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
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
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
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
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."
Sarah Hancock is currently in her final year of studies at San Diego State University's
Rehabilitation Counseling Program (just voted 9th in the Nation by U.S. News & World Report)
with a psychiatric emphasis. A portion of her internship was spent as the Coordinator of
Disability Services Office for Alliant International University's San Diego and Irvine Campuses.
Having embarked on her own journey with a mental health diagnosis, she is passionate about
Psychiatric Recovery and teaching others how to strengthen their "Recovery Toolbox." Sarah
finds comfort in writing, having completed more than 29 journal volumes. She teaches
occasional recovery workshops using principles she learned from Recovery Innovations.
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 the San Diego area with her husband. They have four teenage children.
She currently loves serving as Young Women secretary and ward missionary.