How do you support an adult child who has a mental illness? How do you as a caregiver hang in there when your adult child, who so clearly needs help, refuses it? I get requests from parents and caregivers just like this every week.

Some of you reading this right now may be facing these very situations. Your adult child may be struggling with addiction, maybe it’s a severe chronic mental illness, or maybe it’s both.

I wish there was a simple three step solution. Do this, this and this and your adult child will accept the help they’re being offered. Put these five strategies in place and the rehab program they’re in, the out-patient program they’re involved with will, all of a sudden, turn things around once and for all. 

But it doesn’t work that way of course. Recovery is possible. Recovery should be the expectation. But the cold truth is recovery isn’t guaranteed. Recovery is also relative. Recovery varies for each individual depending on myriad factors – especially how chronic, how severe the mental illness is that the person is dealing with.

There is still reason to hope. There are solutions, though the road may be arduous. 

With this in mind I want to share with you an issue of the Canadian Mental Health Association BC Visions Journal: Supporting Adult Children: Helping Them Find Their Way.

You’ll find first person experiences from parents and caregivers. Like Holly Horwood, whose daughter lives with severe schizophrenia. She describes what they have gone through as a family and explains what has helped and what hasn’t. 

You’ll read about the pivotal part support groups play in the lives of caregivers. Other articles offer strategies for setting and reviewing boundaries, how to hang in there as a parent when your adult child doesn’t want help and tools to support them when they do. 

You can learn about additional resources, and communication strategies to help your adult child in this Psychology Today post: “Help Your Loved One with Mental Illness with These Resources”.

In particular look at #6 and watch Dr. Lloyd Sederer’s TEDxAlbany talk ‘When mental illness enters the family’, where he describes key steps to help someone who doesn’t want help.

Watch how my parents coped and navigated my unwillingness (or perhaps better said my inability) to accept help in my theatrical keynote (available for purchase here should you be so inclined).

If you love an adult child with a mental illness and/or substance use issue, my wish is that you realize you’re not alone and as a result feel some relief and hope and also discover some new resources for your journey.

Visions Journal is a free magazine produced by the British Columbia Division of the Canadian Mental Health Association. Electronic subscriptions are free to anyone. Print subscriptions are free to anyone in BC. The cost is $25 for a yearly subscription outside of BC. Click here for more info.

You can view past editions here.

© Victoria Maxwell



September is fast approaching. In light of this, I thought it apropos to write a post regarding accommodations for students with mental health issues in a post secondary setting. 

Creating accommodations help students who have mental illness reach their academic potential. Whether you’re advocating for yourself, or helping to advocate for someone else here are points to keep in mind.

1. Accommodations are a right, but are negotiated.

2. Determine what changes would be most effective for your specific illness or illnesses. It may take some experimentation.

3. Role-play asking for the accommodations to gain confidence before actually requesting them.

 With few exceptions, teachers and schools are very amenable and experienced in accommodating students with disabilities. As part of the American Disabilities Act and the Canadian Human Rights Act, they have an obligation to fulfill reasonable accommodations requests.

Dr. Sarah Helm, Diversity and Inclusion expert, cites “according to the National Center for Education Statistics, individuals with depression, mental, emotional, or psychiatric conditions now represent approximately 24% of college students with disabilities and have become the largest cohort of post secondary students who identify having a disability” (Helm, 2012; NCES, 2009).

Despite this, fellow students and teachers still can lack understanding, sensitivity and patience. The more comfortable you are with your mental health needs the easier it will for you to communicate with teachers. In the classroom, you are not required to disclose what illnesses or disabilities you have. But you will need to be able to discuss what accommodations will be helpful. You can, if you choose, to disclose voluntarily. But that is a decision that is very personal, and should be made carefully.

There are both informal accommodations (strategies students can implement on their own) as well as ones that are formalized through disability services on campus. Two people with the same condition may not need the need the same classroom strategies. Here are a few examples of formal accommodations:

– Due date extensions

– Time extensions on exams

– Quiet and/or alone place for taking tests

– Ability to complete work at home

– Advance notice of course expectations

– Study buddy or academic coach

– Alternative forms for assignments

– Alternative types of study resources

– Pre-arranged breaks to get fresh air and move around

Dr. Helm explains “counseling centers and disability services offices have been increasing their level of support for students with psychiatric disabilities; yet despite these existing support structures, students are not seeking assistance from disability services offices due to fear of disclosure and the negative stigma” (Collins & Mowbray, 2005; Helm, 2012).

