How Mental Illness Affects the Family

The human mind and behavior of people has fascinated me from the time I was a young teen. I wanted to see a psychiatrist then, just to ask questions and validate that I wasn’t crazy. Growing up in my chaotic home there were times when I wondered if I was. Like many people experiencing the 1950’s and ‘60’s I knew there were changes afoot and I was both excited and frightened of what was looming ahead. It is no wonder then, that my career path led me to work in the mental health field.

When mental illness enters the lives of families it is devastating and costly. Years of therapy and hospitalization, along with medication, may help to stabilize a person however, it is financially draining. If that person is unemployed or does not have adequate insurance treatment may falter. Cut backs in the economy reflect a steady rise in mental illness.

Mental illness is also an emotional drain. Witnessing the de-compensation in the stability of a loved one creates apprehension for those offering support. NAMI, the National Alliance on Mental Illness is a worthy organization that offers support for families and friends affected by a mentally ill person, as well as educating the public and bringing mental illness into the light.

Very simply, every person who meets with a psychiatrist or mental health professional is given a primary diagnosis that is classified as ‘Axis I’. Diagnostic tools vary, however, the DSM-IV, Diagnostic and Statistical Manual of Mental Health, published by the American Psychiatric Association, is the book which care providers refer to in order to best treat the patient’s symptoms. Gambling, for example, was not part of the original DSM; however, it is included in the DSM-IV.

Classifications can range from adjustment disorders to personality disorders and from mood disorders to psychosis. It is updated periodically and the updates are indicated by the number following the title; hence, we are now in the 4^th revision. Revisions occur because our culture has changed from when the DSM was initially written, and the current copy has included new pathologies that were not seen before.

Perhaps it is from my own struggle with understanding why people act the way they do, or the fascination of why one person in a family grows up mentally healthy, while another family member succumbs to mental illness, that touches me when I am working with psychiatric patients. It is a disabling disease that I know about first hand.

My nephew is an older teen that has had more than his share of hard knocks coming into this world. His start began as a premature baby who suffered seizures at birth; hence, he has some neurological damage. Even greater is that he was born to two mentally unhealthy people.

His father, my youngest brother, is an untreated and undiagnosed paranoid, delusional man who believes he was kidnapped by aliens when he was a young man. He will point to a scar on his forehead as proof that he has a chip implanted in his brain. In addition to this, he will become violent when things don’t go his way.

His mother is severely afflicted with cerebral palsy. She is wheelchair bound, has a voice machine that she manipulates the keys to ‘talk’ for her with her contorted hands and she has an eighth grade education. She also suffers from reality issues.

He is currently seeing a psychiatrist, who I have been dissatisfied with from the beginning. Living in a rural area does not afford one the luxury of many places to choose from. But, when a parent wants the best for her child there are sacrifices that will be made. My search for a new clinic has paid off and we will meet his new doctor soon.

Because his father has delusions I am vigilant with any signs that J may show. I have been suspicious on some occasions and am keeping a record of both my gut feelings and what I observe. He has a certain look that comes over him when he is ‘checking out’. Although he denies this I have witnessed the affect as well as the tone of his voice, the movements of his body-it is bizarre; as if he is gone somewhere else and a soulless entity has taken over his body.

Other times he rages, as his father does, hitting walls, picking up items to throw across the room, threatening to stab and kill. It is disconcerting to say the least. In the end, after it is all over, he is submissive-a meek, sad ‘boy’.

I have the advantage of knowing him as a little boy; his family history; his father as a young boy growing up in the same household; his grandparents and their parenting style, which is influential; and the family dynamics that he was born into. I also have the advantage of understanding, from an outside perspective, of what he is going through from my many years of working with psychiatric patients.

His advantage is that I love and care about him, so I stick it out and advocate for him. But, even I have my limits, and when he rages at me in an abusive way I have to maintain firm boundaries and consequences; and try not to take it personally. Sometimes, that is difficult to do.

It is important, if there is a history of mental illness in the family, to be aware that you or your children are at a higher risk for mental illness. It does not mean that it will happen, but that the possibilities, due to mental vulnerability, is greater.

If depression runs in your family be aware of your own moods and watch if your child becomes moody, withdrawn or complaining. Children can feel suicidal, too, and they are capable of finding ingenious ways to end their lives if their condition goes on treated. A loss of interest in normal activities, tearfulness and a sense of hopeless or helplessness are all signs of depression. The rage among teens now is to cut. Not a new phenomenon, technical tools like the internet and cell phones has accelerated the support for this activity. My nephew is a cutter. When his emotions get the best of him he will secret himself away and superficially slice his skin in areas that are covered-upper thighs, belly, etc. Then, he will write about how it relieves his pain. I am trying to teach him alternatives, but I cannot do the work for him.

Mood Disorders, such as bipolar, or manic-depression, as well as personality orders, (antisocial p.d. or borderline p.d.), can be debilitating if not addressed. These diagnoses are showing up in greater numbers in the teen population, especially in homes where the environment is stressful and there is a poor example of good coping skills. Indicators may be a labile mood, sexual promiscuity, extravagant makeup or spending sprees, (manic); to feeling depressed and suicidal, like there is nothing to live for-and living becomes a burden.

Psychosis is a break from reality. A first schizophrenic break will often occur as a young adult goes away to college. A predisposition with this disease may be stressed to the max with the change of routine that a college teen faces-adjusting to new surroundings, being away from the familiar home environment, the tension of school pressure, and a number of other factors. Usually parents will report that their child’s ‘weird’ behavior is drug induced, not wanting to face the disheartening news that their child is mentally ill.

Observe for changes from the norm and differences comparatively with other people or teens/children your child’s age. A simple checklist would be to engage in conversation.

1. Is the conversation an easy one, or is the person more irritable with being questioned, or skewing a normal conversation into something it isn’t?

2. Does the person claim to be receiving messages from the television or radio-or God?

3. Does the person reference wanting to kill themselves or harm others?

4. Is the person withdrawn to herself or her room?

5. Do you hear yourself or observe your loved one talking to someone who is not there?