More people are talking about mental health these days as awareness of its importance grows. The connection between one’s thoughts, feelings, and behavior is real, and it is encouraging that more people, including celebrities, are realizing that and being open about their mental health struggles.
Still, with all the much-needed discussion taking place, it’s not always apparent that someone close to you may be struggling with their mental health, including members of your family. Mental illness can affect anyone for any reason. No one is immune, but that fact does not mean it’s easy for people to acknowledge it openly and talk about it.
This guide aims to help you or someone you know approach a member of your family about mental health issues they may need help dealing with. As you consider how to handle this issue, it will help you recognize the signs of mental illness, the types of mental illness people experience, and some things you can do to become comfortable with this challenging topic while you try to help the people you love and care about.
Mental illnesses, also known as mental health disorders, are any disease or condition that affects how a person thinks, feels, behaves, and/or relates to others, per MedicineNet. These illnesses affect the brain and change people’s moods and behavior, in many cases without warning. Mental health disorders affect one in five U.S. residents every year, according to the National Alliance on Mental Illness (NAMI), and one in 25 adults in the U.S. experience a serious mental illness every year, the organization says.
Common mental health disorders include:
- Anxiety disorders
- Bipolar disorder
- Borderline personality disorder
- Eating disorders
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Substance use disorders (SUDs)
Per Mental Health America, there are more than 200 classified kinds of mental illness. Anxiety, depression, PTSD, and bipolar disorder are the most common among the U.S. population. All of these disorders range in severity from mild to severe. Many of these disorders are treatable, and all of them can disrupt someone’s life if they are not diagnosed or managed properly.
Some people hide their mental health issues so well that no one would suspect they have them. Other people’s issues are hiding in plain sight, but their loved ones may not notice because they don’t know the signs that something is amiss. So, the first thing to do is to know what to look for. If you suspect that your family member is acting differently or is not acting like their usual self, then it is worth looking into it further. The change could be temporary, or it could signal that something more serious is wrong.
While mental health is about the mind and one’s emotions, it can manifest as physical symptoms affecting different parts of the body. People who are struggling mentally can have headaches, stomach pains, and aches in their backs or necks or other parts of their bodies. The Mayo Clinic shares other physical signs of mental illness, including:
- Foggy, cloudy thinking, or struggling to concentrate
- Feeling “down in the dumps,” the “blues,” or sad
- Feeling excessive fear, worry, or guilt
- Low energy, extreme tiredness
- Problems sleeping (getting off to sleep or staying asleep)
- Weight loss, weight gain, poor grooming, or poor hygiene
- Increased isolation from loved ones
- Mood swings
- Challenges handling daily stress or feeling unable to deal with problems
- Detachment from reality (delusions)
- Paranoia, hallucinations
- Sex drive changes
- Changes in eating habits
- Substance abuse (drugs, alcohol)
- Explosive anger, history, violence
- Suicidal thoughts, suicidal ideation
Signs of mental illness can vary depending on the person’s age or life stage. A young child may have temper tantrums, while an adult may withdraw from everyone. Both behaviors are among the symptoms of mental illness. The type of mental health issue one is experiencing will determine their signs and symptoms. This list, while not exhaustive, is a good place to start when you suspect that your family member’s behavioral changes could be at the root of a larger issue.
Keep Track of Your Observations
Take notes about the kind of behavior you are noticing in your loved one as well as what they share about their physical well-being. These can be clues to what is going on with your loved one. A person who is tired all the time but sleeps a lot at odd hours of the day could be dealing with depression. A person who can’t seem to relax or regulate themselves to calm down may be experiencing extreme anxiety or struggling with PTSD.
Remain Mindful and Thoughtful
Before you approach your family member about their mental health, you want to do your research and share what you find as well as what prompted you to inquire in the first place. This will help you figure out what you want to say as well as how you want to address it. It could also help your relative to see and understand that you care and that your concern is not an attempt to judge them or find fault with them.
