Help mentally ill family member

Family Members and Caregivers | NAMI: National Alliance on Mental Illness

Having a child with a mental health condition can be a challenge, but there are ways to help make things easier. Begin by taking notice of your children’s moods, behaviors and emotions. Early intervention, especially with signs of psychosis, is critical because mental health conditions often get worse without treatment.

Many conditions are cyclical and periods of strong symptoms may come and go. Symptoms aren’t visible all the time. Children may also hide certain symptoms by saying and doing what they believe is expected of them.

What to Do if You Notice Symptoms

If you think you notice symptoms, schedule an appointment with a licensed psychiatrist or psychologist as soon as you can, or if that is not possible, then with your pediatrician or primary care physician. Make sure that you provide your healthcare professional with as much detailed information as you can:

Past mental health evaluations and other medical records
Descriptions of symptoms, when they began, and whether they have changed over time
Any medications or other medical treatments that your child is receiving
Anything else that is requested or that you think might be valuable information

If a doctor, psychologist or counselor does not provide a diagnosis or referral to another professional, you should ask why and consider their reasoning. If you disagree, trust your instincts and seek a second opinion. It is often better to be cautious than to ignore a potentially serious problem.

If your child reports seeing or hearing things that are not there, without the influence of drugs or alcohol, then you should seek medical treatment immediately. This may be an episode of psychosis. Such episodes might also include: spontaneous violent behavior, denial of reality, nonsensical and paranoid claims, removal of clothing, reckless and dangerous behavior, or claims of invincibility and other special powers.

Even though there are a variety of treatment options available, it can be difficult to locate and secure the proper treatment. You can find directories of mental health professionals and treatment facilities through PsychologyToday and SAMHSA.

How to Continue Helping Your Child

Learn All that You Can

In addition to seeking help from healthcare professionals, you should educate yourself as much as possible about your child’s mental health condition. NAMI Basics is an educational class that teaches parents and other family caregivers how to cope with their child’s condition and manage their recovery. You can also find information about specific mental health conditions and treatment options on our website.

Talk with Your Child’s School

Check to be sure that your child is receiving appropriate care and services at school. Children with mental health conditions may struggle in school without assistance, leading to frustration and stress. Fortunately, the law requires that schools provide special services and accommodations to children with mental health conditions that interfere with their education. Learn more about how to acquire necessary educational services.

Work with Your Child

You need to remain respectful and understanding of your child’s feelings even if everything seems to be working against you. You should avoid getting angry at them for behaviors that are not under their control. This does not mean you can’t set limits or impose discipline. What it does mean is that you must set your expectations in consideration of your child’s mental health. This is often referred to as part of “finding a new normal.”

Although it can be hard to accept, people who develop mental health conditions may never be the same as they were before. Expecting the same standards of behavior from prior to the onset of their mental health condition will only cause frustration and stress for everyone.

How to Hold Your Family Together

When you have a child with mental illness, it is easy to let your concern for them grow to consume your life. Here are some things to remember:

Take Care of Yourself

While it is your responsibility to care for and support your child, it is also your responsibility to take care of yourself. You may have to adjust your priorities or your lifestyle, but you should avoid letting the challenges posed by your child’s mental health condition make you neglect other important parts of your life.

In some cases, the stress of raising a child with a mental illness can contribute to the experience of mental health challenges by a parent. If you begin to feel that you are struggling with sadness or anxiety, do not hesitate to seek treatment for yourself. Caring for your own mental well-being will serve as a model for your child to follow, and ensure that you are healthy and able to care for your child.

Take Care of Your Family

Remember that if you have other children, they may resent being pushed to the side if all the attention is placed on their sibling’s mental health challenges. Make sure that they understand what their sibling is going through, and that you spend time with each of them. Keeping a happy and balanced family can be very helpful in reducing stress levels for everyone, which can help alleviate symptoms of mental illness.

Get Your Family Involved

If you live with a partner or spouse, or have other children, try to get them involved in being an advocate for your child. You may find that you deal with challenges and obstacles differently than them, but you should find ways to combine strengths to overcome any weaknesses. Be ready to compromise, listen and be open to new ideas.

