Information is from “When Someone You Love has a Mental Illness” by Rebecca Woolis, “The Complete Family Guide to Schizophrenia” by Dr. Kim T. Mueser and Susan Gingerich, and the Palo Alto Medical Foundation.
The best answers for how to respond to the symptoms of your loved one’s mental illness come from their treatment team. As I’ve said previously in this series, I’ve found it can be hard to get answers from the team quickly. This information below is from respected sources and my own experience to help when you need to respond immediately.
Responding to Anger
First, if you are angry or upset at your loved one, separate until you can calm down. To deal with their anger, you need to remain as calm as you can, and stay in control of yourself. When your loved one is angry:
- Do not approach or touch your loved one without permission.
- Give your loved one an escape route out of the situation.
- Don’t give into angry demands that violate your boundaries.
- Do not argue with irrational thinking.
- Acknowledge the person’s feelings.
- Protect yourself from injury.
If necessary, call the police and ask for an officer trained in dealing with the mentally ill. More cities are creating special units that include social workers and EMTs to respond to mental health crisis calls. This is excellent news, and I hope the trend continues.
If angry outbursts become routine, you need to discuss this when everyone is calm and can agree to some steps. This could include:
- A medication review
- Venting energy via exercises, such as hitting a punching bag or yelling in a place where it won’t bother anyone.
Dealing with Bizarre Behavior
Bizarre behavior is a symptom and is often related to delusions. This can include strange rituals and OCD-like activity and unusual beliefs acted out.
If the behavior is harmless, you can ignore it if you wish. (For example, if your loved one can’t go get ice cream because everyone can read his mind at Graeter’s). Focus on positive behavior, and ignore bizarre behavior.
If it constitutes a problem (running around the neighborhood naked, doing dangerous things, damaging property, etc.), you can ask the person to stop. They may or may not be able to do this.
Focus on the consequences. Tell the loved one that the behavior may end up with them being in jail or the hospital. You can remind them of previous experience, if applicable.
If necessary, you may need to call 911 and ask for an officer trained in dealing with the mentally ill.
Dealing with Negative Symptoms
Blunted Affect is a facial expression that’s almost blank and conveys no emotion. The person still feels emotions, but they don’t show them. Ask how they are feeling.
Poverty of Speech means that the person barely speaks. The person cannot help this. Do things together where the focus is not on talking: shopping, nature walks, movies.
Apathy and Anhedonia are when your loved one no longer enjoys activities or things. Apathy is a symptom, and not under the person’s control. At the core of this is a belief that activities will not be fun.
- Acceptance is the first step. “I know he’s doing the best he can.” “He’s not lazy; this is a symptom of his illness.” “Difficulty doing things and following through are part of this illness.”
- Invite the loved one to join you in day-to-day activities (grocery shopping, going to the dry cleaner, etc.).
- Regularly schedule enjoyable activities (going to a museum, going to get pizza, going to a park). Lower your expectations.
- Take baby steps and praise progress.
- Increase daily structure.
- Focus on the future, not the past.
I hope this series on dealing with symptoms has been helpful. Please let me know what topics you’d like me to cover in the future.