‘My son is lazy, he is unable to get up and go to college on most days.’
‘My daughter eats nonstop these days. She has bloated and doesn’t seem to care.’
‘My sister is constantly worrying about everything…she should learn to manage her worries.’
‘My husband is unable to manage his work stress, he starts drinking every evening and doesn’t stop.’
These are statements I often hear. We may feel frustrated and angry with someone in our family as we think it to be that person’s difficult, lazy or negative behaviour. We wonder why, despite all the support and encouragement, the family member appears constantly worried, is unable to get up and sleep on time, displays erratic eating habits, and, in short, seems unable to perform routine activities of daily life. We may believe that it is easy to ‘snap out’ of such behaviour with willpower and determination, and are left feeling confused as to why the person cannot be like others in the family.
Could it be that this debilitating behaviour of our loved one is due to some mental health problem? Most of us believe that mental disorders ‘happen to someone else’. In fact, as per the latest report of the World Health Organization, not only do 56 million Indians suffer from depression, another 38 million Indians suffer from anxiety disorders. In October 2016, the National Institute of Mental Health and Sciences Bengaluru released a mental health survey that said that the incidence of depression is roughly one in every 20 Indians.
Feeling of sadness, anxiety, worry, irritability or sleep problems are common for most people at some point. However, when these feelings get very intense, last for a long period of time and begin to interfere with school, work and relationships, it may be a sign of a mental health problem, for which a person needs help.
Examples of signs and symptoms include feeling sad or down, confused thinking or reduced ability to concentrate, excessive fears or worries or extreme feelings of guilt, extreme mood changes of highs and lows, withdrawal from friends and activities, significant tiredness, low energy or problems sleeping, detachment from reality (delusions), paranoia or hallucinations, inability to cope with daily problems or stress, problems with alcohol or drug use, major changes in eating habits, sex drive changes, excessive anger, hostility or violence, suicidal thinking and numerous unexplained physical ailments.
When a person is living with a mental health problem that is not being treated or managed, the whole family gets affected. It often leads to disrupted family routine and financial costs, with the family members also getting stressed and anxious. Most families are not ready to accept and cope with learning that their loved one has a mental problem. It can be physically and emotionally trying, making them vulnerable to the opinions and judgment of others.
This often leads to a denial of the warning signs and worrying what other people will think because of the ‘stigma’. Thoughts such as, ‘if I had been a better father, mother, wife etc. this would not have happened to my loved one’ and ‘I may have caused the mental illness due to something I did or didn’t do’ also causes great pain.
What should family members do in such situations? The most important thing is to accept that these feelings are normal and common among families going through similar experiences. The fact is, mental illness is caused by a combination of biological, environmental and psychological factors. It is helpful to make a comparison to a physical illness. For example, many people get sick with a cold, but only a few get really sick with something more serious like pneumonia. People who have a cold are usually able to do their normal activities. However, if they get pneumonia, they will have to take a stronger medication.
Just like people need to take medicine and get professional help for physical conditions, someone with a mental health problem may need to take medicine and/or participate in therapy in order to get better.
If the family member senses that the person needs help to feel better, the best thing is to connect them to professional help. If they resist seeking help and feel hopeless (which may also be a symptom), they can be supported by the family member in meeting a mental health professional and discussing the symptoms and appropriate next steps for the person. Dealing with mental health issues can lead to: improved recognition of early signs of mental health problems, earlier treatment and greater understanding and compassion, which naturally leads to better outcomes for the person and the family. Families have consistently reported positive changes after they have got the right help for their loved ones.
The author works in the area of mental health and is closely involved with the removal of stigma associated with mental health issues.