"My sister has a mental illness. These are words that still feel awkward to speak. As a teenager I fought against it, thinking she was just going through some sort of phase would soon grow out of it. I mean, she wasn’t born that way. Surely, she would wise up and blossom into the cool, sassy big sister I always wanted. But as weeks turned into months, and months turned into years, there wasn’t much improvement, and my once bright-eyed, beautiful sister began to outwardly show signs of depression, bizarre thinking, and physical deterioration. I was hurt, angry, and embarrassed. I blamed my parents for not doing enough and even questioned God. What was the point of giving me a sister if she wasn’t going to be a sister? I was self-centered and preoccupied with my own sense of loss and grief over the sibling I expected to have—the one I thought I should have. But now I know better.
I can’t tell you that I have my feelings about my sister’s condition all figured out. It has been an ongoing struggle…
We are taught to love our family members despite their shortcomings. But what do we do with those unspoken feelings of disappointment that plague us when family members suffer from an elusive mental health condition? It would almost be preferable if they were physically sick; people get that. But how do we explain when a family member suffers from mental illness? How do we answer the cutting question, “What happened?”
No one chooses mental illness to affect their family, but when it happens, it is important for family members to come to terms with it and decide how to cope. This is easier said than done. Many family members have been torn apart by mental illness, making it difficult for them to be supportive of the emotionally vulnerable family member who needs it the most. I can’t tell you that I have my feelings about my sister’s condition all figured out. It has been an ongoing struggle, but I let my values and psychological expertise override much of my complex feelings so I can cope the best way I know how. I thought I’d share some of the issues I’ve had to address, in hopes that it may help you better cope with mental illness in your family.
How did this happen?
This is a common question, yet difficult to answer. There are many factors that contribute to mental health issues including genetics, psychological functioning, and environment. While someone may have a genetic predisposition to an anxiety disorder, it does not mean the person will have an anxiety disorder. Psychological functioning (e.g., a sense of control over life events) and environment (e.g., turbulent vs. stable) play a large role in determining whether or not the anxiety disorder presents itself. My sister was a bubbly, energetic child who was unable to withstand the stressors associated with adolescence, a turbulent and disorienting period for many. She may have had a predisposition to a mental illness, and the onslaught of negative thinking—along with her environment’s inability to understand or adequately address her disorder—triggered a decline in her mental health. If you are uncertain as to what contributed to your family member’s mental illness, it is likely a complex mix of factors, and treating professionals can better help you target and address key areas.
We are often so emotionally involved with family; their success is wrapped up in our own happiness.
How do I interact with my family member who struggles with mental illness?
For years, I tried to change my sister and make her into what I thought she should be. I yelled, I talked, I pleaded, but none of it worked. I thought she could reason her way into wellness, but she couldn’t— not she wouldn’t.
It can be very difficult to understand the limitations of family members who suffer from mental illness. We are often so emotionally involved with family; and their success is wrapped up in our own happiness and sense of satisfaction. But once we accept their limitations, we can release the disappointment and resentment we may feel, and are more fully able to be who we are.
Will my family member ever get better?
This is a complicated question because prognosis depends on the nature and chronicity of the illness, the type and quality of treatment the person receives, and the person’s ability and willingness to participate in treatment. Nonetheless, mental health disorders are not typically viewed as “curable” in the same way physical disorders are. This is largely because mental health functioning is perceived as falling along a continuum rather than categorical. Even relatively mentally healthy people struggle with mental or emotional distress at times; and while their symptoms may not be severe enough to qualify as a disorder, the longer a person struggles with emotional distress or poor mood, the higher the risk for developing a mental health disorder. Family members and treating professionals are in a unique position to assist vulnerable individuals with living the best life they can.
How can I make sure my family member gets the appropriate treatment?
My sister often received inadequate and intermittent treatment. My parents, as loving and supportive as they were, never fully understood my sister’s condition or how to treat her. They did not have experience with mental illness, and relied on well-meaning doctors who gave tentative diagnoses and non-specific recommendations. Unfortunately, mental health treatment is not an exact science, and unless the person is presenting with a well-known disorder, their mental illness can often be misdiagnosed or go undetected for a long time. This is the case with my sister, who had a tendency to remain isolated and kept her thoughts and feelings to herself. Once family members detect a problem, it is important to get an evaluation from a licensed professional, and be actively involved in treatment to ensure that key issues are being addressed. Treating professionals rely on informed family members who can offer valuable pieces to the puzzle. But we can lose hope when we see no change, and this is why it’s important to communicate concerns to treating professionals who are in the position to provide guidance, education, and support. Sometimes you may have to go through several treating professionals before finding the right one, but don’t be discouraged. Keep searching for answers and follow recommended treatment.
Now I understand I was trying to cope with grief and loss; but I didn’t know it at the time because no one had died.
Do I need counseling?
During my freshman year in high school, my parents sent me to a therapist to help me better cope with my sister’s condition. Not savvy about the therapeutic process, I poured out my heart and soul over the anguish I felt, hoping the therapist would fix my sister for me. I didn’t realize I, too, needed some fixing. Now I understand I was trying to cope with grief and loss; but I didn’t know it at the time because no one had died. Grief counseling is not often considered for those coping with family mental illness, but research suggests that it can mitigate some of the stress of coping with relatives who suffer from mental illness. While there is no physical death, there is what is known as the “non-infinite loss.” That is, a chronic sorrow due to the perception that one has lost the “real” child, sibling, parent, etc., to mental illness. And because the relative is still living, it creates ambivalence and contributes to a complex loss experience. These feelings may be further exacerbated by the waning support of friends and extended family members who may not understand the illness, or not know what to say or how to help. This can lead to a sense of isolation and a feeling of being different than others. Counseling can address these issues, and help family members normalize thoughts and feelings associated with complex loss.