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What Can I Do? Helping a Friend or Family Member with a Mental Illness

by Mike on October 9, 2008 · 16 comments

caring partner sm What Can I Do? Helping a Friend or Family Member with a Mental IllnessIt’s hard to know what to do when a friend or family member has a mental illness.

All of us know that the support of family and friends is an essential element in the recovery process. 

But how to give that support is outside the experience of most people. We want to do something, but we feel our hands are tied.

Actually, there’s a lot you can do. This post is rather long, but it offers a wealth of information to help your friend, your family member — and you under these headings:

  • How it feels when you first learn of your friend’s or family member’s mental illness
  • Do not abandon your friend or family member in their time of crisis
  • How to talk to your friend or family member about mental illness
  • Support strategies you can use
  • What to say if your friend or family member is unreasonable or delusional
  • When your friend or family member is not manageable or is out of control
  • For more information

How it feels when you first learn of your friend’s or family member’s mental illness

Grief, confusion, anger are normal emotions

When you hear of or suspect that one of your friends or family members has a mental illness, you may experience emotions such as shock, grief, sadness, anxiety, confusion, guilt, shame, and anger. It is important that you accept your feelings as normal, and to not feel ashamed of them. While you work through these feelings, please remember that:

  • It is essential to understand that neither you nor the person with the mental illness are to blame for it. There’s nothing that either one of you could have done to prevent it.
  • Many of these feelings are the result of the negative associations that mental illness carry in our society. It is imperative that you break through this stigma in order to give your friend or family member the help they need and deserve. It isn’t easy, because our daily language, the assumptions we grew up with, and the media are saturated with it. I have written a series of posts entitled, “Scapegoating and the Stigma of Mental Illness, Part 1” and Part 2 that can help you do this.

Often, friends or caregivers of the mentally ill do not know what to do for themselves, either. It is easy to become stressed out and lose sight of your own needs when you become deeply involved in helping a friend or family member. I have written a post entitled “How to Take Care of Yourself When Your Partner Has an Anxiety Disorder” to address just these sort of issues. Though it has specific help for partners and Anxiety Disorders, there’s a lot of general help for friends and other family members, too.

Do not abandon your friend or family member in their time of crisis

Do something, even if just a phone call

Above all, it is important that you not abandon your friend or family member in their hour of greatest need due to your own emotions or the stigma of mental illness. It is all too common for people, in their confusion about what to do, to do nothing to help or support them. Many of the mentally ill are simply abandoned by friends and family, or as bad, treated as if nothing were wrong at all.

When I had “the big breakdown” some years ago, I was totally abandoned by friends and my extended family. Perhaps they did not know what to do, or were negatively affected by the stigma of mental illness. Needless to say, they were not there for me in my time of greatest need. I cannot tell you how much this hurt or how alone I felt in the morass of mental illness. I can say without question that it lengthened my recovery time a great deal. It also has distorted our relationships since — that is, if our relationship survived it at all.

Please, if you have a friend or family member who needs help, break through your reluctance and give them support, even if it is just to call to let them know that you are thinking of them. 

How to talk to your friend or family member about mental illness

Show your friend or family member that you care

It may feel awkward, embarrassing, or intrusive, but don’t avoid having a conversation if you suspect your friend or family member has a mental health problem. It’s important to talk about it, so they know that they have nothing to be ashamed of. It’s possible they are already being treated and didn’t know how to tell you. In that case, you have an opportunity to offer your support. If they haven’t yet been diagnosed, your concern and encouragement might be just the thing they need to seek professional help.

The most important thing you can say to a friend or family member when beginning this conversation is that you care. Make it clear that you want to help them. Keep in mind that this conversation isn’t about offering advice. Rather, it’s about listening to them without being patronizing, judgmental, or trying to solve their problems yourself. Remind them that you care, you want to support them, and that mental illness is very treatable. 

Here are a few ideas to get you started:

  • “I’ve noticed that you seem a little down lately. Is there anything I can do to help?”
  • “I feel as though you’ve been distracted the last couple times we’ve seen each other. Do you want to talk about it?”
  • “I’m concerned about you. If something is wrong, I’d like to help.”
  • “Because I know you well, I can tell when something seems different. Can we talk about it?”
  • “Our relationship means a lot to me. I know when I need help, you’re here for me. It seems like you could use some help right now, and I want to do whatever I can.”

