Caring for someone with a mental illness

1. Caring for someone with a mental illness Evelyn Gonzalez

2. Caring for someone with mental health problems brings unique challenges. Mental health problems vary greatly in severity. Mild problems are common and can be helped with understanding and support. If someone you love has mental illness, it is important for you, your loved one, and your loved one’s healthcare team to work together.

3. Examples of signs and symptoms include: • Feeling sad or down • Confused thinking or reduced ability to concentrate • Excessive fears or worries • Extreme mood changes of highs and lows • Withdrawal from friends and activities • Significant tiredness, low energy or problems sleeping • Detachment from reality (delusions), paranoia or hallucinations • Inability to cope with daily problems or stress • Extreme feelings of guilt • Alcohol or drug abuse • Major changes in eating habits • Sex drive changes • Excessive anger, hostility or violence • Suicidal thinking Signs & Symptoms Signs and symptoms of mental illness can vary, depending on the particular disorder, circumstances and other factors. Mental illness symptoms can affect emotions, thoughts and behaviors.

4. Supporting someone with a mental illness is a challenging experience that pushes you along unexpected and unknown paths. Trying to make sense of your feelings, the illness, and the whole situation brings many questions with sometimes even fewer answers. This is not an unfamiliar experience, many families and carers often relate feeling this way.

5. Mental Illness affects every member of a family - whether parent, spouse, child or sibling. Most people have had limited or no previous experience of mental illness and may experience a whole range of feelings. The Initial Shock

6. “It’s traumatic to learn that a loved one has mental illness, and families go through a process of shock, anger, and grief”

7. Some of the reactions commonly experienced by family members are: GUILT: Where did I go wrong? Did I do anything to cause this? STIGMA: What will other people think, who can I talk to? FEAR: of what will happen to them or of the person harming themselves or becoming violent. FRUSTRATION/ ANGER: at being unable to do anything or get any real help. HURT: at criticism from people who just don't understand. GRIEF: at the loss of the person as you knew them before the illness.

8. Mental illness can be disabling for your loved one, especially during an episode of depression, mania, or psychotic behavior. While these episodes are occurring, you may also benefit from professional healthcare assistance.

9. Suggestions that help on a day-to-day basis while caring for someone with mental illness:

10. Identify reasonable and obtainable goals. Setting expectations too high sets everyone up for stress and failure. Encourage and recognize progress, even if it is less than what was hoped for. Goals for some people may be taking a course at school or part-time volunteer work; for others, an achievable goal may be getting out of bed and coming to the dinner table.

11. Learn to reduce stress. • Stress is a normal part of life, and as a caregiver, you may experience higher levels of stress because of your responsibilities. Your loved one may not be able to interpret your stress as something apart from them or their behavior—and they may not be able to handle your stress. Stress may make people with mental illness vulnerable to relapse. It is important as a caregiver to take steps to reduce your own stress as well as provide direction to your loved one on ways to reduce their stress.

12. Talk to each other and to the healthcare team. • Communication is important if you're going to work together.

13. Be encouraging and supportive. A critical, over-involved, or overprotective attitude may be threatening to people who are ill and may undermine their confidence.

14. Learn problem-solving techniques. It's important that people be able to solve their own problems. However, you can all work together to identify problems and possible solutions.

15. Be sensitive. • Avoid comparisons to friends, colleagues, or family members. Other people's success at work, school, or in their social lives may only worsen demoralization.

16. Encourage compliance in taking medication. • Families should encourage loved ones to follow the clinician's instructions regarding their medication. Without nagging or criticism, you can help them remember to take their medication by pointing out how much they have accomplished.

17. Avoid relapse by knowing the early signs. • If you notice your loved one losing interest in things, becoming increasingly depressed, having difficulty concentrating, withdrawing socially, having difficulty making decisions, having sleep problems, feeling overcommitted or over expansive, or if you notice other feelings or actions unique to your loved one, call the clinician immediately. Getting professional help early enough may prevent a relapse.

