Mental Illness: Information for Family and Friends

Coping tools for people who have family members with bipolar disorder or another mental illness.

Supporting Someone with Bipolar - For Family and Friends

Although there are different types of mental illness and symptoms, family members and friends of those affected share many similar experiences. There is a lot you can do to help your friend or relative. However, you need to look after yourself, too.

Get Help Early

Don't ignore warning signs of mental illness in a family member or friend. The sooner the person receives treatment, the better the outcome is likely to be. It will help if you:

• Encourage the person to see a general practitioner (GP) or other doctor for an assessment
• Make an appointment with the GP yourself to discuss your concerns and what can be done (if the person refuses to see a doctor.)

Common Reactions
The distress associated with having a family member with a mental illness may lead to feelings of guilt, anger or shame. Acknowledging these feelings is the first step towards resolving them. It is important to understand that neither you nor the person with the mental illness are to blame for it.

A positive attitude helps
Developing a positive attitude will help you to provide better support for a friend or family member with a mental illness. It will help if you:

• Find out as much as you can about mental illness, treatment and what services are available in your area.
• Find out if there are any education and training courses for carers that you can attend.
• Recognize and accept that symptoms may come and go, and may vary in severity. Varying levels of support will be required at different times.
• Develop a sense of balance between your own needs and the needs of the person you care for.
• Contact a support group for carers or relatives and friends of people with a mental illness.

Recognize Your Limits

You should decide what level of support and care you are realistically able to provide. Explain this to the friend or relative with the mental illness as well as the health professionals involved in their care (for example, the psychiatrist or case manager.) This will ensure that the type of support you are unable to provide can be arranged in another way. You should also discuss options for future care with health professionals and other family members and friends. This will ensure continuity of care when you are unable to fulfill your role as a carer.

Develop Plans

Plans to cope on a day-to-day basis
It is important to encourage a sense of structure in the life of a person with a mental illness. You can:

• Develop predictable routines - for example, regular times to get up and eat. Introduce gradual changes to prevent boredom.
• Break tasks into small steps - for example, encourage someone to shower more by helping them put out towels and choose clean clothes.
• Try to overcome a lack of motivation - for example, encourage and include the person in activities.
• Allow the person to make decisions - even though it can sometimes be difficult for them to do this and they may keep changing their mind. Try to resist the temptation to make the decision for them.

Plans to deal with disturbed behavior
Try and discuss strategies with the person and health professionals to deal with:

• Suicidal thoughts - talk about the thoughts with the person and discuss why they are having them. Suggest things to distract the person from the suicidal thoughts. If the thoughts persist, especially if the person experiences hallucinatory voices that suggest suicide, inform their doctor.
• "Manipulative" behavior - for example, where the person with the illness tells one person untrue stories about mistreatment by the others who care for them. Establish whether the behavior is being used to get extra help and support. Try and involve the person in activities, which will make them feel less resentful towards others. Check out the stories before you react.
• Aggressive or violent behavior - this may be associated with psychotic symptoms or alcohol or drug abuse. Involve health professionals promptly. For aggressive behavior associated with extreme stress, try to develop an atmosphere that is open and relaxed.

Report aggressive behavior
If someone is persistently aggressive, you should report actual or threatened violence to the treating health professionals (and the police, if necessary) immediately. If you live with someone who is persistently aggressive, seriously consider ways you can live apart. It is very likely that living apart will work out better for both of you.

The Effects of Mental Illness on Brothers and Sisters

Mental illness can lead to a variety of emotional effects for brothers and sisters of the affected person. For example, they may feel:

• Confusion about their sibling's changed behavior
• Embarrassment about being in the affected person's company
• Jealous of their parent's attention
• Resentment about not being like their peers
• Fear of developing the mental illness

What brothers and sisters can and can't do

What you can do
If your sibling has a mental illness, you can:

• Talk honestly about your feelings and encourage others in the family to do the same
• Be active in improving mental health services - for example, through local mental health support groups
• Avoid making the ill person the axis around which the family revolves
• Maintain your focus on living and enjoying your own life

What you can't do
If your sibling has a mental illness, you can't:

• Be totally responsible for their welfare
• Make your sibling behave in a certain way - for example, force them to take their medication
• Solve all their problems or feel you ought to
• Lessen the impact of the illness by pretending that it is not there

Things to Remember

• Neither you nor the person affected by the mental illness are responsible for their condition
• It may help to contact a support group for family, friends or carers of people with mental illness

next: A Guide to Balanced Bipolar Living For Patients and Caregivers
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