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PBS's 'This Emotional Life': Mental Health and the Family Tree

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"The two most powerful warriors are patience and time."

-- Leo Nikolayevich Tolstoy

Thanks to the recent closing of many mental health facilities as a result of today's tough economic times, the subject of mental illness has been getting a lot of attention lately. The National Institute of Mental Health estimates that 26.2 percent of Americans aged 18 and older -- that's one in four adults -- suffer from a diagnosable mental disorder in a given year. Though no one likes to think of the possibility, the chances that a family will at some time face the specter of mental illness within its ranks are all too real.

While concern for those directly plagued by psychiatric issues is certainly a priority, surprisingly little information is geared toward the effect such an illness has on the loved ones and friends of the sick patient. Unlike cancer or heart disease, whose conditions can be qualified, psychiatric disorders continue to stand as an enigma to much of the modern world. This often leaves those closest to the patient wondering both how to feel and what to do when dealing with the ramifications that are sure to present themselves.

Though advances in diagnosis and treatment have done much in recent years to dispel the stigma attached to mental illness, it can often be difficult for a loved one to come to grips with the reasons behind the illness and the feelings of guilt and confusion that often ensue. It is important to remember that mental illness is just that, an illness of the brain, one that often affects the thinking, judgment, moods, and behavior of the patient. Because of this shift in acceptable thought processes, many people find it difficult to understand the reasons behind the disease itself, as they attempt to categorize the patient's actions, thoughts and emotions in their own healthy terms. When they cannot come to grips with the nuances of the disease, many of those close to mentally ill patients blame themselves rather than the disease for their lack of understanding, while placing the burden for their loved one's condition on their own shoulders in a continued effort to make sense of what has happened. Such behavior often manifests itself in the following ways:

• Guilt. Many family members of the mentally ill believe that they should have been able to control the actions of their loved one. They blame themselves for letting the situation get so out of hand.

• Embarrassment. Social stigmas continue to play a role in the treatment of the mentally ill, and many loved ones have trouble in admitting to the nature of the disease as well as the ramifications it may cause within their family and social circle.

• Confusion. When first acknowledging their loved one's illness, many people cannot come to grips with the reasons behind the disease or the effects it has had on their behavioral patterns.

• Anger. It is common for family members of the mentally ill to feel angry at the patient in the belief that he or she is not really sick, but only looking for attention or an excuse to shun responsibilities.

• Resentment. When a family member becomes mentally ill, his or her burdens are often forced onto the shoulders of those closest to him, adding increased pressure to an already demanding situation.

• Fear. When a loved one is diagnosed with mental illness, family members often wonder if they are susceptible to the illness as well.

• Frustration. The nature of this illness makes it difficult for loved ones to provide the help the patient needs to get better, leaving them to feel inadequate and increasing feelings of guilt.

Helping Family Members Cope
Assisting a friend or family member who has been diagnosed with a mental illness can be a time consuming, heartbreaking, and often thankless task. It is the nature of the illness to rebel against help of any sort, and family members and loved ones often bear the brunt of the patient's frustration at being unable to control himself as he has been accustomed. The key to successfully embarking on a path back to wellness is to remain as non-judgmental as possible. By removing the added guilt of facing up to what he or she is doing to the family, the patient will be better able to focus more readily on getting better.

Recent years have brought about exciting new developments in the diagnosis and control of many major mental health issues, though it is important to note that every patient has his own specific rate of recovery. For a friend or family member, the best way to stay effective in assisting a loved one's treatment is to maintain objectivity and a sense of self. Though it will certainly be difficult to watch as a loved one struggles with his illness, nothing is gained if the rest of the family is pulled down with him. The following guidelines may help you to maintain focus and a positive attitude when faced with the daily tribulations that arise from supporting a mentally ill loved one:

• Confide in a friend. Due to the convoluted nature of the disease, it is often helpful for family members to discuss treatments and behavioral issues with an outside party. This helps to maintain an objective perspective on the effects of the disease.

• Maintain realistic expectations. Do not expect the disease to be cured overnight, if at all. Recognize that frustration and setbacks will play a large part in the progression of the patient's recovery, and any negative actions on the part of the patient have no bearing on the ways in which you have provided support. Unlike most physiological diseases, mental illness is often directly connected to mood swings, which do not necessarily indicate that the disease is progressing.

• Accept help whenever it is offered. When taking on the added burden of a mentally ill loved one, it is essential that family members do not become overtaxed themselves. In order to provide adequate support, the needs of the entire family, and not just the patient, must continue to be met.

• Maintain a sense of humor. As with any situation involving a sick loved one, a positive outlook can make even the most difficult times more bearable.

• Take time for yourself. Remember, your sick loved one is only one part of your life, and you can best serve him or her by staying focused yourself. It is important to spend time every day doing something you enjoy such as a hobby or exercise to allow yourself time to recuperate and eliminate stress.

Wrestling with the intricacies of mental health disorders is no easy feat. If you are dealing with a family member who has been diagnosed with a psychiatric condition, it is of utmost importance that you understand and accept the fact that your loved one's condition is an illness, no different than if he or she had an issue with the lungs, heart, or stomach. Guilt and embarrassment should play no factor in helping your loved one to cope with the demands of the illness, nor should blame be added to the already substantial burden of caring for the sick. The sooner you can accept this illness for what it is and begin to manage its consequences, the sooner your loved one will be able to embark on the journey to recovery. By accepting both the disease and the patient, family members are much more likely to successfully navigate the troubled waters found in any crisis of mental health, and the added strength they find will surely benefit the loved one in need.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.