When mental illness hits, it can hit hard. It hits the person who has it hard and it hits the family equally hard – though in very different ways.

One of the most common questions I get after my workshops and keynotes is, ‘How can I help my loved one when they don’t think they need help to begin with?’ So common in fact I’ve written two previous posts, one on my Psychology Today Blog: How to Help Your Adult Child if They Have a Mental Illness and another on my own: Families Falling Apart. There are many reasons for not wanting help. Denial, shame, anosognosia (the inability to be aware of one’s illness – a frequent symptom of psychosis itself ). 

Regardless of the reason, as a family member or friend, it can feel powerless. I’ve been on both sides of the path. I was that ‘someone’ with bipolar disorder, anxiety and psychosis who wouldn’t accept the diagnoses for years. I am also the daughter of a mom with bipolar disorder and severe anxiety, who has accepted the diagnosis, but does little more than take medication, which unfortunately succeeds in alleviating only a few of her symptoms. Good treatment involves more than just medicine.

But there are steps you, as a loved one, can take. Here are a few to help you help your family member or friend move forward on the journey to recovery and wellness. Take what you like and leave the rest.

1. Remember the journey to accept that there IS a problem, is theirs alone. You can help prep the ground, by having discussions and listening with an open heart, by setting clear boundaries, by offering information when appropriate. You can help create an environment that increases the chances of the person reaching out for help, but you can’t do it for them.

Anyone who’s been in this position knows, it takes more than one conversation. It takes many. It’s about opening the door of possibility. It’s about voicing your concerns with compassion and clarity and without judgement. Difficult, I know – especially when the struggle has been going on, in some instances, for years. But the rewards of avoiding power struggles, directives and arguments are great. A list of resources follows at the end of this post.

At the same time, it’s about setting boundaries for your own well-being and recognizing you are not responsible for their health and happiness. If you’re a parent of an adult child, this is one that is most heart breaking to learn and understand. Letting go is tough even when the adult child is well and thriving.

2. Rebuild trust and rapport. When family members ask me how to help their loved one, the issue has frequently been going on for quite some time. During that period, entrenched power struggles usually have developed and mistrust on both sides has been established. Your adult son or daughter, brother or parent, may continue to get angry when you suggest anything. The trick is for you to NOT get angry back. Easier said than done. Tools from Dr. Xavier Amador’s LEAP (Listen Empathize Agree Partner) method (below) may guide you how to listen without creating power struggles and rebuild trust essential for healing. Dr. Lloyd Sederer’s TEDx talk offers excellent tips and encouragement.

It was important that my treatment was a shared decision-making process; that those around me, both parents and professionals, didn’t try to convince me to do something. I needed to have people empathize, understand and reflect back my experience. The more I felt respected and heard, the more open to suggestions I became because I felt like I was being empowered not attacked.

3. Evaluate whether you really are the best person to talk to your loved one right now. Be honest. If conversations almost always end with tempers flying, another person who has his/her best interests at heart and can communicate more easily is a better option – at least for now.

4. Invite your loved one to go to the doctor together to address a legitimate physical issue. The problem could be poor sleep, or frequent headaches. You might feel that they stem from a mental health issue, but tending to a physical complaint is often easier to address first.

If mistrust and tension in your relationship is high, this may not be a good option. But, it’s surprising what sometimes works. The goal is to have them be willing to see someone for a general check-up. In that appointment have a mental health check-up too.

