Despite the prevalence and our increased understanding and acceptance of mental illness in society today, many family members still harbor fears and uncertainty surrounding how to help someone close to them who has a mental illness. Some of these fears, while understandable, are also irrational - that maybe I'll "catch" what they have, that it's probably genetic, so I'm going to get it too, that whatever I'll say to my family member will be the wrong thing.
Understanding with Compassion
These fears for many are grounded in the historical stigma and misinformation surrounding mental disorders. For decades, anybody who was diagnosed with a "nervous condition" was often hospitalized as an inpatient for years. Many were never released, spending most of their lives in hospital wards for the insane. Doctors didn't really understand why these people were disturbed, only that their families didn't want to deal with them and their "crazy behaviors" any longer. So they gladly acquiesced to warehousing family members in wards designed for a lifetime of living.
But in the past two decades, researchers and doctors have made great strides in understanding how to administer effective treatments for mental disorders. These treatments, both medication- and psychotherapy-based, allow nearly anyone with a mental disorder to lead a full and rich life. The diagnosis of a mental disorder or condition is no longer a stigmatized sentence to a life in a hospital ward and of being ignored by one's family.
Yet families often don't know how to handle a family member with a mental disorder, or one who was once "ill" and is now "better." They don't understand what caused the disorder in the first place, and are afraid of coming down with a similar condition over time. It's not surprising this sentiment is still prevalent. Researchers still have few definitive answers regarding the causes of mental disorders, although there are many competing theories (including brain chemistry, personal development and upbringing, physical brain abnormalities, etc.). However, we still don't know what causes the majority of mental disorders.
Information, then Action
Families would do well to read and learn all they can about the mental disorder the family member is inflicted with. Websites, such as PsychCentral.com, books, and informational brochures all contain a wealth of useful information that can help a person better understand the symptoms, course, scope and treatments available for a disorder. Knowledge is the key to answering many common questions and putting to rest many common fears. For instance, mental disorders are not virus- or bacteria-based, therefore you can't "catch" the mental disorder afflicting the family member. While there may indeed be genetic indicators and links, the causal relationships are not well understood for most disorders. In other words, even if your brother or daughter has schizophrenia, that doesn't mean you're going to get it too.
Once armed with the knowledge of the particular disorder, it's time to take action. If the family member isn't already seeking treatment for their concern, you should help them with finding appropriate care. In America, this often starts with checking your insurance benefits and seeing how you're covered for mental health care. Most primary care physicians or family doctors can do an initial, if cursory, diagnosis of many common mental disorders (such as depression, bipolar disorder, ADHD, etc.). However, this should only be the first step of treatment. You should obtain a referral to a mental health care specialist for further evaluation and a definitive diagnosis (preferably from a psychologist, experience clinical social worker or the like - someone armed with years worth of differential diagnostic experience).
That mental health specialist will schedule a one to one and a half hour appointment with the family member. This intake interview consists of obtaining a lot of background information, family history, and history of the current problem in order to make an accurate diagnosis for a mental disorder. If the symptoms or lifestyle of the family member warrants it, the clinician will also schedule or refer you to a psychiatrist for a medication evaluation. From there on out, a treatment plan will be formulated and the family member is well on a path to recovery.
Privacy and Helping When Help isn't Wanted
Of course, once you help your family member navigate the healthcare maze of treatment providers, insurance coverage, and diagnostic evaluations, you should step out of the picture of their care. Respect your family member's privacy. Most family members, unless they are under-age children, can take care of themselves. Maybe they just needed that little nudge to get help, or the unconditional support and acceptance you offered them. It might surprise you, but for many people, a little kindness and support is all that's necessary.
What if the family member doesn't want to get help? All you can do is share with them the information you gathered on the condition you believe is afflicting them, and gently offer them support and a kind word of encouragement. Once. Just once. The biggest mistake family members make is to give others their unsolicited advice every time they see the person about what they think is wrong with the person, and that they need to get help. That's not support, that's nagging. And nobody likes to be nagged.
You cannot make anybody else do anything they don't want to do. You may think you can, by punishment, anger, withdrawal of love or attention, etc. But all you will have done is gained newfound resentment from the family member and a renewed determination to undermine their own treatment. This is not a healthy way to approach treatment of any kind and should be avoided at all costs.
With this advice, your family member should be thankful of your support, encouragement, and guidance in a time when they are likely a little afraid and don't know where or who to turn to. Sometimes all a person needs is a little guidance and support to find direction and hope. Because of your unique relationship with your family member, you are in an ideal position to offer this. Good luck.Last reviewed: By John M. Grohol, Psy.D. on 4 Oct 2005
Published on PsychCentral.com. All rights reserved.
They called me mad, and I called them mad,
and damn them, they outvoted me.