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Why Won’t They Take Their Meds?
Tag / caregiving
Listening to People Who Have Mental Illness
Good communications with people who have mental illness starts with listening well. Really hearing someone’s feelings and thoughts is a great gift of love and respect.
People with mental illness could be experiencing auditory hallucinations, overwhelming feelings of depression, intense anxiety, and cognitive disorganization. So we need to avoid arguments and heated communication.
They may feel lonely, inferior to others and disrespected. You may be able to have an influence on these feelings when you demonstrate your positive regard for them. When you show that you accept them and have compassion for them, you offer hope and understanding. As a positive benefit, they may respond better to your requests.
What Not to Do: Types of Bad Listeners
This list is from Listening for Heaven’s Sake – Class Notes by Equipping Ministries International. Do any of the listeners below remind you of you? Particularly when you are under stress?
| Type of Listener | Characteristics |
| The Interrogator | Asks lots of questions Focuses on the details Satisfies their own need to know Focuses on facts rather than feelings |
| The General | Gives orders Takes command or control Assumes responsibility Focuses on the outcome |
| The Pharisee | Blames and shames Condemning outlook Focuses on the person being “bad” Says “You should” or “You ought to” often |
| The Labeler | Oversimplifies problems Pigeon-holes people Believes that putting a name to it equals a solution Has a quick-fix mentality |
| The Casserole Person | Tries to cover over pain with food Avoids the unpleasant Expects kind actions to remove pain |
| The Historian | Focuses on the past Can’t remain in the present Speaks triggered memories Loses focus on the speaker |
| The Bumper Sticker | Gives trite answers Oversimplifies problems Is quick with clichés |
Steps Toward Being a Good Listener
- Relax and be calm.
- Minimize distractions. (Can I turn off the TV?)
- Make eye contact unless it is threatening.
- Discuss one topic at a time.
- Ask for opinions and suggestions.
- Don’t take it personally when it’s the illness talking.
- Avoid bringing up the diagnosis.
- Don’t use sarcasm.
- Speak simply and directly.
Next time we’ll discuss the basics of therapeutic communications: using reflective listening and I statements.
Helping Them Cope
Note: This post is adapted from information I learned in the NAMI Family-to-Family program. We highly recommend attending this program to learn more about mental illness.
Having a mental illness and dealing with the world takes enormous courage and determination. As we have previously written, many people develop defensive coping strategies.
These negative behaviors are actually typical for any person with a life-changing or life-threatening illness. (They include irritability, denial, abusive language and resistance to treatment.) For people with mental illnesses, the behaviors are even more counter-productive. This can be very upsetting to you.
So what’s the best way to react? Here are some suggestions from NAMI:
- Respect and protect your loved one’s devastated self-esteem. Don’t criticize them. Keep nagging and negative remarks to a minimum.
- Punishment, argument and pressure make things worse.
- Ignore as much negative behavior as you can. Praise positive behavior as much as you can. People with mental illness are more likely to improve when they can see behaviors earn them approval and recognition.
- Accept the symptoms of the illness. You don’t punish a child with a stomach virus for vomiting. Know what the symptoms of the illness are, and try to separate that from the person’s behavior. You cannot argue someone out of a depression or delusions.
- Accept that your loved one may not be able to fulfill a normal role in the family. Reduce your demand for emotional support and “carrying your weight.”
- Make these allowances, yet treat the person as a regular member of the family.
- Encourage independent behavior. Allow them to do what they can, which can vary from time to time. But, again, don’t push.
- Live in the present. You have a right to grieve, and you may need professional help to do so. But don’t live in the past or focus on “what could have been.” One of the best things you can do for your loved one is to accept that they have an illness that makes life harder, but not impossible. This is how it is.
- Be patient. When our loved ones take steps toward more independence, it’s very scary for them.
- Be kind to yourself and the rest of the family. This is hard. Don’t criticize yourself or others when you make a mistake. Give everyone in the family some grace.
