Even before the COVID pandemic, nearly one in five American adults was dealing with a mental illness of one form or another. Their attendant struggles ripple outward into the lives of family and friends. Serious mental health conditions run high among unhoused and incarcerated populations: According to the National Alliance on Mental Illness (NAMI), 37% of inmates in state and federal prisons have a diagnosed mental illness. In the United States, suicide is the 10th leading cause of death.

And then the coronavirus struck, exacerbating social isolation and economic insecurity. Anecdotal and preliminary data suggest a widespread blow to mental health. A CDC survey from June 2020, for instance, reported double the pre-pandemic rates of anxiety or depression, new or increased substance use, and stress-related symptoms.

But psychiatrist Margaret Chisolm, a professor at Johns Hopkins University School of Medicine, insists mental illness need not define people nor consign them to a life on the margins. History provides examples of artists, writers, and visionaries (such as Dr. Martin Luther King) who have pursued their full potential despite addiction, depression, eating disorders, and other serious conditions. Dr. Chisolm has seen many patients manage their illnesses and soar. She calls this flourishing—a journey toward satisfaction, happiness, and financial security.

Dr. Chisolm has gathered insights from decades of clinical and life experience into From Survive to Thrive: Living Your Best Life with Mental Illness, an interactive guidebook for patients and their family members—or just about anyone—searching for a path toward greater well-being. Among her observations:

• Successful treatment considers the whole person. Reducing people with mental health conditions to “diseased brains” or “imbalanced chemical profiles” ignores the important role of our unique histories and personalities.
• Everyone experiences periods of “demoralization,” but what can bog us down—or set us free—is the story we tell ourselves about those turbulent times. Human beings make sense of life’s chaos by imposing a narrative, with a setting, a sequence of events, and an outcome. If that story has led to a defeating explanation of circumstances or events in our lives, we can “rescript” it with more positive and uplifting interpretations.
• Although people may not be able to change their temperament, they can control how they react to their feelings. All of us are born wired with differing levels of neuroticism, extraversion, openness, agreeableness, and conscientiousness. These remain fairly stable as we age. But when we can recognize who we are (“the gift of individuality”) and what provokes us, we can avoid unhelpful responses and move closer to flourishing.
• Mental health professionals best serve a patient when they hold off on diagnostic labeling until they understand that person as an individual. Information gathering should include a detailed history; conversations with the patient’s friends, family, and other care providers; a comprehensive mental status exam; and observation before interpretation.
• Some mental conditions require professional treatment and medication, but we can all benefit from “metaphorically kicking ourselves in the rear.” Nature and nurture contribute to behavior. Although we can’t undo biology and history, we can make good, commonsense choices: to keep learning, working, and connecting with family (of any kind) and community. One good choice often leads to another.

“Into each life, some rain must fall,” wrote poet Henry Wadsworth Longfellow. As Chisolm notes, rare are the individuals who find their life perfect. “Most of us are works in progress.” But we all have the power to act and, with reasonable expectations, to reach our goals