Recovery is a verb—a process—for many individuals living with mental health disorders. For people like myself, there’s no fixed point at which we can say, “I’m in remission!” or “I’m cured!” Instead, we must manage our illness (or illnesses) for the rest of our lives, leveraging learned coping skills and physical practices, interpersonal relationships, therapeutic intervention, and/or medication. For too many people, however, these important treatments are out of reach.
According to Mental Health America’s most recent State of Mental Health in America report, more than 60 million adults in the U.S. experienced a mental illness in 2024. In 2022 and 2023, though, a quarter of these adults reported an unmet need for treatment, while more than five million were uninsured. Of the more than 46 million adults who experienced a substance use disorder, more than 77 percent did not receive any treatment. According to provisional data from the U.S. Centers for Disease Control and Prevention, more than 49,000 people died by suicide in 2023.
For anyone familiar with healthcare in the United States, this won’t come as a surprise. Our healthcare system is complicated, unjust, and leaves too many behind, regardless of which health condition someone lives with. In 2025, for example, the New York Times reported that “officials skipped patients on [organ transplant] waiting lists for nearly 20 percent of transplants from deceased donors,” leaving hundreds of patients out to dry, regardless of severity of illness or length of time on the registry. Furthermore, the investigation found that more than 1,200 people died over five years after being skipped while at the top of a waiting list. There are number of reasons for this, but the results remain the same: people frequently don’t receive the care they need.
When it comes to mental health, stigma and misinformation add to the complexity of receiving care. Mental health and substance use disorders, often combined under the umbrella of “behavioral health,” are often seen as moral or personal failings as opposed to legitimate health conditions. While these types of conditions are not the same, responses to disclosure tend to be similar. “Just cheer up,” someone might say to a person experiencing depression, or they might say, “Just quit!” to a person with a substance use disorder.
But if recovery were that easy, millions of people wouldn’t be suffering.
Those of us lucky enough to have access to therapy and medications can attest to the importance of these supports—if we find the right ones. All therapists are not created equal, and a person in the midst of experiencing symptoms might need to experiment with a number of providers and try various therapeutic modalities before finding the most helpful ones. Medications, similarly, often take trial and error. Even if someone finds a cocktail that works, many psychiatric medications come with a host of potentially life-altering side effects. Are the benefits worth the risk? How many other medications are needed in order to manage these side effects?
Take weight gain, for example. It’s a common side effect across a variety of psychiatric medications, as outlined by Harvard Health Publishing. With all the discomfort, risks, and comorbidities associated with being overweight or obese, weight gain has huge implications. For some people, the symptom management benefits of a particular drug outweigh the potential harm of side effects. For others, however, these side effects are unacceptable for any number of reasons, which can lead to jumping around between medications to find a combination they can live with.
Another critical consideration for both therapy and medications: cost. If one is lucky enough to have decent, low-deductible insurance coverage, cost may not be a barrier to treatment. But for those with high-deductible insurance or no insurance at all, these costs can be insurmountable. For example, the list price for Vraylar, an atypical antipsychotic used to treat schizophrenia, bipolar disorder, and major depressive disorder, is more than $1,500 for a 30-day supply. Insurance may or may not cover this particular treatment, particularly if a patient has not “failed first” on other medications. Patients can apply for various savings offerings, if eligible, but imagine dealing with symptoms of these mental health conditions while needing to fight for treatment. Not an ideal situation, to say the least.
But once a person accesses help, is provided crisis support, or their symptoms become manageable, they might be able to engage in other activities that support recovery. These activities might include dietary changes, exercise, creative pursuits, or attending peer support groups. I’ve personally turned to yoga and meditation, as well as copious time spent journaling, to support my own mental health recovery. Therapy came first, for me, followed by medication, then these other tools. But my journey is but one example. Others’ stories of recovery, such as those shared in the “Living Successfully with a Mood Disorder” course from the Depression and Bipolar Support Alliance, share more paths to recovery than I could ever describe.
Recovery is possible for all people experiencing mental health conditions, if a person has the ongoing supports and care they need. Just as symptoms are variable across individuals, recovery will look different for everyone.
If you are in crisis or need immediate support, please call 988 to connect with the 988 Lifeline or text HOME to 741741 to be connected to the Crisis Text Line.
Casey Coukos 