So it is imperative students with psychiatric disabilities understand they have a right to reasonable accommodation as well as protection from discrimination stemming from stigma. Colleges need to recognize that insidious stigmatizing attitudes towards those with mental illness have subtle yet far reaching ramifications. On-going dialogues about mental health and mental illness on campuses are crucial so stigma and it’s consequences are lessened. In doing so, students can be propelled from the fear of disclosure and requesting support to the freedom of accommodation and academic success.

 An excellent resource is the Higher Education Support Toolkit: Assisting Students with Psychiatric Disabilities from Boston University Center for Psychiatric Rehabilitation.article continues after advertisement

© Victoria Maxwell


 References:

Helm, Sarah PhD Career Development Experiences and Employment Concerns of Job-Seeking Students with Psychiatric Disabilities PhD diss., University of Tennessee, 2012 http://trace.tennessee.edu/utk_graddiss/1304

National Center for Education Statistics (NCES). (2009). 2007-2008 National Postsecondary Student Aid Study (NPSAS: 08). Computed by the Data Analysis System (DAS-T) Online Version 5.0 on June 29, 2009

Collins, M. E., & Mowbray, C. T. (2005). Higher education and psychiatric disabilities: National survey of campus disability services. American Journal of Orthopsychiatry, 75 (2), 304-315.


Diagnosis doesn’t equate acceptance (as many of you well know). I certainly took my sweet time in accepting my conditions. Mental illness, particularly psychosis, wasn’t something I had been striving for in my 5-year life plan.  

Below are questions and approaches my family, psychiatrist, other health professionals and my friends could have used to help me become more aware and more accepting of what I faced.

A caveat however. If someone is experiencing a psychosis or a severe lack of insight (anosognosia*) these suggestions may not be appropriate or at the very least will need to be adapted. For tips about how to communicate with someone in a psychosis these videos might be helpful. Though neither is a psychiatrist they have good information (suggestions start at 6 minutes 48 seconds).  I don’t like his finger pointing (which you’d think he’d know isn’t a good way to communicate). Some advice and examples are a bit flip and graphic, but some information is excellent.

Another video to watch is: https://www.youtube.com/watch?v=_ss_CMUdH2U She makes an excellent point about being a ‘comforting force not a challenging force’.

Here are 10 strategies that could have helped me feel understood, empowered and more willing to investigate the treatment and help being offered:

1. I wish…someone asked me exactly why I didn’t want to accept the diagnosis. Why I didn’t want to take medication. When the reasons for resistance are shared, erroneous assumptions can be discussed, potentially corrected and new actions can take place*. E.G: I believed medication was a ‘cop-out’ and meant I was weak. I believed if I did enough therapy and got to the ‘root’ of the psychological reason I was depressed, I wouldn’t experience it anymore.

2. I wish…someone validated and empathized with me regarding my resistance to medication instead of trying to get me to see it their way. That doesn’t mean agreeing with me but it meant acknowledging my position. Arguing with me and telling me to take it only made me feel more misunderstood, and forced me more into myself.

3. I wish…someone validated and empathized with me regarding my resistance to medication instead of trying to get me to see it their way. That doesn’t mean agreeing with me but it meant acknowledging my position. Arguing with me and telling me to take it only made me feel more misunderstood, and forced me more into myself.

4. I wish…someone helped me understand the truth about mental illness, and showed me how to investigate those objections, allowing me to come to my own conclusions. That is, do some basic stigma busting with me.

5. I wish…someone asked me if I wanted to talk about my psychoses. Because I did want to talk about it. I wanted to, needed to make sense of it.

6. I wish…someone validated and explored with me the profound, life-changing spiritual elements of my psychosis. It’s important to note, not all aspects were negative and not all were meaningful. Instead, what happened was my insights and experiences were labelled as pathological and part of the illness, something to be discarded and forgotten. It wasn’t until I met my psychiatrist, Dr. Dillon, who discussed my experiences with neutrality, curiosity and compassion.

