When someone you love has a mental illness

Living with a serious mental illness affects not only the person with the condition but everyone in the family. Mental illness can take many forms.

The most common are anxiety conditions such as panic, phobias and generalised anxiety; depression, schizophrenia, bipolar disorder, eating disorders, and obsessive-compulsive disorder.

A person with a mental health condition is likely to experience considerable tension and distress in their lives and this can affect those around them. Apart from this their behaviour towards others in the family and to those outside the family can often cause concern and strong feelings in those closest to them. This can be in the form of anger, fear, grief or confusion, particularly if the behaviour is aggressive, repetitive or unusual.

You may find you are grieving for the person that you once knew and now cannot see in the person they have become. This grief may need time and patience to understand as you come to grips with the changes in the person’s life and trajectory. The dreams you had for them may no longer be possible and this may take some time to adjust to.

However, it is important to remember that most mental health conditions are in the form of ‘episodes’. This means that they are not necessarily permanent or the changes enduring. People recover from mental illness and often learn a great deal about themselves in the process. This can help to become more insightful and informed and often better people to live with as a result.

If the person is your child or your sibling

It is important to have open communication in the family when a member has a mental illness.

Talking with each other about the problems other family members are having can relieve a sense of isolation that can arise if everyone stays silent and doesn’t talk about what is happening to the family. By sharing it you can work together to support and encourage each other and prevent further problems occurring in other family members.

It is common for those caring for someone with a mental health condition to experience anxiety and depression themselves. So looking after yourself with time away or just getting outside the house to walk around the backyard can be essential to maintaining your own mental health. Keep up a balanced life as much as possible with breaks, changes of scene or setting, or connecting with friends via phone or skype or email. This can relive the isolation and ‘cabin fever’ that can occur.

Always keep reminding yourself that the person themselves is still there and relate as normally as possible with them so they can keep up the bond with you as much as possible. Avoid speaking to them as if they are a patient or sick. Normal communication is very important in helping them to find their way back to you when times are difficult for them.

Be clear about what is acceptable or OK behaviour in your family home and make sure everyone is on the same page so that acceptable behaviour is affirmed by all members. For example, it may not be OK to swear or use a loud voice or be aggressive so that others feel afraid.

If it is possible you may need to gently and firmly remind the person of what is OK and not OK, always remembering to do it in a way that lets them know they are loved and accepted but that it is their actions that are not OK. Letting the person know they are loved and valued regardless, is a vital part of remaining connected with the person who is unwell. Sometimes this has to be said quite explicitly, more than you might in everyday life with someone who is mentally well.

If the person is your partner

The person with the mental illness may be your partner, so communication about everyday things that usually don’t cause a lot of tension, may become muddled easily and arguments and emotional explosions can occur. If this has happened or is likely, you may need to be the party who takes responsibility for being clear in your communication so that you can help them to be as clear as possible about the everyday difficulties and issues that healthy couples experience.

Every couple experiences differences of opinion or points of view that can erupt into problems out of proportion to the real problem. In this case it is helpful to be calm and clear yourself. Know what pushes your own buttons and work out a plan for dealing with this moment in yourself so you do not explode and add to the emotional discharge.

Having a partner with mental illness may require you to do extra things, take more time or be ready to step in to make situations OK when they feel overwhelmed. As above you will need to keep a balance in your life if your role has become that of carer as well as partner. What do you need in your life to remain healthy in your own mind and heart? It might be keeping up a healthy diet, a hobby, maintaining friendships, regular exercise, or doing something together that is outside your routine. You may need to talk this through with someone you trust to get some ideas.

Be vigilant about domestic abuse (verbal, physical, sexual, emotional and financial) and be ready to care for your own interests by making yourself safe if that is necessary. If you have children and their parent is the person with the mental illness you may need to spend time explaining or debriefing with them about their experience or understanding of what has happened or just explaining the condition in ways that make sense to the growing minds. Often children do not need a great deal of information or very complex information. Rather they need honesty and clarity in small bites that satisfy their need to understand. They will come back later when they need more information.

