Posted by: Susan Stewart | February 9, 2010

Recovery – New Research

As I read the National Institute of Mental Health’s (NIMH) recent research, I sighed, “It’s about time.” It’s about time to look at mental illness from a recovery standpoint. It’s about time to recognize that treatment needs to begin with the first symptom episodes. It’s about time . . . family members seemed to intuitively know this.

NIMH’s research project Recovery after an Initial Schizophrenia Episode (RAISE) is exploring the effectiveness of of early and aggressive treatment. RAISE examines an aggressive approach to early treatment at the first onset of symptoms. The researchers are looking at two different approaches that have the same goal: To lessen long-term lose of functional abilities. They are also seeking to disseminate the learned information quickly into community settings to make a transition from research to practice. (A summary of RAISE)

Just what is it that family members seemed to know that researchers are just learning?

First, early diagnosis and early treatment. It is still standard practice not to diagnosis any mental illness in early teens, even though symptoms may be pronounced and clear. For some mental illness, such as Borderline Personality Disorder, it is recommended not to give a diagnosis to a teen unless the symptoms have been present for a year or more.

In our family’s situation, by the time a diagnosis was given, the destruction caused by the mental illness had set in. Our son had also turned 18, and we were prevented by law from making appointments for him. He was too ill to decide for himself, but intervention wasn’t an option. How often we have said, “If we’d only known sooner.”

The reasoning is to not “stigmatize” a young person with a mental illness diagnosis. Too often the person is stigmatized by anti-social behavior and criminal record before a diagnosis is given and treatment started. Early intervention can help prevent destructive behaviors later on.

Second, families have known that recovery is possible. Sometimes that recovery requires more than a handful of pills and a once-a-month, 30-minute appointment. Recovery is person oriented; not method oriented. Recovery occur more often when it begins early and aggressively. The goal of getting this researched model into the community quickly will help get boots on the ground toward real recovery that leads to independent living.

Third, research needs to focus on a recovery model. Yes, it’s important to know why the brain operates the way it does. Yes, it’s important to know what medications may help. But, more needs to be done to promote recovery, not maintenance, as the goal for those suffering with mental illness. We family members want our loved ones well, not just medicated.

I applaud NIMH and the researchers (John M. Kane, M. D. and Jeffrey A. Lieberman, M. D.) for taking this bold and important step to promote recovery from mental illnesses.

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Posted in Future, Recovery, Research

Posted by: Susan Stewart | February 2, 2010

Start Fresh

January is over, so it doesn’t seem like the beginning of the year any longer. Why would I even be talking about a fresh start? It’s never too late; you can start fresh, make new resolutions any time.

For many of us our resolutions have come, and gone. Each year on January 1, many of us decide to start fresh; we’re going to do things differently. We may have put on our list such things as less stress, more happy time, not get angry as much. That’s not to mention the more traditional lose weight, read more, or go to the gym.

Each year many of us hope and pray that our loved one will have a better year. Some of us may even resolve to do more to help—be more supportive or facilitate recovery. Maybe we even resolve to “help” our loved get treatment and medication, and “help” our loved one be well.

Jeremiah 29:11 begins with “I know the plans I have for you …” God has a plan for me and my loved one. I’m looking forward to the plan he has for me; but am I looking forward to the plan he has for my son? I don’t know.

Right now, I can see the plans God has for me–at least for the next few weeks. I don’t know what he has planned for my son, and that’s probably good. I can’t make my son change. I can’t make him be in treatment. I can’t make him do what is necessary to get his meds. He has so many wild ideas in his delusional mind. I can’t even make him hear or understand God’s plan for him.

So, what can I do? First, I can remember that God said he has a plan for me. That doesn’t mean there’s no plan for my son. It means my son’s plan isn’t mine. My focus needs to be on what God wants me to do. Sometimes that means just waiting for my son to take the next step.

Second, I can support my son in his positive efforts, while remembering I can’t change him. I can’t make him start fresh. Only my son can choose to make that fresh start.

Third, I can be there when my son has a full-blown relapse, and needs love and support. I can be there when his delusional mind has strange ideas. I can just be there.

