Helping a Loved One with Mental Illness
In order to understand what your loved one with mental illness is experiencing and how best to help, it is necessary to communicate. The danger in doing so, however, is that mental illness results in distorted thinking patterns and irrational belief systems. Once you are aware of what these are, they can be labeled and discussed to the point that your loved one may be able to catch him or herself using them.
The following list was taken from a handout received at the Northwest Human Service Center in Williston, North Dakota, during cognitive therapy for depression and anxiety
1. Filtering - Filtering puts the focus on a single negative detail taken out of context, isolated from positive details, thus coloring the entire event as negative.
2. Polarized Thinking - In polarized thinking, there is no room for middle ground; everything is extreme - black or white, good or bad.
3. Overgeneralization - Overgeneralization is a broad, general conclusion based on a single incident or event.
4. Mind reading - A mind reader makes assumptions or judgments based upon the thoughts he or she perceives other people have.
5. Catastrophizing - Catastrophizing is worrying about bad things that are not likely to happen. Statements beginning with "what if" are characteristic.
6. Personalization - Personalization is a narrow point of view where everything centers on the self and its relationship.
7. Control Fallacies - There are basically two control fallacies, one of total external control - the individual is helpless and dependent on others, and one of total internal control - the individual is all powerful and others are dependent upon him or her.
8. The Fallacy of Fairness - The fallacy of fairness says that all things should be "equal" in order to be "fair."
9. Emotional Reasoning - Emotional reasoning is making judgments and decisions based upon subjective feelings rather than reality and facts.
10. The Fallacy of Change - The fallacy of change says that a person will be happy if those around him or her will change their actions.
11. Global Labeling - Global labeling is taking a general statement and applying it to a larger set of circumstances.
12. Blaming - Blaming is shifting the responsibility for one's actions onto someone else.
13. Should Statements - A person who uses should statements has an invisible list of rules and expectations for people's actions. If they or others violate the list, then guilt and/or bad feelings result.
14. Being Right - Being right means always proving that one's own point of view is correct, therefore, others are wrong and need to change.
15. The Fallacy of Heaven's Reward - The fallacy of heaven's reward says that good will always triumph, and those who sacrifice for and do good will receive a reward in heaven.
Hello Depression, come on in! It's really good to see you! All the others have abandoned me, you'd think I had the flu! They didn't want to hear me talk of troubles I am having. They'd rather speak of politics, prose, and the money they are making.
But me, I never have enough of anything, you see. I feel deprived of happiness, no one cares about me. My life is really worthless now, I'm not good enough to live. Even my Father in Heaven will not his Spirit give.
You're the only one who really cares, so I'll hang on to you. I can hide behind your face. Please stay! I really need you!
Talk about symptoms
Even though there are standard definitions for various mental illnesses, everyone experiences their own illness differently. Read all you can about the illness your loved one has been diagnosed with. Learn about the medications, modes of treatment, and ways to make life as normal as possible.
Because our bodies and minds change with the circumstances of life, symptoms and illnesses change. At one point, your loved one may be diagnosed with depression. Another time, with anxiety, and still another, with bipolar. All may be correct given the presenting issue at the time of the diagnosis. Make a symptom chart that outlines how the illness affects your loved one. Put it in a place where all can see it.
Example of symptom chart
Not wanted or needed
8-10 hours daily
Sleep all the time
Constantly active, dancing, singing, moving, talking excessively
Enjoy a variety of activities, including moving, sitting, standing, and resting
Slow, shaky, weak, want to just lay around and do nothing
Lack of desire to eat due to issues with the digestive system
Able to maintain weight by choosing nutritious foods in appropriate amounts
Eating more than needed in an effort to curb bad feelings
Decisions based on future that is not here yet
Make the best choice after considering the options
Avoid decision making, depend on others
Mixture of delusions, TV shows, extra-terrestrial, and memories
Here and now
Past negative experiences
Use of unorthodox methods of cleaning
Use good personal hygiene, want to look best
No desire to take care of self
Talking all the time, no personal boundaries
Reciprocal relationships, care and concern for other's welfare
Withdraw from social situations
Don't want to take medications for fear they will cause harm
Take medications as directed
Forget to take medications, have to be frequently reminded
God is telling me what to do, I am his messenger
Pray to know what to do and follow the spirit
Feelings of darkness, others are out to get me
Talk about treatment options
Decision-making is difficulty when you have a mental illness. Your loved one may need assistance finding appropriate medical personnel, medications that work, and activities that will not exacerbate the illness due to increased stress. Treatment for mental illness is also very subjective, and can be done in a variety of different settings.