The Mental Illness Holiday Survival Guide
The holidays can be some of the worst days of the year when your family is dealing with mental illness. Not only is it TOO DARN DARK AND COLD, but it’s also a time when expectations of being Merry and Bright can seem especially hard for your family.
Why the holidays can be hard
Having a mental illness makes you extra vulnerable to the demands, pressures and expectations of the holidays. We deal with:
- The demands of the culture, like parties, shopping, baking, cleaning and entertaining.
- The changes of schedule, which can be really challenging for a person who has a mental illness. Getting out of normal routine can lead to forgetting meds and getting self-care out of balance.
- Family functions and crowds that trigger anxiety.
- Financial stresses because your loved one is not being able to participate.
- A pronounced sense of the passing of time. Gathering with cousins, friends and family reminds your loved one of all the “normal” parts of life that seem out of reach to him.
- The noise, which can make the noise in their heads worse.
The stress can make your loved one have more symptoms. In fact, a NAMI study found that 64% of people with mental illness report that their symptoms are worse during the holidays. And that can make you even more anxious.
Make your loved one a priority in planning
Yes, you can make the holidays a little less stressful for your loved one with mental illness. Their health comes first. And you may be surprised to see that this helps your mental health as well.
Any family member who is inconsiderate or otherwise difficult to your loved one should be kept away. I banned a brother-in-law for horrible comments during a holiday dinner. We didn’t make a big deal of it; we just never invited him again. He’s now dead, and I’m still glad I did it.
Set expectations
Let your loved on know the plans ahead of time. Make the holiday as consistent as you can.
For you, accept that your holidays are different now. If you can get rid of your unrealistic expectations and be honest with your loved one and all the other family members, it will go better. Just remember: You can’t force anyone to be happy.
Know your loved one’s limits … and your own
Is being around family a trigger? Are crowds? You need to be aware of this.
Acknowledge your feelings. If someone close to you is suffering from a mental illness, it’s normal to feel sadness and grief. If it’s a child, a sibling or a parent, Christmas can hold a lot of memories.
Avoid feeling guilty. Around the holidays, many people want to be many things to loved ones. We don’t want to hurt anyone’s feelings. So we put pressure on ourselves. Pleasing everyone is unrealistic.
At the same time, let participation be your loved one’s decision.
Keep your routine
Try as much as possible to maintain routines like:
- Sleeping
- Regular meals and good nutrition
- Exercising
- Taking medication
- Keeping appointments with mental health professionals
- Attending support groups
Think about the warning signs of relapse. If you start to see them, encourage them to retreat to a normal routine.
Provide dignity
Help your loved one to keep her dignity. Provide a gift fund or another way to allow her to give gifts, so she won’t feel left out if she has no money.
If crowds or frenzy are a problem, encourage them to shop online. Or offer to help pick up the things they need.
Consider volunteering. The satisfaction of giving to others can help you put your own problems in perspective.
Scan every situation that’s coming up to make sure that your loved one won’t get unwelcomed attention.
Keep the celebration small and safe
Hey, it’s a good excuse to keep the unofficially crazy family members away. You want a small gathering of your own family. Period. Otherwise it’s too stressful for your loved one.
Identify what they really want to do.
Don’t overschedule. Pick and choose. If your loved one will be uncomfortable in a situation, it’s ok not to go.
Encourage your loved one to keep connected and not be isolated. Spending time with a friend or family member … even just one … can help.
Keep it short. Keep it informal.
If you have to do the Big Family Thing, let your loved one stay home. Big groups can be too much for your loved one, especially when you have to Put On a Happy Face. If you have a large family and lots of traditions, you can encourage your loved one to pick her favorites and let go of the rest.
Setting specific times for family traditions, like baking special food, decorating the house, wrapping gifts or attending community celebrations, gives the person something to look forward to.
If any of your extended family members really want to see your loved one, they know your phone number and where you live. Something private is better. And try not to be bitter if no one asks. (There’s a reason God chose you to be this person’s lifeline. Not everyone can deal with this.)