My fresh start for the year? Do less, so I can do more. The fewer things I have on my to-do list, the better I’ll do each item. I will also take a fresh look at how I support my son. Ill or well, he will know he is loved—by me and by God.

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Posted in Devotions, Future, God's Plan

Posted by: Susan Stewart | January 25, 2010

It’s About You

One of the hardest steps for a family is accepting that a loved one has a mental illness. The next hardest is accepting that you are also a “victim” of the illness.

I don’t like using the word “victim;” it is such an overused word. Mental illness, like so many other biological illnesses, affects family members. As is often expressed, you are now heading to a new normal.

It’s not necessary, or desirable, to just “accept” the diagnosis. Surely you must come to terms with it by realizing there is a problem. Family members must move beyond acceptance to coping.

It is easy to focus on your ill loved one because it is new and your natural tendency, especially for parents, is fix the problem. Eventually the fixing will destroy you if you don’t take time for yourself.

Coping begins with self-care. Just because you become a victim of your loved one’s illness, doesn’t mean you have to be a hostage. You may have become a hostage if you feel as though you’ve lost control of your life. Now is the time to take back control.

Make time for yourself.

One of my first questions when our son was returning home after a suicide attempt was, “How do we ‘watch’’ him?” I didn’t get the answer I wanted, “You don’t.”

I was preparing to have a 24-hour watch, and doing it myself if I had to. That was neither possible nor practical. In the emotion of the moment, I wasn’t thinking; I was reacting. I didn’t, couldn’t, think about myself.

I later learned that I needed to get away. For the sake of our marriage, my husband and I needed time alone. For the sake of faith, I had to learn to trust God completely. After all it is only he who is in complete control of anything.

No matter how diligent you are, you will not be able to control your loved one or the symptoms of the illness. You can only control yourself. If you’re tired and emotionally drained, you’ll lose control.

Don’t focus your energy, or your life, on the mental illness

When my son was diagnosed my first reaction was to learn all I could about mental illness, and his diagnosis. Not just because I didn’t know what the diagnosis meant, but because I somehow believed if I had the facts, I had control of the situation.

My quest for information became an obsession. Each new tidbit led me on another rabbit trail. I let my work fall behind. I talked continually about mental illness to anyone who would listen. I spent hours on the phone trying to find the best treatment for my son. And, I formulated a plan for my son.

I really hadn’t gained any control over the situation. Further, I was drained. I was feeling pressure from an ever-growing to-do list. The focus of my life became mental illness as I kept looking for the one thing that fix the problem.

Maintain your normal routine.

Routine is stability for your ill loved one, especially after a psychotic break. It helps return to normal, albeit that new normal. If your routine is to get up early for a run, go. If your routine is dinner at 6 p.m, do it. If your routine includes coffee with your neighbor, have it.

If you adjust your routine to match the new normal of your loved one, you’ll soon be tired, depressed, and resentful. None of which will help you when you may be needed.

Find support.

There are many support groups, both in person and online, that are just for you. People who understand both the nature of mental illness and what you are going through.

We Christian have been taught that we aren’t suppose to put ourselves first. It is selfish and, well, un-Christian. After all, aren’t we suppose to put others first? Especially when someone is need. I don’t think Jesus taught us to neglect our basic needs.

Jesus knew the importance of taking care of himself—physical, mentally, and spiritually. How many times did Jesus go off alone, or with the three close friends? At Gethsemane he lamented that his friends couldn’t stay awake with him. (Matthew 26).

He was God incarnate, but still his human body needed time away to refresh and recharge to continue helping others. Jesus knew and demonstrated that he couldn’t take care of the many needs around him if he didn’t take some time for himself.

Having a loved one with a serious and persistent mental illness is a roller coaster at best. Even if your loved one is doing well, in recovery, and stable, crisis is at any moment. Crisis is only a phone call away.

We never know when our loved one will relapse. Sometimes, we can see some signs. Often we cannot. There is little preparation. If we haven’t taken care of our own needs, we won’t be prepared to take care of the emergency.

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Posted in Families, Family Member, Parents, Stages of Dealing, coping, self care

Posted by: Susan Stewart | December 1, 2009

Anosognosia – Not Home for the Holidays

My son attended our family Thanksgiving gathering. It was good to see him; but that’s about all that happened.