Stigma

The way mental illness is viewed in society has improved a lot in recent decades. However, there is still some stigma or prejudice against people with a serious mental illness. You may be concerned about letting people know that your relative or friend has mental illness. Choose wisely to share information with people you trust and whose judgment is not going to be prejudiced but is more likely to be helpful and supportive.

When people ask, you may need to work out a way of explaining the situation in a manner that is faithful to the person you love and helps the other person to understand.

Get help from professionals

There are many organisations available now to help with information, ideas and practical support. Examples include beyondblue, and Mental Illness Fellowship, which provide education and information for carergivers, and for people with mental illness.

You are not alone and you will benefit from joining in education and support groups so that you can gain from the experience and wisdom of those who have gone before you.

 

Express your feelings?

I once had a client who said when I asked what feelings he felt, “I don’t seem to have feelings”. This dismayed him and his eyes began to fill up. Slowly it dawned on him that he did indeed have feelings and that he experienced them so rarely that he thought he had no feelings at all. This was normal for him.

On the other hand I have also had clients who seem to have so much feeling that they come in weeping or angry and have difficulty talking without exploding in tears or rage. Usually it is tears as we are not all that comfortable to express rage in front of others.

Feelings are an important dimension of being human and they are present in all of us. If we are biologically human we have feelings. I am sometimes asked, “But if I have feelings, tell me what they are because I can’t feel them?” Examples of feelings include love, sadness, anger, rage, gratitude, guilt, grief, and anxiety.

How we experience our feelings can vary from person to person. In some households you may find that there is so much feeling expressed that it seems chaotic and out of control, even unpredictable. This brings us to a distinction. There is a difference between EXPRESSING and EXPERIENCING.

Expressing is when we do or say something with our feelings, i.e., Cry when we are sad, or hit or shout when we are angry. This becomes aggression. Anger is the feeling and aggression is the action or words. Experiencing on the other hand is when we have the physical experience of the feeling inside our bodies, without expressing it.

To help understand feelings better here we can identify three parts to a feeling. There is the COGNITIVE label or thought that goes with a feeling, i.e., we know we are angry and recognise it.

The second part is the physical experience of the feeling in our body. This is slightly different for each feeling. Sadness, feels heavy, comes into our chests and causes us to fill up with tears and crying so our nose runs and we have tears. Anger on the other hand is hot and it rises from our stomachs into our chest and up our spine into our shoulders and arms, We form fists and clench. We feel stronger and breather faster in readiness for action.

Anxiety is different again. In anxiety we have a sense of something coming from above and pushing down, raised heart rate in palpitations, dry mouth, shakes, tight chest causing sighing, increased need to go to the toilet to pee, and muscle tension in various body areas. Anxiety can also go to our gastro-intestinal tract, causing pain, nausea and bloating. If anxiety becomes chronic the muscles can become stuck in a tense state causing significant pain. Third, anxiety can affect our senses so we have temporary visual problems, hearing difficulty, or a sense of feeling drifty or in some cases blank out altogether for brief periods, leaving us with no memory for parts of conversations. Other words for anxiety include stress and tension.

The third part of a feeling is the IMPULSE. This is an urge we have to act in a way that releases the rising energy generated by the physical and cognitive parts of the feeling. This may be the impulse to cry, to hit, to shout, to hug, to walk up close to someone you love, look them in the eyes and tell them you love them.

When a feeling is experienced it is all internal, not communicated to others and is not expressed. All feelings can be experienced without expressing them.

When a feeling is expressed it is discharged or exploded out and others can see it or hear it in the actions that we have the urge to do or words we want to say.

An example is anger. This is the feeling. It is internal to the person and is experienced as heat rising like a volcano. As described above it causes a rising sense of strength and the impulse is to strike out, to grab, to throttle or to kick. We rarely give expression to this impulse so most of the time people around us are safe. However, some people have trouble containing the impulse to act and they express the feeling in aggressive or even violent actions, i.e., road rage.

