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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