He didn’t interact much, only responding when asked questions. Kept away from the crowd of people. Ate little. He was here, but he wasn’t.

It’s not uncommon for our ill loved ones to be mentally and emotionally separated. James Pavle, Executive Director of Treatment Advocacy Center, put it this way,

“There are many barriers to keeping in touch for those with severe mental illness.  . . . in these severe instances the term has a double sense: 1) physically separated from family and friends and/or (2) cognitively separated from reality by virtue of the condition anosognosia, or lack of awareness that they are even ill.”

Anosognosia is what separated my son from the family this year. He knows he has been diagnosed with a mental illness, but he lacks awareness that it is affecting his life and his relationships.

Xavier Amador describes this condition as “lack of insight” in his book I am not sick I don’t need help A book I highly recommend if your loved one doesn’t accept or seek help.

This type of separation is hard for families. We see the poor condition our loved ones are in, and there is nothing we can do. Sadly one of two things often happens.

First, we push; we badger relentlessly for them to do something, anything. We explain how their life would be better. We may even talk in glowing terms of another person who is in recovery.

Second, we ignore, or even reject, our loved one. More often the rejection is from family members who don’t understand the situation.

Neither of these is helpful. With the first approach, our loved one may avoid the badgering by cutting off contact. The second, well, no one wants to be around others who ignore or reject us. Our ill loved ones don’t either.

What can we do?

Accept that our loved ones cannot fully understand they are ill or recognize the symptoms. Think about it: If you don’t think you’re sick, you don’t think you need treatment.

Encourage any step toward recovery your loved one may take. Sometimes that won’t look like what we think recovery might be. But, any positive step is important.

Talk with other family members. Many of them who are not seeing the effects of the mental illness just don’t get it. They may not even after a chat, but it can lead to a little more sympathy with the situation.

Accept your loved one. No matter the illness, God has great plans for each person. Your loving acceptance can be the stepping-stone for your loved one to reach for those plans.

Pray. Not just for your ill loved one, but also for other family members to understand. Pray for God’s plan to be fulfilled.

Read also “Keep in Touch.”

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Posted in Families, Holiday, coping

Posted by: Susan Stewart | November 18, 2009

Holiday Resources

How often do you enter November with vision of an old-fashioned, family holiday? “This year will be different,” you say to yourself and any family members who will listen.

I’ve given up this fantasy, and choose instead to be content with a Griswold Christmas. (If you haven’t seen National Lampoon’s Christmas Vacation, rent it now and enjoy the reality of the holidays. WARNING: Sexual innuendo and one instance of X-rated language.) The lowered expectations on my part have improved the season for me and my ill son.

But, what about other family members? Those who only come when invited for a family event. Those who expect everyone, including our ill loved one, to behave in a manner befitting a Curry & Ives scene.

Most of these family members just need to be educated on what the holiday social gatherings do to you and your ill loved one. They need to understand why expectations need to be lowered so all can enjoy the family time on their own terms.

I came across two resources that may help you with the holidays. These are resources you can share with other family members and friends, to help them understand that Mr. Curry, Mr. Ives, and Mr. Hallmark were presenting only a vision of holiday celebrations, not fact.

Mental Illness: Coping with the Holidays is from Mental Health Ministries. This downloadable pdf brochure tells why the holidays may not be holly-jolly and how to cope with it.

10 Tips for Surviving Thanksgiving with the Dysfunctional Family is a featured article in PsychCentral’s November newsletter. This newsletter also has an article of holiday blues. Both provide good and readable information and ideas.

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Posted in Families, Family Member, Holiday

Posted by: Susan Stewart | November 6, 2009

It’s The Holidays, Again

(This is the beginning of a series about helping our loved ones and ourselves through the stresses of the holidays.)

It’s that time of year again: The Holidays.

The time from Thanksgiving until New Year’s Day is probably the most stressful period in America. Expectations are high; reality is low. The pressure to perform has become so great that many people are opting out.

Probably most stressful are the expected family gatherings. These events can be hard. Let’s be honest, do we really know all those cousins that we only see once a year? And, again being honest, do we sometimes just want to skip the whole affair?

