Don’t Hit Rock Bottom: The Value of Early Mental Health Treatment

The myth that you need to hit rock bottom in order to recover is a dangerous fallacy that keeps people from seeking the help they need. Understanding why you shouldn’t hit rock bottom and why early treatment matters is essential to making the best decisions for you or your loved one. So too is recognizing the value of residential treatment when outpatient care fails to fully address your needs.

The myth of rock bottom is powerful. The idea that we must hit our lowest point in order to find the strength to seek the help we need and commit ourselves to recovery is one of the most common narratives we hear again and again in the world of mental health and addiction. When your loved one is resisting treatment, the myth can in some ways be comforting; their time simply hasn’t come. The myth tells you that they are not yet at a stage in their personal process to receive care—they haven’t reached their lowest lows, those that will propel them toward healing. They just have to wait.

Families of those struggling with mental illness aren’t the only ones who often cling to the rock bottom myth. Many of us living with mental health disorders set arbitrary markers in place for when to seek what kind of care. Weekly therapy may seem sufficient for now, but if things get really bad, that’s when you’ll look into residential care. Despite the fact that you are living in a constant state of illness and not seeing real, lasting improvement on an outpatient basis, residential care may seem like such a drastic step that it requires drastic symptomatology—something definitive. When you lose your job. When your marriage falls apart. When you try to kill yourself. That’s rock bottom. That’s when you’ll go.

But just as the myth is powerful, it is also dangerous. “[Over and over again people are told] they had to let their kids, their husbands, their wives, whoever it was, they had to stand back, not intervene, let them hit bottom so they would crawl into treatment and say, ‘Please help me,’” says David Scheff, author of Beautiful Boy: A Father’s Journey Through His Son’s Addiction. “That idea, it is so dangerous. It has killed so many people.” Because the truth is that with each step you take toward rock bottom, the more difficult recovery becomes.

Why You Shouldn’t Hit Rock Bottom


The lie of rock bottom tells us that by falling into the depths of despair, we will finally be able to summon the desire and motivation needed to participate in healing, and it is only then that true progress will be made. The truth, however, is that in the case of every single illness, early treatment leads to better outcomes. It is true for mood disorders, it is true for psychotic disorders, it is true for anxiety disorders—it is true for every single mental illness that has been studied. There is no condition that benefits from delaying care.

According to Mental Health America, “Early intervention, accurate diagnosis and effective treatment of mental health conditions can alleviate enormous suffering. Providing early care can help people to more quickly recover […] and ultimately lead more meaningful and productive lives.” The evidence for this is ample. As Caroline Miller, editorial director of the Child Mind Institute, writes, “The right treatment within the first two to three years after the first [psychotic] episode has been shown to decrease relapses of psychosis by more than 50 percent and prevent much of the disability associated with a psychotic illness.” Research also shows that “treatment delay [is] associated with a persistently more adverse course of illness” in people with bipolar disorder, and early intervention is now considered a priority in bipolar disorder treatment. Meanwhile, people who fail to recover within three months following a traumatic event are at risk of developing chronic PTSD. The data is consistent, regardless of the nature of your mental health disorder: the best way to heal is to seek care quickly.

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Why Early Treatment Matters


The reasons early interventions produce better outcomes are complex and not always fully understood. What we do know, however, is that all forms of mental illness disrupt normal brain function and can, over time, produce both physical and functional changes in the brain. These can include abnormal neurotransmitter function, loss of gray matter, structural neuronal changes, and damaged neuronal connectivity. While the brain is a resilient organ with a remarkable ability to heal, that healing is most successful if initiated early. If treatment is delayed, the damage to the brain may become progressively worse, making it more difficult—or even impossible—to reverse the destructive impact mental illness has had on your brain.

At the same time, untreated mental illness wreaks havoc on your life emotionally and behaviorally, often preventing you from being able to participate in vital activities such as work, school, and relationships. The isolation, loss of purpose, damaged self-esteem, and strained social connections that so often arise out of mental illness can be devastating and push you further and further into despair. In the absence of healthy coping mechanisms, you may develop maladaptive emotional and behavioral patterns that become more deeply rooted as time goes on. Recovering from these painful aspects of mental illness takes time and the more severe your illness is, the more difficult it becomes. Seeking treatment early gives you the opportunity to limit the damage done and makes the path to recovery less arduous.

The Value of Residential Care


While increased awareness of mental illness in both general and clinical settings is helping people connect with treatment earlier than they have in the past, the treatment must be of the right kind and quality in order for true healing to be possible. Treatment should not simply be a holding pen that prevents you from getting worse or keeps rock bottom at bay. Instead, it should open up the door to true recovery and a restoration of self; your mind, body, and spirit should all be engaged in a project of healing and the creation of new paths toward stability, joy, and love. If that kind of healing is not happening within an outpatient environment, it is time to consider residential care.

Unfortunately, many people resist the idea of residential treatment because they do not believe that their suffering is severe enough to warrant the intensity of care residential environments offer; they believe they have to hit rock bottom before residential care becomes a possibility. This is a dangerous fallacy; if outpatient treatment isn’t actually treating your illness in a meaningful and comprehensive way, your illness essentially remains untreated.

The truth is that residential treatment isn’t just for people who have hit rock bottom, nor should it be; as with all forms of treatment, it is more effective the earlier it is initiated. Rather, residential treatment is for anyone whose needs are not being adequately addressed on an outpatient basis. Here, you will find people with a wide range of conditions and experiences. What they share is not a severity of illness, but a commitment to self-growth and discovery that will ultimately allow them to lead richer, more authentic lives. By making the commitment to recovery in a place where you are able to fully engage in the healing process, you can optimize your chances of success and create the best possible outcome for both your illness and your life as a whole.

Bridges to Recovery provides comprehensive, residential treatment for people struggling with mental health disorders as well as co-occurring substance abuse disorders. Contact us to learn more about our innovative program and how we can help you or your loved one start the journey toward lasting wellness.

Image Source: Elena Saharova