Measuring someone's clarity of thought and overall level of functioning is a complex undertaking, whether or not the subject has a psychiatric disability. When we are dealing with anyone and obtaining facts about them, whether they are an acquaintance, friend or relative, most people automatically will perform guesswork as to the level of the person's functioning.
Over the years of being mentally ill and in contact with other persons with mental illness, I have had a chance to observe numerous people with mental illness, including myself. Some have had jobs or gone to school, some have not, and all have had their own challenges and assets.
The longer a person with mental illness goes without a relapse, the more their mental processing might improve. Or, processing might not improve if the necessary conditions aren't met.
In the process of dealing with life, a human being can grow, develop and improve. When essentially normal mental functioning is restored, it allows someone to chart their path. It is then up to that person as to whether they will get better with age, or, by allowing entropy to take over, will go downhill.
Examples of a person's "functioning level," might include but are not limited to: the amount of activity they can handle, being able to carry on an intelligent conversation, being more interested in life compared to less interested, attention span, making better or worse decisions, and being able to deal with adverse or good situations that arise.
Avoiding relapses of severe mental illness entails being medication compliant. If someone can go ten years or more without a relapse, it may bring an amazing level of clear thinking.
People with schizophrenia may feel as if their medication is preventing them from thinking. However, the difficulty may lie in the initial illness. Blaming the medication for difficulties that may actually come from the illness is a common misperception.
People with mental illness may have "mini-relapses" that can sometimes be induced by harder than usual circumstances, or by a spontaneous change in brain functioning.
If a person with schizophrenia begins to backslide a little, it may impact both the judgment of what's real, as well as the person's decision-making. If so, the person might, unfortunately, proceed down an incorrect path of thought.
If such a person decides that one of their main delusional perceptions is real, then every thought that follows will be based upon that error. Thus, a small relapse of psychosis can turn into a major relapse if it is not dealt with soon enough. If a small relapse is dealt with through getting treated, the bearer can soon get back on track with improvement in his or her level of functioning.
If a person with schizophrenia is taking the minimum dose of medication, a level that just barely keeps them out of the hospital, I believe it is less likely that the person's level of functioning will improve. The same idea goes for people who are on an excessive dosage of medication, since this isn't good for you, either.
However, if someone is adequately medicated and put into a good environment, improvement is more likely to take place. Part of a person's environment is created by oneself and results from the person's actions.
In fact, part of the environment in which we all live is our internal environment, made up of thoughts, perceptions and feelings. Some people have a good degree of control of their internal environment through meditation, affirmations, and/or self-coaching. Meanwhile, others do not have that ability.
People who are addicted to illicit drugs and/or alcohol have a tendency to deteriorate over time. Dual diagnosis treatment (for people with both a psychiatric illness and a substance abuse illness) exists.
Making an effort in life will almost invariably create a better outcome than not trying. However, not everyone is able to do that.
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