Learning to live with and manage a mental health condition is tough enough without the additional stress of denial and outright disbelief of family members. People who are diagnosed with a mental health condition often require time to adapt to the reality. The adaptation process generally comes in stages (similar to those of the grief process). Everyone goes through this adaptation process at their own pace. Many factors influence the adaptation process, including one’s willingness to take in new information and assimilate it into a new reality.
Family members may also need time to adapt to the news. Their adaptation process goes through similar stages, and it takes as long as it takes. In some cases, family members simply never accept reality. This can happen for many reasons, but often it has to do with outdated information and fear. One of the myths about mental illness is that it occurs rarely. Likewise, people tend to consider only those chronic and persistent diagnoses such as Schizophrenia and severe cases of Bi Polar Disorder as mental illness. With over 200 diagnoses of mental health conditions, there is much room for confusion and misinformation.
Regardless of the cause, the result of this denial of mental illness is usually more problems for the person with the condition. People report feeling judged, blamed, condemned and shamed for their mental illness when family members won’t accept the reality. In my work with families who experience this initial resistance and/or denial, many come around eventually. Most do not want their reactions and behavior to make things worse for the person with the condition. Unfortunately, some are so set in their ways of thinking that they are unable or unwilling to integrate new information into their version of reality. Here are some things that may help.
Education for Family Members
Sometimes if helps to take your family members along to an appointment with your doctor or therapist. Hearing the information from a professional who can talk about the causes (not bad parenting, usually), treatment and prognosis may help. They can ask questions and hear about the science behind the diagnosis.
Organizations like NAMI (National Alliance on Mental Illness) offer support groups, literature, information and referral. They usually offer family programs to allow family members to talk to others who have been through a similar situation. Many family members are more open to non-medical people who understand their situation.
Understand the Adaptation Process
A lot of research has been done about the process people go through to assimilate a new diagnosis into their reality. Most are stage theories, and generally follow a pattern that includes a period of shock or denial, followed by a time of looking for solutions that may include some anxiety and desperation. Inevitably there is a long period of anger and sadness that finally results in acceptance, or adaptation.
With mental illness and other diseases/disorders that have periods of remission, the periods of remission often lead to a renewed period of denial – the symptoms are gone so it must have been a misdiagnosis. This is seen a lot with Bi Polar Disorder and Major Depressive Disorder, when the periods of reprieve from the symptoms may last for months or longer. In these situations, the adaptation process usually starts over and follows the same path. Some people cycle through this adaptation process over and over with each remission and exacerbation.
Family members often see these periods of reprieve as evidence that the person does not have a mental illness, rather than understanding the episodic nature of the illness. Be aware of how the adaptation process works. This can make it easier to recognize and manage your reactions, and those of your family members. Educate them about the episodic nature of your illness if you have a diagnosis that follows unusual patterns.
Take Care of Yourself – Regardless
Part of your recovery must include a plan for coping with the naysayers. Obviously, your recovery would be easier with the support of family members and friends. However, if they are not willing or able to be a part of your recovery, you must accept that and find a way to cope with any feelings of rejection, blame, etc. Here are some ideas for coping with family members who are not supportive of your recovery, for whatever reason.
· Self-care must be your first priority. You can’t be a good parent, spouse/partner or employee if you don’t take care of yourself.
· Learn how nutrition, exercise, sleep and stress impact your mental health diagnosis and make the necessary lifestyle changes to support your recovery.
· Have a family meeting (with your counselor or doctor if needed) to discuss what you will do for your recovery. Let others know how they can help you, if they are willing. If they are not willing to help, try to get agreement that they will not sabotage your self care plans, ie. arrange child care for times when you will be in therapy, doctor’s appointments or exercising.
· Be assertive – if someone fails to honor their commitment that is necessary for your recovery, talk to him/her about it. Explain why you need them to honor their commitment. If they are unable to fulfill their prior commitment, make different arrangements.
· Revisit your recovery plan if you find it is not sustainable. Sit down with the family again and ask for their help in addressing the problem areas. If you can’t get the support you need within the family (watching the children while you go to the gym), find support outside the family. Ask a neighbor, hire a sitter, go to a gym where child care is provided, etc.). Get creative and be persistent.
· If you find you can’t overcome the obstacles with family members on your own, insist on family therapy. Often a family therapist can identify barriers and help you overcome those as a family.
"Mental Illness and the Family: Recognizing Warning Signs and How to Cope." Mental Health America. N.p., n.d. Web. 26 Sept. 2013.
"Common Family Reactions to Mental Illness." Lecture. Common Family Reactions to Mental Illness. University of Oklahoma Health Sciences Center. Web. 26 Sept. 2013.