About 51 million people in the United States have some form of emotional or mental disorder. Because mental illness is so common, many Americans cope with the day-to-day struggle of sharing a home with a person who is mentally ill. Living with a person who has a mental disorder can be challenging and stressful, and most family members are not adequately prepared for the experience. Many families also fear the stigma that still surrounds many types of mental illness. But effective treatments exist for many mental disorders, and help is readily available. The first step in dealing with a loved one's problems is to recognize the warning signs of a mental disorder:
• confused thinking
• long periods of depression
• extreme mood swings (from elation to sadness)
• high levels of fear, worry, or anxiety
• withdrawal from people and activities
• significant changes in eating or sleeping habits
• delusions or hallucinations
• thoughts of suicide or homicide
• denying the existence of a problem
• unexplained physical illnesses
• substance abuse
The symptoms of many mental disorders are similar, so many families share the same experiences. The behaviors—including withdrawal, angry outbursts, or
Concerns disorganized speech—that characterize certain mental disorders can be shocking and embarrassing when performed in public. If you are in such a situation, remember that the person cannot help what he or she is doing. Try to encourage the person to move to a more private place until he or she is calm. Discuss with the person's doctor what to do in such situations so that you can be prepared the next time.
To help fight the stigma of mental illness, you can become an advocate for your loved one. Ask the doctor about the person's specific needs and try to fill them. For example, someone who has delusional disorder (see page 360) may be able to hold a job but may need an understanding boss who is willing to overlook the person's delusional behavior as long as it does not interfere with work. Many people have misconceptions about mental illness; you can work to correct these misconceptions and help them change their attitudes and the way they interact with people who are mentally ill.
Many people who live with someone who has a mental disorder find it helpful to join a support group. These groups offer a protective environment in which you can share your concerns and learn coping strategies from people who face similar challenges. If there is no local support group that deals with your particular situation, consider starting one. Other people in similar situations may be happy to participate.
Family or individual counseling often benefits partners or family members. A therapist or counselor familiar with the type of mental disorder involved can teach you about the disorder and suggest ways to handle typical situations you may encounter. Talk to a number of therapists before beginning counseling to find one who is knowledgeable about the disorder and with whom you feel comfortable.
Having a person with a mental disorder in the family alters the dynamics of family life. The affected person tends to become the focal point around which family life revolves. Caregivers or other family members can often feel slighted and overwhelmed, and may become resentful. Children, especially, can feel ignored. They also may feel embarrassed when an insensitive friend makes fun of the affected person. It is important to try to balance the needs of the person with the needs of the other members of your household. Plan special activities with the other members of your family—especially your children—to make them feel included and to draw you together as a family.
Caregivers can easily become overwhelmed by their responsibilities. Because of this, you should not attempt to handle everything yourself; the full responsibility of caregiving should never fall on one person. A caregiver who is on call 24 hours a day will burn out quickly. Schedule regular breaks from your care-giving duties. When you need an unscheduled break, arrange to have a dependable relative or a friend fill in for you.
Keep an updated list of things that need to be done. Identify as many people as 363
possible who can provide help. Every member of your household can participate Mental or contribute in some way. Ask your friends and relatives, too. Offer them Dis°rders choices from your list, such as doing chores, running errands, preparing meals, making telephone calls, and providing company. Be direct. Do not hesitate to ask for help whenever you need it.
If family members or friends cannot help, contact volunteer and community organizations, as well as your doctor and local hospitals and health organizations. If you belong to a support group, ask the group members for suggestions. You also may want to hire a professional caregiver through a licensed home health agency, such as a visiting nurse association.
Caring for yourself is an essential part of being a caregiver. To succeed as a caregiver, it is vital that you follow a healthy lifestyle. Eat a nutritious, well-balanced diet (see page 4), exercise regularly (see page 11), do not smoke (see page 107), and get plenty of sleep. Try to limit your intake of caffeine and alcohol. And be sure to use relaxation techniques (see page 119), such as meditation and deep-breathing exercises, to relieve stress.
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