- Private clinics - advantages include increased choices in the types of treatment available, qualifications of individuals providing treatment, and options for counseling. Disadvantages are higher costs for treatment, and the need for private insurance that covers the treatment chosen.
- Major medical facilities - advantages include connection with learning facilities, having the same doctor for in-hospital treatment as for clinical work, increased research and use of innovative treatment options, and access to charity for the needy. Disadvantages are the lack of personal service, and less focus on available choices or options for treatment.
- Human service centers - advantages are the provision of case management and community involvement services for the individual. Public funding is available on a sliding fee scale depending upon the needs of the individual. Disadvantages are that the atmosphere is geared toward high poverty and low intellectual ability cases.
- State Hospitals - advantages include state funding if treatment is court ordered, residential treatment for long term problems that require months to resolve, and resources that may not be available elsewhere. Disadvantages are that the person may have to be away from family members for an extended period of time, and the possibility of needing to become a ward of the state.
Help your loved one have the skills needed for their everyday life. Make sure that they are eating nutritious meals, getting enough sleep, taking their medication(s) regularly, and following the directions given by their doctor and/or counselor. Assist them with issues such as problem solving, conflict resolution, resource management, critical thinking, and establishing appropriate relationships.
It may be necessary to use a bit of "tough love" by saying and doing things that your loved one may not like, such as limiting time on social networks, controlling financial resources, curbing inappropriate behavior, and establishing other boundaries that are necessary for safety and protection.
Your loved one will go through times when life seems more difficult than they can bear. Your choice to remain kind and considerate, even showing compassion, may make the difference between them choosing life and death. With you in a key position as a loved one, your actions of acceptance or rejection will have a dramatic affect on their view of the value of life. Take time regularly to be kind and do things together that your loved one finds enjoyable.
As you do so, you will find that your loved one develops hopes and dreams, and shares them with you. Allow this to take place, it is a normal part of human existence. Whether or not these dreams materialize does not matter, what matters is that your loved one sees something positive in his or her future. Time will tell whether or not these things happen, you need not be a pessimist and tell them that life will never be fulfilling. That only adds fuel to the fire of their mental anguish.
Help your loved one get connected with people outside of your immediate family or household circle. Encourage interaction especially in religious settings, as members of religious organizations are more likely to be loving and accepting of mental illness and its accompanying life difficulties. For your sake, see that there is a support circle of friends and acquaintances that you meet with regularly, without the company of your loved one. This allows you to get the support and strength that you need to continue in a supportive role.
Burnout is highly probable and likely for you as a caregiver. Watch for feelings of irritability, impatience, and especially a non-caring attitude. These are signs that you have given more than you have available and are running on empty. See that you have things you enjoy that you are able to do on a regular basis to keep yourself emotionally and physically strong. As you do so, you will be able to be there for your loved one when they need you.
You may also need professional counseling to help you understand and deal with your loved one's mental health difficulties. That way, you can ask questions, get insight into coping techniques and treatment options, and keep yourself emotionally healthy. It is well worth the time and effort!
Is this really happiness and joy I'm feeling?! It's been so long, it seems like years, my head with glad thoughts is reeling! Just yesterday the clouds were there hiding the bright sun. But now they're gone, the light comes in. I can actually have some fun!
I can run and skip, jump and play, and smell all of the roses. I watch a child, so innocent, and marvel at cute feet and toesies. I feel a sense of newness, of freshness in my life. Gone is the pain and sadness I felt, the frustration and the strife.
The Lord is now a part of me, like he's never been before. I know him well, he's at my side, he's opened up the door. I gave my burden unto him, it had become so heavy. I could no longer carry the load; my body and soul were weary.
All I must do is walk with him, and work along by his side. He points to others that I can help through his Spirit, that in me abides. As long as I continue to love and serve as he, my burden he will carry, and walk alongside of me.
Celebrate the good times
All mental illnesses have times when there is a lull in the action, where symptoms are minimized, treatment has been effective, and a smile is on the face of your loved one. When this happens, take the time to celebrate. Do something fun. Dance to some music, go to the park, go out to eat, or just get some balloons and blow them up and pop them. Whatever you do, make it fun and enjoyable, and do it often enough that you look forward to the next time it happens.
Celebrating the good times keeps life choices positive and upbeat, and down times in perspective. Mental illness is much like chronic physical illness, it must be managed with positive daily habits and choices, an understanding of the need for medical treatment, and communication with providers and each other. All of these things bring an added measure of good will and camaraderie between you and your loved one, and make life that much better. The time you take to help your loved one deal with their mental illness will increase the quality of life for both of you.
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