Stage One: Transition
The day my son called and told me about his attempted suicide, followed by telling me that he had been diagnosed with a mental illness, I tried to maintain a “sunny attitude.” Part of the charade was so he wouldn’t get angry and hang up. And, part was due to not knowing what else to do. It was three days before I cried.
Bryon’s diagnosis has changed him forever. The diagnosis has changed our family forever. And, we needed to learn how to cope with the change.
One of the ways we started to cope was by taking classes with other families who were in the same position as us, other families who also didn’t know what to do next. We all learned there are stages to dealing with mental illness for us, just as with any traumatic change in a family.
By the time a diagnosis is given, a family has already progressed into, and sometimes through, transition. This is the time when we see our loved one move from health to illness.
Often our loved ones are very ill before we know or realize that it is more serious than simple teenaged rebellion. Too often, it takes a traumatic event to find out that our son or daughter has a very serious brain disorder. Many times, by the time it is diagnosed, family members have given up and don’t know what else to do but reject the one they love.
For many families, like ours, the change isn’t recognized as an illness. Since most mental illnesses begin to manifest in the late teens to early twenties, the symptoms are viewed more as rebellion than symptoms. A rejection of what has been taught.
We knew absolutely nothing about mental illness. We knew something was wrong with our son. The change was gradual, but a change nonetheless.
We sought help in the place we thought best, our church. No one there was prepared to recognize the symptoms of mental illness. We were trying to manage symptoms that were unmanageable. Over the years, we have learned that other parents go through the transition in much the same way.
Because the transition stage is before a diagnosis is known, it is scary and hard. Pour it out to God. Let Him carry you through this time of struggle and change.
Your loved one may not get a professional diagnosis for years. As you learn more about mental illness, you may see the telltale signs and know what the problem is.
Once you know it is an illness, you’ll be able to move on.
Stage Two: Denial
I had never heard of Borderline Personality Disorder when my son was first diagnosed. My first reaction was to find out everything I could about it. As part of my research, I looked for a way to quickly fix the problem so my son could get on with his life. I was dealing with my son’s diagnosis with denial. I moved immediately to stage two of dealing.Stage one (transition) is generally before the diagnosis is made. Transition usually happens as we see the symptoms of mental illness without knowing what is causing them. Stage one is a time of confusion, sadness, and anger.
Once getting a diagnosis, a reason for the confusing behaviors, denial is usually the next stage of dealing. It is easier to deny the existing of a serious brain disorder than to accept that our loved one will never be the same. Like other serious illnesses, mental illnesses are difficult to accept.
There are several reasons for denial.
Lack of knowledge. Mental illness can be an enigma. Little accurate information is in the general public. Most of the time when we hear about mental illness it is associate with violent incidents – the unexplained beating, killing, or destruction of property. We don’t understand mental illness as a biological disease, in the same way that diabetes or cancer are disease.
Fear. We are afraid that our loved one will become what we perceive as mentally ill. We are afraid for their future, and ours.
Guilt. It’s not unusual, especially for parents, to wonder if something we’ve done has caused this illness.
Stigma. We don’t want others to know about our loved ones brain disorder because of the stigma attached to it. While in denial, we don’t admit to anyone, including ourselves that this is a permanent, although recoverable, condition.
No life transition can be handled alone. Before giving up, seek support through family support groups. Find a NAMI (National Alliance on Mental Illness) affiliate, a MHA (Mental Health America) affiliate, or even an online support group (family_4_family@yahoogroups.com). Find out exactly what your loved is going through. Learn that you are not alone.
This is a vulnerable spiritual time, especially if you believe you raised your child in the “way he should go” (Pro 23:6). You may not be receiving support from your church or Christian family members. You feel like a failure, and are ridden with guilt.
Remember, this too will pass. As you learn more about mental illness, and find you are not alone, you will be able to move on.
Stage Three: Anxiety
Many family members get stuck in the Denial Stage, never moving on to really dealing with the mental illness of their loved one.
Leaving Denial means believing this terrible thing has really happened. While in the Denial Stage, it is easier to think all the bad symptoms will magically go away, or there’s some other reason for them. Leaving Denial is often scarier than staying put.
Once you believe the diagnosis is true, the next stage is frightening – it is the Anxiety Stage. Being here brings three typical responses.
