Families who have one or more members with severe, persistent mental illness face unique challenges. Complex family dynamics, social isolation and often unpredictable behavior can take their toll. Other ways that mental health issues impact families include:

• The family may change its rules or patterns.  The ill person may no longer do chores, and the family may withdraw from social situations.
• Friends may withdraw from the family.
• Everyone is walking on eggshells around the person.
• Family members vent their frustration on non-ill family members.
• Parents may be stricter with non-struggling children.
• Family members may blame themselves.
• Family members may become resentful of the ill person for the disruption the illness has caused.
• Family members may be ashamed of the ill person’s struggle.

Under these circumstances, the primary caregiver or other family members may develop depression and anxiety. This also impacts the entire family. In fact, the additional stress can be overwhelming. But there is hope. The ideas below come from people who have lived experience, as well as NAMI, Mental Health America and the Veterans Administration.

When You Are Struggling

Learn all you can. If you develop depression or anxiety, learn all you can about the illnesses. Taking good care of yourself is critical to caring for your loved ones. Connect with other people experiencing these issues in support groups or meetings. Attend local mental health conferences and conventions. Build a personal library of useful websites and helpful books. Learning is an active thing you can do that gives you a feeling of control where control is possible. Ideally, you should learn about your loved one’s illness as well as depression and anxiety.

Recognize early symptoms. Identify possible warning signs and triggers that may aggravate your depression or anxiety symptoms. With this knowledge, you can recognize an emerging episode and get the help you need as soon as possible. Don’t be afraid to ask your friends and family for help—they can help you monitor your symptoms and behavior.

Partner with your health care providers. Give your health care provider all the information he or she needs to help you recover—including any reactions to medications, your symptoms or any triggers you notice. Develop trust and communicate openly.

Know what to do in a crisis. Be familiar with your community’s crisis hotline or emergency walk-in center. Know how to contact them and keep the information handy.

Avoid drugs and alcohol. These substances can disturb emotional balance and interact with medications. You may think using alcohol or drugs will help you “perk up,” but using them can hinder your recovery or make symptoms worse.

Eat well and exercise. To relieve stress, try activities like centering prayer, meditation, yoga or Tai Chi.

Deal with unresolved grief.  Do you have a mixture of persistent feelings of sadness, anger and frustration about your loved one’s mental illness?  Seek more help if you know that you are still grieving over the illness.

Helping Another Family Member  

In these circumstances, some family members may develop depression or anxiety. This is a heavy load for a caregiver dealing with another loved one with mental illness. Getting support is essential for you to continue be helpful. Some suggestions include:

Be proactive in keeping the family as strong as possible.

• Eat, sleep, connect with other people and turn to God.
• Take a break when needed.
• Go places as a family even if the ill person does not go.
• Encourage all family members to continue with regular activities.
• Know some days are better than others, and all things pass.
• Consider family therapy.

Learn more about your loved one’s condition. Learning about depression and anxiety will help you better understand and support your loved one.  They do not need to “hit bottom” to get better. In many cases, hitting bottom means suicide.

Communicate.  Speak kindly and honestly. Don’t scold or blame people with depression or urge them to “try harder” to “just be happy.” Instead, make specific offers of help and follow through with those offers. Tell the person you care about them. Ask them how they feel and truly listen.

React calmly and rationally. You can’t fix the person, but you can walk with them through this time. Even if your family member or friend is in a crisis, it’s important to remain calm. Listen to their concerns and make them feel understood—then take the next step toward getting help.

Find emotional support from others. Share your thoughts, fears and questions with other people who have loved ones with similar conditions. If they won’t get help, you should.

Schedule pleasant events and encourage an increased activity level.  Assist your loved one in making plans at specific times and dates to do something pleasant … a walk in the park, a movie, etc.

Correct unhelpful thinking. Help your loved one challenge thoughts about how things “should” be.  You need to learn about cognitive distortions and how to gently help a loved one to understand them.   I recommend reading  “Feeling Good: The New Mood Therapy” or “The Feeling Good Handbook,” both by David D. Burns.