It is possible you may discover that some members of your family have little interest in supporting you and your child in dealing with challenges posed by your child’s mental health condition. It is also possible that a spouse or significant other may be a negative influence on your child. They may demand discipline for behaviors your child cannot control, deny that there is anything wrong or insist upon an irrational course of action.

Helping to raise a child who has a mental health condition can be stressful, and it is unrealistic to assume that anyone, yourself included, will always react in an ideal way. However, you must also realize that it is your responsibility to protect your child, even from others that you care about.

Maintaining a Healthy Relationship | NAMI: National Alliance on Mental Illness

Relating to someone you love who has a mental illness can be difficult and frustrating, but there are strategies you can use to improve your communication with them. There may be a lot you don’t know about how your relative sees things when they’re symptomatic. These tips can help you build a stronger foundation for your relationship.

To get started on a better path in your relationship with your family member, first acknowledge that you can’t change them, only yourself. But the changes you make can improve your lives together. It’s critical to know as much as you can about their illness so you understand what they may be going through.

Don’t Buy Into Stigma

Be clear with yourself about who the person you care about really is. Even if we’re very close to someone with mental illness and advocate for his rights, we may also have our own preconceptions and false beliefs about mental illness. We have to learn to separate the illness from the person.

Understand Confusing Behavior

Because many of the symptoms of mental illness express themselves through social behavior, it’s natural to feel hurt by the symptoms. We tend to assume behavior is conscious and deliberate.

For example, when you invite your brother to dinner with friends and you feel embarrassed by his obsessive checking of whether he locked his car, you’re tempted to see him as someone who’s choosing to embarrass you. This may be how some friends and strangers see him, too—that’s the effect of stigma. When people around you see your relative this way, it can be hard to remember the truth: that he has an illness, and that the behavior is part of his symptoms. That doesn’t excuse cruel or violent behavior, but it’s an important reality to keep in mind.

See Opportunities for Improvement

You and your relative can still make conscious choices that improve your situation. You may agree to cooperate on communicating better, you may each work on keeping up friendships and other supportive relationships, you may each see a psychologist for talk therapy. The fact that you can control some things some of the time doesn’t negate the fact that the illness is real, not a character flaw, or anyone’s fault. Your relative’s capacity to make positive choices will depend on how severe her symptoms are at any given time.

Get Support from Other People

You know there's more to your loved one than her illness. You may value her sense of humor, her familiarity with your past, her ability to listen and her advice. When someone has a mental illness, she may feel it threatens her identity and self-respect. As with any other illness, your loved one will have periods when she's learning to cope with her illness’ challenges. During these times, she may seem self-absorbed and unable to give her usual attention and energy to others.

Both you and your relative will be better able to cope if you expand your own support network, beyond her. Strengthen your connections with other friends and family. This takes some pressure off your relative to help you as she did before she was ill. She can instead put that energy toward moving toward living well. At the same time, you may resent her less and feel strengthened by getting the social support you need.

Expect Decent Behavior

Making adjustments to accommodate for your relative’s illness doesn’t erase the need for basic structures and expectations. Tell your relative the standards you need him to meet so you can live well together. Make sure your loved one knows that you see him as a whole person, and that you expect him to follow those standards.

Two of the most important standards to meet are that your home is a safe space and that you have a plan for what to do when safety of your loved one or the family is threatened. Prepare yourself and your family to handle crises. Tell your relative about the standards you expect for daily life. For example, that you won’t continue an interaction with your father if he starts screaming at you. Use the communication tips below to have more productive conversations with your relative.

Learn to Communicate Effectively

Developing good communication skills will improve all of your relationships, but they’re especially important when mental illness is in the mix. Effective communication is largely about building good habits. You can make choices that improve your chances of getting the results you want. Maybe you want to be able to ask your granddaughter to shower without getting into an argument, or tell your husband his smoking worries you without him giving you the cold shoulder.

A very good way to approach this is to use statements that give your perspective, rather than imposing perceived behavior. For example, try "I am concerned because you don't seem interested in what I'm saying.", instead of "You're not listening." Making thoughtful changes to how you communicate can move you closer to your goals.

