Managing Depression and Anxiety

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.

Dealing With Anxiety

Note: The information in this post comes from NAMI, Mental Health America and the Veterans Administration.

Anxiety is the most common form of mental illness in the U.S., affecting 14% of the population before the pandemic. The KFF Health Tracking Poll from June 2020 reported that the number had risen to 40% of adults during 2020. Typically, the National Institutes of Health reports that 18% of adults and 8% of children and teenagers have anxiety.

Anxiety disorders are a group of related conditions, each with unique symptoms. All the types of anxiety disorders do have three major things in common:

  1. Extreme fear and dread, even when there is nothing to provoke it
  2. Emotional distress that affects daily life
  3. A tendency to avoid situations that bring on anxiety

Anxiety also can be an early warning sign of a relapse in other forms of mental illness, including schizophrenia.

Symptoms

People suffering from anxiety disorders typically experience one or more of the following symptoms:

  • Mood and thinking:  Worry or concern, fear, irritability, or difficulty concentrating.
  • Behavior:  Avoidance of feared situations, escape from unpleasant situations, trembling, and agitation (such as pacing)
  • Increased arousal: Perspiration, heart palpitations, muscular tension, butterflies in stomach, mild nausea, dizziness, shortness of breath, headaches, sweating, tremors or twitches, frequent urination, diarrhea, insomnia and fatigue

The most common types of anxiety disorders include:

Generalized Anxiety Disorder (GAD)

GAD produces chronic, exaggerated worrying about everyday life. This worrying can consume hours each day, making it hard to concentrate or finish daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension or nausea.

Social Anxiety Disorder

More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g. saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.

Panic Disorder

This disorder is characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset.

Phobias

We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions. To avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.

Causes of Anxiety Disorders

Scientists believe that many factors combine to cause anxiety disorders:

  • Genetics.  Studies support the evidence that anxiety disorders “run in families,” as some families have a higher-than-average amount of anxiety disorders among relatives.
  • Environment. A stressful or traumatic event such as abuse, death of a loved one, violence or prolonged illness is often linked to the development of an anxiety disorder.

Diagnosis

Physical symptoms of an anxiety disorder can be easily confused with other medical conditions, like heart disease or hyperthyroidism. Therefore, a doctor will likely perform an evaluation involving a physical examination, an interview and lab tests. After ruling out an underlying physical illness, a doctor may refer a person to a mental health professional for evaluation.

Treatment

Because different anxiety disorders have their own distinct symptoms, each type has its own treatment plan. Common types of treatment include:

Helping Ourselves

Leading a balanced lifestyle helps us manage symptoms. The suggestions from people who have lived experience with anxiety are similar to those who live with depression:

Learn all you can. Learn about your loved one’s mental illness, our own anxiety, and the many treatment options available. Connect with other people experiencing anxiety in support groups or meetings. Attend local conferences and conventions. Build a personal library of useful websites and helpful books. Learning is an active thing we can do that gives us a feeling of control.

Recognize early symptoms. Identify possible warning signs and triggers that may aggravate your symptoms.

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.

Avoid drugs and alcohol.

Get physically healthy.

Anxiety is common. Especially in difficult times. As a caregiver of a person with a mental illness, you are likely to experience it occasionally. Be sure to take it seriously. You have to help yourself first before you can help the people you love.