For all the research that has been done in the last 20 years on the brain, the organ at the top of the spine retains its essential mystery. We know more now than ever how the brain works, how it has developed over the centuries to do the miraculous things it does, and what is happening to it when it gets injured. Doctors, parents, coaches, and professional athletes are more alert to the dangers of brain concussion. Neurologists study to become adept at repairing the brain with surgery, cellular transplant, or electrical stimulus. Every one of us has a stake in the health of our minds. But no one may ever come to understand what to do when a brain loses its essential emotional balance.
Serious mental illnesses (SMI), like bipolar, major depression, schizophrenia, schizoaffective issues, and severe personality issues, can result from physical or chemical abnormalities in the brain or hormonal imbalances. These are currently treated with hospitalization, a variety of medicines, and several kinds of therapies including group, art, music, physical, occupational, individual, couple, and family therapy. These efforts do help a person with acute episodes create some safety from self-harm and violence to others. But we currently have no cure for the worst afflictions of the brain. Those afflicted with SMIs bear this burden without much hope of recovering their former selves. It can be a terrible, life-changing diagnosis.
Many in this situation also try to help themselves with illegal drugs and alcohol. It’s estimated that nearly half of those with an SMI may also be addicted to drugs. It’s quite easy to see that chronic emotional issues, coupled with occasional medications from a hospital stay, plus a chemical dependency—legal or otherwise—is a recipe for chaos. And that’s exactly what can happen. These are the majority of those we call the homeless: adults whose psychological instability and addiction make any kind of stable life impossible. They are those whose schools, work places, doctors, community programs, churches, friends, and family, in an uncoordinated effort, tried to help but ran out of options, money, beds, time, or energy.
If you have a family member with an SMI, it almost certainly has affected your life. If you are like most of us, the early months or years were a mix of denial, sorrow, anger, and accommodation as you tried to learn how to manage life with someone who couldn’t stay in the lanes of the average emotional highway. You may have had more than your share of blinding rage at promises broken and soaring optimism with the hope of a new doctor, a new medicine, a new religion, a new apartment. And then the up-and-down cycles of recovery and relapse, of stabilization and hospitalization, continued. It feels out of control.It’s easy to see how many people give up on those who are the most mentally unstable. In the grand scheme of life, it’s to your emotional and spiritual benefit not to lose touch with your family member who struggles to stay mentally balanced. You may the only connection he or she has to a person who remembers who he or she was before, who has the same family features, who serves as a reminder of his or her place in the human family. You may be the only person with whom he or she can share childhood memories. To keep your own life in balance, to have good relationships, keep your job, and sleep well at night, you will need a simple but unyielding strategy when it comes to dealing with your loved one.
Here are my suggestions:
- Education: Get informed about your loved one’s diagnosis. Have a basic understanding of his or her medications. Attend family meetings held by the local hospital or other care providers. Learn about the long-term physical and mental outlook of the SMI. Speak to an attorney if financial support, inheritance, property, arrest, or civil commitment issues arise.
- Support: Seek out the understanding, company, and expertise of others who struggle with an SMI in their family. Support groups such as NAMI (National Alliance on Mental Illness) and those run by your county or local hospitals or churches are excellent places to find ongoing information, support, and referrals to local mental health resources. Here, you can grieve the person your loved one may never become, and figure out how to live with the person as they are.
- Clear personal boundaries: You will need to figure out how to care about your family member while leading your own life. Your job, your marriage, and your children will all suffer if you can’t say no to requests you can’t fulfill, to demands on your time that can’t be met, to assumptions about money you can’t meet. You may need to find a qualified mental health professional to help you manage, grieve, and maintain your limits, especially if you are connected to your family member in any helpful way.
SMI can be devastating and can destroy every good relationship in its wake. One day, we may have more than a bucket load of powerful psychotropic drugs to help manage, and even heal, conditions like schizophrenia. But until then, if you have SMI in your family, do everything you can to manage its effects and continue to lead the life you want. You’ll need help to do it; it’s a long journey.

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