COPING WITH MENTAL ILLNESS OR ADDICTION IN THE FAMILY

A major reason for family disintegration and a source of family stress is coping with a family member who is exhibiting symptoms of mental illness and/or addiction. Mental illness such as severe anxiety, depression, bipolar disorder or schizophrenia, create an imbalance in the family with resentments and feelings of guilt or shame. A mentally ill family member creates real difficulty maintaining cohesion and engagement in the family system.

It is important to become knowledgeable about the family member’s illness. Taking on shame or judgments about oneself or about the patient is unfounded since these disorders have a strong genetic influence. A parent or spouse holds little responsibility for the illness’s inception. Taking care of yourself is just as important as taking care of your family member.

Dr. Paul Standal encourages getting as involved in treatment planning as much as the family member allows and encouraging them to follow through on their treatment plan even when they want to quit. However, one’s expectations for change need to be tempered by the realities of the complexity of your family members condition. Goals may be small and improvements slow in coming.

Some conditions do require that your family member take medication to remain stable and make improvements. It is important to encourage them to continue taking their medication even when they feel they don’t need it. Once they are stable on a medication, do not encourage them to stop taking it without discussing this with their therapist and doctor.

If your family member has an addiction, especially if they are also diagnosed with a mental disorder (dual diagnosis), be conscious not to sabotage their recovery and stability by engaging in enabling behaviors, buying them drugs or alcohol or having these in your interactions with your family member. Certainly it is important to be aware of the signs and symptoms of depression, particularly with children and adolescents.

Take advantage of the stable periods with your family member to learn to discuss your observations in a loving, concerned manner and to help reduce damaging or destructive behaviors that occur when they are having symptoms. Being able to communicate in the face of hostility or anger is extremely difficult, but managing your own hyper-arousal is an important key to managing your situation.

Under no condition do you condone or tolerate physical violence or emotional abuse by them. It is very important that you establish firm boundaries with the family member, indicating that, even if they have an illness, they have no right to be physically or verbally abusive. If they are, you must call 911 to have them removed temporarily from the home to a safe place. If your family member persists in being unsafe in your home, you will need to make other living arrangements for your family member.

People with mental illness and/or addiction have high incidence of suicide. It is important to know the signs of suicidal ideation or intent and know the difference. It is important to act immediately when this occurs by supporting the family member, calling Dr. Standal, or calling 911.