Questions like these would have helped:

  • What did I learn?
  • What was it like?
  • What happened?
  • What aspects did I want to talk about, but was afraid to? And why?
  • What am I sad about? What did I lose? What do I need to grief?
  • What am I afraid of, concerned with and how can it be addressed?
  • What am I confused about?

7. I wish…someone could have helped me integrate a medical model with a spiritual perspective sooner and explained to me that it is possible to have both a spiritual experience and a mental illness; that one does not negate the other.

8. I wish…more people praised my scepticism; it meant I was deciding things on my own and the choices I made were intrinsically motivated.

9. I wish…someone informed me sooner the severe negative and anxious feelings I was experiencing could be part of a mood disorder not just a set of emotions and low self-esteem.

10. I wish…someone had explained cognitive therapy more clearly. When I was told my thinking creates my feelings, I felt I was being blamed for my depression.

Kay Jamison states in her book ‘An Unquiet Mind’ that we don’t know why some people walk through the door of acceptance or walk through it easily and others don’t. We also don’t know when people will do it. What I know for sure is, when we meet people where they’re at, when we’re curious and respectful, it helps people feel safe. People who feel safe are more willing to take risks and try things. That’s what happened for me at least.

© Victoria Maxwell


*NAMI defines anosognosia “when…someone is unaware of their own mental health condition or they can’t perceive their condition accurately”. Click here for information about it in the context of mental illness.


Mother’s Day 2019 just happened.

Mom, I’d like to say ‘thank-you’ to you publicly. To say how much I love you, Mrs. Velma Maxwell. How the person you are, at 88, makes me smile, feel good, and warm. How I still feel like a cared for daughter even though I’m frequently more the mom taking care of you.

It wasn’t always this way. I was a brat. You could be infuriating. Our ups and downs were compounded, literally by both of us having the same diagnosis. Bipolar disorder and anxiety. The apple doesn’t fall far from the tree. Perhaps more accurately the nut doesn’t.

The anxiety that needles my stomach and muddles my mind offers a way in for me to comprehend all those years when you fretted and paced and wrung your hands. My depressions that hover like mist and manias that sizzle the bottoms of my feet close a gap of misunderstanding and impatience.

I was a teenager, and embarrassed by you. Angry, confused and scared by your manic rage as a child, so easily was thrown at dad, impaling him with insults, slurs and cacophonies of profanities.

But over the years we found a way to use our love and insane similarities to overcome our differences. Today, the things we do give me a quiet joy. We hang out and play double solitaire. Eat take-out lunch I bring in from the Eighties Restaurant. Your beloved toasted triple decker clubhouse sandwich with fries and chocolate milkshake.

We talk about inconsequential things that aren’t. The TV shows you’re watching and the ones you won’t. ‘Law and Order: SVU’ your favourite that you always watch. The Big Bang Theory, the one you won’t because it’s ‘dumb’. How the food at the nursing home is awful, but Linda the care-aide is ok.  How the Canucks (who you follow devotedly) won’t be getting anywhere near the play-offs this year.

Thank-you mom for having a knack for always helping me feel loved. You are in my heart always.

© Victoria Maxwell



This week is the 68th Mental Health Week founded by the Canadian Mental Health Association! That’s a whole heck lot of talkin’, learnin’ and awareness buildin’ about mental health!

My contribution this year is shedding some light on psychosis in the hopes it will increase compassion. I wrote this for my Psychology Today blog a few years ago, but it bears repeating.

Dear Hospital Emergency Ward Staff,

When you see me in a manic high, wrestled in here by my father; or as you watch my mother, sitting with me in the waiting area, holding my hand while I ramble gibberish to an invisible friend, please remember this: I may be crazy but I can hear. I may be mad but I can see. I may be insane but I’m still smart.

I can see you rolling your eyes when my behavior is bizarre. I can hear you when you shout to the security guard to ‘catch the crazy woman’ as I fly to find some scissors. I know you’re referring to me when you look at me but whisper to your colleague, then purse your lips and shake your head.

I don’t want to be running around the emergency ward in florid psychosis looking for God. I don’t want to be strapped to a gurney needing sedatives to calm the fire in my brain while I scream for the Mother Ship to beam me up.

Maybe it’s because you’re burned out, under-resourced, over-taxed, understaffed and over-stressed. But, I am a human being before I’m a ‘frequent flyer’, the ‘nut case who must be on drugs’, that patient who can wait because ‘she’s non-compliant’.

