Why do some people manage their symptoms better than others?

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Not to promote the "Who is Sicker than Who" Olympics here. It's just occurred to me that oftentimes I notice that some people with mental health issues seem to be extremely proactive and very good at managing their symptoms while others continue making the same mistakes and having the same issues as they did before.

Now everybody is different and mental illness is different for everybody, but I have noticed even in my own life how some people with more severe mental health problems than me such as Bipolar Disorder or BPD are very self aware and very sensible about their treatment and self care. Obviously I don't know the full extent of their issues, but I am in awe of their abilities while I have much less severe issues and seem to be very bad at managing my stress levels, my executive dysfunction, my anxiety, my low mood, etc.

I've noticed that in online communities, some people are incredulous to the fact that other members of the community suffer the same condition as them as they are comparatively much more high functioning while having the same symptoms. It's sad that people do that, but I get it. It can feel frustrating to see others just do so much better than you while you're way behind. You know not to compare yourself to others, but you can't help it - it feels crummy when you consistently fail to meet your target goals in therapy or just in life. It's even worse when you have worked hard at it and seem to fail anyway.

Could it be that these people are just more persistent and much more proactive? Could it be that some of these people just have a great therapist? Maybe a very supportive family? Could they just have the grit and integrity to soldier on even though it's difficult? Or maybe they have more realistic therapy goals than others? Perhaps they don't ruminate as much and use that mental energy on something productive?

It's fascinating and I'd really like to know what your thoughts are.

I think it is very circumstantial. Depends a lot about what tools you have and how you learn to use them. I guess everyone is at different stages of their process to deal with their health issue. No two people are the same, even though biologically the body responds the same way, psychologically the cause and how you deal with it is different. Some people have it easier than others, some hide it better than others. In the end of the day, we are all dealing with something. What you might find it easier to cope, another will find it extremely difficult.

That's true. I think I may also be operating on the fallacy that certain treatments are going to work for me because they are the most recommended by doctors. However not every problem can be fixed with mindfulness, nor does it claim to. Not everybody does well with traditional CBT and may do better on a different kind of therapy. I think some of my lack of progress has to do with the patchy mental health support I have had throughout my late teens and adulthood. I wasn't referred for CBT (even though they said they would) and I only got to see my CPN every two to three weeks and she hardly did anything. Compared to how people get weekly sessions with a therapist who works closely with their case, I suppose I can't beat myself up for not making the progress I want to make.

Plus, I was moving between different cities for months at a time so trying to refer me was just unfeasable. And when I did do a few weeks of CBT based therapy through the uni, I did see a difference, albeit a little one.

I know I am awful for compounding my own problems and self fulfilled prophecies, but I guess that's the nature of the beast, isn't it?

I can relate with you. In my late teens I had problems with depression and SI, but never got the tools I needed to learn to deal with it. More than 10 years later, many different psychologists after, and taking antidepressants on and off, I need to make my life easier for me.

For many mental health issues like depression and anxiety (I have GAD) you can manage without the pills, but it is obviously harder. I workout a lot, eat healthy and do things that I find enjoyable and stop doing things that make me miserable. I think with years you will eventually learn what works for you. But meeting a psychologist for longer than 2 months has really helped me - just talking about my issues helps me make it less catastrophic (when you say things out loud, it often sounds ridiculous, and it often is ), as well as hearing her point of view to help me snap out of it (I am quite obsessive). I actually asked her to meet every week, and now we meet every two weeks, and I will decide when to stop. Now I am moving during the summer, and I will continue meeting another psychologist in the new place.

If you stick with something it always gives results. Be patient. I don't know what you have, but in all cases, one has to be patient, because things never change over night. Eyes on the goal, and ignore the rest

I'm currently in the process of an ADHD diagnosis which obviously takes a very long time. The diagnostic tools they use seem pretty straightforward but I reckon that my next session is in a months time because they need to make sure that my answers on the screening tool are consistent and not contingent on external factors. That's fair enough, but it sort of leaves me in the dark while I try to be a functioning adult.

For the sleep problems I have, the GP recommended that I exercise more often. My sister thinks it's a good idea as she reckons I have a lot of nervous energy that doesn't properly go to good use. Plus, I'm a bit overweight so I could do with it. Unfortunately thought exercises don't work for me to get to sleep because I just can't control my racing thoughts without being exhausted. So I guess physical exercise is the better option at this rate.