Support strategies you can use

You need to be proactive

There are many things you can do to help your friend or family member — and yourself, too. Most of the following suggestions start with you. You need to be proactive in helping your friend or family member, not only in your dealings with them, but in your personal preparation as well.

Following is a list of tips for things to you can do to help your friend or family member, and yourself:

  • Accept your feelings. You may find yourself denying the warning signs,worrying what other people will think due to stigma, or wondering what caused your family member or friend to become ill. Accept that these feelings are normal and common among others in your situation.
  • Avoid being judgmental. Keeping an open mind will help to create a safe and comfortable environment for your friend or family member.
  • Develop a positive attitude. It will help you to provide better support for a friend or family member with a mental illness, and will help you through your own difficult emotions.
  • Educate yourself. Learn about the diagnosis, symptoms and available treatments. Mental health associations, public libraries and the internet are all good resources. (See list below)
  • Recognize and accept that symptoms may come and go, and may vary in severity. Everyone has a different rate of recovery. Varying levels of support will be required at different times throughout recovery.
  • Be compassionate. Recognize that your family member or friend may feel scared and confused after receiving a diagnosis. Although some people are relieved to get diagnosed and actively seek treatment, it may be devastating to others.
  • Motivate. Encourage your friend or family member to learn about what treatments and services will promote recovery. Help them follow through with medication and the instructions their therapist will give.
  • It takes time. Recognize that finding the right treatment or services can take time, and can involve a process of trial and error. It can be very frustrating. Be patient, and encourage your friend or family member to be patient, too. 
  • Talk about what they find helpful. Make conversations about their mental health difficulties easy and open. Try asking about what helps them when things are tough. By talking openly, you are letting the person know about your love and support for them. You may like to talk about what you have read and ask how they feel about it.
  • Practice “active listening.” Listen to your family member or friend and express your understanding back to them. Acknowledge the feelings they are experiencing and don’t discount them, even if you believe them to be symptoms of the illness.
  • Understand the challenges of medication. Although treatments have improved tremendously in the past decade, they can also lead to side effects that can make your family member or friend want to stop taking the medicine. There are many psychiatric medications, and sometimes it takes a while to find the right one with the least side effects. Encourage them to speak immediately to their health care provider about any problems related to medications. And urge them to keep taking their medication until a better one is prescribed.
  • Recognize that feeling better, getting better and staying better are distinct stages in recovery. Your friend or family member may feel better relatively quickly, but if they do not continue treatment until they get better and stay better, a relapse is almost certain. Urge them to keep taking their medication and seeing their therapist until they are released.
  • Recovery from mental illness isn’t only a matter of “just staying on your medications” or regularly visiting a therapist. Self-esteem, social support and a feeling of contributing to society are also essential elements of recovery and should be supported.
  • Offer practical help. Offer to drive or accompany your family member or friend to medical and other appointments. And, if they want you to, discuss the treatment, side effects or other issues with the doctor and treatment team. You may need to do other things they are unable to do, such as shop, run errands or clean the house.
  • Give respect. Always respect the individual’s need for and right to privacy. People with mental illnesses have the same right to be treated with dignity and respect as anyone else.
  • Respect your friend’s or family member’s limits. There may be times when they say they are not able to do something because of their illness. It is important that you respect this and don’t put extra pressure on them. For example, people who are taking medication often are not able to drink alcohol. This may make it hard for them in certain social situations. If you know they are unable to drink, it may be helpful when you socialize with them to choose to do something that doesn’t involve alcohol.
  • Recognize your limits. No matter how hard you try, there will be times when you just don’t understand your friend or family member, or don’t know what to do next. You get tired and frustrated, too. Sometimes it is best to just step away a short while and take some time for yourself.
  • You should decide what level of support and care you are realistically able to provide. Explain this to the friend or family member with the mental illness as well as the health professionals involved in their care. Don’t commit to things that you know you cannot do.
  • Make sure that you have contact numbers. Having the contact numbers of people like their psychologist, doctor or psychiatrist is often important in helping your friend or family member through a crisis. It means that you can contact someone who knows them should they be in a situation where they are unsafe.
  • Maintain hope. There is hope for recovery, and with treatment, many people who have mental illnesses return to productive and fulfilling lives.

