The Family Room — Families Struggling with Mental Illness

It’s The Holidays, Again

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.

Expectations

Holidays are hard. Crowded schedules, family expectations, self expectations, and physical and emotional drain.

For our loved ones who suffer with brain disorders that cause emotional distress, all the stress of the holidays is even worse. While we are planning joyous celebrations, our ill family member may be just trying to deal with the daily struggles of the illness.

One of the definitions of struggle is “make great physical effort.” It is great effort for someone suffering with a mental illness. Trying to maintain a sense of normalcy is hard. Often they give up because the struggle is too hard.

Unwittingly we have expectations for our loved ones during the holidays. This year, maybe this year, nothing will happen. Maybe this year, there won’t be an “incident.” Maybe this year, everyone will enjoy the holiday gathering. Maybe this year, it will be a Hallmark® holiday.

Expectations from extended family can even be higher. Those who aren’t with our loved one all year don’t understand the struggle. Often they are overcome by the stigma of mental illness. Or, they fall victim to misinformation.

Whatever your holiday celebration, it can be anything but holly, jolly. During this month, I’ll be sharing some tips to help you and help our loved one survive the struggle of the holidays.

Take care of yourself

With so much to do and so much on your mind, you can forget about yourself. After all self-care isn’t on your to-do list. And, for too many of us – especially moms – self care seems, well, selfish.

Even if the gang isn’t coming to your house, you are making plans just the same. Part of those plans may be helping your ill loved one, navigate the stress of holidays with no relapse. But, if you are walking a tightrope with your own physical and emotional needs, you can’t reach out and help someone else without risking both of you falling.

Here are some ideas to care for yourself, so you can care for your loved one. And, both of you can enjoy friends and family during the holiday season.

1.    Get plenty of rest.

• Even if you have overnight guests, don’t feel like you have to stay up all night. Having guests is hard work. Get some rest so you can enjoy the visit; rather than looking forward to the day they leave.
• You can’t make it through that to-do list if you don’t have the energy to do so.
• No one appreciates a tired, crabby you.

2.    Cut down that to-do list

• Determine what is essential and important. Everything else goes to the hope list. (I hope we have time for this, but if not we’ll enjoy Christmas anyway.)
• To cut down the list: 1) Put it in order of priority. What is important to you and your family? 2) Draw a line in the middle of the list. 3) Cross off everything in the bottom half of the list. Transfer those items to your hope list if you’d like.
• Look at what’s left. Decide what you must do, and what others can do. Your ill family member may want to be involved with some of the holiday task and traditions. This is one way to be involved without having to meet other’s expectations.

3.    Watch your diet.

• Be careful with all the holiday treats – candy, pies, cookies. Just the over indulgence in this area can make you physically tired and have less energy to cope.
• Don’t over eat at the wonderful holiday dinner. Limit portions and slowly enjoy what’s on your plate.
• Limit alcohol intake. Go ahead; toast the New Year with a glass of wine. After that drink non-alcoholic beverages. Alcohol can dehydrate your system, deplete other nutrients, and you’ll feel worse and have less energy.

Anosognosia – Not Home for the Holidays

Just these three simple steps will help you have the energy and emotional stamina to help your loved one navigate the holiday stress. These simple steps will help you enjoy the Holy Season as well.

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.”