When a Family Member Has a Serious Mental Illness
By: Russ W
Tags: Psychology, Loss, Grief, Depression, Mental Health

Photo by @felipepelaquim on Unsplash

Shame Prevents Treatment

While studies have proven that the family is not the source of the individual’s mental illness, the reality is that stigma still exists in society today.

When the person’s mental illness is known, it serves as an “out-group” differentiator to friends and acquaintances. It separates us, “the mentally healthy,” from them, “the mentally unwell.” To many, it continues to be a dividing line between what is normal and what is abnormal and therefore inferior. To these acquaintences, your family becomes the family with mental illness issues.

This label is socially discrediting and can lead to individuals being rejected and discriminated against. In Jones’s interviews, participants explained that others in their community began looking at them in a different way, as if intentionally searching for evidence that the patient’s relatives were mentally unwell too.

Over time, this stigma can become internalized and turn into shame and the devaluation of the self. If you’ve read anything by leading shame researcher Brené Brown, then you know that shame is a negative reflexive emotion that thrives on silence and isolation. Shame is like putting a gag order on your psychological trauma, preventing you from processing it externally and instead leading you to withdraw socially.

This shame is one of the reasons that many families have a hard time seeking therapeutic help to manage the complex change in their family dynamic. Even when they finally do overcome their shame and seek out help, it can be incredibly difficult to articulate their feelings given their often-contradictory nature.

As for the family member with these forms of serious mental illness, one of the many challenges is that they can be oblivious to their illness, which is a condition known as anosognosia. A prominent study in the New England Journal of Medicine revealed that as many as half of patients with schizophrenia and bi-polar disorder are unaware of their illness.

Not only does this mean that patients can be resistant to participating in psychiatric care, it also means that they can exhibit extreme denial and become combative towards the family members who are trying to help them treat their mental illness.

Despite years of lobbying and encouragement from myself and other family members, my relative resisted treatment at all costs. Whenever the subject of treatment or seeing a therapist arose, they refused to consider themselves unwell and typically dug their heels in deeper about the reality of their delusional construct of reality, projecting blame onto others.

Ultimately, it was not until this individual called the police to apprehend their criminal stalkers, a feature of their delusional construct, that they were placed on a 72-hour psychiatric hold. After a long-period inpatient, this relative was treated with medication, which helped to eliminate the delusions. Unfortunately, as can happen upon release from inpatient treatment, this individual quickly stopped taking the medication and has subsequently reverted to the previous state.

In the United States, state-based laws typically prevent individuals from involuntary commitment to a mental institution unless they demonstrate a grave danger to themselves or others. You can view your state’s laws on involuntary treatment at the Treatment Advocacy Center, a nonprofit organization dedicated to eliminating the legal barriers to the treatment of serious mental illness.