt disconnected from the community in my hometown, I found a new community through a therapeutic school and a support group. Eventually, those steps turned into leaps, like volunteering at a summer camp in another state and applying to college.

Fast-forward to today, and my world is spinning once again. It’s not quite how I might have imagined it before my mental health crisis, but I have found a meaningful life with a vocation as a therapist, writer, consultant, and trainer. I tease my partner, meet friends for coffee, and celebrate holidays. I am not a ghost.

Inertia

Unfortunately, my experience of inactivity after a mental health crisis is common. Most serious mental illnesses begin in young adulthood, a time when, on average, people are spending upward of 60 hours a week on productive activities like school, work, friendships, and hobbies (Jackson et al., 2019). Once mental illness sets in, that average drops to less than 45.

While we dance to the music of adolescence and young adulthood, creating lasting relationships and vocational progress, our worlds are rapidly changing. Mental health conditions like psychosis, severe depression, or a manic episode can place our plans on hold. Disruptions like hospitalizations, time away from work/school, and intensive treatment can make it tricky to keep up. Getting on with life is a challenge.

Swimming Against the Current

Once time has passed, an inertia can begin. We tend to lose momentum and routine. Once prized dreams can feel out of reach. Yet, if we can swim against this current, it is possible to re-engage with life. A recent study that followed individuals who had completed treatment after experiencing an initial episode of a schizophrenia spectrum disorder found that after three years, 79 percent had symptom remission and 38.9 percent had made a full recovery (Li et al., 2022). Physical activity and family support were significant predictors of recovery.

Swimming against the current can be intense, however. Letting go of all-or-nothing thinking to focus on what really matters is a first step. With mental health recovery, sometimes we need to adjust our roadmaps to accommodate the unexpected. These detours do not have to represent relinquished dreams. Yet, adjustments might be necessary to the pathway taken.

Many psychotherapies, including recovery-oriented cognitive therapy and acceptance and commitment therapy, often focus on the values underlying a goal rather than the goal itself. Such a mindset creates flexibility allowing us to experience small successes each day and appreciation for the reasons that we had our goals to begin with.

For example, I had a goal of returning to school because I missed feeling part of a community. Micro-steps like going to the grocery store, attending therapy appointments, and spending time at the library assisted me in my value of community while simultaneously helping me prepare to re-enter high school.

How Family and Friends Can Help

Support from family and friends can be invaluable in the journey toward mental health recovery. Recognizing the life-changing impact that a mental health crisis can have while also remembering that your loved one is the same person behind their eyes as they were before mental illness is key. Difficulties with motivation, focus, and task completion are common in many mental health conditions. Symptoms like these are not signs of laziness and can be frustrating.

Inviting your loved one to join you in activities like game night or doing each other’s nails is one way you can help them re-engage with the world. Even if they are not able to accompany you, invitations like this can be a reminder that they are welcome. Most of all, you can show up like you always have and give them the same respect you would give to anyone after a major life event.

Often, after a mental health crisis, people fear that those around them will not see them the same way. Unfortunately, sometimes people ditch because they do not know the “right” way to meet their loved one. The truth is, often there is nothing extraordinary required. There are no magic words that you are expected to know, and you don’t have to be your loved one’s clinician. In fact, they would almost certainly rather have you as a friend or family member than as another provider. Just being there and encouraging them as they get back up is enough.

A Possibility and Reality

Re-integration after experiencing a mental health crisis is a reality for many. With support, mental health recovery can be a possibility for all. If you or someone you care about is struggling, there is hope. Life goes on, and the resilience people are capable of is amazing. We are not ghosts.