Navigating the Turbulent Waters of Mental Illness in the Family

Intermittent illness?

I would like to hear the doctor's advice, thank you! A family member has been diagnosed with a mental illness but has never sought medical attention personally; an elder consulted privately.
His condition fluctuates between normalcy and sudden episodes.
When he is stable, he is willing to go out and meet friends, but during episodes, he sometimes has delusions that someone is trying to harm him from behind.
The targets of his suspicion change frequently, and when he is emotionally unstable, he tends to throw things around.
I really want to send him to a treatment facility where he can be isolated, but the elder mentioned that after a while, he would be released, and they are concerned that if he goes to such a place, he might return with even more emotional volatility.
When he is in a state of rage, the household is always noisy and lacks peace.
Medication may help control his condition somewhat, but he is unwilling to take it regularly.
The elder has thought of some methods to get him to take medication occasionally.
He enjoys smoking at home, forcing other family members to inhale secondhand smoke, but the elder is reluctant to let me advise him, fearing it might provoke his irritability and trigger an episode.
He is unemployed and spends money extravagantly; I have tried to persuade him to change his ways multiple times, but the elder prefers to maintain peace and has chosen to give him whatever he wants for a long time.
As a sibling of the patient, I am often expected to tolerate and accommodate him.
Once, during an episode, he suspected me and I insisted on reasoning with him, which provoked his anger, and he hit me a couple of times before others intervened.
He might have felt disrespected and threatened to take his own life, but after grooming himself, he left the house with his wallet and was eventually persuaded back by other family members.
After a while, he seemed to forget those actions and suddenly initiated communication with me, which I really don’t want to engage in.
Although he often expresses suicidal thoughts when feeling down, he actively seeks medication when feeling unwell, yet he is unwilling to seek medical attention on his own.
As a family member, I have been living in this fluctuating atmosphere for a long time and am afraid that others will know about our situation.
Gradually, I have started to distance myself from my original friends.
I have always been somewhat reclusive, and I dislike going out, feeling increasingly hopeless about life and lacking motivation.
I don’t know who to confide in; the elder only wishes to maintain a facade of peace, but I feel that not everything can be forgiven.
I also feel that I have some issues, though I can’t pinpoint exactly what they are.
I can appear normal in public, but I am very afraid of crowded places.
When I am outside, I can act normally, but I actually feel very exhausted inside.
Is the karma between the patient and the family members an unsolvable vicious cycle?

Niming, 20~29 year old female. Ask Date: 2020/11/21

Dr. Qiu Junda reply Psychiatry

Hello.
The focus for family members with mental health issues is primarily on encouraging medical care, and for now, it is best to let the elders make the judgment.
Regarding the difficulties you mentioned in your interactions with family and the part where you stated, "I also feel like I have some issues," it is recommended that you seek counseling at a medical facility.
Alternatively, you can call the Ministry of Health and Welfare's helpline at 1925 to discuss your concerns.
Professional staff will provide guidance and referral services, which should be beneficial.

Reply Date: 2020/11/21

More Info

Navigating the complexities of mental illness within a family can be incredibly challenging, especially when the affected individual exhibits fluctuating behaviors and symptoms. It sounds like you are in a very difficult situation, where the mental health of a family member is impacting not only their life but also the lives of those around them. Here are some insights and recommendations based on your description.

Understanding Mental Illness
First, it's important to recognize that mental illnesses can manifest in various ways, including mood swings, paranoia, and impulsive behaviors. The individual you described seems to experience periods of relative normalcy followed by episodes of distress, which can be indicative of conditions such as bipolar disorder, schizophrenia, or other mood disorders. These conditions can lead to significant disruptions in daily life and relationships, both for the individual and their family members.

The Impact on Family Dynamics
The emotional toll on family members can be profound. Living with someone who has a mental illness can lead to feelings of anxiety, frustration, and helplessness. It’s common for family members to feel the need to tiptoe around the individual to avoid triggering an episode, which can create an atmosphere of tension and fear. This dynamic can lead to isolation, as you mentioned, where you feel compelled to withdraw from friends and social activities to avoid drawing attention to your family’s struggles.

Seeking Professional Help
One of the most effective ways to address these issues is to seek professional help. While it may be challenging to convince your family member to engage with mental health services, it is crucial for their well-being and for the peace of mind of the family. Here are some steps you can take:
1. Encourage Open Communication: Try to foster an environment where your family member feels safe discussing their feelings and experiences. This can sometimes help them feel more comfortable seeking help.

2. Consult a Mental Health Professional: If possible, consult a psychologist or psychiatrist who can provide a proper diagnosis and treatment plan. Family therapy can also be beneficial, as it allows everyone to express their feelings and learn how to support one another.

3. Educate Yourself and Your Family: Understanding the specific mental health condition can help demystify the behaviors and provide strategies for coping. Resources such as books, support groups, and online forums can be invaluable.

4. Set Boundaries: It’s essential to establish healthy boundaries to protect your own mental health. This might mean limiting interactions during particularly volatile times or finding ways to disengage from arguments without escalating the situation.

5. Self-Care: Don’t neglect your own mental health. Engage in activities that bring you joy and relaxation, and consider speaking with a therapist yourself. It’s important to have a support system outside of your family.

6. Crisis Planning: Given the potential for crises, it may be helpful to have a plan in place. This could include knowing who to call in an emergency, having a safe space to retreat to, and understanding when to seek immediate help.

Addressing Substance Use and Other Behaviors
The smoking and spending behaviors you mentioned can complicate the situation further. These habits may be coping mechanisms for your family member, but they can also exacerbate mental health issues. It’s important to approach these topics delicately, as confronting them directly may lead to defensiveness or aggression.

Conclusion
In conclusion, navigating the turbulent waters of mental illness in the family requires patience, understanding, and often professional intervention. While it may feel like a never-ending cycle, there are ways to break the pattern and foster a healthier environment for everyone involved. Remember, you are not alone in this, and seeking help is a sign of strength, not weakness. It’s crucial to prioritize both your well-being and that of your family member, and to take proactive steps toward healing and understanding.

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