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Knowing what to expect as a carer

There are many experiences and situations which all families dealing with mental illness will share.

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Male carer talking through a leaflet with elderly man

Recognising the problem

At first we may be only dimly aware that all is not well. We may attribute the problems to drugs, alcohol, ‘growing up’ or menopause. Low-level symptoms may persist for some time before becoming serious. Symptoms may suddenly disappear and then recur.

The stigma attached to mental illness may lead some people to deny their loved one’s problems or make it difficult to take the necessary practical steps. Some disorders convince the affected person that they are fine; the rest of the world is out of step. Diagnosis can be complicated by physical symptoms or life circumstances.

Society’s attitudes

The family may see or imagine fear, animosity or ridicule all around them. Even when friends and neighbours mean well, they may be unsure about what to say or do. This can make it difficult for a family to reach out for support.

Family soul-searching

People worry about the causes of mental illness - about heredity and past thoughts, deeds and words which might have tipped the balance in their loved one’s life.

Revolving around the illness

The mentally ill person often becomes the family’s focal point. The others no longer pursue their own interests or see their friends. This may store up guilt for the sick person and resentment in the others.

Unusual behaviour

Behaviour is often difficult to accept - occasionally melodramatic. This is not always due to the condition; medication also changes a person’s moods and reactions. Our stereotypes will lead us to expect ‘dangerous’ behaviour, however unlikely it may be. Suicide is usually a greater threat, and suicide threats should never be taken lightly.

Is mental illness ‘catching’?

It is not entirely unknown for symptoms to be ‘contagious’ (shared delusions, for instance), but it is exceptionally rare. The stress of the situation itself, however, does pose a threat to the emotional stability of family members.

What can I do to help?

The day-to-day management of symptoms may cause anxiety. We are never sure whether our words and actions will help, hinder or merely aggravate the loved one’s condition.

Therapy may present problems. Though therapy is usually beneficial to all in the long term, in early days it may cause temporary problems. A patient’s condition may get worse before getting better. Later on, the patient may develop a strong trust in the therapist at the expense of family opinions and feelings. A good therapist will anticipate these problems and help the family to cope.

If the person must be hospitalised... The family may feel a sense of failure and guilt, finding it difficult to adjust to the sudden loss of their central focus, and having trouble establishing new routines and inter-relationships.