I understand that I’m hard to understand and hard to manage. I know your job is trying; that you do your best; that you do care. But please don’t forget that just like you, I have a heart. A heart that hurts when someone judges me for something that isn’t in my control; when someone doesn’t see that really I’m doing everything I can to get well even though it doesn’t look that way.

Because I also feel when you, the paramedic who wheels me through the hospital doors, stream such soft compassion from your eyes and gently nod goodbye to me. I sense when you, the nurse whose name I do not know, rests your hand on my shoulder with such respect that dignity rises from my feet.

So please remember, even when I’m laughing like a drunken hyena, and my father paces the green linoleum while my mother strangles her panicked hands, and all three of us wait for the attending doctor, I am aware of the kind light in your face as you tell us (including me) that you wish there was more you could do but hopefully it shouldn’t be much longer. No matter how crazy I may be, I am aware. And when your heart remembers that, my heart does too.

Let me know what you think. What has it been like for you if you’ve been in a psychosis or if you’ve been with someone while they’ve been in one?

© Victoria Maxwell



Feeling powerless over symptoms often goes with the territory when you live with mental illness. At least it can for me, particularly with anxiety and depression. This isn’t just the case for those of us diagnosed but also those who love and support us. They can feel at the mercy of these debilitating conditions when they’re at their peak.

Like a ragdoll in a tug-o-war between two kids or one in the washing machine (the ragdoll, not the kids) I can feel like I’m at the whim of my symptoms: negative self-talk, extreme fatigue, racing heartbeat, racing thoughts, incessant worry, rumination, lack of focus, aches and pains, hopelessness, emptiness – and those are just the pleasant ones. Kidding.

I enjoy feeling in charge of my mental health. Most weeks I am. But not always. Not by a long shot.

So what do I do? What can you do if you feel like this?

This is a strategy I’ve set up with my husband. It’s not a miracle solution, but it can help lessen the blows of bipolar disorder, psychosis and anxiety that I live with. It can help my husband better weather them too.

Let your loved ones help you. Enlist them into your wellness journey:

My husband knows me well. He catches signs of things shifting up or down better than (and before) I can sometimes. We all have our blind spots.

He’ll see me filling the Britta jug over the top line, or I’m getting up earlier (much earlier) than usual. Or like today, he’ll catch me making a grocery list and doing laundry at 5:00 in the morning. We’ve created a code word so to speak to signal I might be hypomanic. With kindness and enthusiasm, he’ll say ‘Oh. Spazzy Maginty is visiting us today!’

Another day, I fidget a lot in my favorite chair when we eat breakfast together. Or I won’t look him in the eyes when we talk. He might gently ask me ‘How are you doing?’ or more specifically ‘How’s your anxiety?’.

A different instance, he mentions my complexion looks grey and I’m sleeping longer than usual. Or he might recognize I haven’t run in a couple weeks. He’ll smile, look at me and ask if everything’s ok, knowing that likely it’s not.

His comments aren’t criticism but instead observation. Facts that I’ve changed from my baseline of wellness. It’s meant lovingly and delivered that way. It’s information I can use to my advantage. If I take steps to care for myself, I may prevent the anxiety, depression or hypomania from blossoming further. It’s not guaranteed, but it can reduce the intensity.

I’m not to blame for my conditions, and he’s not saying I am. I am however responsible for my health and reaching out for help when I need to.

My next steps are to be on the alert. Revisit and perhaps double up on my wellness tools. I check to make sure I’ve taken my meds and taken them properly. I’ll review and adjust my sleep patterns. Ask myself if I’m putting too much on my plate and if I need to, take things off. I’ll look at my exercise and aim to do a bit more, or do any if it’s fallen off the radar. I’ll call a friend and spend some quality time with them – phone or in person, doesn’t matter to me. As the incomparable Julie Andrews sings (sort of) these are some of my favorite (‘wellness’) things.

Ideally this will result in the levelling off of my symptoms. This isn’t rocket science. But it’s amazing how if I don’t see my warning signs early enough, and make the needed adjustment, how off course I can really go. And I’ve gone off course. Really off course in recent months. Think psychosis (twice) and major anxiety. But with the help and delicate diplomacy of my husband and my own willingness to accept assistance, getting back on more stable ground is possible.