Keep in mind that your loved one may already know that something is different but not be ready to address it. It takes a lot of sensitivity when talking about any form of mental health, so it helps to be mindful and thoughtful when addressing a mental health issue.
What Causes Mental Illness?
Generally, the specific cause of mental illness isn’t known, per MedicineNet. However, per the health website, several factors can play a role. Mental illness can run in families and can be passed down through genes. Chemical imbalances in the brain can cause mental illness, and certain stressful environmental conditions can, too. Per MedicineNet, events such as a family member’s death, divorce, or dysfunctional family life can bring on a mental health disorder in individuals. Psychological trauma suffered at any point in life can lead to mental and emotional instability.
How mental illness affects a person also depends on factors unique to each person, including:
- Overall medical history
- Lifestyle (diet, exercise)
How Early Can Mental Illness Start?
A recent large-scale analysis of data from nearly 200 epidemiological studies found that 14.5 years is the peak age of onset for mental health disorders across the globe. According to the analysis, people who have mental disorders have a lower life expectancy of 10 to 15 years as compared to the general population. It also encourages early intervention and says it can improve several outcomes.
Women and Mental Health Disorders
Mental disorders also can affect women differently, as the National Institute of Mental Health (NIMH) says. Depression and anxiety are found to occur more commonly in women, and their symptoms of mental disorders can be brought on by hormonal changes involving their menstrual cycles. Women may experience certain disorders differently, it says, such as bipolar disorder and schizophrenia.
Mental Illness and the Family
As noted earlier, mental illness often affects how people relate to others around them. Family members are among the first to notice changes in their loved one and the first to be affected. Relatives who do not understand what a person with mental illness is experiencing may have a strong emotional reaction to them. As a result, many family relationships suffer and become strained.
A person may feel rejected if their family member struggling with depression rejects their invitations to go out. Parents may feel they’re having a challenging time getting through to a child with attention deficit hyperactivity disorder (ADHD), or other children in the family may feel ignored by parents who spend a lot of attention on a child with mental illness or learning disability.
Family members may also struggle with seeing the changes a loved one goes through as their mental illness grows more severe. Some family members may blame themselves or others in their family for their loved one’s illness. They also may feel doubt that something can be done to help their loved one, or they may feel helpless. Some family members start to avoid loved ones with mental health issues either out of fear of not knowing how to handle it or not wanting to be around the person. They may shame the person, argue with them, or have little patience with them. None of these behaviors help the person who has a mental illness.
If this is you or someone you know, it is important to understand that a mental illness is not something to be ashamed of. It is an illness, not a moral failing. It is important to educate yourself about your family member’s mental health condition and find out what kind of help they need. If you suspect that there’s more going on with the person you are concerned about, then it’s time to get help for them. The first step is to find out exactly what is going on so that you both know how to address the mental health disorder.
Getting a Diagnosis for Mental Illness
Mayo Clinic shares three things that can be done to determine if your loved one’s condition is indeed a mental illness. They may have to undergo:
- A physical medical exam. This will help rule out if any underlying physical conditions are causing or contributing to your loved one’s symptoms.
- Lab testing. Your loved one may be given laboratory tests that screen their tissues, blood, urine, or other symptoms to diagnose their condition.
- A psychological examination. During this procedure, a medical doctor or mental health professional will ask your loved one questions to gauge their symptoms so they can determine if they have a mental illness. They may cover questions concerning behavior, thoughts, and feelings. Your relative may be asked to fill out a questionnaire that provides more information and insight into the challenges they are facing.
During a first appointment, you or your loved one should come prepared with questions that can help you determine if the medical professional you are working with is the right fit. You can ask them about their area of specialty and how long they have been working with patients with mental health disorders. You can also ask about their credentials and their approach to helping people with mental illness. You will also want to cover questions about your insurance plan, such as if your plan is covered and what it covers.