If it’s tough for us, imagine for a moment what it must be like for our ill loved one. Strangers milling around, hugs and kisses from those strangers, and noise everywhere. Some of our loved ones just can’t handle so much input at once.

Then there’s the lack of understanding. Distant relatives often don’t understand what mental illness is. A holiday party is usually not the place to try and explain what it means for our son, daughter, brother, or sister to hear voices or to have unusual fears of people. Even the famous Monk has a hard time explaining to those closest to him why he must touch every parking meter.

One way you can help your loved one is by not forcing attendance at these events.  At the last minute, our son decided not to attend the family Thanksgiving dinner at his brother’s house. He said that he just couldn’t “deal with it.” So be it. He was more comfortable, and there was no holiday incident.

Allow your loved one to leave anytime during the party. Maybe a short visit with everyone will be o.k., but to sit down at the table with 20 strangers may be just too much to ask for.

Sometimes our loved one wants to be part of the preparation, but not part of the main event.  This is a good way to be a part of the celebration without having the stress of the family gathering or high expectations of the day.

Remember your loved one’s mental well-being is more important than a possible offense to a third cousin.

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Posted in Families, Family Member, Holiday, coping | Tags: , ,

Posted by: Susan Stewart | August 6, 2009

Coping: Self-Care

One of my first questions when our son was returning home after a suicide attempt was, “How do we ‘watch’’ him?” I didn’t get the answer I wanted: “You don’t.”

I was prepared to have a 24-hour watch, and do it all myself if I had to. That was neither possible nor practical. In the emotion of the moment, I wasn’t thinking; I was reacting. I didn’t, couldn’t, think about myself.

Mental illness, like many other biological illnesses, affects you and your family as much as your loved one. Your family will begin to move beyond acceptance of the diagnosis. A crucial next step is learning to live the illness, or coping.

It is easy to focus on your ill loved one because it is new and your natural tendency, especially for parents, is fix the problem. You may begin to feel as though you’ve lost control of your life.

It’s vital to your ability to cope and care for your loved to take care of yourself. If you are emotionally, spiritually, and physically drained, you can become physically ill. You will surely be unable to assist your loved one in the way that may be needed.

Now is the time to take control of the new normal.

1. Make time for yourself.

I learned that I needed to get away. For the sake of our marriage, my husband and I needed time alone. For the sake of faith, I had to learn to trust God completely. I was trusting myself instead. I needed to plan time with him.

You will not be able to control your loved one. You can only control yourself. If you’re tired and emotionally drained, you’ll lose control of everything.

2. Maintain your normal routine.

Routine is stability for your ill loved one, especially after a psychotic break. It helps return to “normal”, albeit a new normal. If your routine is to get up early for a run, go. If your routine is dinner at 6 p.m, do it. If your routine includes coffee with your neighbor, have it.

If you adjust your normal to match the new normal of your loved one, you’ll soon be tired, depressed, and resentful. None of which will help when your loved one needs you.

3. Find support.

There are many support groups, both in person and online, that are just for you. People who understand both the nature of mental illness and what you are going through. You cannot go it alone. There is comfort and hope in knowing others feel and react the same way you do.

This may seem un-Christian. After all, aren’t we suppose to put others first? Especially when someone is need.

How many times did Jesus go off alone, or with the three close friends? He was God incarnate, but still his human body needed time away to refresh and recharge to continue helping others.

If God the Son needed time off to rest and re-coup, don’t you?

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Posted in Families, coping, self care | Tags: , , , , ,

Posted by: Susan Stewart | May 1, 2009

Stages of Dealing: Acceptance

Like any traumatic change, acceptance is at the end.  Whether the change is due to loss of income, illness, or a job change, a point comes when the new way of life is accepted.

This last stage of dealing with mental illness comes when you realize there is a problem and it is not the end of the world. Something has changed for your loved one AND for you. Once at this stage, you can begin to acknowledge that your family member is ill.

Acknowledgment of mental illness is not giving up. Like other major illnesses, mental illnesses can be treated with medication, therapeutic assistance, and a network of support. You are an important pillar in that network of support.

