One day, during a conversation with a friend about why some people seem unable to end cycles of harmful behavior, I said something I was amazed and impressed to hear coming out of my mouth. I know it's considered impolite to refer to one’s own accomplishments as impressive (for some reason), but here's what I said:

“In order for someone to change and become functional with a mental illness, they need awareness, intention, motivation, opportunity, and support.”

Nothing I've seen since making that statement has changed my opinion of its truth, except the caveat that there are other things needed. I couldn't think of exactly what they might be, other than possibly perseverance, which to me is implicit in any undertaking, be it becoming an astronaut, baking a cake, or managing your mental health.

So let me break this down for you.

Awareness

“The first step is admitting you have a problem.” This statement has been repeated and reduced to flip jokes so often that it has become a cliche. Having others tell someone they are harmful to themselves or others and the individual realizing, agreeing, or being able to state this for themselves are entirely different things. Some people may even agree they are doing certain things, but disagree the behavior is a problem. Denial and blame-shifting interfere with an individual’s ability to change.

Intention

Even when awareness and agreement that, yes, this is a problem, occur, if the person has no intention of doing anything about the issues, change cannot take place. This may be because the person does not believe there is any chance their efforts to change will be successful, or perhaps they fear losing social connections who would not support or approve of the change. Many things can destroy intention.

Motivation

The driving reason to do anything is somewhat linked to intention. But even if a person is aware and intends to change, if there's no motivation to do so, the changes will not happen. Or if it does, it may be entirely a result of nagging on the part of another, and therefore not sustainable and doomed to collapse. Although it may seem less likely that motivation would be the thing to stymie a mentally ill person, depression, aspects of the Autism Spectrum Disorders, and other challenges could all allow for it.

Opportunity

All of these words represent a complex set of circumstances and ideas. It's my opinion that if even one is missing, it will make the task of becoming functional with mental illness enormously difficult. Opportunity is no exception. If all the other conditions I'm describing are met, but the person decides they are too busy to begin the work required, or when they begin the search for help they encounter roadblocks and lack the ability to persevere toward their goal, the likelihood they will overcome their mental challenges is remote.

But what about money?

Money and opportunity are tricky. While being able to afford professional help and medication is important and valid, there are many, many other things any given person with access to the internet can do to move toward positive change.

If someone remains unable to afford professional help and/or medication for a long period of time, it's possible that professional help and/or medication might be necessary for them to become able to afford them.

This is a paradoxical and confusing circle.

A good way to explain it is a story I've heard people with ADHD tell in regards to filing taxes (in Canada). The cost of hiring a professional to attend to this grueling task is more than offset by the potential rebates and absence of fines and late fees that would result if the person with ADHD filed their own taxes. Medication too can allow people to be more productive and work more than is necessary to cover the costs of their meds, as well as improving personal lives.

Support

I've already written about the paradoxical aspects of the role support plays in creating positive change. I believe no positive change is an island. Support can come from many different sources such as family, friends, coaches, therapists, doctors, pets, or even fictional universes. In this context, even medication can be considered a form of support. I am no doctor, but from what I understand, medication, when working correctly, supports the brain’s chemistry in ways it isn't doing for itself. Strategies and techniques for mental health and life management are a major portion of my personal support.

What pillars hold up your functionality?