As for executive dysfunction, I'm trying to set timers and incentives to actually complete daily tasks, such as giving myself only a few minutes to do dishes so that I have to do it quickly. That way I am less likely to lose focus. My family are trying to help by writing lists whenever they want me to get something done because I'm not going to remember it if it is not written down. Obviously I write my own lists, but my biggest issue is trying to remember to make my goals realistic (especially for projects). It feels frustrating because there are so many things I want to do but struggle to maintain anything for long enough without burning out or getting bored. I am also terrible under pressure so I need to learn how to manage that. Honestly, I can't even begin to tell you everything I suck at when it comes to executive function. Just frontal cortex is just a slacker.

As for depression, I am on antidepressants. I have been on the same antidepressant for years and I don't like it. I gained a significant amount of weight since starting it and while I am happy that it helps me function, I am sick of needing it. I feel like I should be past this. I would at least like to reduce my dose down to 30mg to see how I manage. I think it is something I should bring up with my doctor again.

That last one fits me closest. After a series of traumatic events in the 1980s (bankruptcy, divorce, homelessness, joblessness, et cetera), I was determined to make something of myself, even if it gained me the reputation of a mean, ruthless jerk. I burned a few bridges behind me (the ones that others hadn't already burned), and took off on my own. This determination was more than just a very strong wish, it became a vendetta - my only reason for living.

Now I have an MSEE, a comfortable home, a lovely wife, veteran's benefits, and a portfolio of investments to finance my retirement.

I know that others may be unable to function without support from others; but I'll never go back to living like that if I can at all help it.

I hear stuff like that, and it really gives me hope. Honestly it does.
I'm no where near that position, but I get really hopeless occasionally (often?).
People wonder where I get the energy to exercise so intensely at a moment's notice- it's intense excruciating determination to do so. I know "brute-forcing your way through everything" is definitely not the smartest way to do stuff, but sometimes it's the only trick up my sleeve that I have.
In the meantime, I should work on smarter strategies to work on what I want to work on.

However, there is ALWAYS someone above you and below you- in every single domain and aspect of life. ALWAYS. There will be someone that did much more than you with much less or as much as you and still did more, people are just utterly different.
Also, it is good to sometimes check around you to look and see how others are doing in comparison to yourself and to see what you can learn, but I find that it is MUCH MUCH MUCH more useful to think of living as a race against yourself and your own goals for the trajectory of your life, than as a competition or fight against others who are also running- all at different point in their lives.

Why do some people manage their symptoms better than others?

Two thoughts:

1. they may simply have learned to temporarily compensate but the symptoms still exist and the piper will need to be paid later.

2. the Blank Slate theory, that everyone is identical at birth in terms of mental & emotional abilities and all behaviors good or bad are a result of learning. It never had any actual science to back it up, was just a well promoted pet theory in the 1960's and 70's and was debunked years ago. Yet it persists in our cultural memory. In reality, everyone is born with different mental abilities and tendencies toward different emotional reactions. Layered on top of that are our learned behaviors, some of which are set during specific developmental periods & some of which are actually are plastic and can be un- or re-learned.

In other words, everyone is born different and grows to be a different person. In light of this, people will have varying degrees of each symptom and varying degrees of innate ways to compensate and learned ways to either hide it or accept it and maybe work around it. It's not helpful to ask then why some manage better than others when there is no proof that they are even 'managing' the same things.

Wow, these are some great responses!

On the subject of determination, I was way more like that when I was younger. When I started college, I was reading all the time and trying to learn whatever I could about film theory. I was also working at a cinema and working on film workshops outside of college. I pushed myself to the point of regular sleep deprivation and digestion problems. In fact, it happened to me at uni and it happened to me at my last job. I'm not afraid to go the extra mile, but I am afraid of the state I was in when I pushed myself like that. I think the high cortisol levels led me to my current weight issues, haha. But then perhaps part of being determined is knowing your limits and learning to use self care to increase your productivity. Because I didn't do that, I've consistently set myself up to fail, so no wonder I'm a pessimist.

Regarding the Blank State Theory, I agree that our culture often assumes that everyone starts the same as babies even though, right off the bat, we are all born in different environments and different socioeconomic conditions from one another. That's not even taking into account the genetic factors that come into play. So I suppose that is why we are often told not to compare ourselves to others. That being said, there are certain standards expected of people in terms of adapting to the working environment, for instance. In my line of expertise, you have to work long hours and you have to finish work by a ridiculously short deadline. There are real issues with workers rights and burnout but sometimes you just have to get on with it or else you can't get a leg up in this world. My fear is that I will not be able to get on with it for very long. But then again, perhaps I have to accept the limitations of my disability. Not giving up but rather finding a nice medium and putting my needs first.

This.

Personally, I manage as well as I do thanks to the nhs putting me through boatloads of therapy, I'm able to put up a very effective mask but it can be exhausting.