Resources:

  • Crisis Lines:  If you need help immediately, please search this list of crisis lines and centers and contact one of them right away.
  • Download this free Mental Health Resources and Tips e-guide I created from my website. It has many of the resources listed here and others for loved ones, individuals living with mental illness and employers and staff.
  • Dr. Lloyd Sederer’s TEDx talk ‘When Mental Illness Enters the Family offers excellent tips for parents, loved ones and others when supporting someone who is struggling with mental health issues but isn’t able to see they need help. In addition to his talk, he has a widely praised book “The Family Guide to Mental Health Care: Advice on Helping Your Loved Ones
  • Dr. Mark Komrad’s video has some good points. I wouldn’t watch the first part but from 49:30 minutes he describes when, how to talk to someone, some do’s and don’ts. Some of his approach is paternalistic, but some of the tips are useful. His book “You Need Help! A Step-by-Step Plan to Convince a Loved One to Get Counseling may be a helpful read. I can’t vouch for the info as I haven’t read it yet, but it comes recommended.
  • Dr. Xavier Amador’s book “I don’t need Help, I’m Not Sick describes his well-known LEAP (listen, empathize, agree, partner) approach. This post gives a concise summary of his LEAP programThis video illustrates a role play contrasting a traditional communication method and his LEAP method: Dr. Amador focuses heavily on anosognosia (when someone lacks the ability to be aware that they are ill). He makes a point to differentiate this from denial. You can find individuals who have been trained in his method on his referrals page.
  • Practical tips for family and friends on the “Living with Mental Illness: A Guide for Family and Friends” website.

I hope these resources help. Let me know if they do. If you have ones not listed here that are especially effective, please mention them in the comment box.

If you’d like to receive more information like this, sign up for my newsletter. You’ll receive a free e-guide addressing anxiety, depression and perfectionism.

© Victoria Maxwell

Before you go all nuclear on me saying ‘how dare you make fun of people with psychiatric disorders!’, check my two previous posts about my rules for finding the humor in mental illness: rules for finding the humour in mental illness and 13 One-Liners About Being Crazy. Mean-spiritedness, degradation are NOT my M.O.s

The two most important tenets in my rulebook:

    1. If you don’t have mental illness, it ain’t your rodeo to ride in. I live with multiple mental health issues. It’s up to me if I want to joke about them or not. If you have mental illness, you have the same choice.
    2. I don’t make fun of people with mental illness. Yes, I may make fun of myself, but mostly I discover the humor in the situations I find myself in because I have mental illness.

Why bother finding the comedy in pain? The overarching reason: for me, it is healing.  I hope you have some giggles as you read these and as you giggle I hope you heal (just a smidgen).

Ok here goes. Warning: some corny, really corny jokes ahead.

  1. Mental illness runs in my family. Which is sort of weird, because my parents weren’t very athletic.
  2. I’ve never had paranoid delusions. Somebody told me I did, but I know they’re lying.
  3. I’m lucky, I have very little side effects from my medications. They can fit right into my pocket.
  4. In the beginning my eating disorder meant I had dessert before my entrée. But then it got serious and developed into compulsive overeating – as opposed to apathetic overeating.
  5. Hallucinations are when people see things that aren’t there. I totally understand that.  An ex-psychiatrist of mine had them. I know for a fact, she never saw me. I don’t know what she was seeing, but she definitely didn’t see me!
  6. I’m on Zoloft and Epival and many other planets.
  7. I have psychotic breaks – my car stops at all delusions.
  8. I have an anxiety disorder…which means my anxiety orders dis and dat.
  9. I’ve faced mental illness. Stuck my tongue out at it, shook my fist at it and finally gave it the finger.
  10. What does it mean when people say “I don’t believe in drugs for mental illness”?  ‘Cause they seem pretty real to me. I think those people might have a delusional disorder.
  11. It makes perfect sense mental illness runs in my family. I’d run too if I had a family like mine.
  12. Where do they get these names for psychiatric drugs? No wonder we don’t like taking them. They sound like a bad storyline from a Star Trek sequel. You know: Captain Zoloft and his commander in chief Colonel Paxil are involved in negotiations with the Prozac Nation and the Lithium Liberation Army.
  13. I still have psychotic breaks from time to time – which are very different than coffee breaks. You don’t get paid for psychotic breaks.

If you like this post, sign up here to receive my newsletter. You’ll also get my handy dandy ‘7 Steps to Escape Perfectionism, Anxiety and Depression’ e-guide as a thank you gift!

© Victoria Maxwell