How to Help Your Adult Child If They Have a Mental Illness

Seven steps for parents who love an adult child with a mental illness.

Posted Sep 25, 2015

Mysianne/Flickr
Source: Mysianne/Flickr

"I beg you take courage, the brave soul can mend even disaster" ~ Catherine the Great

Every month I receive emails from parents (just like you perhaps) of adult children who have a serious mental illness. You tell me many things, but the one on which you all agree is how painful it is to see your son or daughter in anguish yet at the same time not accept help. They're angry with you, blame you, yell at you, yet need your help desperately. You tell me how helpless, how lost and how hopeless you feel. It is a journey of great pain. But there is also great hope. I know. My parents were on this very same journey. For five years, I was in and out of the hospital because of psychotic episodes. I not only refused help but refused to accept the diagnosis of bipolar disorder with psychosis and generalized anxiety disorder.

“H.O.P.E.: Hang On Pain Ends” ~ Unknown

There are myriad reasons a person refuses treatment. They can (and for me did) include denial, anosognosia1 (ie: the inability to recognize you are ill), shame, emotionally overwhelming, stigma, lack of access to good treatment, insufficient education about mental illness, fear of change, and lack of skills or support to move through change.

But there are steps you as a parent or support person can take, at least initially, if you are facing this situation. The suggestions may help you feel a little less powerless, a little less alone, and a little more hopeful.

Know this: Change is inevitable, recovery is possible and adult children can get their life back; maybe not the exact life they had before the illness, but a life worth living.

"Recovery is a way of living a satisfying, hopeful and contributing life, even with the limitations caused by illness...(it’s developing) new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness." ~ Bill Anthony

I’m not a parent of someone who has a mental illness. But I am someone who saw what my parents went through as I struggled to make sense of my own psychiatric disorders and find my road to recovery. (In this previous post my dad offers advice to parents trying to help their adult child. This post describes strategies to help someone with a mental illness who doesn't want help.)

This is not only your adult child’s journey, but the entire family also embarks on it together. Mental illness becomes a whole family condition, chaotic and frightening. You know this.

But I also know this:

  1. You can do it. But you can’t do it alone.
  2. Things will change.
  3. Recovery (for the adult child and family) is possible.
James/Flickr
Source: James/Flickr

Here are seven suggestions to make your current difficult situation a little more tenable:

1. Stop the power struggles(or judgments) with your daughter or son. How do you do this? Listen to what your adult child is telling you. Don’t correct them, don’t try to change them or convince them. Just listen. Summarize what you hear them saying. Just because you are listening and reflecting back what they say, does not mean you agree with them. It does mean you are doing everything you can to understand them and their experience. Like anyone, people with mental illness want to be heard, want to be understood. And frequently for someone with a mental illness, this doesn’t happen. Really understanding what they are feeling (ie: empathizing) can rebuild trust. It’s not easy. Believe me. But it can build bridges where bridges were previously imploded. Check Dr. Amador’s website and book (I Don’t Need Help! I’m Not Sick) for more instructions on what it means to empathize and actively listen.

2. Remind them (and yourself) you are both on the same team. But don’t just tell them, show them. Show them by working collaboratively: listen without an agenda; partner in decision-making, set boundaries when necessary. Telling the adult children what they need, what they should do, or what you know will help them will only make them dig their heels in even more. You've probably already experienced this.

3. Recognize you might not be the best person to help them. It may not be fruitful to say you are on the same team. Sometimes there’s too much animosity, so much trust broken (on both sides) that your adult child only sees you (at the moment) as an enemy. Because of the current (yet temporary) volatile nature of the relationship, it may be best to find out who, if anyone, they do connect well with. Is there someone who they will listen to; who they do trust or confide in? That person needs to be someone who has their best interest at heart (obviously), not someone who enables them or aggravates the situation. For example, not a person who they drink with or who encourages them to believe you are an interfering parent. A close friend, a trusted uncle, a former teacher they admire, are options.

4. Ask your adult child what they need to feel safe. They may not know. They may not be able or want to calm themselves down to express what they need. It may be about helping them learn to calm their anger. Are they willing to go to counseling, not for mental illness but to sort out some life dilemmas; to solve some issues. Even if they blame everyone else for their problems, you can mention counseling can be a place to talk about that. And with that, a good therapist can help them gain insight and learn problem-solving skills.

5. Sometimes the only thing left to do (but also the most important) is letting them know you are there and not going anywhere. When or if they want to reach out, you'll be there, without judgment, with love and curiosity. The most important element for me was to know that my parents, even as I pushed them away, loved me unconditionally, and would be there. They might not like how I was behaving, but I knew they loved who I was. Even as I refused their help there was a part of my consciousness, a part of my soul that heard them, that registered how much they cared. This is true for your son or daughter.

6. Set boundaries. You do not need to nor should you tolerate verbal or physical abuse (nor should your adult child). You may have to say 'I love you. I'm here if you want help, but I will not allow you to berate me (yell at me, swear at me, threaten me etc). It might be about giving them space, you taking space or telling them they need to leave. Always ensure they are safe and not at risk of suicide or harming someone else. If they are at risk, then taking them to the emergency ward (or if they refuse but are still at risk, calling the ambulance or police) will be necessary.

7. Don’t do this on your own. Make sure you get help. The old airplane emergency adage applies: take care of yourself first before you help someone else. You are no good to anyone if you are overwhelmed. There are other families willing to help and talk with you. Find a support group for parents of someone with a mental illness. The expertise in those rooms is invaluable, life-saving even. Check with your local mental health clinics, your doctor, your community resources and local mental health organizations (DBSA, CMHA, SSC, NAMI)2. These resources connect you with people who have similar challenges, link you to community organizations, and offer you emotional support and encouragement. The resources and support groups are usually offered at no charge. 

This path may be long. It may be arduous. But it gets better. It’s not your fault. There is help. There is hope. Reach out. Please.

If you’d like more information about anosognosia please watch this video which includes a talk from Dr. Xavier Amador, an expert in the area.

© Victoria Maxwell 2015

References

Depending on where you are located, check with your local Depression Bipolar Support Alliance (DBSA) or National Alliance on Mental Illness (NAMI) chapter or if you are in Canada: your Canadian Mental Health Association (CMHA) or Schizophrenia Society of Canada (SSC) branch.  The SSC helps families dealing with ALL types of mental illness.