What to say if your friend or family member is unreasonable or delusional

Approach from their point of view

If your friend or family member is paranoid or having delusions, don’t argue with them. Instead, approach the topic from their point of view: “That must be scary. I’d like to help,” or “I can understand why you’re upset. Can we figure out together how to make this better?” Be supportive and respectful and offer to help find someone they can talk to about their state of mind.

What to say:

  • “I’m bringing this up because I care about you.”
  • “Nothing you could tell me would change our relationship.”
  • “I’m here for you if you want to talk.”
  • “If you were sick with an illness like cancer or diabetes, I’d be concerned. A mental health problem is no different.”
  • “What can I do to help?”

What not to say:

  • “You’re acting really emotional lately.”
  • “Lighten up!”
  • “What you should do is…”
  • “All you need is an antidepressant and you’ll be back to normal.”
  • “I know you would be embarrassed if anyone knew about this, so we’ll keep it just between you and me.”

When your friend or family member is not manageable or is out of control

When medication and coping strategies don’t work

For those who have a mental illness, there may be periods of time when things are simply not manageable. Harder times may be triggered if your friend or family member has been over-stressed, if there has been a traumatic event, or there has been a change in medication. These things can generate difficult symptoms that are very hard to control, particularly if they haven’t had time to learn coping strategies.

If you are concerned that your friend or family member is getting beyond their ability to manage their mental illness, it is important to encourage them to talk to a trained professional they trust, such as their doctor, psychologist or psychiatrist. Remember, you should keep a list of contacts either with you or in an easy-to-access place for emergencies.

If you think that your friend or family member is out of control or likely to hurt themselves or others, find help immediately, even if they don’t want you to. Do not try to handle it alone. Stay calm and call the appropriate numbers on your list of contacts. If you need to, do not be afraid to call 911. 

The National Suicide Prevention Lifeline is a 24-hour, toll-free suicide prevention service available to anyone in a suicidal crisis. If you need help call 1-800-273-TALK (8255). You will be routed to the closest possible crisis center in your area.

For more information

A wealth of information is available

There’s a wealth of information available by phone, mail, and online. For online searches, Google is your friend. But remember that there are a lot of quacks, hucksters and snake oil salesmen just waiting to take your money with claims of a cure. See my post “Can Anxiety Disorder and Panic Attacks Be Cured” for more information. Watch out for sites sponsored by drug companies, or those who have an axe to grind. Look for sites that are peer-reviewed or have stated resources for their information.

Who can you trust, then? Three of the best online resources for general information are:

The following are grassroots organizations devoted to promoting mental health and reducing the stigma of mental illness. They both offer general information, and have helplines:

Mental Health America

2000 N. Beauregard Street, 6th Floor

Alexandria, VA 22311

703-684-7722

800-060-6642

MHA Helpline: 800-273-TALK (8255)

Web site 

National Alliance on Mental Illness (NAMI) 

200 N. Glebe Road, Suite 1015

Arlington, VA 22203-3754

703-524-7600

NAMI Helpline: 800-950-NAMI (800-950-6264)

Web site 

What do you think?

  • Do you have any further suggestions to help your friend, family member or yourself?
  • Have you ever been in a position to help a friend or family member with their mental illness?
  • Do you have any good information sources you could add?

What can you do now?

Your comments are always welcome, and are important to this blog’s community! Leave a comment now.

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Resources used in this post:

Better Health Channel. (2007, July). Mental illness — family and friends. Retrieved October 6, 2008 from Better Health Channel Web site: http://www.betterhealth.vic.gov.au/BHCV2/bhcarticles.nsf/pages/Mental_illness_family_and_friends?open

Koenig, Vicki. (2006). Mental Illness — Information for Families. Retrieved October 6, 2008 from Sanctuary Psychiatric Center’s Information Network Web site: http://www.spcsb.org/articles/mental_illness.html

Mental Health America. (2007, May 16). Supporting Friends and Family Who Have Mental Illnesses. Retrieved July 1, 2008 from Psych Central Web site: http://psychcentral.com/lib/2007/supporting-friends-and-family-who-have-mental-illnesses/

Reach Out. (2007, June 30). Supporting a Friend with Mental Health Difficulties. Retrieved October 6, 2008 from Reach Out Web site: http://www.reachout.com.au/default.asp?ti=277

Support a Friend Iowa. (2008). How to Begin a Conversation. Retrieved October 6, 2008 from Support a Friend Iowa Web site: http://www.supportafriendiowa.com/HelpaFriend/Howtobeginaconversation/tabid/76/Default.aspx

For further reading:

What a Difference a Friend Makes web site 

Rosalyn Carter’s book, Helping Someone with Mental Illness: A Compassionate Guide for Family, Friends, and Caregivers

©2008 Anxiety, Panic & Health. All rights reserved.