3 Step to Help Prevent Relapse of Mental Illness

Note: Do these steps with your loved ones while you’re well, not when you’re struggling with acute symptoms.

To set the stage ask yourself:

What are your cues? Be specific. Ask your friends and loved ones to chime in about the warning signs they see. Compare notes.

Who do you want to be your ‘cue companion’? How do you want your loved ones or friends to approach you? Decide who and what’s most comfortable for you. You don’t need a husband, or even someone who lives with you. Just someone who cares.

What will your next steps be when they mention something? Have a list of your most effective wellness tools that you’re willing to commit to. Then pick one and do it. Be honest and clear about what you’re willing to do when warning signs start to rear their heads. Set yourself up for success Think tiny adjustments.

Then:

  1. When warning signs arise, your ‘cue companion’ has permission to mention what they see.
  2. Review your wellness tool list (with your loved one if you like)
  3. Take action: add, adjust said tools as needed.

Sometimes I worry, even feel ashamed at times, how much focus it takes to ‘manage’ my mental illnesses; that I might be a burden with all my mental health problems. But Gord has told me when he’s asking me about them, he wants to know. It’s ok, more than ok to talk about my mental health. Go figure?!

I’ve come to realize that this little 3-step system is as much of a sanity saver for him as it is for me.

Try this out with your loved ones and let me know how it goes. Or, if you have a similar system already in place, let me know how that works for you!

© Victoria Maxwell

Some of you know my story. Many of you don’t. Every experience is unique and equally valuable.

Though our stories are ours and ours alone, it always amazes me how similar our journeys can be sometimes:

I’ve met more than a handful of people who have run down the street naked in a psychosis. Psychosis seems to prompt a shedding of clothes. Funny (or maybe not) depression doesn’t inspire the same behaviour.

Other shared experiences include traumatising incidents in the emergency room for both loved ones and those of us with mental illness. Damage done usually due to underfunded and understaffed hospitals, lack of services and overworked health professionals.

I also realize how lucky I have been and still am.

When I was diagnosed, it was the 90’s. I was a 20 something, middle class, white woman, living in one of the most affluent countries in the world boasting universal medical care – Canada.

There were treatments available: pharmaceutical and psychological. Though far from perfect, these treatments were more humane than anything that existed in the 30’s, 40’s, 50’s, 60’s and even the 70’s when my Mom was diagnosed.

I also wasn’t struggling with addiction along with bipolar disorder, anxiety and eating disorder.

Addiction complicates accessing help and achieving recovery.

Incomprehensible as it is to me, addiction treatment, is largely still siloed and separated from other mental illness help.

Now, I’m a middle-aged, middle class, white woman in Canada. I am still very lucky and that luck is part of the reason why I have fared so well.

Others are not so fortunate. The social and economic inequities many individuals face, have a powerfully negative effect on mental health. Long lasting and intractable at times.

It’s not a fair fight for them. As such recovery is more difficult. 

I’m also lucky because my conditions responded to treatment well – medication and different forms of therapies and lifestyle changes. Yes, I put effort into my recovery.

But, effort and trying alone does not determine if recovery happens. I know people who try really, really, REALLY hard and are very proactive in their mental health yet wellness eludes them, through no fault of their own. These illnesses are confounding.

Every person who has mental illness and everyone who loves someone with a mental illness has a story that is unique and important.

This is a very brief description of mine.

Warning: humour ahead. The humour I use is not to minimize the very real suffering that mental illness causes. Humour is one of my wellness tools. Feel free to laugh along with me and about me.

I was diagnosed with bipolar 1 disorder with psychosis, generalized anxiety disorder, mild temporal lobe epilepsy and an eating disorder when I was 25. Not really something you run and put on your resume under achievements. Well, actually, nowadays I do.

I didn’t initially embrace the idea of having a mental illness.

No, I flat out denied it, for 5 years. Even after four psych ward stays, multiple suicidal depressions, psychotic episodes, countless manias. Even after having to move in with my parents, losing my car, career, friends and money.

Even after running down the street naked in a psychosis, I wouldn’t accept I had a mental illness.

Eventually however, I did. With the guidance of caring (and extremely patient) parents and healthcare professionals and friends and support groups and peers, I did.

But it was still another journey of 5 more years to get back on my feet living independently, working,  enjoying the company of friends and in a loving relationship.

