It had become a crisis.

I was awakened in the middle of the night by my au pair, a young woman from overseas who helped care for my children. She was crying, shaking, and terrified. As I struggled to understand what she was telling me I surmised that my husband had secretly entered her room in the middle of the night. She opened her eyes to see his shadow looming over her with a threatening glare in his eyes. “My children are my cubs and I am a lion who will protect them!” he hissed.  She thought she was going to be killed or raped, before he finally stormed off. “Call the police!” she sobbed. “Something has to be done.”

My husband, a physics professor at a local university, had tipped into psychosis as part of his recurrent bipolar disorder.  His behavior was becoming increasingly bizarre. I feared coming home each day to discover what new thing he had done. Sometimes he disassembled appliances and spread the parts all over the floor. Another time he took all the children’s elementary school projects and school notices and taped them over the walls, covering every spot. He would only communicate with me via written post-it notes. My worried calls to his therapist were met with skepticism and non-action. I felt helpless.

That night, I found my husband sitting in the basement, sullen and refusing to speak. He had a delusion that I was trying to hurt our children. This was not the first time I had to call the police. They came to the home, took a report, and ultimately did nothing. After all, my husband had harmed no one and was not suicidal. My au pair quit the next day, leaving me without child care for four small children while in full-time graduate school with a mentally compromised partner at home. I don’t blame her. At times I wanted to quit too.

Why do they act like that?

A distressed woman looking down.
Mental illness affects the whole family.

It can be difficult when someone you care about struggles with mental illness.  They may behave in ways that don’t make sense or are even frightening. It's easy to believe that those with mental illness are doing it on purpose, but these behaviors and states are a part of the disorder.

People with mental illness have a problem that is like any physical illness. Major mental illnesses like bipolar disorder, schizophrenia, and obsessive-compulsive disorders are brain problems that cause people to have thoughts and feelings they don’t want to have. These problems are largely genetic in nature, although other factors contribute as well. The temptation is to condemn and shame people who are suffering from these conditions. One problem is that shame and stigma are often what keep people from getting the help they need. Those who suffer do not want to have these problems, and usually don’t want others to know they have them either. The best medicine that loved ones can offer is compassion and loving encouragement to get help.

How can I live with this?

Although compassion and encouragement are essential, it can be very hard to live with someone who is ill.  It is not their fault that they have these problems, but it is their responsibility to get help and stay well, if they are able. You can help yourself by getting support and education from organizations like the National Alliance on Mental Illness, many of which offer educational lectures and support groups for family members.  I found this very helpful in dealing with my own distress and confusion over my husband’s behavior. 

You will need to decide what your limits are, and you may need to reduce your role in your loved one’s life for your own mental health.  Eventually, I had to move out of my home for the well-being of myself and children, and we divorced shortly thereafter.

What I can do to help?

A doctor speaks to a patient.
Find a qualified professiona.

The best thing you can do for your loved one is to help them find a mental health professional who has a lot of experience with the specific problem he or she is facing. Many clinicians claim they can treat anything, but that is just not so. Make sure the therapist you are vetting has the training and experience needed to be effective. One problem that I faced was a mental health professional who was in over her head. She conceptualized my husband’s major mental illness as a marriage problem, so her techniques were ineffective.

What if my loved one refuses help?

There is a joke that goes “How many psychologists does it take to change a light bulb? Only one, but the light bulb has got to want to change.” So, we want to encourage our loved ones to get help, but can’t make them do it. Badgering may be counterproductive as it makes people want to dig in their heels. Humans generally have an innate need for autonomy, and often don’t like being told what to do. You can only decide what you are going to do in the face of this challenge.

If your loved one is a danger to self or others, you may be able to have the person involuntarily admitted for inpatient treatment. This may be helpful or even life-saving. Conversely, many people with mental illness leave the hospital and don’t continue with needed medication or follow-up services, so they end up back where they started. They may be hospitalized many, many times in what we sometimes refer to as the psychiatric revolving door.

What if I don’t know where my loved one is?

It can be hard when you don’t know where your loved one is and if the person is safe. I know the pain of this firsthand.  My ex-husband has been in and out of mental health facilities over the years. Although we no longer have an emotional connection, my children worry about him.  I feel for them and hope he is well, but at the moment he is homeless.  Sometimes I see pictures of him on FaceBook playing guitar on the street for money.

In a situation like this there is not much you can do, and sometimes the hard part is letting go of your feelings of responsibility. You may feel guilt for not having done enough or shame for believing that you caused the problem in some way.  You may need to admit that you cannot fix it. You can pray for your loved one, if that is part of your belief system, and you can find personal meaning in the experience by being a support to others who are also suffering. 

Making sense out of senselessness.

In terms of finding meaning for myself, although I would not wish this on anyone, I believe it has made me a stronger person and better clinician.  I felt like a failure for a long time after these things happened, and it took years before I could talk about my experiences to anyone outside my closest circles.  Although no two people have the same experience, there is much I do share with the worried parents, partners, and other family members I see. When they are hurting because of someone in their lives that has major metal illness, and I can say, “I understand,” and I think I really do.

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