When people ask
The best answer I’ve found to the question … How is he? … is “About the same.” That’s tough enough for you to answer. So please don’t put your loved one in a situation where he or she has to answer the question.
During this time, we may find ourselves at extended family gatherings or at parties with people who do not understand the illness. Some people may be uncomfortable and not know what to say to you. Others may say hurtful things or offer cliché advice out of ignorance. It is helpful to prepare by knowing who may be at a gathering.
When the event is at your house
If you are having an event at your house, discuss it in advance with your loved one so he or she knows what to expect. Accept his limits. Accept her choices. Acknowledge his feelings.
If the person wants to be more visible during the holiday, brainstorm some things in advance. What will he say when asked how he is? What will she do during the gathering? Is there a quiet place to retreat if needed?
Work out a plan. The loved one can walk a dog, or go outside.
If someone offers to help you with any holiday preparation, ACCEPT.
Finally, don’t drink alcohol, especially if you are around family.
When you go to other people’s houses
Don’t overschedule. Ensure that the person will be able to do their regular nightly routine.
Tell the person whose home you are visiting what you may need in advance.
Go in multiple vehicles or take other modes of transportation so you can leave when you need to go.
Please don’t put yourself in a position … helping cook at someone else’s home, for example … where you can’t leave with little notice. If you are stuck, have someone … a sibling or spouse … available to get the person home if needed.
All your great preparation may result in your loved one refusing to participate at the last minute. And that’s OK.
Have yourself a merry little Christmas
When you make out your own Christmas wish list, ask for things that will reduce stress, whether it’s a massage, a day trip, a cleaning service or a gym membership.
Eat right. Avoid the alcohol. Sleep. And write out a list of things that you are grateful for this year.
Live in the now.
I also create my own holiday rituals that are 100% under my control. I celebrate Advent, with a creche, a reading plan and activities that mean a lot for me.
Advent is a time of waiting. We are all waiting for the days when our loved ones will be well, whether here on Earth or in Heaven. You can lift this thought up as you celebrate.
New Resources to Help Families
For Addiction, Eating Disorders and Mental Health Issues
SouthJerseyRecovery.com is a free web resource providing information about addiction, eating disorders, and mental health issues.
Studies have found that when someone with a depressive disorder abuses alcohol, both disorders are impacted and often become more severe. In the same vein, major depressive disorder is the most common co-occurring mental health condition among those with alcohol use disorder.
To spread awareness to the public, the organization recently published a guide covering depression and addiction where we expand on the connection between depression and drug addiction, treatment options, FAQs and more. You can find it here: https://www.southjerseyrecovery.com/treatment-programs/dual-diagnosis/depression/
Suicide and drinking are linked, and it is important to be able to tell when someone who drinks may be at risk of killing themselves. You can find that information here:
For Children’s Mental Health
We’re previously recommended Nationwide Children’s Health’s programs for families dealing with childhood mental illness, including the On Our Sleeves campaign. The pandemic has worsened the situation, with one in 5 children experiencing mental health issues in a year.
If you would like to learn more addressing the policies and problems that are making it difficult to help children with mental illness, visit the Collaboratory for Kids & Community Health website.
The collaboratory focuses on four main areas:
- Improving neighborhoods.
- Addressing inequities.
- Creating population health strategies to address the national shortage of providers to care for children’s mental and behavioral health.
- Developing value-based care programs for those with limited financial resources.
For Seniors and Their Caregivers
Caring for seniors, no matter how much we love them, comes with a lot of challenges, including higher levels of psychological stress. This becomes worse when the senior has mental health issues. We will be covering this issue soon on Loving Someone With Mental Illness.
Meantime, caring.com has a caregiver’s guide that covers burnout and stress, including how to identify and manage each. We also discuss respite care options and share a list of helpful resources for caregivers.
You can see them here:
If you know of other helpful resources, feel welcome to let me know. Thanks!
Finding Peace in Dark Days
Note: This post also appears on my other blog mindfulchristianyear.com. Because loving someone with mental illness causes so many dark days, I also wanted to share it here.