I laugh when I think of how life works. I would never have the career I do, had I not gone crazy in the first place!

I was originally trained as an actor. But my career derailed – untreated mental illness has a way of doing that. When I returned to work, I got a job as a receptionist. It was good, stable and healthy.

But, I craved more creativity in my life. I needed creativity in my life.

I started writing about my experiences. I submitted to a disability arts festival to “read from my book”. I was accepted. But, I didn’t a have a book. I didn’t even have excerpts.

So, I got to work, and wrote. Wrote not a book, but a monologue for the stage. Acting was what I knew. People liked it and asked “Is it part of a one-person stage show?” I said “Sure.” Ummm.. it wasn’t, but I know opportunity when it knocks.

From there I wrote a full keynote show. I started presenting it at organizations and conferences locally, then across North America, then internationally.

Since then I’ve written four more theatrical keynotes. Now I have a career speaking about mental health, smashing stigma, and leading wellness and creativity workshops .

I love what I do. I get to talk openly about what I used to be ashamed of. People want to hear about it. People want to feel comfortable talking about mental health. When I share my story and I see faces in the audience nodding in agreement back, it’s like finding brothers and sisters I never knew I had. And for an only child, that’s pretty cool.

Staying well is an ongoing process. I don’t take my mental health for granted. I can’t. I need to do certain things everyday to stay well. Exercise, meditate, take medication, eat well, sleep enough – to name a few.

My life is very different from what it was when I struggled with severe depression, suicide, anxiety, psychosis and my eating disorder. It’s taken a long time but I’ve got pretty good at managing my conditions. But, I’m always learning.

Now my focus is on healing, creativity, flourishing and gratitude. It’s also about sharing those things with others.

What is your story? Send me an email or comment below and let me know.

© Victoria Maxwell

Every month I receive emails from parents (just like you perhaps) of adult children who have serious mental illness. You tell me many things, but the one on which you all agree is how painful it is to see your son or daughter in anguish yet at the same time not accept help. She’s angry with you, blames you, yells at you, yet needs your help desperately. You tell me how helpless, how lost and how hopeless you feel. It is a journey of great pain. But there is also great hope. I know. My parents were on this very same journey. For 5 years, I was in and out of the hospital because of psychotic episodes. I not only refused help but refused to accept the diagnosis of bipolar disorder with psychosis and generalized anxiety disorder.

“H.O.P.E.: Hang On Pain Ends” ~ Unknown

There are myriad reasons a person refuses treatment. They can (and for me did) include: denial, anosognosia1 (ie: the inability to recognize you are ill), shame, emotional overwhelm, stigma, lack of access to good treatment, insufficient education about mental illness, fear of change and lack of skills or support to move through change.

But there are steps you as a parent or support person can take, at least initially, if you are facing this situation.  The suggestions may help you feel a little less powerless, a little less alone and a little more hopeful.

Know this: change is inevitable, recovery is possible and your adult child can get her life back; maybe not the exact life she had before she got ill, but a life worth living.

 

“Recovery is a way of living a satisfying, hopeful and contributing life, even with the limitations caused by illness…(it’s developing) new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.” ~ Bill Anthony

 

I’m not a parent of someone who has a mental illness. But I am someone who saw what my parents went through as I struggled to make sense of my own psychiatric disorders and find my road to recovery. (On this  previous post on my Psychology Today blog my dad offers advice to parents trying to help their adult child. This post describes strategies to help someone with a mental illness who doesn’t want help.)

This is not only your adult child’s journey, the entire family embarks on it together. Mental illness becomes a whole family condition – chaotic and frightening. You know this.

But I also know this:

  • You can do it. But you can’t do it alone.
  • You can’t change your loved one. But things will change.
  • Recovery (for the adult child AND family) is possible.

Here are seven suggestions to help make your current difficult situation a little more tenable.

7 Steps for Parents who Love an Adult Child with Mental Illness

1. Stop the power struggles with (or judgements you have) of your daughter or son.

How do you do this? Listen to what your adult child is telling you. Don’t correct her, don’t try to change her or convince her. Just listen. Summarize what you hear her saying. Just because you are listening and reflecting back what she says, does NOT mean you agree with her. It does mean you are doing everything you can to understand her and her experience.

