In the course of my activities involving family members and companions who are helping a loved one with depression or bipolar, there are several problems that repeatedly come up. A recurring challenge that I believe to be one of the most important for me to meet and successfully overcome lies in that crucial area somewhere between hope and hopelessness.
When months go by without noticeable improvement in your loved one’s behavior, it’s difficult not to give in to discouragement. Who wouldn’t become discouraged if their loved one:
- Stopped taking their meds without telling anyone because they were feeling so well that they decided on their own they didn’t need them anymore.
- Made some inappropriate choices which came to the attention of authorities.
- Started self-medicating again after a long period of sobriety, undoing much of the gains which had taken so long to achieve.
- Withdrew from activities they used to enjoy and is now becoming more and more isolated, some days even having difficulty getting out of bed or leaving the house.
- Blames the companion or family for their illness and all the problems that continue to result from having it.
- Once again has been hospitalized.
If we allow ourselves to get stuck in disappointment we can soon be overcome with a sense of hopelessness. We must not allow this to happen. We need to keep in mind the fact that it is our loved one’s illness that’s causing the problems. We know there are better treatments available and we just have to find them. We must not give up hope. We must continue to expect things to get better with time, and for ever longer periods.
Take care of yourself. Make positive and hopeful decisions. Expect recovery. Always expect recovery.
When we grow up in a relatively stable family with parents who love and nurture us into adulthood; when we make a decision to spend our life with someone who has won our heart and we’ve chosen him or her to see us through the future regardless of what that future may hold; when we have children and make any and all necessary sacrifices in order to eventually propel them from the family nest and out into the vast unknown of self-survival…we do all this with expectations that we will have some challenges along the way, of course, but nothing that we won’t be able to handle.
Our parents will grow old and we expect they’ll need help getting to and from doctor visits, help with the marketing and perhaps even with preparing meals from time to time.
Our chosen partners will help us with the older folks, no doubt, but a day will probably come when we may even have to help our partner, too; there’s plenty of time to decide on how best to take care of those needs of the future.
Any children we gather along the way (our own, or through marriage or adoption) are our responsibility for a time but we know the day will come when they will be knocking on our door to gratefully repay all the kindnesses we have bestowed on them throughout their formative years… kindnesses they will be eager and prepared to return.
Then, out of the blue, our loved one comes down with a brain illness. Totally unexpected. We’re not sure of the details yet. All we know is they’ve crash landed somewhere and we really don’t know what to do, or if there is anything we can do. Besides worry. We find ourselves doing a lot of that.
Scientists sometimes refer to occurrences of this kind as unanticipated stress. We never see these situations coming, and often they are extremely stressful. Upheaval takes over. Turmoil rules the day. Everything in our life is upended. We’re frightened. It’s difficult to leave the house. Unanticipated stress, we soon discover, is stress of the worst kind. We're afraid that we and our loved one may not be able to survive this terrible situation. How do we survive such challenges? Where should we start.
A family support group may be a good place to find out. They're just about everywhere. If you need help finding one, let us know.
Brain illnesses are stressful--not only for the person who has the illness but also for the companion or family member who is caring for that person. When our role has unexpectedly become that of “caregiver,” we soon find it is an entirely different world than just fluffing up pillows and ladling out chicken soup.
The life of a caregiver can be demanding, usually more stressful than we had ever imagined. Faced with baffling medical symptoms, we may find ourselves having to make doctor appointments, keep track of medications, take care of finances--only to be the target of undeserved criticism and abuse. When did we sign up for this? we may even wonder. When things in our life upset us on a continuing basis, our feeling of being frazzled and overwhelmed may be our bodies warning us that our own health may be getting dangerously out of balance.
Scientists tell us that stress is a normal response to circumstances that are making us feel threatened. When our bodies go into a “fight-or-flight” reaction mode, sometimes referred to as stress response, it is our way of protecting our self. It’s automatic, and can even save our life. However, specialists also warn us that beyond a certain point too much stress stops being helpful and can cause significant damage to our health, more than we may realize.
Stress overload can affect our mind, body and behavior in a number of ways. We’re told that different people experience stress differently. Some of us become agitated or angry and overly emotional. Others become depressed and withdraw from normal activities. Sometimes, unfortunately, an overload of stress can even paralyze us.
Knowing our stress limit is very important. If we feel our tolerance level maxing out it may be time to talk to a therapist or doctor. Supportive friends and family members can help; we don’t want to allow ourselves to isolate. It’s important to keep an optimistic outlook, and this may be a time when spiritual guidance could make a positive difference. We should all learn how to become calm without resorting to drugs or alcohol. Remember, we are the best ones to monitor our stress level. It’s very important for caregivers to always have that in mind in order to keep our emotions in balance while maintaining our own health.