Suffering is a given in any life. But, for some Christians, suffering is a shock. A sign that God isn’t paying attention. Or a symptom that they are praying incorrectly. The idea that a Christian life is all prosperity and popcorn is widespread … and wrong.
“I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.”
Jesus, John 16:33
How can we “take heart” when pain and sorrow, fear and loss take up center stage in our lives. God is omnipotent. God can do anything. God could fix this in a second. Why does He allow our suffering?
Jesus warned us that we would have trouble on Earth, but He encourages us to remember that He has overcome the world. In fact, He says “so that in me you may have peace” in almost the same breath. So what does that mean exactly when pain, sorrow and loss are center stage in our lives? And how do we get there? I believe some answers come from Paul’s words about his pain and trouble in 2nd Corinthians 12:6-10.
Even if I should choose to boast, I would not be a fool, because I would be speaking the truth. But I refrain, so no one will think more of me than is warranted by what I do or say, or because of these surpassingly great revelations. Therefore, in order to keep me from becoming conceited, I was given a thorn in my flesh, a messenger of Satan, to torment me. Three times I pleaded with the Lord to take it away from me. But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong.
Paul, 2nd Corinthians 12:6-10
This statement makes perfect sense when combined with the idea of a God who consents to Satan’s request for test a person, as He did to Job (Job 1:6-22) and to Peter (Luke 22:31).
God knows that suffering develops humility, a true understanding of who we each are and who God is. Without this depth of awareness, we can’t be in a strong relationship with God. Our trials not only build faith and character; they also open our eyes to the reality of our existence
Jesus prays for us in times of temptation and suffering. For example, He told Peter that He had prayed that Peter’s faith would not fail. It’s notable that Jesus did not pray that Peter would not deny Him. He knew the terrible experience was necessary for Peter and for all who later learned about it.
The phrase “What doesn’t kill us makes us stronger” is not from the Bible. It’s from “Conan the Barbarian,” with the script slightly misquoting Nietzsche. Actually, suffering makes us weaker, which is a good thing.
Why? Because God wants people to see His presence in His Christians (and not just in Paul and Peter, either.) Suffering breaks up the vessel of our self-centeredness, our self-regard. A broken vessel displays the light of God’s presence within to others. Maintaining faith, joy and hope during a serious calamity is the best Christian witness we can ever give.
How do we do that? The good news is: It’s not up to us.
God tells us, as He told Paul: “My graces are sufficient for you.” I believe that this means that God will give us the abundant graces we need to deal with suffering without fear and anxiety, but with His peace and joy. All we need to do is be open to accept these graces.
I have found this to be true in my life. I open myself up to God in continual prayer and thanksgiving, using Christian mindfulness. God fills me up with peace and joy even in the hospital waiting room, in a locked psych ward with a loved one, at the funeral home, on the scene of the accident, in the board conference room and during the dark of the night. It’s not up to me. God is doing it for me and through me.
When we suffer and rest in God’s grace, God responds.
I will give you the secrets of darkness, riches stores in secret places, so that you may know I am the Lord, the God of Israel who summons you by name.
Isaiah 45:3
Kay Warren, co-founder of Saddleback Church, has called this experience “gritty grace.” Maybe the abrasion we feel is good for everyone.
How Children’s Mental Illness Hurts Workplaces
Earlier this year, Nationwide Children’s Hospital released a first-of-its-kind study on how pediatric and adolescent mental health crises impact the workforce. The answer is: Hard. Very hard.
The study is titled “The Great Collide: The Impact of Children’s Mental Health on the Workforce.” Funded by the Nationwide Foundation, it is part of Nationwide Children’s Hospital’s On Our Sleeves movement.
It found that among working parents:
- 53 percent have missed work at least once a month to deal with a child’s mental health issues.
- 54 percent have interrupted their work to answer communication about their child’s mental health situation during work hours.
- 85 percent think it’s a good idea to talk about their children’s mental health issues, but few have done it.