Some households have a lot of expressed emotion flying around. They shout at each other, swearing and calling each other names when they feel anger toward each other. These are rarely emotionally safe places to grow up. Children form defensive shells around themselves, learn how to handle feelings and intimacy from watching their parents and other adults and do the same themselves. They are often punished for it by the very parents they are modelling.

Couples can sometimes engage in expressing feelings to each other and this can be destructive if it is done in the heat of the feeling and without respectful concern for the emotional safety of the other person.

Expressing feelings is not as healthy for us as experiencing the feelings, knowing what they are and understanding the meaning of the feeling for us. This is all internal and only then does it lead to external actions toward other such as raising a concern, sharing thoughts and having a discussion together to reach an understanding of an issue that concerns you both.

For example, people will say to me, “But what do I do with it once I experience it?” The answer is understand it. If a couple are angry with each other and discharge their anger by shouting and calling each other names, swearing at each other or making statements about their past behaviour in anger or rage, the feeling is expressed but is this helpful? Not likely. The most likely result is that there is increased distance between the people and they do not communicate easily. There is silence and hurt. This can create loneliness and isolation.

The other alternative may be if both parties notice they feel angry, experience it internally, understand why they feel angry, understand the importance that the other person’s actions or words have had for them and only then once the feeling is understood, they engage with the other person to share their thoughts and that they have felt angry.

This is much more emotionally safe for each person. Words are not said in anger and people are not hurt intentionally because the love we have for the person is also felt alongside the anger. It is true that we can experience more than one emotion at a time. I have had clients say to me, “If I get angry that means I don’t love them anymore.” We can feel angry at the people we love most in the world.

Experiencing feelings first is more emotionally safe, better for relationships and better for us individually than expressing emotion without the experience.

See what feelings you can recognize in yourself. Monitor your own inner emotional life more closely by noticing what changes in your body when you have interactions with others. How do you feel when you are waiting for your partner to come home? Love? Anger? Sadness? Joy? Gratitude? All of the above? Nothing?

Expressing or discharging emotions does not communicate feelings and create understanding. Rather it pushes people away and creates hurt and loneliness.

Experiencing feelings enables us to create intimacy and closeness with others that is respectful, safe, and enjoyable. It also enables us to be productive in our work because our energy is available for creativity and effort. Finally it enables us to experience pleasure and enjoyment in our lives.

 

Psychotherapy at McCarthy Psychology Centre

People who may benefit from therapy with Bernie McCarthy may present with the following conditions:

  • Anxiety (panic, agoraphobia, OCD, generalised worry, phobias, Post Traumatic Stress Disorder)
  • Depression
  • Medically unexplained symptoms (MUS) including chest pain, back pain, jaw pain, headaches and migraines, skin conditions including psoriasis and exzema, reflux and bowel disturbance
  • Eating disorders
  • Personality disorders
  • Fibromyalgia
  • Chronic fatigue
  • Transient cognitive disturbances such visual blurring, going blank, mental confusion
  • Relationship distress and life changes
  • Grief
  • Many of the above conditions will present with co-morbid depression/ anxiety.

For more information on the approach Bernie uses in therapy please click on the link here.

AGE

13years +

FEES

First session is a trial therapy of two hours – fee is $280.00 (out of pocket $155.50). Subsequent sessions 50-60 mins – fee is $195.00 (out of pocket $70.50). A low fee is charged for patients on government benefits and pensions and in some circumstances bulkbilling is appropriate. Discuss this with Bernie McCarthy

Medicare rebates under Better Outcomes for Mental Health program

AVAILABLE:

Monday to Friday 8am to 6pm

CONTACT FOR APPOINTMENTS

For appointments call 0408 145 819. The link above will take you to the page for details of location, fees, and Medicare rebates.