See It from Their Perspective

Learn as much as you can about your relative’s illness and what they experience. Because of their symptoms, they may perceive things differently than you think. They may be feeling strong emotions like fear, have low self-esteem or be experiencing a delusion or hallucination. All this may be going on even if they don’t express it.

Put yourself in their shoes and try to think about how they’re feeling, rather than only what they’re saying. Adjusting your communication style with their possible experience in mind respects them, and makes it more likely that they’ll really hear and understand you.

If your friend or relative has done something that bothers you, give them the benefit of the doubt by first assuming the problem is not that they’re not motivated to change, but that they’re not yet able. It can be tempting to assume that the person is deliberately being difficult. Maybe your loved one doesn’t particularly like cleaning up, but she means well. She gets distracted in the moment and forgets to clean, even though she knows she’s supposed to. Ask her if something is making it harder for her to clean. If she simply forgets, would a sign on the kitchen door or fridge help? What does she think the sign should say? Ask her for ideas, so you’re cooperating on something.

You’ll notice that in this example, you’re still able to express the core of how you feel: you’re upset by the person’s actions, and you want them to behave differently because you’ll feel better. This method of communication is less likely to pile on the resentment—both theirs and yours—and more likely to get you both what you want.

Focus On Your Larger Goals

When you’re upset, try to remind yourself what your true, long-term goal is. It may be to live peacefully with your partner, or to encourage your child to eat more healthily. Your true goal is probably not to win an argument or to remind them of how much you put up with for their sake, but when we’re upset, we can get defensive.

Start conversations soon after something happens that upsets you, but after you’ve had a few minutes to cool down and talk calmly. You’ll be more likely to agree on recent facts, and you won’t let dissatisfactions build and worsen into resentment. Pursuing your larger goals doesn’t mean burying your feelings; it means communicating your most important feelings well.

Use Direct, Simple and Clear Language

To have a more productive conversation, start off on the right foot. Get the person’s attention first (“Can I talk to you?”). Cover one topic at a time and share small amounts of information at once (“I want to talk about tonight’s dinner”). Say exactly what you mean (“It’s been a long time since we cooked together, and I miss doing that. Would you help me make dinner tonight?”) rather than hinting at it (“You never do anything with me anymore”).

Describe What You Want and Why

State the facts of the situation, because usually that’s an area in which you can agree (“These forms are due back to your school tomorrow, and you haven’t filled them out yet.”). Say exactly what action you’re requesting the person to take, and how you’d feel if they’d do that (“Please read and sign them before we have lunch. I’d feel relieved knowing they’re done, and we can enjoy the rest of the afternoon knowing you’re ready for school”).

Describing a positive outcome can be very motivating. For example, you could say that you’d appreciate their help taking the trash out, or that if they joined you for a walk you’d be happy to be spending time together. Ask the person for suggestions on how to improve the situation; if they help create the idea, they’re more likely to give it a try.

How to deal with sick family members

Dear readers of the psychological page!

For quite some time now I have been receiving letters asking how how to deal with seriously ill family members . Usually I answer the respondent personally, but as time has shown, these questions can arise sooner or later for any person.

Someone close to you fell ill, the disease is severe and the treatment is long. The usual measured life is changing, along with the fear for a loved one, there are also many problems: domestic, financial, physical. In such a situation, not only a sick family member, but also his environment needs emotional support, psychological help. And at this time it is important not to succumb to stress, not to lose psychological and physical strength and become a powerful support for the patient. As the saying goes, either you are part of the solution or you are part of the problem.

When close people fall ill, very often, worrying about him, relatives begin to experience emotional and psychological problems - the family realizes its helplessness in the face of a loved one's illness, relatives may feel guilty towards the sick person. It becomes difficult to fully manage your personal time and interests, there is not enough strength and time for other relatives who need your care.

Chronic dissatisfaction of personal needs, growing emotional tension, constant anxiety for a loved one - a family lives in such stress. If the treatment process is long, then the increasing psychological and physical stress can lead to exhaustion of the strength of loved ones, which means that family members may experience psychological difficulties, increase tension within the family circle, and deteriorate health. Gradually, a state sets in that forces a person to fence himself off from the disease, from communicating with a sick relative. Such reactions of the family are natural in this situation. Psychological help can help tired relatives.

