How to live with a family member who has a serious mental illness

Mental disorders affect not only those who live with them, but also their loved ones.

Many people around the world live with serious mental illness. Their families often feel embarrassed and isolate themselveswith this burden. Aside from tragic episodes, great silence hangs over these difficult situations.On the occasion of the World Schizophrenia Day, Jean Canneva the former president of the French Union national des amiset familles des maladies mentaux (the Unafam) offers his advice to families who no longer know how to help their loved ones.

What are mental disorders?

This term does not apply to minor or short-term problems but more serious medical conditions. They lead to a psychological dis-ability, which should be distinguished from a more easily detectable but permanent intellectual disability. Mental disorders are progressive and do not result from intellectual deficiency.

These serious disorders, which tend to marginalize those suffering from them often, often emerge in adolescence. It is initially hard to tell them apart from the usual teenage moodiness. A disorder can be identified by the persistence and aggravation of its symptoms: reduced autonomy, development of obsessive ideas and unpredictable reactions. Its excessive and persistent nature affects the personality of those who suffer from it.

What are the different mental disorders?

The psychoses encompass schizophrenias and manic-depressions, manifested to variable degrees. The category includes two very different realities for people.

What are the signs that should alert family members?

There are two major symptoms to discern: there is the cyclical kind of delirious excitability (easier to detect) and the bouts of creeping anxiety (fear of crowds, of the passage of time, of death …). These are the two “classical” symptoms of oversensitivity, but a mental disorder exacerbates them and won’t allow the sufferers to easily switch from one to another. This inflexibility prevents them from adapting and puts them into conflict with their environment, hence the suffering. Each of us may experience some level of existential anxiety, but normally it’s compensated by the productive activities that help us carry on. For someone suffering from a mental disorder this gap remains wide open. There is nothing wrong with their intelligence but they cannot use it properly.

These problems are not due to the weakness of character, but to psychological, biological, and social factors. Mental disorders are like nothing else.

It’s difficult for parents not to feel guilt: “What did we do wrong in a way we brought them up to get this result?” What would you tell them?

The risk is the same in all countries, among all professional and social groups. It’s no one’s fault. Persisting with this sterile view (which is natural at first) wears one down, prevents one from moving on and poisons relationships. Parents don’t cause these disorders. Contrary to widespread opinion, heredity doesn’t play a major role in psychiatric illnesses. Another prejudice, refuted by psychiatrists, that persists to this day, concerns the so-called “abusive and possessive” mothers.

My second response would be to say: get informed to avoid all remorse. These disorders are still not well-known. Don’t isolate yourself; seek advice from other families facing the same problem. We can make pretty poor decisions on what to do if we’re all alone.

When should a person seek professional help and what can we do to convince the patient or their family?

The patients and their families must work in partnership with medical personnel and social workers.All alone, even the most experienced among them, will be confounded by the complexity of the problems they encounter. The commitments to specialized institutions are primarily reserved for critical cases. The majority of patients live on the outside.So, their families are the first concern.

Initially, patients and their families feel too embarrassed and tend to isolate themselves, but acknowledging the problem is the first step. To reconnect, we must extend our hand to them. Especially since in 40% of cases, the people suffering from mental disorders still live with their parents; and in over 70% of cases, their families are seriously involved. Support groups can also be of great help. We can’t avoid the truth for too long (“Tomorrow, things will go better …”), because without treatment and without help, we’re heading for disaster.

Finally, the remission periods giving rise to new hope and followed by relapses can exhaust anyone. The intensity of mental suffering is terrifying – it’s the essential argument that convinces most people to seek professional help. They feel embarrassed and can’t see the cause or the reason for their illness. It’s in these times that they need help from those who won’t judge them.

Is it best to consult several specialists? Can the help of a therapist be enough?

The treatment of mental disorders falls on medical professionals. Therapy is beneficial, but it’s not enough. Both medicine and therapy are usually needed. But since psychiatric disorders impact rapport with others, conflict with specialists can come into play. Patients may become disappointment with their practitioner and seek others who can understand them. If they develop a special bond with a specialist, they often accept to be treated by them. To ensure the continuity of treatment, switching from one doctor to another too often is inadvisable.

Must the patient know their diagnosis?

When the person is young, establishing their diagnosis may prove difficult. That’s why many practitioners refuse to do it; the disorder doesn’t necessarily become chronic. The second reason to be prudent is the multiple forms these disorders may take. Finally, mental health specialists suffer from a very bad image: it’s enough to recall all the “clichés” about psychiatric hospitals from the past. Some patients can accept the diagnosis, others cannot.

What to do in the case of a crisis? What can we do to prevent the patient from feeling resentment toward his family?

In critical situations you must call an emergency number, it will be impossible for you to cope on your own. But the way you handle yourself in this crisis should be planned in advance.

All those who suffer greatly, silently call for help. When offered assistance with respect it will calm the tensions. I’ve seen patients who were glad to be hospitalized or even asking to be hospitalized, so someone finally takes care of them: having shown initial resistance, they are relieved to see that someone wants to help them get better.

How can we improve our communication with the loved one who suffers?

Actively listening to them is beneficial. The communications must be clear, precise and rooted in reality, and trust. You need to be sincere. People suffering from psychological disorders are hypersensitive and can easily detect that you are deceiving them. For example, your facial expression must never conflict with your positive discourse. Avoid all criticism, interpretations, sarcasms and threats. But if you are unhappy with them, you must clearly let them know, don’t blame them or become over-emotional. You must also learn how to deal with the unpredictable, chronic nature of disorder. And helping other families will allow you to support to one another.

Isabelle Larroque