Treatment: The Next Step for Addressing a Mental Health Disorder
While mental health disorders are treatable, it doesn’t mean everyone who needs treatment receives it. One study found that 11 years is the average delay between the time a person’s mental disorder starts and the time they receive help for it. Data show that in 2018, only 64.1 percent of adults in the U.S. received treatment for their mental illness.
A network of professionals can help your family member get customized help for their disorder. The professionals that can provide the right guidance based on their specific needs include:
- Mental health aides
- Other peer-support professionals
As your family member considers treatment, you will want to think about:
- The kind of treatment they will need
- How long they will need treatment
- Any personal situations or circumstances that could affect their participation in a treatment program
- Their current disposition and state of wellness (physically, mentally, and emotionally)
- Their support system
- The family’s ability to provide a strong support system and/or supportive environment
Don’t Leave a Mental Health Disorder Untreated
It is important that a person receives mental health treatment as soon as possible. These disorders will only worsen without the right help, which means your family member will continue to struggle daily with activities, tasks, and responsibilities. They also will see a further decline in their relationships, and support is what they need right now. Once your loved one’s needs are assessed, a professional will recommend the treatment setting they need. The professional could recommend any of the following:
Inpatient Mental Health Program
Depending on how severe your family member’s condition is, they may need round-the-clock intervention at a 24-hour residential facility. A structured and monitored environment can provide intensive therapy and keep the person from harming themselves and others. It also ensures they receive the proper care as needed.
An on-site stay in an inpatient facility means your family member will receive care from professionals who understand their unique needs and can give them medications, ensure they have the proper nutrition, receive rest, and participate in the therapies they have been assigned. Residential care for mental disorders can include:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Individual therapy
- Group therapy
- Medication therapy
- Recreational therapies
- Family education programs
Outpatient Mental Health Program
Your loved one may be able to receive treatment at an outpatient mental health facility while living at home. Under this arrangement, they can attend therapy for a predetermined number of hours a week. People in an outpatient program usually have a mild-to-moderate disorder and are able to maintain their independence. This type of program can offer:
- Partial hospitalization
- Intensive outpatient care
- Individual therapy
- Group therapy
- Family therapy
- Intensive outpatient care (requires more hours than standard outpatient care)
- Support groups
- Medication therapy and management
If Your Loved One Also Has a Substance Use Disorder…
Millions of U.S. adults with mental illness also have a substance use disorder (SUD). Dealing with both at the same time isn’t uncommon. However, trying to manage both is challenging, especially if the individual isn’t receiving professional treatment for either one. If your family member abuses drugs or alcohol, they may be doing so in order to feel like they can manage their mental illness. Unfortunately, this is not the proper way to handle a mental disorder. In many cases, a person can end up with addiction issues in addition to their mental struggles.
People who have mental illness and addiction have what is called co-occurring disorders or dual diagnosis. Effective treatment for dually diagnosed people requires that they receive treatment for both types of disorders at the same time. This helps them recover from both and reach their sobriety goals. It also helps them make their daily lives more manageable.
Your family member’s doctor or mental health professional should know about your loved one’s substance use history. Having this information can help them determine if medication should be prescribed and in what dosages if it is used. It can also help them find programs that address substance dependence and mental health issues concurrently.
Psychotherapy for Mental Disorders
Residential and outpatient programs use psychotherapy to help individuals address and work through their mental health issues. Your family member will receive therapy recommendations based on their needs and situation. They may be recommended to take:
Cognitive Behavioral Therapy (CBT): Cognitive behavior therapy is a popular form of therapy that is used to treat various mental health disorders. People who receive CBT learn how their thoughts and behaviors are linked. They also become more aware of self-defeating thoughts and behaviors and learn how to redirect their thoughts so they can reach a healthier outcome that is appropriate for the situation they are facing. CBT can be adapted to fit various therapy settings.
Dialectical Behavior Therapy (DBT): This therapy approach teaches patients to accept their unhealthy thoughts, behaviors, and feelings, live in the present moment, and work to find a balance between accepting themselves and their desire to change. They also learn ways to relieve stress and work on their relationships. People with borderline personality disorder (BDP) and other mental disorders can benefit from DBT.
