We’ve heard our elders share the perspective, “Well, at least you have your health…” We typically think about physical health. But what about Mental Health, which can be particularly challenging because you can’t necessarily see it, it can be unpredictable, and it often comes with stigma attached- leaving families to cope silently on their own.
When mental illness occurs, family members may deny that the person has an ongoing illness. Certainly, there can be denial prior to a diagnosis, yet sometimes family members may find relief in the diagnosis- some form of answer. Other times, family members may feel denial, anger, or grief related to the diagnosis. More often than not- family members have a mixture of emotions and support can be helpful in coping with the diagnosis and on-going illness.
During an acute episode family members may be alarmed by what is happening to their loved one. If hospitalized, they may be relieved when the symptoms have subsided and the loved one returns home. Often, the hope is that the past is over and the future now begins- minus the illness. Thoughts often circle around research- hoping to find answers that will point to something physical that could have caused the symptoms, and that they will not return.
It is often difficult to accept the diagnosis. But, even for those family members who do accept the diagnosis, they may feel they have to protect them from others who do not. Or, they may accept the diagnosis, but believe that the illness is totally debilitating which is typically not the case. Families can become very pessimistic about the future or believe that the illness is the destiny rather than a piece of the puzzle that will help them plan for the future and manage the illness.
One of the biggest challenges of mental illness is predictability and differentiating mental illness symptoms from general stress reactions. Just because a person who is mentally ill is angry, doesn’t mean they are having “an episode.” Those with mental illness get angry from time to time and it can be perfectly normal- to expect a person with mental illness to never get angry would be unreasonable, and unhealthy. The goal is not to fully distinguish the feeling of anger, but to manage coping with the feeling of anger as it relates to their illness.
Predictability can be a challenge- if a patient with cancer goes for chemotherapy treatment, there might be expected side effects that typically occur. This allows for some kind of rhythm in relating to the patient and supporting the patient as well as caregiver around treatment cycles. Depending on type of mental illness, individuals and family members can develop a plan for coping with symptoms before, during and after an episode even if there is not a regular pattern as it relates to the calendar (i.e. certain stressors may increase likelihood of episode and one cannot fully control all stressors all the time).
Often illnesses come with a stigma- many times out of our own fear (that could happen to me!) or anxiety related to proper etiquette in supporting the patient or family member. Once an illness is understood, people often feel more at ease and are able to support those with illness. However, those with mental illness and their family members can be reluctant to discuss their diagnosis or needs because they don’t know how people will react. It can be exhausting, bewildering, and frightening and families are often unwilling to take risks in being hurt or rejected. Families, themselves, may have trouble understanding any difficulties their loved one is having. Or, they may be hoping that they’ll “snap out of it.”
Certainly the constant stress and concern can create turmoil as life can be unsettled and unpredictable. Families may feel sad, exhausted, worn out, discouraged, trapped, out of control, and/or at their wit’s end. Further, children may acclimate just fine only to grow into adulthood and then find themselves lost at coping in their own nuclear family- where a spouse did not live with a loved one with mental illness and "lenses" and coping strategies are very different. Fortunately, with support, families can develop a plan and set limits to manage situations now and in the future. They can begin to feel their feelings without shame.