Like anyone, someone with mental illness wants to be heard, wants to be understood. And frequently for someone with a mental illness, this doesn’t happen. Really understanding what she is feeling (ie: empathizing) can rebuild trust. It’s not easy. Believe me. But it can build bridges where bridges were previously imploded. Check Dr. Amador’s website and book (I Don’t Need Help! I’m Not Sick) for more instructions on what it means to empathize and actively listen.

2. Remind her (and yourself) you are both on the same team.

But don’t just tell her, show her. Show her by working collaboratively: listen without an agenda; partner in decision making, set boundaries when necessary. Telling your adult child what she needs, what she should do, or what YOU know will help her will only make her dig her heels in more. You’ve probably already experienced this.

3. Recognize you might not be the best person to help her.

It may not be fruitful to say you are on the same team. Sometimes there’s too much animosity, so much trust broken (on both sides) that your adult child only see you (at the moment) as an enemy. Because of the current (yet temporary) volatile nature of the relationship it may be best to find out who, if anyone, she does connect well with. Is there someone who she will listen to; who she does trust or confide in? That person needs to be someone who has her best interest at heart (obviously), not someone who enables her or aggravates the situation. For example, not a person who she drinks with or who encourages her to believe you are an interfering parent.  A close friend, a trusted Uncle, a former teacher she admires, are options.

4. Ask your adult child what she needs to feel safe.

She may not know. She may not be able or want to calm herself down in order to express what she needs. It may be about helping her learn to calm her anger. Is she willing to go to counselling , not for mental illness but to sort out some life dilemmas; to solve some issues or secure some essential basics (housing, sleep, friends). Even if she blames everyone else for her problems, you can mention counselling can be a place to talk about that. And with that, a good therapist can help her gain insight and learn problem solving skills.

5. Let her know you are there for her.

Sometimes the only thing left to do (but also the most important) is letting her know you are there and not going anywhere. When or if she wants to reach out, you’ll be there, without judgement, with love and curiosity.

The most important element for me was to know that my parents (even as I pushed them away and argued with them), loved me unconditionally, and would be there. They might not like how I was behaving, but I knew they loved who I was. Even as I refused their help there was a part of my consciousness, a part of my soul that heard them, that registered how much they cared. This is true for your son or daughter.

6. Set boundaries.

You do not need to nor should you tolerate verbal or physical abuse (nor should your adult child). You may have to say ‘I love you. I’m here if you want help, but I will not allow you to berate me (yell at me, swear at me, threaten me etc). It might be about giving her space, you taking space or telling her she’s needs to leave. Always ensure she is safe and not at risk of suicide or harming someone else.  If she is at risk, then taking her to the emergency ward (or in the worst case scenario, the calling the ambulance or police) will be necessary.

For further excellent strategies watch Dr. Lloyd Sederer’s Chief Medical Officer, NY Office of Mental Health video ‘When mental illness enters the family’. https://www.youtube.com/watch?v=NRO0-JXuFMY

7. Don’t do this on your own.

Make sure you get help for yourself. The old airplane emergency adage applies: take care of yourself first, before you help someone else. You are no good to anyone if you are overwhelmed. There are other families willing to help and talk with you. Find a support group for parents of someone with a mental illness. The expertise in those rooms is invaluable, life saving even. Check with your local mental health clinics, your doctor, your community resources and local mental health organizations (DBSA, CMHA, SSC, NAMI)2. These connect you with people who have similar challenges, link you to community resources, and offer you emotional support and encouragement. The resources and support groups are usually offered at no charge.

This path may be long. It may be arduous. But it gets better. It’s not your fault. There is help. There is hope. You are not alone.

Please email me with your own strategies and feedback about my suggestions. I’d like to put them into a future post (anonymously of course, if you wish) because there is strength in numbers and wisdom comes from diverse and multiple perspectives.

© Victoria Maxwell

  1. If you’d like more information about anosognosia please watch this video which includes a talk from Dr. Xavier Amador, an expert in the area.
  2. Depending on where you are located, check with your local Depression Bipolar Support Alliance (DBSA) or National Alliance on Mental Illness (NAMI) chapter or if you are in Canada: your Canadian Mental Health Association (CMHA) or Schizophrenia Society of Canada (SSC) branch.  The SSC helps families dealing with ALL types of mental illness.