The stages of dealing with mental illness in the family are not easy. For some it is a very long process. There will be many ups and downs. Even after reaching the stage of acceptance, you may slip back to a former stage such as denial or changing emotions. Once you’ve reached this point, though, it will be easier to work your way back to acceptance.

Acceptance means you are coming to terms with the validity of the illness. Acceptance means recognizing that your loved one will not be the same as before the illness. Acceptance means you can be part of the network of support. Acceptance means hope.

Still, if you set your heart on God
and reach out to him,
If you scrub your hands of sin
and refuse to entertain evil in your home,
You’ll be able to face the world unashamed
and keep a firm grip on life, guiltless and fearless.
You’ll forget your troubles;
they’ll be like old, faded photographs.
Your world will be washed in sunshine,
every shadow dispersed by dayspring.
Full of hope, you’ll relax, confident again;
you’ll look around, sit back, and take it easy (Job 11:13-19 MSG)

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Posted in Family Member, Future, Hope, Stages of Dealing | Tags: , , ,

Posted by: Susan Stewart | March 30, 2009

Stages of Dealing: Changing Emotions

The sudden burst of anger shook the entire household. Where did that come from? What triggered it?

It’s not your ill loved one ranting and raving; it is you.

Changing and conflicting emotions are not unusual when you are trying to cope with the overwhelming reality of mental illness in the family.  When you begin to realize your loved one has a chronic condition, when reality sets in, your mind and body will react.  That reaction is not always what you expect.

Your emotions can suddenly move from frustration to anger to resentment. Or, on another day, you will feel an overwhelming grief. (We will discuss grief in another post.) Other days you will feel great sympathy and compassion for your loved one, while you question your ability to cope with the symptoms. You come to a point where it seems too much to handle.

In many ways, this is a good thing, although it is definitely disconcerting. The upheaval of emotion comes when deep down you begin to accept the reality of the illness. Your mind and heart are confused, so they go off wildly on their own.

When the anger or the deep sadness hits suddenly, you may not know what to do or how to handle it. You may not recognize it is happening. You may question even your own sanity. Be assured it is normal. And, this too will pass as you learn more about your loved one’s disorder.

During these periods of shifting emotions, some people will question you – “Why do you put up with it?”  Advice offered by people, even counselors, who don’t have knowledge or understanding of mental illness can further distress you.

Learn all you can about your loved one’s illness. Find the support of other families who understand what you are going through. Don’t try to ride the waves of emotions alone.

Email support: http://health.groups.yahoo.com/group/family_4_family

Mental health news: http://my.alltop.com/skstewart

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Posted in Families, Mental Illness, Parents, Stages of Dealing | Tags: , , , ,

Posted by: Susan Stewart | March 19, 2009

Stages of Dealing: Seeking Explanations

Why? The human response when bad things happen – death, loss of job, disease, mental illness. Our inquiring minds go into hyper-drive seeking an explanation for the unexplainable.

I will never know why my son has a mental illness. Oh, I know the biology of it. I know various other facts. But, I’ll never know why God chose my son over my neighbor’s son. That doesn’t stop me from wondering why.

Some people look for blame. Who or what can we blame? Like any other chronic illness, there is no one to blame. You didn’t cause it. Your loved one didn’t cause it. Society didn’t cause. Like diabetes, cancer, or high cholesterol, it happened.

Instead of seeking an answer to “Why?” seek facts. Learn all you can about your loved ones disease. Mental illness in general, your loved one’s disorder specifically. Find out the treatments. Find resources in your area?

I found comfort in some of the facts. Just knowing that my son’s behavior is the result of illness, not a character defect helped me move to a more comfortable place. As I learned the facts I was able to start helping him recover.

Seeking information will help move you to a more stable place on the stage of dealing. It doesn’t change the diagnosis. It does help you deal with it more rationally.

Bad things happen. Although we may never know why, with facts we can move forward.

To learn more about mental illnesses:
Amen Clinic
National Institute on Mental Health
Mental Health America

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Posted in Families, Family Member, God's Plan, Mental Illness, Stages of Dealing, Uncategorized | Tags: , , ,

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