Supporting a Family Member with Mental Illness

I  went to a Bipolar/Depression support group recently and was struck by how much the support of family members contributes to the well being, or lack thereof, of people suffering with mental illness.  Not just any support, but knowledgeable support.   Three people in the group described family members that had taken the trouble to learn everything they could about the illness their child or spouse had, and to make adjustments in their lives to accommodate the unique needs of someone who is bipolar or suffering from severe depression.  These people were saved additional stress at home that can be caused by living with people that don’t understand, and in the absence of understanding, unintentionally make things worse.   

I have seen both sides of mental illness.  I’ve experienced my own struggles, having been diagnosed with Bipolar II many years ago, and I have children that have experienced mental illness as well.  My family members are all supportive of me to a degree, but none of them have taken an active interest in learning about the illness or how to interact with me when I am in the throes of an episode.  Perhaps it’s because I’m usually stable, and because Bipolar II isn’t as extreme as Bipolar I.  I’m never fully manic, so I’ve never had episodes that lead to psychosis, and I’ve never been hospitalized.  When I’m depressed, I isolate myself, so my depression isn’t obvious to the family members that don’t live with me, and to those that do live with me, I often make excuses of a physical illness to explain why I’m missing work and spending most of the day in bed.   I manage to function and maintain stability without a knowledgeable family member actively providing support, but life would be a lot better if the people closest to me took the time to understand the illness and to learn techniques to help me through my hard times.  Life would be better for them as well, because the same resources for learning how to help someone cope with mental illness, also teach how to cope while living with someone with mental illness. 

When my son, Eliott, became ill with schizophrenia as a young adult, I became a knowledgeable support person for him.  I read several books, took the “Family to Family” class through NAMI, joined an online forum for parents of children (mostly adult children) with schizophrenia, and went with him to his psychiatrist’s appointments.  My interaction with him was guided by this knowledge, and I was there with him through every crisis and every success.  Tragically, and despite my efforts, Eliott took his life. 

When my daughter developed anorexia and anxiety, my husband and I became active participants in her recovery and I am certain that our involvement reduced the duration of her illness and helped her develop the tools to help herself when she is tempted to return to anorexic thinking and behavior. 

How can I say a knowledgeable family member can help, when I do okay without one, and my son took his life when he had one?  My experience with my daughter is one reason, but the real answer is that I say only that it will help; it is not a cure or a substitute for treatment with therapy and medication.  Eliott’s life was better and he had periods of improvement because of my support, but ultimately, it is up to the person with the mental illness to take responsibility for their own well being.  Eliott’s illness was severe, and one effect of his illness was that he didn’t believe he was ill.  As a result, he stopped taking medication every time he started to feel better, and spent most of his visits with his psychiatrist fighting with them about the diagnosis.  This is why he lost his battle, but my support wasn't wasted because I know his suffering was reduced, and I increased his chances of surviving, even though the illness eventually succeeded in killing him.  Helping him helped me as well.  I could not live with myself if I hadn't done everything I could for him.  

In contrast to Eliott's experience, I faithfully take the medications prescribed and I practice the coping techniques taught to me in therapy.  Yet, as most people with mental illness will attest, even with treatment, there are ‘break through” symptoms.  For me, that means I still have periods of depression.  When I experience these, I see my psychiatric nurse-practitioner a few extra times and she usually prescribes a temporarily adjust my medications to lift me out of it.  Beyond that, I just do my best to get through it – knowing from experience that it is not permanent.  Yet I long for the compassionate understanding of someone who knows how best to be with me when I am depressed.  I believe I would rise from the darkness of depression sooner, and be able to maintain more functionality, if someone close to me was a partner in getting me out of bed and doing the things that I know I need to do to get better.

The people in the support group proved this to me.  The three people that impressed this upon me described specific things their family member did that helped them make the changes they needed to make, and helped them cope with the pain and confusion experienced due to their illness.  These three seemed to be the most confident in their ability to survive and feel safe despite immense difficulty in their lives.  There were others there that described a lack of support, or family members that tried to help, but because they hadn’t learned how, actually made things worse.  These people seemed less stable and more at risk of their mental illness taking a greater toll on their lives.

If you have a family member who lives with a mental illness, I urge you to to learn everything you can about what it’s like to live with that illness, the best way to help someone with the illness, and coping strategies for yourself as a support person or caregiver. 

If you live with a mental illness yourself, please try to educate your family members during times that you are feeling strong and free of symptoms (or at least not in the midst of a very bad episode).  A very good first step is the “Family to Family” class through NAMI – I can’t recommend it enough.

I’d love to hear any tips from readers for improving family relationships when mental illness affects the family.