Stages of emotional response to mental illness

What does one do when a beloved  family member, who has always been competent, begins to have ideas such as: “My thoughts are being transmitted out into the world” or “People are putting bad ideas into my head” or “Everything I see and hear has some special meaning, cosmic importance and makes  reference particularly to me” or “The voice of God is giving me commands” or “I am sick, sinful, everybody is after me” or “I am Jesus.”

by Marion Bono
by Marion Bono

To further complicate matters, it is no longer possible to reason with the loved one. They cannot be convinced that these ideas are not real.

How do families respond to this catastrophe? This is a crises. There is chaos, shock, trauma. There is disbelief, denial. In the meantime, their family member gets more bizarre. He might be extremely paranoid, thinking that the CIA is after him. Or he might be moving so fast and talking so fast that he becomes confused. His thoughts and ideas are loosely connected. He often becomes argumentative, making embarrassing scenes at home and in the public.

Even if the family is lucky enough to work with a psychiatrist when these signs first appear, they often cannot, will not believe what the psychiatrist tells them.  They hope against hope that this is not a mental illness, that this will never happen again. They try to normalize life, get things back to the way it was before these strange things appeared. They want their family to return to the way things were.

What does the family need during this initial stage of dealing with this catastrophic event? They need support, comfort, empathy. They need help finding resources, such as Crisis Intervention, housing, Social Security disability. They need to know the prognosis of this illness. They need to know about NAMI.

When the family enters the second stage of the emotional responses, they may be learning to cope; they must learn how to deal with the anger, guilt, resentment, and grief about what has happened to their lives and the life of their loved one. They need help recognizing what is going on. In addition, they need

a safe place to vent their feelings. Education about mental illness will give them hope. They will learn to take care of themselves, how to empathize with their mentally ill loved one, how to communicate and problem solve. They will learn about the mental health system and will have an opportunity to network with others who have been down this same road. They will learn how to “let go.” They will learn about NAMI.

Finally, with education, family members will come to a life changing understanding and acceptance of mental illness. Hopefully, they will move into advocacy and action to improve the lives of those with mental illness. They will restore balance in their life. 

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Marion Bono, a member of NAMISWLA, facilitates a support group and teaches the Family-to-Family course, from which these articles are taken.
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