{ 13 comments… read them below or add one }

Kim Woodbridge
Twitter:
October 10, 2008 at 5:41 pm

Wow! What a lot of information. Unfortunately, there is still such a stigma on mental illness that people will abandon you who would never do so with a physical illness. It makes it so much harder for people to get health and proper care.

I think it can be really hard for family, especially spouses, to not feel that they are somehow to blame. Or to not internalize it when the person who is ill blames them.

I have been in the position to help someone with a mental illness but the person would not allow me to help. It was very difficult.

Reply

Стоматолог October 27, 2008 at 8:42 pm

Мне эта инфа пригодится!

Reply

John Haydon
Twitter:
December 2, 2008 at 3:29 pm

Mike,

Thanks so much for taking the time write this all out. I especially like the support strategies section.

Adding this to my blogroll – finally.

Thanks,

John

John Haydon’s last blog post..johnhaydon: RT@mikenichols0 ! Article worth reading: "Helping a Friend or Family Member with a Mental Illness" http://is.gd/9VHb – Mike – thanks!

Reply

Mike December 2, 2008 at 10:25 pm

Thanks, John, for the comment and the compliments!

Most of the strategies I got from my sources, but I added quite a few that I’ve learned over the years.

I don’t have a blogroll yet — nowhere to put it! I’ve thought about having a separate page for it, though.

Reply

Teen Anxiety
Twitter:
October 5, 2009 at 1:21 pm

This is an excellent article on what family can do. Many loved ones of anxiety sufferers don’t really know where to start or how to help.

Reply

Terry January 5, 2011 at 12:52 pm

I just found this site and I wish to thank you. I am on the other side of the coin: the family member who was mentally ill and abandoned by family. Reading this has helped me put things into perspective. I had been giving them the benefit of the doubt for years, thinking that mental illness is so ugly that they should not have had to deal. When I read your blog, I came around. They abandoned me — perhaps out of fear or ignorance or whatever — but they abandoned me nonetheless. I’m not at fault — or am I? No, I would say not. I was out of control, and precisely because I had no control over myself, I should not be shunned. I think.
Terry recently posted…Jair e Cláudia LeitteMy Profile

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Adrienne Smith January 8, 2012 at 7:38 am

Thank you for this valuable information. My son said he tried to commit suicide but that is as mucha as I have been able to get out of him. Following is a brief overview of our situation. If you have any specific advice I will be so happy to get it. Thank you.

