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.
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.