Table 2 Coding framework of mental health recovery
Main theme | Examples |
|---|---|
A. Domains of Post-traumatic growth A.1 Relating to others | “My relationship with my sister and my niece makes me happy, I have no children, my niece calls me mama” (#15) “There was a psychiatrist who taught me in the church, he helped me, he knows about my illness, he supported me, checked on me regularly, and he motivated me. All that was for free” (#8) “My sister Nora is very close to me; I trust her very much” (≠ 1) “I now have compassion for others, I can connect with people, I was arrogant before the experience of mental illness. I now help people and engage in volunteer activities, the pain I went through gave me empathy for others” (≠ 8) “I learned how to be assertive, how to set boundaries and how to express my feelings without shame” (#3) “Recovery means being assertive and being able to defend the self from abuse or harm” (#5) |
A.2 Spirituality | “Being a believer has a huge impact on me, it calmed me down after the constant anxiety and fear which were massive after discharge from the hospital” (#1) “I was scared to deal with people, I had no idea what to do in life and work. After my spiritual relation with God, these fears haven’t disappeared completely but were less” (#13) “I turned out to believe that I shouldn’t worry too much about everything, all what I should do is to work hard, God is there for me” (#6) “The spiritual and religious practice have helped me in my journey so much” (#4) “I’m close to god, I do the prayers that have helped me in my journey with the mental health problem” (#8) “ religion gave me serenity” (#16.) |
A.3 New possibilities | “My experience with the mental health issue made me see my options in life from a different prospective; I can now see the opportunities I have and I can use it all” (#8) “The experience of mental illness made me mature, if you look at my life in 2017, I was staying at home, although I had achievements like admitting to medical license exam step (1), but now is the best stage, I am realizing my dream, my social life is very satisfying” (#9) “I would not achieve what I have now without passing through what happened to me, without the trauma, my life would remain on the old pattern I had before the experience of mental illness” (#1) “The experience of mental illness made me mature, if you look at my life in 2017, I was staying in home, although I had achievements like admitting into the medical license step 1 exam, but now is the best stage, I am realizing my dream, my social life is very satisfying” (#13) “so I would not achieve what I have now without passing through what happened to me, without the trauma, my life would remain on the same pattern it has prior to admission to the hospital” (#17) “having faith that new possibilities exist” (#6) “I realized that there could be other possibilities in life I could enjoy” (#3) |
A.4 Identity and Strengths | “After my recovery, I feel full from inside now, before it was emptiness” (#4) “I regained my ability to dream and this is a big achievement” (#7) “I’d say that my personality was markedly changed during this recovery process, I now see the difference between myself and the person who was admitted to the hospital 9 months ago, I used to be a very shy person who keeps to himself and absorbs abuses from others and accumulate bad thoughts and feelings to the limits of mental breakdown I’m no longer that” (#11) “ Being resilient has helped me a lot, it is important for people who have mental health issues to move on and keep going with all the struggles we face” (#8) |
A.5 Appreciation of life | “I feel better as I try again, I try to be better, I try to have dreams, I resist surrendering to death. I hated being dead where I’m still living” (#10) “. I started doing things I like again although in the beginning I wasn’t feeling happy to do it but with time, I regained my passion toward it” (#15)” I decided to do what I’m supposed to do as God wants me to be alive. when I feel down, I remember how I buried myself. I started to resist with my whole power and I feel scared to evoke my old identity” (#7) “Recovery means to feel the blessings you have even in the presence of struggles. It means you don’t feel disconnected” (#13) “Recovery means being able to live a better life, not just surviving, living. I know I’m recovering as I started to love myself” (#17) “I resist surrendering to death. I hated being dead where I’m still living. I started doing things I like again although in the beginning I wasn’t feeling happy to do it but with time, I regained my passion toward it. I decided to do what I’m supposed to do as God wants me to be alive” (#11) “When I feel down, I remember how I buried myself before, I resist with my whole power and I feel scared to evoke my old dead identity” (#7) |
B. Acceptance | “The idea that relapse is possible, I’m not afraid of it” (#1) “Relapse can happen again, I think I’m prepared, I know what I should do” (#2) “I accepted my downs and relapses alongside doing my best” (#3) I accept all what I have been through either good or bad” (#1) “What I feel from my journey is I’m worthy of respect “(# 4) “In my views, I think recovery is acceptance, acceptance is the core of recovery and being free. The therapist has a role in teaching the patient how to accept his vulnerable human nature” (#15) “Recovery means accepting pain not avoiding it because avoiding it is inhuman and illogical” (#15) “Recovery means being able to deal with the pain, being able to receive and give love” (#5) “accepting one’s journey as it is and being able to deal with its reality” (#6) “I accepted my feelings (#3) “I can now forgive and let go of the past” (#7) |
C. Functional recovery | “Recovery is to be able to complete your daily tasks and be up to your role in your family and surroundings, and able to engage with people around you” (# 2) “Work is important to me it is a big step” (# 9) "doing something useful in life is very good. By logic, what is its benefit (laughter), just to be happy in life without doing anything useful??? (#1) “it’s all about the ability to work, work is important” (# 10) “I think to recover from a mental disorder is achieved when a person can do his daily tasks and ease through the day without any disruption that comes from the mental disorder he suffers from. For me, waking up every morning, going to my work” (# 11) “I know that I’m improving when my interaction with people around me gets better, being able to create relationships and gain social skills and engage in many activities” (#12) “Recovery means that you can go on with life, do your duties, resume your activity” (#13) “I now go to work, I pray, I go to a dietitian, I go out weekly with my sister, and I go to gym. I have a strong will, there are lots of achievements I guess” (# 14) “I hated the disability resulting from mental illness, I know myself, I’m not that disabled, now I’m functioning, have a prestigious career, aspiring to do post-grad studies” (# 8) |
D. Hope | “I love life despite its pain, I was sure my feelings, and my love of life can help me get through anything” (#7) “I’m still lonely and I still lack the full ability to communicate with people but I still have hope and dreams” (#7) “The recovery process gave me hope and an optimistic view on the future” (# 2) “Hope is the key; I never give up” (#8) “It is my ability to find hope” (# 6) |
E. Clinical recovery | “I know I’m in recovery when I’m not doing any bizarre behavior or being aggressive” (# 12) “when I no longer experience symptoms” (# 9) “I feel like recovering when the somatic symptoms and nervousness decrease” (# 15) “I feel like I have improved 90% (that’s my parameter), when I feel good, no nervousness, no anxiety, no insomnia” (# 16) “Recovery means absence of most symptoms till 90%, I sometimes experience symptoms but not disabling like before” (# 8) |