When a loved one is diagnosed with a mental illness, it can bring up a lot of questions. What kind of care do they need now or what will they need in the future? Are they going to be OK? What can you do to help?
Importantly, the answer to the third question is: a lot.
For people with mental illness, family support can improve adherence to recommended treatment, reduce relapse and hospitalization, and lead to better overall health.
“Professional healthcare providers are only one part of a person’s care team; it’s really loved ones and chosen family who are there day in and day out, supporting people at their best and worst, who really sustain a person over the course of any illness,” says Mollie Forrester, a licensed social worker and director of Patient and Family Experience at UW Medicine, Department of Psychiatry and Behavioral Sciences.
And family isn’t constrained to blood relatives but includes anyone who is part of a person’s support network that they trust and can rely on. So, whether you’re a friend, sibling or partner, there are ways you can connect with your loved one and help them get the care they want and need to feel better.
Learning about the diagnosis and available treatments can help you start answering some of those swirling questions about what to do. It can also build compassion and allow you to prepare based on the reality of your loved one’s condition.
For example, learning about schizophrenia, which often presents in late adolescence or early adulthood, a time when kids are typically differentiating from their parents, might help you better understand the symptoms your child is experiencing but also ways to effectively partner with them. Or if a relative has dementia, learning about the disease allows you to start preparing for a future when they may need around-the-clock care.
“If the diagnosis is a serious, chronic condition, education can help you be ready for what may be more of a marathon than a sprint,” Forrester says. It is important to seek information from reliable sources such as specialized professional, academic and governmental organizations (check out the resource section below to help get you started).
Ultimately, educating yourself can help you better understand what your loved one is experiencing, as well as help you realize what you need for your own well-being as a caregiver.
Be with them
You want your loved one to know that their diagnosis doesn’t change how you feel about them.
“When a person is diagnosed with a mental illness, a lot of the time there is stigma, and it can be a really isolating experience. Some people think it’s a failure or tell themselves, ‘I should be able to pull myself out of this,’” Forrester says.
Spending time with your friend or relative helps reinforce that you love them and that they aren’t alone. Just being there — even if you don’t have the right words to say or aren’t sure what to do — can help show that you care. Time together also allows you to partner with them in noticing new symptoms or changes, such as if they start struggling to enjoy activities they previously liked, which could be a sign of relapse.
Act as a medical liaison
Think back to the last time you saw your doctor. Do you remember all of their recommendations? Or every side effect of a medication they prescribed?
Remembering the details at a doctor’s appointment is hard for everyone, and it can be even more challenging if you’re dealing with a mental illness. On top of not feeling well or thinking clearly, your loved one might now have to manage multiple appointments, find available therapists and stick to a new medication regimen.
“It’s a lot to manage. We can all use encouragement and benefit from having a team on our side,” Forrester says.
One way to help is to volunteer to take on some of the medical management tasks. Offer to schedule appointments, provide transportation or attend meetings to take notes on what the doctor says. You can also look up therapists that take your loved one’s insurance and compile a list of those who have openings.
Build skills to meet them where they’re at
The best way to help will vary from condition to condition and from person to person. But learning about practices that have been shown to work gives you a solid foundation to build on.
One evidence-based technique Forrester recommends is behavioral activation that can help support people with low mood or depression. The idea is to use behaviors to help activate better moods or feelings. It can be hard for someone who is depressed to want to do things — even the things they love. Instead of waiting for your loved one to initiate an activity, try offering easy ways to engage, like going for a walk around the block or eating lunch together in the garden. You can also encourage them to do the activities they previously enjoyed even if they don’t feel like it in the moment, because the action might in turn stir up positive emotions.
If your loved one is experiencing psychosis, learning how to come alongside them can help you engage and feel more connected. UW Medicine’s Psychosis REACH program provides training for families and carers so that you have the skills you need to support your loved one. Similarly, the Memory Hub offers training on how to problem solve and communicate with a loved one who has dementia.
“If you are just butting heads, it’s not therapeutic or good for the relationship. Saying something like, ‘Wow, that must be really stressful or hard or scary’ or whatever it is, gives families or caregivers a way to connect around symptoms,” Forrester says.
Reach out to resources (aka don’t go it alone)
Just like you don’t want your loved one to feel isolated, it’s important that you find support and community for yourself, too.
“There’s no need to do this alone. You can learn from the people who’ve forged the path before you,” Forrester says. “We’re piloting an exciting new program at UW Medicine that will teach families and caregivers how to be effective members of their loved one’s care team by drawing upon the lived experience of others. There’s a whole community that can offer support.”
Get connected by checking out online resources (Forrester recommends the National Alliance on Mental Illness, National Institute of Mental Health, and Substance Abuse and Mental Health Services Administration) joining peer support groups or accessing local options, like the Memory Hub or New Journeys or Psychosis REACH.
Be sure to also take time for yourself and be mindful of your own capacity, boundaries and needs. It’s OK to talk to your loved one about what you can’t do and then partner together to find a solution that works for both of you. Working together to problem solve in this way may even bring you closer together.
“Being invited in to be a caregiver by a loved one who is struggling is really a privilege, but it doesn’t have to be a one-way street,” Forrester says. “Any illness will ebb and flow. You want to see the relationship as two-way: a dynamic fluid process that is more sustaining for everyone involved.”