Caregivers must take care of themselves if they’re going to be physically and mentally able to care for a loved one who has a brain illness. There are few things more important than caring for an ailing loved one. Caring for ourselves first, however, may be one of them.
Cognitive behavioral therapy (CBT) is a blend of cognitive therapy and behavioral therapy that helps people change their thinking away from unhealthy and defeating thoughts and directs their mind’s attention to more functional, uplifting and constructive ones.
Through a process learned in talk therapy, the patient can alter dysfunctional thought patterns (which lead to distorted and negative views of themselves and the world around them) to a more accurate and healthier thinking process that results in positive and healing outcomes.
This powerful psychotherapeutic approach demonstrates the power of thought. If we believe something it becomes our truth, whether it is actually true of not. The renowned psychiatrist Aaron T. Beck, who created cognitive therapy, understood that we have the power to identify our own distorted thoughts and change them to be more accurate and thus more rewarding.
People with mental disorders who are fortunate to have a therapist trained in cognitive restructuring are having dramatic positive results.
In some parts of the world, such as the United Kingdom, CBT is recommended for a number of mental health disorders. Care providers and companions everywhere might be wise to check it out as a possible tool. When it comes to helping someone recover from a brain illness, we should leave no tool unexamined.
Sometimes a person in a hypomania state will give us cause for concern, and rightly so. Although our loved one may appear to be functioning fairly well with lots of activity and accomplishments, there is an aspect to their behavior that just doesn’t seem right. Our discomfort alarms keep going off. So what may be triggering them? There is something that we are seeing or hearing that is nudging us out of our comfort zone and into worry. Possibly several things.
There are some who believe that hypomania has so many positives that it can outweigh the negatives. Our loved one may even believe this. We might hear a great deal about creativity and courage, and less need for rest or sleep. We may see a super-friendly and uninhibited person racing around helping others, perhaps strangers, with little thought to the state of his or her own needs or general health.
Many companions who have gone through these episodes with a loved one, unfortunately, have come to witness a definite downside to this illness state. What at first may have been an unusual but tolerable activity soon morphed into a distracted, agitated and fast talking person caught up in a reckless spree of poor choices and extremely inappropriate behavior.
The outcomes of untreated hypomania can be quite costly, on many fronts. What should we do when our flighty and easily irritable loved one has obviously climbed into an elevated state and is moving still higher? Having them seen by their doctor, we eventually decide, would be the safe and intelligent thing to do. Many companions would agree: this is the course to take. But what if a loved one refuses to see their doctor? What if they insist they are getting a lot done and having entirely too much fun to want to change anything. What can a concerned and caring companion do then?
Many companions are faced with this question, only to find that answers are not always easy to come by. Any suggestions that may have worked for you that you’d like to share?
“Primary Care clinicians are not fully trained to diagnose or treat mental health problems, yet people with these conditions typically are seen in primary care more than any other setting,” so says the U.S. Department of Health and Human Services in a recent issue of Research Activities, a publication of the Agency for Healthcare Research and Quality (AHRQ). The practice of underqualified physicians diagnosing and treating people without integrating mental health professionals into the process, is resulting in depression and other mental health problems being misdiagnosed or inadequately treated and inappropriate psychotropic drugs being prescribed with little follow-up.
The article goes on to say that the “training in mental health for primary care physicians is very superficial and not very deep…and they don’t know what to do if anything goes wrong.” There are presently major barriers to integration of mental health in the primary care setting, such as reimbursement problems and a fragmented workforce. Research is showing, however, that wherever a team approach is utilized, costs go down and patients get better.
Overall, integrated health care seems better for everyone.
Makes sense to this companion… an integrated approach seems the best way. Any thoughts?
This blog is intended for companions, family members and caregivers who are helping loved ones diagnosed with depression or bipolar. Its primary focus is one of education to aid us in providing intelligent, loving support. We all want and need to learn as much as we can about these illnesses and how best to use this essential knowledge. We recognize, as part of our primary role, a commitment to the following: provide effective, healthy support to our loved one; assist him or her in becoming increasingly stable; encourage them in learning how to successfully manage their illness to prevent relapse in the future. Helping our readers in achieving and maintaining recovery for their loved ones is the ultimate goal of this blog…recovery for everyone.
We are not physicians or mental health professionals. Our aim is sharing knowledge which contributes to our stated goal of recovery. The information provided in this blog is not a replacement for medical diagnosis, treatment or medical advice. It is always recommended that a professional be consulted before changing any treatment or altering any medically recommended program.