My son is 48 years old and besides having a crack addiction since 1980′s, he is very talented in the computer industry, which resulted in him attaining high salaried positions in thst field. He has a teen age son by a previous relationship, a ten year old, beautiful, autistic daughter by his wife, now deceased from a sudden heart attack. This happened while he was in jail. His wife’s adult daughter never notified him or his family until over one month after her burial. The daughter decided to have her mom buried in Peurto Rico. As a result his autistic daughter, six year old at the time, was in the custody of her adult sister and husband. She could not handle the responsibility so my youngest daughter took custody of his daughter. My son was released on parole, to a 9 month, program outside of our area. (90 minutes away). He completed the program however, because of his manipulative, abilities he got through it by the skin of his teeth. He initially said his goal was to save money, get an apartment and take custody of his daughter. That all went askew. Every month after he received his disability check, we would not hear from him for 3-4 days. He had no savings, which was a prerequisite of the program that he somehow got around. He would not visit his daughter to prepare for the transition and taking care of her. Too make a long story after a little over a year, his sister asked him to come stay with her so he could begin to get involved with his daughter, because she was leaving the state, and did not want to take her so far from her dad. He did, but it resulted in them finally getting into a violent, verbal disagreement, resulting in his sister taking out a restrainng order for one year causing him to violate his parole. So he stayed in jail 3 months and wrapped up a 4 year sentence, and was driven to the parole office in our town. As we had previously agreed, I picked him up there, brought him the money I was holding for him along with his cell phone and laptop. We were supposed to look at some efficiencies I had lined up, to assure he had a roof over his head before the day was over, so he could start of on the right foot, and begin rebuilding his life. It did not happen. For some some reason instead of waiting at the parole office which I was only 10 minutes away from, he decided to walk to the Greyhound station to “get coffee” at the Dunkin Donuts there. Not a safe environment for an addict, with ‘prison sneakers and shirt’ easily recognizable by those who hung around that station sellilng drugs. I picked him up there and took him to the Post Office to cash his check. He then informed me he had to do alot of running around before it got late to follow up on some tips the parole department gave him for housing and I never saw or heard from him for over a week. When he finally called, it was from a Psychiatric unit of a local hospital. Its been 3-4 days since that call and I can count on my fingers the amount of words he has said to me during the course of 3-4 telephone calls. I finally told him I believed he relasped, but my concern was with him and how he was doing and what I could do to hel him. He asked who told me that, I told him I am not stupid, I just believed I could be 99 percent sure that he did. The he said: “You want to know the reason I am here? It’s because I jumped!” I asked him jumped where? and he said he didn’t want to talk about it. When I tell him I love him at the conclusion of the calls, he just says “thank you”. He also said his family does not love him either and did not want to give the pay phone telephone number to anyone so they could call, and did not respond to the request of his brother to take his phone number so he could call him. I am so afraid for my son. He will not be able to stay there forever. I don’t know how to get through to him because I don’t know what to say to him. He won’t talk to me, does not want me to visit. So I am hoping you could help me out. What ever you could do will certainly be appreciated. Thankyou.

Reply

Alan Minshull January 1, 2013 at 10:39 pm

My younger brother has a mental health condition which is out of control. He was verbally abused as a kid and left out of family activities by my father. This went on for many years until my mother divorced my father. Both have since passed away.
Now aged 40, my younger brother attempted to take his life several times and this was due to the death of my mother.
My brother then joined a Born Again Christian fellowship and rather than this being a positive it actually did more damage to him as now he rants and raves all day until 5 am every morning.
I live with my brother and have become stressed and lethargic as he keeps me awake all night.
I recently got him to see his doctor and he was referred to a psychiatrist but he never turned up.
I have reached the end of my tether and just do not know what to do now other than pack my bags and leave home.

Reply

Kittleson December 2, 2013 at 4:04 am

Обезболивание в стоматологии Красногорск И как в таком случае поступить?

Reply

стоматологии МО December 6, 2013 at 11:31 am

благодарю за информацию, я не знал этого. современная стоматология Стоматология недорого павшино

Reply

hey January 10, 2014 at 1:27 pm

My depression is genes but family dynamics made me worse. my mom would run from office of psychiatrics . family often unhelpful . i did lots of work and became resentful of standoff family . i often dealt with family dynamics at were harmful and
Would be crazy making. why not say family can be the problem mine were. i was blamed they were hostile and bully
Where is help for people with mental illnesses and family is a problem .

Reply

lilly January 17, 2014 at 11:28 am

I don;t know what to do. I have a brother that is basically worhtless. He does not come out of his room in my parents house and when he does it is when nobody is around. He is 42 years old and has been like this for over 10 years getting worse every year. he refuses to seek help. He believes there is nothing wrong. He is killing my parents. My mom can see things correctly and begs him to seek help, my father just things of him as a poor retarded person and treats him as such and fights with everyone who brings up the issue. He graduated from High School, was a state trooper, studied architechture and MIS but never finished beyond his AA degree. I don’t know what to do and it kills me to see my parents hurting and struggling financially to maintain him. He does NOTHING! I think his a lazy unconcionable asswhole who just has some depression that can easily be treated. What can one do???

Reply

Jean March 13, 2014 at 10:53 pm

My sister has suffered mental illness for decades,it’s very difficult,
as she does not acknowledge her illness and currently her meds have worn off ( invega ) we needs alternatives to 911. One reccommended program that evaluates and provide encouragement
is >Healthnet.com

Reply

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