18. Caring for yourself

19. Caring for someone with mental illness takes a good deal of energy, balance, and hard work. You may need to constantly change schedules, make and keep medical appointments, keep track of medications, and more—not to mention the emotional toll. It can be a day-in, day-out grind ...without a day off. As the days fill up, it's important to remember to schedule some time for yourself, as impossible as that may seem. Here are some simple steps you can take to recharge: Call a friend Go for a long walk Curl up with a book Rent a favorite video Take a hot bath Have a massage Write a letter Listen to your favorite music Take 10 minutes to do whatever you like best

20. 1. About to crash http://www.youtube.com/watch?v=9PSGNx6vbJk 2. War Inside my Head http://www.youtube.com/watch?v=nDWcAqL41t0 3. Goodnight http://www.youtube.com/watch?v=H56m8CYdov0 4. Solitary Shell http://www.youtube.com/watch?v=EbMC4QiVBzs

21. About to Crash The lyrics tell of a girl who has one of the most well known of all mental illnesses: Bipolar disorder. With bipolarity, a patient suffers from manic episodes alternating with depressive crashes. Bipolar mania often involves heightened energy, flight of ideas. Manics will often work for hours on end to the point of exhaustion and will often neglect their other duties to attend to whatever goal they have set their minds on at the time. Bipolar sufferers tend to get worse when the affliction is untreated, and her father/spouse, presumably, has seen this.

22. War Inside my Head This movement tells the story of someone who suffers from post-traumatic stress disorder, as some soldiers do after war. The lyrics show he served in Vietnam. The chorus reveals he has flashbacks experiencing instances where he believes that he is still in Vietnam. The second verse implies that he may believe he will have the condition indefinitely During the final chorus, it is revealed that his anxiety has become more pronounced.

23. Goodnight Kiss This is a song about a mother who has lost her child, in one form or another, and is suffering from post-partum depression. There is also evidence of the child having been hospitalized at some point, or perhaps died during child birth. The mother struggles between believing that the loss of her child is her. A heart monitor, and a baby crying can be heard in the later part of the song, suggesting a medical problem with the baby; the manic laughter of a doctor also suggests a recurring nightmare that the sufferer has. The lyrics also suggest the death of more than one child on separate occasions.

24. Solitary Shell This person most likely has Asperger syndrome. The lyric tells us that he started off quite normal. He learned to walk and talk on time, however, he did withdrawal from social contact . The title, "Solitary Shell", shows that he is quite reclusive. The lyrics end with a plea for social acceptance from a peer or relative.

26. Mental illnesses are serious medical illnesses. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence. Mental illness falls along a continuum of severity. Even though mental illness is widespread in the population, the main burden of illness is concentrated in a much smaller proportion-about 6 percent, or 1 in 17 Americans-who live with a serious mental illness. The National Institute of Mental Health reports that One in four adults-approximately 57.7 million Americans-experience a mental health disorder in a given year. • The U.S. Surgeon General reports that 10 percent of children and adolescents in the United States suffer from serious emotional and mental disorders that cause significant functional impairment in their day-to-day lives at home, in school and with peers. • The World Health Organization has reported that four of the 10 leading causes of disability in the US and other developed countries are mental disorders. By 2020, Major Depressive illness will be the leading cause of disability in the world for women and children.

27. Mental illness usually strike individuals in the prime of their lives, often during adolescence and young adulthood. All ages are susceptible, but the young and the old are especially vulnerable. • Without treatment the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives; The economic cost of untreated mental illness is more than 100 billion dollars each year in the United States. • The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.

28. With appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. A key concept is to develop expertise in developing strategies to manage the illness process. • Early identification and treatment is of vital importance; By ensuring access to the treatment and recovery supports that are proven effective, recovery is accelerated and the further harm related to the course of illness is minimized. • Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery. It is time to take these barriers down.