Tuesday, July 9, 2024

When Mental Illness Shows Up In The Family


Most of us who have undergone mental health challenges, or who have had a loved one confront the demon, know that it can be the worst thing in the world to grapple by ourselves. In our digital age some find it easier to lose themselves online, and try to forget about their depression, anxiety, or runaway symptoms that have no name. But avoidance and neglect of symptoms may worsen the situation.

When mental illness shows up in the family, what can be done about it? My story relates to two earlier time periods of discovery when the stigma of mental illness was so profound that it needed to be hidden from sight or treated outside the family circle in institutions that were rarely effective for dual diagnosis patients.

           I have been a caregiver for two loved ones, a sister, Sharon, with schizophrenia and a son, Michael, with bipolar disease. Both experienced major mental breakdowns that required intervention.

My sister’s story is tragic, since her mental breakdown occurred in 1963, when the men in white coats stealthily took you away in a straitjacket with sirens blaring from your home. Sharon’s excruciating experience of hospitalization had nothing to do with love and support. It was about our father stepping in and arranging for enforced hospitalization, for isolation, for restraint and punishment. Any future trips to any hospital over her entire lifetime left her traumatized and sicker than when she entered the facility.

           My son, Michael, had a different story. His mental breakdown had a variety of symptoms that I began to identify as some real issues, although he shrugged them off as “no problem, Mom.” In his last year of high school Mike began to use drugs, sleep in late, associate with “stoners,” neglect his hygiene, and act out violently, if provoked. I knew something was wrong, dreadfully wrong.

           After months of wringing our hands, my husband, Jim, and I decided we needed to seek help. When we reached out to a highly recommended psychiatrist, I thought our problems were over. Taking Mike into the doctor’s office twice weekly provided  solutions, or so we hoped. Talk therapy alone did not work. Instead, Mike was taught about “contracts” with parents, written agreements about changing his behavior that would allow him to stay in the home. One week the contract worked on Mike’s slovenly behavior—refusing to shower, brush his teeth or wear clean clothes. Another week the contract focused on his shouting at us and defying house rules. Another week, the psychiatrist set up a contract that restricted his stoner friends from coming into the home. It went on and on for months to little avail.

The weekly contracts exhausted all of us: Mike and parents alike. We often left the office feeling even more powerless over Mike’s behavior. Rather than drawing clear limits, these contracts allowed Mike to shred up the written agreement and act out more defiantly than before, often with the doctor’s tacit approval. “Well, he’s an adolescent, Mom and Dad. He just needs more space.”   

Although we had five other children, all of whom were aghast at Mike’s behavior, none of them could grasp why he behaved this way or what could be done about it. Growing up, Mike had always enjoyed loving support from his siblings, but not in these aberrant circumstances. I noticed that as my children began to retreat from his care, Jim and I had to provide whatever family backing Mike seemed to need. We were never given guidelines from this psychiatrist about what to do when Mike went berserk, and ignored our entreaties to calm down. The mental health thinking at the time did not offer peer therapy for the acting-out adolescent, or family therapy for the whole family, or even educational support for overwhelmed parents. It was a private affair among parents, psychiatrist, and mental patient.

In a one-on-one conversation with the psychiatrist about Mike’s drug use, the psychiatrist laughed off my concerns, saying “I can give him medications that will override the street drugs.” What medications were those? I thought. Of course, these were a mirage.

 In that moment I determined to place our son in recovery, and 14 different institutions later, and throughout his twenties, Michael jumped from home to hanging out with friends to homelessness, and institutionalization. Mike knew he was in trouble. We talked with him about limits. He knew those limits. When he defied them, the cycle would begin, departure from home and ending up in a recovery facility and finally a half-way house. We continued to support Mike financially and lovingly throughout this period, including throughout his marriage, which lasted five years. Mike was given limited custody with his son, and they developed a strong bond that persists today.

My adult son, Mike, has taken joy in those periods where he has sober mental health in between his only-too-frequent relapses. In such cases he is on his own today with a year of recovery behind him. With a shrinking support structure, though, we can only hope for the best.

When do parents stop caring for their severely mentally disturbed child? Answer: Never. When do parents move to protect themselves and other members of their family from outrageous behavior. Answer: Immediately. But not without first finding the resources that work for both you and your loved one. I always add the proviso: as long as it is possible for parents to shoulder the care responsibility. **     


** Check out my memoir, “Raging Currents: Mental Illness and Family” that expands on this story and offers a range of resources for bipolar disease.

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