- Up to 50 percent are thinking about their children’s mental health while at work.
The study also found that working parents under age 40 are more concerned about their children’s mental health and more likely to select jobs offering benefits that give them access to mental health services.
If these numbers seem high to you, it’s because of the secrecy involved in dealing with a child’s mental illness. You don’t call in because your child is sick; instead you claim to be sick yourself. I know this from experience.
During the 1990s, I had a young child with mental health issues. My boss once denied me a raise specifically because of the number of phone calls that I received from my child’s school. I frequently had to go get my child at school due to behavioral problems. (My co-workers joked that I should put a courier slip in her hair on a barrette, so the courier could bring her to the office when needed. That way I wouldn’t have to leave.) I held my breath until 2:30 p.m. when school was out every work day. And that was before we had to start homeschooling for the child’s safety from bullying.
Nationwide is adding resources for parents on OnOurSleeves.org as well as rolling out a program for employers soon. Parents need this help. Therapists rarely have time to help parents with all the caregiving issues around having a child with a mental illness. Yet it’s so, so common.
Keep Your Own Record
Even today, it’s hard for medical institutions and doctors to piece together a medical record. So it can be helpful to create your own medical treatment record for your loved one with mental illness. That way you have something ready when you need to provide information.
The excellent book “When Someone You Love Has a Mental Illness” by Rebecca Woolis suggests that your record contain information about:
- Your loved one’s level of functioning before becoming ill.
- Highest level of school attained
- Work history
- Level of basic life skills (cooking, cleaning, money management, experience with independent living)
- Social skills and relationships with peers
- Significant achievements
- Their symptoms.
- What they are
- When they began
- Worst episodes with dates
- Most effective treatment so far
- Treatment history.
- Dates of psychiatric hospitalizations
- Diagnosis
- Types of medication used and their effectiveness (with dates if possible)
- Types of therapy used and their effectiveness (with dates if possible)
- Your loved one’s level of functioning between hospitalizations and treatments.
- The names, addresses, phone numbers and emails of all members of the treatment team (psychiatrist, therapist, social worker or case manager).
- Medical insurance information.
When you are dealing with mental health professionals, you want to appear credible. You make the best impression when you are courteous and respectful of their time. Try to understand that these professionals are under constraints such as:
- Not being able to be effective with those who refuse treatment.
- A heavy caseload.
- Lack of adequate funding.
- HIPPA and other confidentiality regulations.
Even if the illness is decades long, try to go back through your documentation to create a medical record. It will probably be more helpful than the record that the treatment team has.
Ask Anything
Loving Someone With Mental Illness is a support group for friends and families of those with severe and persistent mental illness. Meeting twice a month on Zoom, we share our stories, learn more about dealing with mental illness and pray together.
During October and November 2022, we are holding a series of conversations about things we question in our lives. This is a judgment-free space to connect and process questions about things, such as “Why did God allow my loved one to get sick?” and “Does God heal?” These discussions are part of our Alpha series.
If you’d like to join us at Loving Someone With Mental Illness, contact karentwinem@gmail.com.
Columbus-Area Respite for Caregivers
Columbus-area caregivers now have a free program that helps both the caregiver and a loved one with mental illness. ADAMH, Concord Counseling Services and NAMI have teamed to provide this respite program for caregivers to all Franklin County, Ohio, residents.
Please Google “mental health respite programs” to find similar programs in your area.
A respite program allows a trained professional to spend time with your loved one so you can do other things. You’ll get a three-hour block per week to yourself so you can enjoy self-care and tend to other responsibilities. Even better your loved ones with mental illness get to enjoy activities they pick and interact with other people safely, with a trained mental health professional nearby.
The mental health specialist spends up to three hours a week or 12 hours per month between 7 a.m. and 9 p.m. with your loved one. They can do activities at home or out in the community. Flex funds are available to help pay for the activities. There’s no waiting list at this time.
For more information about the Concord respite program, call 614-501-6264 or click here.