Thin Ice Twice

For some of us who have a mental illness, recovery may be like making our way across a lake in winter. The lake, its top a smooth surface of glistening ice, appears safe. At first we hesitate. Finally, we step out. Although the ice feels solid as we carefully step further away from shore, we can’t shake a fearful thought: in some places the surface may be too thin to safely support us, and at any time it could break and we’ll plunge down into a dark icy abyss from which we’re not likely to return.

For those of us supporting a loved one in recovery, the trip across the ice can be just as challenging. We’re afraid about the firmness of the ice, too. Will it prove to be reliable? What if we think we hear the ice start to crack--should we immediately pull our loved one back? We’re not even sure we should be out there with them. If they go down, what’s to prevent us from going down with them?

All of us involved in recovering from the affects of a brain illness, or supporting someone else who is, will have times when we have second thoughts and want to hold back. This is especially true when we’ve never been in this situation before, and we’re not sure that we will achieve the outcome we seek. We’re concerned about the risks involved.

One way to cross a lake in the dead of winter is to seek out others who have successfully crossed the same lake. They will have some experience about crossing safely and can make wise suggestions about where to cross and just how best to go about it. The same holds true for recovering from a mental illness. Others who have been involved in recovery and have experiences of what has worked successfully (or not) can pass on valuable information as well as provide insight and suggestions on what has worked for them (or what hasn’t worked).

Procrastinating from taking any action toward recovery is not helpful. It may even propel things to becoming worse, and possibly catastrophic. Doing nothing is probably our worst choice.

Action with movement toward recovery is essential. How do we do that while avoiding getting caught on thin ice?

Talk with your doctor and therapist. Attend a support group, regularly. Read as much as your can about successful methods of recovery. Learn as much as you can about the illness you’re involved with. Do all these things while you’re taking continuing action.
Stop thinking about it… just do it.

Establishing Trust

There are few things as important for a companion or family member in helping a loved one who has a brain illness than having successfully established trust. It is essential. It may even help save a loved one’s life.

When a person is in a depressive state the recommended and necessary tasks of finding a doctor, receiving a correct diagnosis, taking helpful medication, finding an effective therapist and attending the right support group can be insurmountable obstacles for someone in the grips of a serious disease.

Having a strong and supportive companion, family member or caregiver who understands the negative and often defeatist attitudes this illness causes can forestall inaction and minimize or even prevent any worsening of the symptoms. This loving work depends on trust. Without it there are few words, warnings or threats that are going to realistically move a loved one in the direction of eventual meaningful recovery. When an unbreakable bond of trust is in place, a family member or companion can almost always encourage, motivate and move a loved one toward receiving help.

The world is full of people who have allowed themselves to be led to healing, thanks to an unbreakable bond of trust.
It may be one of love’s most vital links.

The Danger of Isolation

Isolation should be a concern for a companion, family member or caregiver when a loved one is depressed over an extended period of time. As a loved one becomes increasingly depressed, activity usually lessens and there is a tendency to withdraw from the company of others. He or she may be caught up in pessimistic thoughts about themselves causing crumbling self-esteem. All interest in pleasurable activities slips away as our loved one’s loss of energy causes them not to want to leave the house. They may even have trouble getting out of bed.

Untreated or inadequately treated depression can lead to serious health challenges, further troublesome consequences and potential risks many companions can’t bring themselves to think about. But such risks are all too real, and we need to recognize isolation for the insidious trap it often becomes. Some doctors describe this situation as a race against time.

This is a major challenge for those of us supporting someone with a brain illness. Our loved one isn’t capable of recognizing just how ill they are, much less how dangerous isolation can be. If he or she were suffering from untreated diabetes or cancer, we might be able to persuade them that they either begin treatment for their disease or they’re going to die. The ability to see consequences of behavior may be readily pointed out to someone who eats sugar or smokes cigarettes and we can at least hope for, and possibly expect, behavioral changes. But someone with a brain illness doesn’t recognize the danger, so they don’t do anything about it.