Advice to relatives of a sick person:

See a psychologist if possible.

Find time to relax. To do this, 1-2 times a week, involve one of the relatives to care for the sick person or ask his friends to visit the sick person. It is important not to feel any remorse about this. Remember: you need rest, it keeps you strong and healthy! This means that you will be more effective in your communication and support of a sick person.

Discuss work sharing with your family. Its even distribution includes a wider circle of people in communication with the patient, which shows him love and value for his family and friends. This is very important for the patient.

Be sure to create conditions for communication with your sick relatives. The opportunity to discuss your own and his feelings, experiences and fears creates an atmosphere of honest, trusting and sincere relations. Denying your negative feelings or the patient's feelings makes it impossible to reduce stress for the patient and for you. Through discussing difficult feelings, you create the trusting and sincere relationship that the patient most needs.

Help and in every possible way encourage the open expression of any feelings of the patient, without giving an assessment, try to see what is behind these statements, feelings and behavior. Often fear is hidden behind aggression. You need to understand that this period will end. Whims, bad mood, reproaches, unfair accusations will end as soon as strength is restored. A small clarification: if a person had a bad character before the illness, then he is unlikely to be a sweetheart and the sweetest person. Although there are such cases.

Demonstrate your readiness to endure all difficulties together with the patient. Do not let the sick leave the world of healthy people. Ask, share news, do not forget about joint joyful memories. Now there are many opportunities to distract the patient from his sad thoughts. Bring him interesting films, books, a selection of your favorite music, arrange some small entertainment that is available at the moment. And most importantly, talk, say everything that we usually put off for “later” and are most often late. Surround your loved one with love like a shield. It is easier for him to live under this protection or perhaps to leave.

Stay true to yourself. You can’t absolutely adapt to the patient, your interests are of course infringed and fade into the background, but there are some boundaries. There is work, there are children requiring attention, there are other circumstances. This should be discussed calmly and confidentially. Talk about your needs. Refuse to fulfill in advance impossible requests, be sure to explain your refusal. Make sure that communication is comfortable for both you and the patient.

Frequently note the improvement in the patient's appearance, activity, good mood and any positive changes in appearance or psychological state. Remember that you are a mirror in which the patient looks, where he sees himself strong and able to overcome the disease.

Be sure to encourage any activity, independence and initiative of the patient, do not try to do everything for him, this gradually makes the person helpless. You can not turn the patient into a baby. Remember that activity in overcoming the disease, the desire to live and fight for your health is the main key to success in treatment. You should not save, but help, each time asking what kind of help he needs and what he can and wants to do on his own.

Encourage independence and all the efforts of a sick family member in the struggle for their own health and self-confidence. Create conditions for strengthening his faith in himself and developing ways to become healthy.

And always remember: you are not alone on this difficult road, there are doctors, psychologists, friends who will help you. Take care of yourself and your loved ones.

IF A RELATIVE IS SUFFERING WITH A MENTAL DISORDER…

Vakulchik Irina Sergeevna, Deputy Chief Physician for the Medical Department of the City Clinical Psychiatric Dispensary

The news that a loved one has a mental disorder can be shocking. At first, confusion and denial are characteristic - "this could not happen to us." The familiar world is collapsing, a new, unclear and frightening reality is approaching, and you have to learn to live in it. Mental illness causes suffering not only to the patient, but also to his relatives, to a greater or lesser extent affecting all family members, changing their lives, plans for the future and relationships between them. In order for life to take place at a higher level of quality, the patient needs the help and support of the whole family. Very often, relatives want to help, but do not know, do not understand how. It has long been known that family relationships can influence the course and outcome of the disease, contribute to both the improvement of the patient's condition and its aggravation.

The most general, universal recommendations for dealing with people suffering from mental disorders.

To begin with, try to learn more about the disease that your relative suffers from, about its manifestations. Knowledge will help you deal with their sometimes "strange" behavior and cope more successfully with the problems that arise due to the disease.

