Summary: New research challenges common assumptions by showing that a prior history of mental health disorders or substance use does not necessarily prevent people from recovering and living high-functioning, fulfilling lives.
Source: APS
Background: Much of the existing research on mental illness has concentrated on chronic or recurring mood and anxiety disorders and substance-use problems that can impair daily life. This focus has reinforced the belief that a history of mental illness typically keeps people from thriving. The latest study revisits that assumption, examining the prevalence and correlates of optimal well-being after psychopathology.
Published in Clinical Psychological Science, the new analysis finds that many people who have experienced mental illness can and do achieve high levels of well-being, strong social functioning, and meaningful quality of life after recovery.
“Our analysis shows how many people recover from mental illness and go on to experience meaningful, well-functioning lives,” said Andrew Devendorf of the University of South Florida, the study’s lead author. “Contrary to traditional clinical wisdom, mental illness and substance-use disorders may lessen—but do not eliminate—the possibility of thriving.”
The researchers also found that longer episodes of illness or having multiple disorders across the lifespan lowered the likelihood of thriving, but did not make it impossible.
Study data came from the 2012 Canadian Community Health Survey—Mental Health, a nationally representative sample of more than 25,000 Canadians aged 15 and older. The survey collected detailed information on lifetime and past-year mental health, use of formal and informal supports, functioning and disability, and other factors that affect well-being.
The research team compared participants’ diagnostic histories—covering conditions such as depression, anxiety disorders, bipolar disorder, and substance-use disorders—with measures of quality of life. Those measures included social relationships, positive emotions, perceived life quality, and the ability to fulfill important life roles.
To determine who was “thriving,” the authors required both symptomatic recovery and high functioning. For example, to count as thriving after depression, participants had to be free of major depressive symptoms and report well-being above the 75th percentile relative to a U.S. adult normative sample. “We intentionally set a high bar for thriving,” Devendorf noted.
Key findings show that roughly 9.8% (about 10%) of Canadians with a lifetime history of mental illness met the study’s thriving criteria. By comparison, about 24% of people without any history of mental illness met the same criteria. Among diagnostic groups, people with past substance-use disorders (10.2%) and depression (7.1%) were most likely to meet criteria for optimal well-being, while those with a history of bipolar disorder showed lower rates (around 3%). Anxiety and suicidal ideation groups fell between those ranges.
Devendorf emphasized that while thriving after mental illness was not the norm, symptomatic recovery was far more common. Approximately two thirds (67%) of individuals with any lifetime mental illness no longer met diagnostic criteria at the time of the survey. The authors suggest that many more people likely achieve moderate to good levels of well-being even if they do not meet the stringent threshold for “thriving.”
These results point to an important distinction between clinical recovery (absence of diagnostic symptoms) and broader outcomes such as flourishing, social engagement, and role functioning. “Therapy and medication are known to reduce symptoms,” said Devendorf, “but there is limited research on how treatments improve well-being and functioning. Now that thriving after mental illness has been documented as possible, future studies should investigate which interventions most effectively promote lasting well-being and life functioning.”
About this mental health research news
Author: Press Office
Source: APS
Contact: Press Office – APS
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Original Research: Closed access. “Optimal Well-Being After Psychopathology: Prevalence and Correlates” by Andrew R. Devendorf et al., Clinical Psychological Science
Abstract
Optimal Well-Being After Psychopathology: Prevalence and Correlates
Optimal functioning following psychopathology remains underexamined. Using a national Canadian sample (N = 23,491), the study operationalized optimal well-being (OWB) as absence of 12-month psychopathology together with scoring above the 25th national percentile on psychological well-being and below the 25th percentile on disability measures. Compared with 24.1% of participants without a history of psychopathology, 9.8% of participants with a lifetime history of psychopathology met OWB criteria.
Adults with past substance-use disorders (10.2%) and depression (7.1%) were most likely to report OWB. Those with anxiety (5.7%), suicidal ideation (5.0%), bipolar I (3.3%), and bipolar II (3.2%) were less likely to report OWB. Having a lifetime history of a single disorder increased the odds of OWB compared to having multiple disorders.
Although a history of psychopathology substantially reduces the probability of achieving optimal well-being, a meaningful minority of individuals with such histories do attain high levels of well-being and functioning.