Treatment for a brain illness often must come involuntarily, an uncomfortable process. The bottom line is this: there has to be treatment if our loved one is to survive. If treatment is delayed then our loved one is in an ever present and always increasing danger. Any companion, family member or care provider:

• Who does not recognize, acknowledge and take positive action to help a loved one in untreated depressive isolation, is themselves in denial of reality and facing a terrible and possibly irreparable outcome;
• Who takes action to help their loved one to trust their support team and do the hard work of acceptance, treatment and recovery can not only expect their loved one to survive but to thrive for having successfully done the work.

The Goal of Medication: Recovery Without Relapse

Medication today is doing more than ever to stabilize sufferers of mood disorders and help them to have happy, functional and productive lives. For a large number of those fortunate enough to successfully manage their symptoms with the help of medicine, the road to recovery has not been an easy one. For many it’s taken months (if not years) for them and their doctors to finally discover just the right combination of medicines to achieve the most favorable results with the least side effects. But all of the time, numerous adjustments and faithful trust they’ve placed in their medical support team has ultimately paid off. This is the great goal the patients, their companions and family members, and the physicians prescribing these medicines have all been working toward: ongoing stability and recovery without relapse.

This is an amazing achievement. Especially in light of all the possible obstacles we meet on the road to recovery that, if we’re not careful, can cause us and our loved one to take our eyes off our goal and lose sight of our direction. When this happens, we can needlessly delay if not entirely derail our rightful recovery.

Here are just a few of those obstacles and why it’s important to overcome them:

• Some allege that the medicines doctors could prescribe for our loved one may cause diabetes or other life-threatening diseases so it’s safer not to take them. Such claims are almost always incorrect and bring about a much more life-threatening situation by inadequately treating a brain illness. This is a concern that must be discussed with the treating physician.
• Psychiatry and psychotropic medicines are destructive to society and should be avoided if not banned altogether. These kinds of charges are usually from science-ignorant cults and have no basis in fact. The closest such critics have ever come to a psychiatrist has been as an actor playing one in a film or on TV. Again, consult your doctor with any concerns you may have. 
• Patients who have taken medications in the past may have experienced unpleasant side effects and now refuse psychotropic drugs to treat their illnesses. This is unfortunate as well as short-sighted. New medications are being developed all the time; some do not produce previous negative side effects. Medicines that are now available may not have been around when the previous unpleasantness occurred. Every day is a new day in the world of medicine, and it’s useful and smart to keep all our options open. Try to help your loved one not to permit the past to overshadow decisions that are more wisely made in the present.

Medication isn’t the only treatment tool available to help a loved one recover from a brain illness, but it is a very important one. Many healthy and happy people are alive and in recovery today because of it.

Depression…It Really Is the Pits

People in an episode of major depression often compare it to something like being in a deep hole, so deep that it’s extremely difficult to climb out of the dark mood they’re in. Left on their own to find their way out of their misery, it is unlikely to happen anytime soon. Their illness will prevent that from happening. Untreated depression seems to lead in only one direction--downward.

Someone in the clutches of deep depression is not thinking positively. Instead, they are often so down on themselves that they may be convinced that there is nothing they can do to lift them out of their depression. They may even believe that they don’t deserve to feel better, perhaps concluding that they are so broken that nothing can fix them. And, if left on their own, it’s possible nothing will. Clinical depression just doesn’t seem to go away with time. Unfortunately, it often gets worse…much worse. Sometimes, untreated depression can be a killer.

If your loved one is in the pits of deep depression, it may be time for you to give them a boost up. Remember, their illness is not going to go away on its own and it’s possibly going to get worse. Don’t delay. A compassionate companion, family member or caregiver is in the best position to take action if their loved one is going to receive the attention and care they need. Taking appropriate action is what successful companions always do.

Help your loved one climb up and out of the pits of depression, and back into healthy recovery and eventual joy. If you don’t know what to do, find out. There are answers to your questions. Ask them. Do it. Take action now.

Always Expect Recovery

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.

Out of the Blue

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.