A mentally ill person does not quite adequately perceive reality and has deviations in behavior. Communication with such people may also deviate from existing norms. The main thing to remember is that a person is not just behaving abnormally, he is sick. One of the features is that such patients need long-term observation and treatment. During treatment, symptoms may come and go. You, as members of the family, should know what to expect from a relative when doing household chores or interacting with other people. For example: you should not require a patient who has just been discharged from the hospital to immediately go to work or even to look for work. At the same time, there is no need to overprotect your relative, underestimating the requirements for him.

Take part in the treatment . Find out which treatment programs are best for this disease and encourage your relative to take part in these programs; Make sure that he takes his prescribed medications, and if he stops taking them, notify the doctor. Also tell which medications are best for your relative.

Help to avoid stress . After all, people suffering from mental disorders often find it difficult to endure situations when they are shouted at, annoyed, or required to do something that they are not able to do. You can help your relative avoid stress by doing the following:
- talk to him calmly, do not say anything that can piss him off, deservedly praise for good deeds.
- do not argue and do not try to deny the existence of manifestations of the disease that you may not see or hear.
- keep in mind that ordinary events - moving to a new place of residence, marriage, or even a festive dinner - can irritate patients suffering from mental disorders.

Habitual routine . An important point that stabilizes the condition of a sick person is the preservation of the usual, simple life routine in the house, for example, a stable time to get up in the morning, sleep time, and meal hours. It is necessary to create a calm, consistent, predictable life as much as possible. This will enable the sick person to cope with anxiety, confusion, to understand what and at what time you expect from him and what to expect from you in turn. Try to make the life of a sick person as ordered as possible, this will protect you from chaos!

Try to be calm . You must keep in mind that a person suffering from a mental illness may experience strong feelings, his thoughts may be confused, flow too slowly, or, on the contrary, quickly, and his feelings may be very strong and contradictory. Communicating with a sick person, especially during periods of deterioration in his condition, it is important to learn to behave calmly and with restraint. Such behavior contributes to the stabilization of the mental state, and in some cases even helps the patient to calm down and cope with anxiety.

Learn how to properly respond to the manifestations of the disease.

Symptom or characteristic	What to do.
Difficulty concentrating	Be brief, repeat what has been said.
Irritability, anger	Do not argue, do not exacerbate the discussion, limit communication.
Inadequate judgments, statements	Don't count on rational discussion, don't try to convince.
Delusional beliefs	Do not argue, but do not support crazy statements either.
Little empathy for others, emotional coldness	Treat as a symptom of mental illness.
Closed	Be the first to start a conversation, try to engage in communication.
Fear	Keep calm yourself, try to calm the sick person.
Self-doubt	Treat with love and understanding.
Low self-esteem	Be respectful, maintain a positive attitude

Celebrate and encourage even small successes, signs of improvement. It is important to set really realistic goals. Get out of bed, get dressed, brush your teeth, wash the dishes, it's not so little. Celebrate even such successes, because self-esteem is built from these bricks. You need to learn to find certain positive signs, and sometimes just words of support and approval in difficult, crisis periods of the disease. And if a sick person himself paid attention to the approaching symptoms of an exacerbation of the condition and decided to go to the hospital, it would be very useful to support him, express approval and say that the ability to independently recognize the approaching exacerbation of the condition is the key to successful prevention of attacks of the disease in the future.

Do not lose hope for recovery, maintain an optimistic attitude. It is very important and at the same time very difficult not to lose hope for recovery. Often a chronically ill person has a hard time, a painful condition can last for months and years, taking away hope for recovery, or at least for a significant relief of the condition. Friends, peers have gone far ahead in life, got a profession, have their own families. It may so happen that it will never be available to a sick person. Therefore, encourage the activity of a sick person, his independence, desire for activity, try to build relationships in such a way that he does not take a passive role in life, declaring himself an invalid and refusing to perform his duties. It is very important that a person suffering from a mental disorder strive for the most independent life.

Show love and respect for your relative. Remember that he often gets into unpleasant situations and sometimes treats himself badly because of illness. By your daily behavior, show that he, no matter what, remains a respected and beloved family member for you. Treat a sick person with respect and love, even if you remind the sick person several times a morning to brush their teeth, sweep the room, change clothes, and clean up the dishes. Never insult the dignity of a sick person!

Healthy family members should remember that their own well-being is fundamentally important: the better they feel, the better life is not only for themselves, but also for the sick person.

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