Guide: For Family and Friends

This is a guide directed at the family, loved ones and friends of someone who has a mental illness diagnosis. This guide is not complete and I welcome any additions that anyone may have. 

Shock, denial, a sense of helplessness, blame, all of these are common reactions to hearing that someone you love has a mental illness. In a prior post I gave advice to those who have a mental illness and now I would like to extend some advice to you.

Support them, love them and be their advocate are the most important things that you can do. Those three things alone can aide them on their road to recovery.

1. Get educated on the illness. Quite frankly most media portrayals of mental illness is based more on misinformation and stigma than fact. Even if you think that you know and understand the nature of mental illness it never hurts to read up on it.

One good lesson that will come from education is possibly learning how to deal with your loved one when they are in crisis. It will also help in differentiating between what is actually a symptom and what is normal human reactions to events.

2. Find support. The road to recovery can be long and rocky. Often times the illness itself with have an impact on family and friends. It helps to have support during this time. Many mental health organizations have either support groups for loved ones or offer up educational classes. Take advantage of these.

NAMI is a great place to start. They offer a variety of resources and tools, both for people living with mental illness as well as for their family and friends.

3. Be there for your loved one without blame and judgment. This is very important in my opinion. Far too often we fall into a pattern of blaming others or worse judging them. Living with a mental illness is hard enough, add the fact that others might blame us or judge up for our illness and it makes it a harder struggle.

Far too often I was accused of playing games, more so when it came to the depressive episodes. This led to me hiding these episodes from not only family but also my treatment team. It is truly scary when I read old journal entries where page after page are passages relating to death and suicide. So close was I to acting on these thoughts, yet I kept that secret for fear of being accused of seeking attention.

Another thing that I encountered is being made fun of for my psychosis. Things I said and did while in the grips of a psychotic episode were often times thrown in my face later. This did nothing to improve me treatment and actually made me more resentful towards those around me and more resistant toward treatment in some ways.

4. Its okay to grieve the loss of expectations, but it is not okay to use that grief to drive a wedge between you and them. Grieve in private or within the confines of the support system that you build, but also realize that a mental illness diagnosis isn't the end.

Help your loved one to define new goals and expectations. They might not be able to live the life as they had before the illness manifested but that doesn't mean they can't have a different life, one just as fulfilling as the other.

The disappointment that I often hear in the tone of voice or see in their eyes is something that still stings when talking with my family.

5. Be patient. Recovering like I said is a long road. There is no need to place undue pressure on the person to be 100% well in a short period of time. It can take time to find the right medications or for therapy to start seeing results. So small steps are okay. Don't expect a person to come home from a hospital stay and immediately get back to the same life they had before.

In regards to my own experience my mother, a nurse became fixated on one medication. I was prescribed it as a mood stabilizer, unfortunately it did not work for me. This became an area of strife between us because she was convinced I hadn't been taking it as prescribed. She ignored the fact that some medications might not work with some people. Even today she has issue with my medications, sometimes telling me that I should be on X medication (the one that didn't work) and not on Y (the one that does).

6. Set limits. This is a hard one to explain and in some ways goes against the above listed. You will need to set limits in regards to violent and disruptive behavior. Even if the person is in the grips of severe psychosis that is not an excuse for you to endure abusive behavior. Set limits and expectations in this areas and stick to it. If possible work with their treatment team in this area.

7. If possible be involved in their treatment. This is a tricky one as often the very nature of therapy is very personal or the illness itself makes the person paranoid of others. It might help if you calmly explain that you would like some including in the treatment, perhaps limiting it to only diagnosis, treatment plan and a pointing toward resources that can better help you support them. Explain calmly that you don't want or need to know every and any private detail that is spoken about in therapy but that you would just like to have the tools necessary to be there for them. It might help if you state that such a session would only occur with them present.