Cure or Management?

There are many conditions that cannot be cured. For every one of those conditions, there are supposed miracle interventions, that people will insist can save you. It’s particularly bad around mental health because rather a lot of people believe that medication will cure you of depression and anxiety. For many of us, it doesn’t. Management is kinder, more realistic and more useful than chasing after a fantasy cure, often. For most people, medication doesn’t cure depression, it’s just a tool to manage symptoms.

I have been on the wrong end of this. I’ve let myself believe that if only I tried harder, ate better, exercised more and worked on myself, that I could beat depression. And then every time it’s come back, I’ve felt like a failure on top of everything else. I’ve watched friends not being cured by meds. I’m also aware of numerous friends for whom the meds are a good tool to help manage things. They aren’t fixed, but they are able to live with their illness.

The idea of a cure can be a way of making a sufferer responsible. If a cure exists, and you aren’t doing everything you can to find it, are you really that ill? Are you being responsible around your illness? Never mind that chasing fantasy cures is exhausting and demoralising. Never mind that help to deal with ongoing problems would be more useful. Focusing on finding a cure can make it harder to deal with what’s really going on, and can add to feelings of guilt and despair. No one’s mental health is improved in this way.

If suffering is somehow the fault of the person experiencing it, then well onlookers need not worry – it won’t happen to them. Belief in cures can be part of what keeps well people feeling safe in face of other people’s distress. Confident that they would get out there and be cured, they don’t have to empathise with suffering, do anything to help, or even treat the sufferer kindly. It is a cruel way of relating to illness.

Grasping that I may never fully get over depression and anxiety was a powerful moment for me. It came up when reading Down Days by Craig Hallam. He talked about not expecting to ever truly recover, and a weight lifted from me. Perhaps not getting better is not some failure – moral or effort based – on my part. Perhaps I do not owe it to anyone else to become well. Perhaps focusing on what I can do to be as functional as possible is wiser. If I treat this as something I will have to navigate for the long term, perhaps I can be more patient, kinder to myself and more comfortable from day to day. The idea of a permanent fix has distorted my sense of what I’m dealing with. Let that go, and I can respond to what’s real and consider what’s truly possible.

I’m better than I used to be. I have no doubt that one of the reasons I’m better is that I’ve become less tolerant of people who want to tell me what I should be doing. I’m no longer open to people harassing me because I don’t manage my mental health in the (uninformed) way they think I should. I’m not internalising the voices that tell me I’m a failure for still being ill.