Help your loved one’s cope with mental illness

‘My daughter means the world to me.  A beautiful, talented and well-rounded personality-it breaks my heart to see her this way.  She used to be bubbly, fully of life and energy, always happy and smiling; until this disaster hit.  All of a sudden, soon after her board exams, we began noticing the changes……. rapid mood swings, temper tantrums and extremely suspicious…. she even accused me of poisoning her food” further sobbing…” She hardly eats or sleeps anymore.  She does not talk to her friends.  Sits at her window, staring outside all day.   My only daughter; how can I help her?”

It breaks my heart, each time I have these conversations with the family members of my patients.  It can be heart-wrenching to see a loved one struggling with symptoms of mental illness especially when you do not understand why or what is happening.

Watch out for the symptoms

What are the warning signs that you need to know about?  A well-known preacher once lost his family, his career and almost his life because those close to him didn’t know what was happening with him.  It took years for him to be diagnosed as bipolar, to be treated and stabilized, during the course of which, he was separated from his wife, his kids, was ridiculed by his followers and mis-understood by the society at large.  (watch out for his story in the upcoming articles).

So, what are the warning signs?

1. Withdrawal from social contacts, friends, family and loved one’s; quitting sports, failing in school or difficulty performing familiar tasks
2. Unusual problems functioning at school, work or social activities, constant fights, or getting in altercations.
3.  Dramatic changes in sleep and appetite
4. Rapid mood changes
5. Changes in thinking, increased sensitivity, illogical thinking, paranoia, magical thinking, increased or illogical beliefs of personal/super natural powers, problems with memory, concentration or speech.
6. Odd behavior’s, loss of interest or initiative, dis connection from self or others

Know that these are not the complete signs of mental illness but are some of the indicators to know that mental illness could be a possibility and the person needs professional help.

Approach the topic:

Approaching the topic with your loved one, or talking about the possibility of a mental illness can be one of the hardest tasks to accomplish.  Yet it is the most important one.  Show your concern and willingness to help.  Make it sound as non-judgmental and matter of fact as possible.  Remind them that seeking help is critical for timely diagnosis and treatment planning.

Most importantly, listen!  Listen to what they are saying and what they are trying to say.  Look for the non-verbal cues.  Put yourself in their shoes and try thinking about what is happening inside their minds. Adjust your communication style as per their ability to comprehend.  Don’t push too hard.

Address potential barriers and the possible solutions:

Mental illnesses can pose several challenges for your loved ones; especially those not living in the same house as you. 

1. Your loved one may have to stop working temporarily because of his illness.  It is possible that he/she might need help with housing, home maintenance and transportation. He might need someone to pick up his medications. Try and find out the local therapists, the community service boards, or other resources that can help.  Ask the social worker in the hospital or the case manager to make recommendations for locally available services.
2. Help with any child care issues whenever possible
3. Get actively involved in your loved one’s treatment plan if he/she gives the consent.  Talk to your loved one’s treatment team to explore various options.
4. Reach out to other family or friends to help with any household chores or responsibilities to ease the stress off the person.

Address the illness; not the person:

Mental illness can be challenging to both the victim and his family.  A loved one dealing with such an illness may not actually want you to be walking on eggshells around them; try to be honest and transparent.  Acknowledge his behaviors.  Is he/she spending too much?  Is he acting embarrassingly in public?  Does he/she pick fights too often?  Challenging as much as it might seem, give him/her the benefit of doubt.   Do not be afraid to talk about the unruly behaviors and how you in collaboration with him might want to address them. Avoid overly dramatic proclamations; or worst still, don’t tell them to ‘stop acting crazy’.  Avoid being confrontational; rather keep your tone low and calm.

Resume “normal” home activities and routines:

 Sometimes, when dealing with mental illness in the family, it might seem difficult to think about anything else.  However, it is important that you don’t allow the entire household to revolve around the mental illness.  Resume your normal activities.  If you are a parent of a mentally ill child, it is important that you focus on the needs of your partner and other children in the family.   

Never forget to intentionally spend time together watching movies, hiking, or having a more peaceful ‘family time together’.

Don’t let your relationship with your partner slide.  Make time for each other.  If it is your partner suffering from mental illness, find a neutral way of discussing his/her needs with your children, without overwhelming them.   Have clear, honest one-to-one communications regularly to know how it affects other members of the family.  It is important to keep the channels of communication open.

Prepare a crisis plan:

A crisis plan must include the telephone numbers of the local rescue squad, the therapist and the local community services board.   Also include the numbers of family and friends who might be available to help at short notice.  Make a list of calming techniques that work the best.  Also, when in a calm mode, make a psychiatric advanced directive and keep a copy of it handy.

Try to keep your home environment as safe as possible:

1. Remove any sharp objects from the vicinity
2.  Lock up all medications, both over-the-counter and prescription medications
3. Teach others in the household; especially the young ones, how to stay safe during a critical moment and ways to seek help
4. Post the number of an emergency contact around the house.

When things escalate, remember: 

Safety first!  When in doubt or confusion-get of the immediate danger and seek help

If you are in imminent danger from your loved one; or a serious property damage is underway; avoid getting into a power struggle and get out of the situation and teach your children to do the same.  Once out of the danger zone, call 911 and ask for law enforcement assistance.  Tell them the nature of the emergency and the person involved is mentally ill.

Help them maintain compliance:

1. Right to decide:  Understand that your loved one may not exactly choose the treatment options that you think would be appropriate.   But giving them the right to decide their treatment will make them feel respected and heard.  It also gives them accountability to comply to their choice of treatment option.
2. You may also talk with your loved one about what would be most suitable way of reminder to help them take their medicines.  Adopt your strategy accordingly; be it phone reminders, checklists, or electronic pill bottles.
3. Cognitive behavioral therapy also called as CBT when combined with another technique called Motivational interviewing has been said to help patients when they cannot otherwise be convinced to take their medication. Talk to the therapist of this option.
4. Long acting medications:  Long acting medications help on maintaining blood levels in patients and helps prevent relapse of the symptoms.
5. Monitoring and reporting side-effects:  Monitoring side effects is crucial for overall safety of your loved one as well as to assure that he continues to take his medication.

Find support for yourself and other members of your family:

 Seek support groups within your community or online to help you cope you’re your loved one’s illness.  Peer-led support groups are available for people living with mental illnesses and also for their family members.  Your case manager or social worker should be able to help you locate these resources.

Take care of your mental health:

At times it takes every ounce of your energy to deal with the mental illness of your loved ones.  it’s often hard to focus your attention on anything else.   Nevertheless, please do take time to care for yourself.  Eat, sleep and live a healthy life.  Get the exercise you need. Make time for things that give you joy. Remember, you cannot pour from an empty cup.  When you take care of yourself; you will be in a better shape to care for your loved one.

Let go of the guilt. 

Know that this mental illness is not the sign of your bad parenting, or anything that you had done differently could have prevented this.  It is normal to feel let-down, embarrassed, fearful or ashamed.  Sometimes you might feel angry when your loved one’s behave or speak in a particular way.   Develop your own coping strategies and stick to them.  Develop a ‘me time’ to help you relax.

Read this article to help you with additional strategies to deal with stress.

When Stress Becomes too Stressful…….