Family Therapy: Because mental health issues can strain or harm family relationships, family therapy helps not only the person with the mental disorder but their family members who have been affected by their disorder. It is important that the person in treatment feels their family’s love and support, but it’s not always clear to family members how they can be a source of support and reassurance. Family therapy shows everyone how to do that. It also helps them understand family conflicts and family dynamics in new ways, particularly how these things may have contributed to the person’s mental illness. This kind of therapy is also designed to help families find new ways to relate to one another and how to move forward in a healthy way.
Medications Used in Mental Health Treatment
If your family member is prescribed medication for their condition as part of their treatment, here are the types used in these programs:
- Antidepressants: Medications in this class treat symptoms of depression, anxiety, and insomnia, among other things. Common antidepressants include selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs). If your loved one needs more serotonin, SSRI antidepressants increase levels of serotonin within the brain. If they are prescribed an SNRI, this medication boosts serotonin and norepinephrine levels in the brain.
- Anti-anxiety medications: A person prone to high levels of stress, panic attacks, insomnia, and other types of distress may be prescribed benzodiazepine medications for short-term use, usually for only two weeks. Be careful with benzodiazepines and use them only as directed. These medications are habit-forming and addictive. Your doctor can also prescribe non-habit-forming medications for anxiety, so inquire about those as an alternative treatment.
- Antipsychotics: People who have bipolar disorder, schizophrenia, or another kind of psychotic disorder may be prescribed these medications to ease confused thoughts, delusions, hallucinations, and paranoia. A person with bipolar disorder may find them helpful for addressing their manic episodes.
- Mood stabilizers: Extreme changes in mood are common in certain disorders. Mood stabilizers help people regulate their moods so they can maintain control over their emotions. Moods can shift between highs (mania) and lows (depression), which commonly happens in people who have bipolar disorder.
A professional can help determine the balance between your loved one’s need for medication and therapy. Your family member should ask as many questions as they want to understand how medication and psychotherapy are used together to help treat mental health disorders.
Helping Your Family Member with a Mental Health Disorder
Put yourself in your family member’s shoes and think about what you would want someone to do to support you through your illness. You can help by staying as calm and reassuring as possible. Having concern and compassion for your loved one will go a long way as you help them. If you haven’t learned for sure if your family member has a mental health disorder, you can start there first.
Find a licensed medical or mental health professional in your area that they can talk to. If your loved one has health insurance, you can call the provider and ask for guidance in locating the specialist you need to speak with. Once you have a few names and do some research, you can call the professional’s office and set up an appointment.
If a medical or mental health professional has formally diagnosed your family member with mental illness, you can do the following:
Help your family member learn about their condition. Having information can ease concerns that you and your loved one may have. It also may prompt them to ask further questions about their health. The answers can help them make informed decisions about their health. It is best to speak with a trusted professional as research efforts can sometimes become overwhelming when there is no context.
Identify the proper treatment program your loved one will need. Treatment programs for mental illness need to be personalized for them to effectively meet the person’s needs. For example, not everyone with bipolar disorder has the same kind of bipolar disorder as there are different forms with different symptoms. While two people can have the disorder, they may need different dosages of the same medication, or they may need different medications altogether.
Encourage your family member to actively manage their mental illness. You can help your loved one learn how to take their medication or assist them with making medical appointments or how to address their concerns when speaking with their doctors. Reassure them that they are in control of taking care of themselves and let them know that they can reach out and ask for support.
Let your loved one know you are there for them. Reassure your loved one that you are there to help them find their way and work through their condition. It is not easy to hear or accept a diagnosis of mental illness for anyone, but take one day at a time, one step at a time. Look for resources that can help you and your relative along the way.
Find support for your family, too. Everyone in your family needs time and space to deal with your loved one’s mental illness. Joining a support group for families of people with mental illness can give you and other family members an outlet to grieve, vent, or even help someone else as you process what your loved one’s mental illness means to you.