"No obstacles are insurmountable when God commands and we obey"
- - Heber J. Grant
June 8, 2012
Dealing with Survivor Mode
by Sarah Hancock

Recently I saw a woman I knew. I looked at her carefully. Her hair was disheveled and greasy. Her eyes looked tired, deep and sullen. She hardly made eye contact even though we'd served together for nearly two years. I recognized immediately that she was in survivor mode. During our conversation I discovered I was correct. Survivor mode.

If you aren't familiar with this term (because I make up my own) I use it to describe what happens when activities of daily living (ADLs) fall by the wayside. (ADLs include bathing, eating, grooming, dressing, and even sleeping) because the primary focus of a person's energy is spent maintaining control over their mind and body (i.e. forgetting to shower or eat because you are so determined to control thoughts and feelings, not the other way around).

If you haven't experienced survivor mode, you probably cannot fathom it. However, the reason I call it survivor mode is because most people can still imagine what would happen when placed in a life or death situation, where the survivor "fight or flight" instinct kicks in.

In survivor mode, even manners and discretion fly out the window because all energy is focused on keeping connected with the world or even alive. Sorry, that may sound extreme to some of you, having never lived with a mental illness. Let me assure you, if you ask your loved one who does experience a severe mental illness about survivor mode symptoms, he'll be surprised you understand it.

When a person with a severe mental illness experiences survivor mode, it is because he is in extreme duress. Generally, it occurs for one or both of two reasons.

First, a person might have every bit of hope drained from him (if you are familiar with Harry Potter, J.K. Rowling describes the feeling perfectly when introducing the effects of the Dementors on her characters). You may think, "This person has everything! Loved ones, friends and associates surround him. He has a job. He has good health. He has the gospel."

You're right. He does.

You may even think, "If I had his life I wouldn't be moping around." However, if you had his life, you would quickly learn he has probably tried everything he can to feel normal, but may (or may not) be diagnosed with a clinical illness.

Depression, bipolar, seasonal affective disorder, and PTSD are all biological illnesses that affect emotions. When I say biological, I mean they are caused by a chemical imbalance in the brain. You may think, "chemical imbalance? When I feel sad, all I do is use positive thinking and I feel fine."

Perhaps you can use positive thinking and feel fine because your chemicals are balanced. If I told a diabetic with a low blood sugar to think about juice to raise his blood sugar, that person would pass out, go into a coma and die thinking about juice.

It's much the same way with biological depression, only the patient doesn't go into a coma. Instead, he goes into survivor mode. If it's a biological disorder, depression hasn't set in because the person isn't grateful, lazy, apathetic, sinful or raised by bad parents. The person's depressed because the chemicals in his brain are out of whack!

The second reason a person can fall into survivor mode is because he experiences psychosis. Think about it. If your energy and focus are spent trying to ignore intrusive thoughts, disregard voices, or question everything going on around you to discern which is real and which isn't, additional mental and physical energy simply isn't available.

A variety of diagnoses can include psychosis. (It's not a definitive list, nor does it mean a person with that label experiences psychosis.) These illnesses include schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder and even situational psychosis due to or medical symptoms not even associated with a mental illness.

If the person is experiencing psychosis that is not induced by illicit drugs, the symptoms aren't due to laziness, poor parenting, possession, apathy or sin; the biochemicals simply aren't stable and survivor mode sets in.

For those of you who have loved ones who face depression, seasonal affective disorder (SAD), bipolar disorder, schizoaffective disorder, schizophrenia or PTSD, you may have seen your loved one go through it, not realizing what was happening. Maybe you even told him to simply "stop it!"

As President Uchtdorf pointed out, that advice works perfectly to stop hating, gossiping, ignoring, ridiculing and holding grudges, but it doesn't hold true for controlling brain chemicals. Chemicals can be changed by food, exercise, supportive environment, sunshine, therapy and (when needed) medication.

The best way to help your loved one in this situation is to not make light of it. Do you think he wants to feel like that? I mean seriously, would you? Stop calling your loved ones lazy, apathetic, worthless, or stupid (not that you would). Instead, encourage your loved ones to take steps towards achieving one or more of the ADLs.

You know how much better you feel when you take a shower, eat a balanced meal, or go for a walk outside. Chances are if you can lovingly talk your loved one into doing the same, he will find a little bit of relief too.

In my experience, often times when people talked to me about poor hygiene habits, commanding me to go take a shower or do a load of laundry, I can honestly say it went in one ear and out the other because my entire focus was elsewhere. However, several true friends and family members helped me out of survivor mode on different occasions by taking time to come over, help me make a grocery list and then take me shopping.

Sometimes friends took me outside for a walk or drove me to the beach, taking the time to listen. One friend invited me to try a fun-smelling shampoo, handing me the bottle. A couple of friends and family members came over to simply help me make my bed and straighten my bedroom. It always eased the situation, if only momentarily, and was always deeply appreciated. Being cheerful and nonjudgmental when offering assistance makes all the difference.

Anyone who is experiencing survivor mode may need professional care. I would suggest a counselor and/or a doctor. (It can become very draining for family or friends to step into a role for which they aren't trained. More often than not, a friend or family member wants to do whatever he can to help the person in need, without establishing healthy boundaries. If those healthy boundaries aren't in place it eventually causes burnout, later leading to anger and resentment.)

Sometimes the smallest act of kindness can get your loved one headed in the right direction. If you are in survivor mode, ask for help from the right source. If you get help, survivor mode will not last forever. As President Hinckley said, "Life is to be enjoyed, not endured."


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About Sarah Hancock

Sarah Price Hancock, a graduate of San Diego State University's rehabilitation counseling Masters of Science program with a certificate psychiatric rehabilitation.

Having embarked on her own journey with a mental health diagnosis, she is passionate about psychiatric recovery. She enjoys working as a lector for universities, training upcoming mental health professionals. Sarah also enjoys sharing insights with peers working to strengthen their "recovery toolbox." With proper support, Sarah knows psychiatric recovery isnít just possible ó itís probable.

Born and raised in San Diego, California, Sarah served a Spanish-speaking and ASL mission for the LDS Church in the Texas Dallas Mission. She was graduated from Ricks College and BYU. Sarah currently resides in San Diego and inherited four amazing children when she married the man of her dreams in 2011. She loves writing, public speaking, ceramics, jewelry-making and kite-flying ó not necessarily in that order.

NAMI San Diego's Fall Keynote Address: Living in Recovery with Schizoaffective Disorder

Having recently moved into a new ward, she currently serves as a visiting teacher.

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