Caring for a Loved One with a Mental Illness

Depression affects over 450,000 people in the country at any one time, and we are working hard as a nation to lift the stigma attached.

Often the focus of advice is towards the person suffering from depression, but carers and loved ones of sufferers are often left feeling helpless, anxious and alone. Watching somebody you love battling something so difficult is very hard, and we want to “fix” things for them with a flick of a switch.

1. Become very clear on what depression (or bipolar) is. Become familiar with the signs and symptoms so that you are better placed to recognise the difference between someone ‘feeling down’ and experiencing depression / someone feeling ‘on top of the world’ who may actually have bipolar disorder.

2. Become aware of the differences between feelings, thoughts, beliefs and actions, and how they can impact on each other.The basic principles of cognitive behavioural therapy (CBT) illustrate how our thoughts, feelings, beliefs and actions can all impact our mood. An example that you might relate to is as follows:

You are in a shop waiting your turn to pay when someone you know comes to stand behind you. Immediately you anticipate her asking about the person you are concerned about and how they are. Notice how thoughts you may have such as ‘Oh no, here we go again’; ‘I know she is just being kind but I wish she didn’t ask’, or ‘I don’t want her to know how he is’ trigger you to feel differently than you had a few moments before. You may feel under pressure, anxious and/or annoyed. You may believe that you have not done enough, anticipate that the other person is judging you and you may react by being curt and changing the subject very quickly. Or you might believe that you have to answer all questions and may give a detailed explanation about the situation, while all the time wishing that you could end this conversation very quickly. However you may believe that this person genuinely cares about you, you may feel relieved, think ‘Oh it is good to have friends’ and you may suggest that you both meet for a coffee to catch up.

The basis of CBT is that it is not the event, but the meaning of the event that is important.

Aware provides two Life Skills programmes, free of charge, which help participants understand the link between thoughts, feelings, actions and behaviour. These programmes can be helpful for you by enabling you to understand a little bit better what may be going on for the person you care about, as well as helping you learn ways to manage the situation and its impact.When we are constantly in the ‘giving support’ mode it can be difficult to ask for and actually take support. So many of us tend to bottle up our own feelings and put on a ‘brave face’. There is a very real difference between talking to someone about a situation with someone we care about in a ‘gossipy’ way, and talking to someone we trust about the challenges we experience in caring for someone else.

3. In the case of bipolar disorder it can be helpful for the person to have a ‘spotter’. A spotter is someone who can ‘spot’ when the person may be becoming unwell and can let them know. It can be difficult for the person themselves to be aware of the mood changes involved – particularly in periods of elation. It is important to discuss this with the person when they are well and to agree a simple plan.

4. Practice actions that are helpful.

These might include:

Giving the person you care about space to feel however they feel
Not taking things personally
Not rescuing, blaming, accusing or threatening
Planning and doing one healthy thing every day that you enjoy
Asking the person how you can help them
Suggest that they do more things that are helpful such as:
• Following the advice of health care professionals where applicable
• Going for a walk in the fresh air
• Reducing or eliminating alcohol
• Reducing sugar in the diet
• Looking for and paying attention to one thing each day that is working well
• Switching focus from how they are feeling to what they are doing
• Doing things like going for a walk or having a shower rather than waiting until they feel like it
• Acknowledging and catching any tendency to dismiss what is going well and focusing only on what is not going well
• Ignoring conversations focusing on ‘feeling better’ and increasing conversations on ‘doing things’

Two of the best ways you can help someone is to:

1. Reach out and let them know you are there
2. Get and take support for yourself

This might seem to you to be selfish but it could well give the person you are concerned about space to take responsibility for their own wellbeing. If you are busy doing things to care for yourself, the other person may feel less under pressure and may follow your example.

In summary, as a carer or family member, you don’t need to feel helpless or alone. There is great support out there. Aware’s website is a mine of information for both sufferers and carers.