When a loved one has a psychiatric disorder, it’s a challenge for the whole family: parents, siblings, friends and relatives. The willingness to come to come together as a unit, accept the diagnosis, look for help, go beyond criticism, blame and judgement will not guarantee recovery, but it makes it far more likely. Denial and disapproval will only worsen the situation.
Family support (and by family, I mean a biological family or a chosen one) is vital to recovery. The support helps minimize the indignities and damage mental illness can inflict on an individual that would otherwise take place had the support not been there in the first place. It also can save a loved one’s life. As a mental health worker I saw the consequences and challenges that resulted when parents, relatives and friends refused to accept the illness or worse ostracised the individual who was struggling.
When I was first diagnosed with bipolar I disorder and psychosis, my parents’ acceptance, love and boundary setting was pivotal. Even when I lacked the ability to accept my mood disorder, I knew in the back of my mind, my parents were a ‘soft place to fall’. When I did eventually recognize I needed help, I knew I could turn to them. And I did. Do not think your kindness falls on deaf ears – our soul or our subconscious or whatever name you’d like to give it, registers far more than we realize.
Tips for supporting a loved one with a psychiatric illness:
1. Inform yourself as much as possible about the illness being faced. Get the truth not the myths. Local mental health associations are terrific resources to help you understand the illness and the route recovery often takes. It’s also an ideal place to find others going through or who have gone through similar experiences.
An excellent reading resource is “I Am Not Sick. I Don’t Need Help!” by Dr. Xavier Amador. His book gives practical suggestions about how to help someone with mental illness who doesn’t believe they’re sick. Understanding lack of insight (or more accurately: ‘anosognosia’) as a symptom of psychiatric disease and appreciating the process from denial to acceptance and then wellness is essential.
2. Start dialogues, not debates. If your family member doesn’t agree she or he has an illness, talk about it; find out why. Listen without trying to change them or their mind. Forget the power struggle. Focus on building trust and rapport.
3. However, in cases where a loved one is in acute psychiatric distress (experiencing psychosis or feeling suicidal for instance), getting him or her into the hospital is the wisest and best choice. I speak from experience, involuntary commitment saved my life. For more on this subject, read the post ‘Should Restraints in Psychiatric Care Be Illegal'?
4. Instead of guessing what helps: ask. Even if your family member has difficulty telling you what would be helpful, asking how you could support, demonstrates you don’t think you know best (even if you believe you do). It gives room for empowerment and self-awareness to take root. See if the requests are doable. Be honest with what you can take on. Once the discussion begins, keep it going. People’s needs shift with the path of the illness.
5. Seek counseling for yourself. The burden of dealing with a chronic and severe illness within a family is an enormous stress and the feelings that arise, conflicting. When my mother was ill with the swings of severe depression, mania, and anxiety, I was worried as well as angry. I needed someone outside the family to freely discuss my frustrations and hurt without the fear of upsetting her. A qualified therapist offers clarity, objectivity, solutions not previously seen and a place to safely deal with the emotions rising from such difficult circumstances. The healthier you are, the better equipped you become to handle demanding situations.
Check with your company or union to see if they have an employee assistance program that includes counseling. Spouses are often eligible too. If you don’t have access to an EAP, with some digging you can find affordable counseling. If you have a family doctor, ask him or her. Local health teams, community mental health centers, family services agencies, churches, even local universities offer supervised practices, and some therapists have sliding fee scales. If you can’t find anything reasonably priced, keep looking and ask others. If we create the demand, there will be a supply. Just ensure those offering services at reduced rates still have the appropriate credentials and experience. If you are going to put yourself in the care of someone, make sure that someone is qualified.
6. Check out support groups for family members of those experiencing mental illness. The resources listed below as well as community mental health teams, hospitals and your family doctor will either offer good programs or know of some. Check your local area for specific groups.
Other important reminders for family members and loved ones:
1. Keep yourself well and pace yourself. Over-extending yourself will only cause further problems in the long run.
2. Avoid falling into the role of ‘fixer’ and ‘savior’. No matter how much you love someone, it cannot save them.
3. Offering objectivity, compassion and acceptance is valuable beyond measure.
4. Know that even if your actions and love may seem to have little impact– they are making a difference. (Trust me.)
5. Have realistic expectations. The recovery process is not a straight line nor is it one that happens quickly.
It bears repeating: your love, acceptance and patience are more effective than you will ever realize. My parents likely will never know how important, how life saving and life changing their support was for me, especially when I was in full resistance mode. So although you may feel helpless and see little progress at times, without those three elements– any other kind of help is empty. It does get better. And please remember, treat yourself with kindness and find adequate support for yourself. A challenge like this is not easy – for anyone.