Back in the Driver’s Seat

Published in Hopkins Medicine - Winter 2022

Most people with mental illness don’t want their lives defined by their condition, Johns Hopkins psychiatrist Margaret Chisolm notes in her new book, From Survive to Thrive: Living Your Best Life with Mental Illness. “They want to get back in the driver’s seat. They want to get back to a life where they can feel satisfied, fulfilled and happy in whatever they do.”

The work serves as a guidebook to move forward. First, Chisolm explains the holistic approach to diagnosing and treating mental health conditions taught at Johns Hopkins. Then she presents four pathways people can use to get unstuck and progress toward achieving a richer, more meaningful existence through involvement in work, education, community or family life.

Chisolm, who has experience seeing patients for more than 30 years, says people with mental health challenges are capable of making vast improvements and can go on to build or resume lives that are happy and fulfilling.

“Psychiatric problems are nothing to be ashamed of, and everybody needs help sometimes,” says Chisolm, vice chair for education for the Department of Psychiatry and Behavioral Sciences and director of the Paul McHugh Program for Human Flourishing, which fosters a humanistic clinical approach to patient care. “Even with severe psychiatric problems like schizophrenia, traumatic brain injury or manic-depressive illness, people can still lead flourishing, full lives. They can still thrive despite — and sometimes even because of — their psychiatric illness.”

As case in point, Chisolm shares her own mental health history starting in the third chapter. As a 35-year-old new mother with postpartum depression, she suffered extreme fatigue and experienced difficulty sleeping, sadness, guilt about working outside the home and worries about the sudden death of her child. She then walks readers through a comprehensive evaluation of her condition, including her family history and a brother with mental illness, and reveals how understanding her own personality type as “an extremely neurotic introvert” helped her process her distress and understand why she needed help.

Throughout From Survive to Thrive, Chisolm sprinkles self-reflection exercises that are simple to follow for patients, or even their caregivers and friends, to assess health and happiness and forge a path to greater life satisfaction. She also presents readers with these uplifting concepts that drive power to change:

Mental well-being and happiness depend on a good fit between a person’s personality and circumstances. Although people may not be able to change their temperaments, they can change the way they think and act in response to events.

There is little people can do on their own to modify underlying changes in the brain leading to disease, but that doesn’t make them helpless. Daily exercise, avoiding substance use, getting a good night’s sleep and getting out of bed during the day — along with seeking professional help when needed — can benefit everyone.

Each of us is sometimes impacted by distressing life events. The process of “rescripting” can help people apply a more positive, optimistic interpretation to memories of these events.

“I wanted to destigmatize mental health,” Chisolm says. “Sometimes these diagnoses are devastating to patients and family members. Some severe psychiatric illnesses can change a person’s life trajectory … It’s a message of hope that these illnesses are, for the most part, treatable. Even when there are chronic symptoms or an inability to recover full functioning, you can still lead a meaningful life.” 

A Personal Prescription for Well-Being

In her new book, a Johns Hopkins psychiatrist’s own account of mental illness and recovery advises readers how to live a purposeful life.

Photo of Meg Chisolm