Constant disquietude is a state of general uneasiness. Even when you aren’t consciously thinking about your loved one or the illness, it is looming there in the background. You may be tense and uneasy all the time and not really know why. Others will notice this change in you. You can best handle the disquiet by talking about it rather than slinking back into the shell of Denial.
Worry. The major reason for the disquiet is apprehension and concern for your loved one and yourself. When I first learned that my son had this brain disorder, I had no idea what it meant. What was the near future going to mean? What about ten years from now? Although I now know more about his illness, and I know recovery is possible, I still worry. I call it a knowledgeable worry.
During the Anxiety Stage, many don’t know what is to become of their family member. Worry seems to be humans’ favorite reaction to the unknown.
Sense of Foreboding. This is also part of the disquiet you feel, that sense of something bad going to happen. Something bad has already happened and the future looks even grimmer.
With all the news reports of people with mental illness going on murderous rampages, how else can one react? Without knowing what the future can really hold, there is nothing left but bad feelings.
The more you worry, the stronger that sense of foreboding becomes, and the more disquiet you feel.
Often, as a Christian family, we were advised to just let God handle it. That is very true. God is not surprised by the details of my life, or my son’s life. But, for humans the unknown is not a normal state. I worried, I fretted, I cried out to God for answers – for miracles. Until I moved through the anxiety stage, I wasn’t in a place to recognize God’s hand in this terrible thing that had happened.
Like the other stages, this one may last a long while. I hope not. The constant anxiety is unhealthy emotionally, physically, and spiritually. Just as you need to move through Denial, you need to move through Anxiety.
Each step through the stages brings you closer to dealing with your loved one’s illness.
Stage Four: 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
Stage Five: 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
Stage Six: 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)
This is the best advice and so true with the stages. I and my family are in a difficult dangerous place. My 28 year old son would rather blame me, the computer,aliens and demons for what has happened to him verses accepting he is ill. I accept he is ill but, he won’t get help. I have been told to throw him out and get him band by a court order from home. Though I accept his illness I have not been able to send him away. He is abusive, demanding, impulsive,destructive, dirty,and thratening. I see the sickness I miss my son. I have gone through anger sadness fear and forboding and thoughts of killing myself and my husband (also mentally ill) and my son. Today am more in acceptance, but unable to take a permanent stand. Such as take your medicine or get out. I don’t know it will work I keep thinking love never fails.
By: pat on November 5, 2010
at 5:35 pm
Pat,
I truly understand what you mean by missing your son. Don’t you want to turn the clock back to a time before the symptoms and see if you change things? That’s the parent in us, which wants to nurse our children back to health.
When I see my son struggling, I truly wish I could just love him back to health.
What your son is experiencing is often called “lack of insight.” It’s the inability for our loved ones to recognize that they are ill. It’s not denial…just can’t see it. It’s another symptom of the mental illness. There’s a really good book, I’m Not Sick, I Don’t Need Help by Dr. Xavier Amador, which explains lack of insight in clear terms.
By: Susan K. Stewart on November 10, 2010
at 5:30 am
[...] Stages of Coping [...]
By: A Phone Call Away « The Family Room — Families Struggling with Mental Illness on November 10, 2010
at 7:45 am
I wish you had a twitter option to share here too. I’d be able to send it out
Angie
By: Angela Breidenbach on March 24, 2011
at 8:12 am
Thank you, Angela. I hadn’t even thought about that. I’m putting on my to-do list.
By: Susan Stewart on March 27, 2011
at 2:37 am
Thanks. Needed to hear that today.
By: Laura Devine on July 26, 2011
at 8:42 am
I’m glad you were blessed. Susan
By: Susan Stewart on August 2, 2011
at 6:59 am
Reality has set in…looking for answers, guidance, direction…hope! i found this site. I am so thankful. I am mostly to the point that i want to turn my back and leave. I feel so weary and ill prepared for what lies ahead. I feel foolish because now that i know what is going on, i think it has ALWAYS been there. Ugh! How could i have been so blind? Never imagined the “problems” were mental illness. Now I fear that my children will be mentally ill too. Please God! i hope not! i see the devestation that it has caused me and my family. The subtle things…all the subtle things over the years…that didn’t make sense…now they make sense. I realize the mental illness has been the undertoe in my husband’s inabilities, in the unexplained, reoccuring problems in my marriage, the unhappiness in my family!
By: P Nobles on October 9, 2011
at 5:26 am