We are hearing a lot about recovery these days and many mental health systems are seeking to transform themselves to a recovery orientation. However, the whole area of psychopharmacology and psychiatric medications remains stuck in an outdated medical model where the emphasis is too often on compliance rather than choice, and obedience to medical authority rather than self-determination. I have become very interested in exploring what a recovery based approach to using psychiatric medications would be. Through a research contract with the University of Kansas, I have had the opportunity to conduct qualitative research on how people who are diagnosed with major mental disorders use psychiatric medications.
One of my major findings has been that people who are recovering do not simply swallow pills in a passive way. Instead, they get active and they understand that recovery is about changing our lives, not just our biochemistry. I have learned that psychiatric medicine is not the only type of medicine that is important to recovery. Personal Medicine, or those things that raise our self-esteem and make life worth living, are vital to recovery. Fishing, meditating, exercising, having dinner with a friend, being a good mom, - all of these things and more can be vital to our recovery. All are forms of what I have come to call Personal Medicine.
Please note that Personal Medicine does not refer to personal concoctions of over-the-counter medications or herbal remedies or street drugs.
When I interviewed people about their use of psychiatric medications, I expected that they would tell me about using pills. To my surprise, they spent most of the interview hour telling me about a myriad of things they did to feel better. They challenged conventional understanding of medication…
When asked to describe their use of psychiatric medications, they described using pharmaceuticals but also spontaneously reported a variety of non-pharmaceutical strategies that served to improve mood, outlook, thought and behaviors. That is, when describing their use of psychiatric pharmaceuticals or "pill medicine", research participants also described a variety of personal wellness strategies and activities that I have called "Personal Medicine".
Personal Medicines were non-pharmaceutical activities and strategies that served to decrease symptoms and increase personal wellness. Personal Medicine was discovered by study participants in the everyday context of their lives. Most often clinicians did not suggest it. For instance, one research participant diagnosed with bi-polar disorder, found that solving mathematics problems was a powerful mood stabilizer. He said:
I think there are a lot of other things that are medication, that are not really considered medication. There's things that you can do that changes what your body does. And it may not be medicine…I still think that one of the best mood stabilizers there is in life—maybe not for everyone but for me—is math. That stimulates your intellectual process. (Joe)
All of the research participants identified unique types of Personal Medicine that they used in addition to, or in place of, psychiatric medications. Personal Medicine fell into two broad categories:
Both increased feelings of wellness and decreased/eliminated psychiatric symptoms and/or undesirable outcomes such as hospitalization. Examples of Personal Medicine included the importance of being a good parent, singing in a gospel group, helping peers, fishing, laughing, going to school, working, taking care of a pet, and cooking for an appreciative spouse.
I think that in a recovery oriented mental health system, the importance of Personal Medicine would be recognized, honored and supported.