Living with a Mentally Ill Person

Mental illness is a health condition that involves the brain. Mental illness causes problems with thinking, mood, or behavior that interfere with daily life and cause distress. If you are a family member or friend of someone who is mentally ill, you have probably been suffering too. You are likely to feel worried, frustrated, confused, and sometimes despairing. You may not understand why your loved one just can't stop these behaviors. You may feel:

• guilty that somehow "all this" is your fault
• angry that your loved one is just seeking attention, being lazy, not cooperating, or doing things on purpose
• confused about your loved one's changed behavior
• embarrassed about the way he or she acts in public
• resentful about taking on additional responsibilities
• afraid that you will also develop the mental illness
• helpless because you don't know what to do

It is important to remember that you can't:

• solve all of your loved one's problems for them
• make your loved one be different
• make the illness go away by ignoring it

How can I help my loved one?

If someone you love is diagnosed with a mental illness, how can you help? Work together with the person who is ill and the team of mental health professionals. Take things slowly, step by step. The speed of progress is not as important as moving in the right direction. Try to maintain a positive attitude toward your loved one. A non-judgmental attitude allows the person to focus on coping and getting well, rather than trying to deal with anger and resentment.

• Help the person develop and follow routines, for example, regular times to get up and go to bed. You should make changes gradually to prevent boredom without creating stress.
• Help the person break tasks into small steps. For example, help someone get to school on time by helping them choose clothes. Work on one thing at a time.
• Help them identify realistic goals. Having goals that are too high sets you and your loved one up for failure. Goals for some people may be working part-time or going to school. For others, coming to the dinner table is a victory. Support and accept what the person can do.
• Help focus the person's energy on activities such as walking, jogging, swimming, and dancing. Activity may calm the person down and give a sense of success.
• Allow your loved one to make his or her own decisions, even though it may be hard. Resist the urge to make the decision even if he or she keeps changing his or her mind. Ignore what you can't change. Let some things slide.
• Try to lower stress for your loved one. Everyday stresses that most people handle without a problem may make some people with mental illness more likely to get worse.
• Be encouraging and supportive. Build up your loved one's self-confidence. When you are critical or too protective, your mentally ill loved one may feel frightened. When you notice improvements, however small, point them out. Your recognition and praise will encourage him or her to keep trying.
• Help the person remember to take prescribed medicine. Try to remind your loved one how much the medicine helps them rather than nagging or criticizing them.
• Talk gently and respectfully. Listen to what the person says. Try not to be defensive. Talk to each other and to the healthcare team. Communication is important if you're going to work together. Seek help from professionals when you need it to deal with:
  • Suicidal thoughts. Don't be afraid to talk about suicidal thoughts. If your loved one continues to think about suicide, especially if he or she hears voices that suggest suicide, inform his or her healthcare provider.
  • Medicine side effects such as sedation and weight gain.
  • Reality checking. If the person with the illness tells you that other people are mistreating them, check out the stories before you react.
  • Aggressive or violent behavior. If someone is aggressive or violent, contact mental health professionals (and the police, if necessary) immediately. Keeping things relaxed may prevent aggressive behavior brought on by stress.
  • Relapse. If you notice feelings or actions that are unusual for your loved one, such as losing interest in things, becoming more depressed, having trouble concentrating or making decisions, withdrawing, feeling overwhelmed, or having sleep problems, call a mental health professional. Getting professional help early enough may keep the person from getting worse.
• Realize that recovery always includes slips and setbacks. The important thing is not to see the setback as failure.
• Decide how much support and care you are realistically able to provide. Explain this to the person with the mental illness and to healthcare providers involved (for example, the psychiatrist or case manager). This will allow for help to be found so that if you cannot provide support, someone else can.

How Can I Help Myself?

Understand that your loved one has an illness. There are treatments and possibly medicine for it, just like a heart problem. You need information about mental illness and its meaning for your family. This will help you know what behaviors to expect and what to do and say if those behaviors are exhibited. Spend time learning more about the illness.

Consider attending a support group. Talking with other people who face the same challenges can help you cope with the mental illness and its impact on your life. Talk honestly about your feelings and encourage others in the family to do the same.

In addition to your needs for information, skills, and support, you face the special challenge of recognizing that your needs and desires matter. Do not deny or minimize your own needs while you try to meet the needs of your loved one. Caring for someone with mental illness can take a lot of energy. Schedule time for yourself. Make time to relax and relieve your stress. Accept your feelings, and find ways of releasing them every day. Some suggestions about how to do this are:

• Talk things through with a friend.
• Exercise regularly.
• Avoid caffeine.
• Eat a healthy diet
• Avoid alcohol
• Engage in a hobby that you enjoy.
• Get adequate sleep
• Go out and away from the person you care for. Examples of outings might be a movie, or lunch or coffee with a friend or another family member.
• Set aside quiet time by yourself every day when you can do something you enjoy. For example take a bath, have a massage, meditate, or even just close your eyes and rest a few minutes.

For more information, contact the National Alliance for the Mentally Ill (NAMI) or Mental Health America (formerly the National Mental Health Association or NMHA).

• NAMI's toll-free number is 1-800-950-NAMI (950-6264). NAMI's web site address is http://www.nami.org.
• Mental Health America's Information Center toll-free number is 1-800-969-6642. The web site address is http://www.NMHA.org.