Serious illness often lands like a bomb in the middle of the family system, disrupting routines and scattering the family members. When it is a mental illness, the impact can be particularly severe, compounded by stigma, fear and social isolation. What can a family do to maintain strong relationships with each other when mental illness has joined the family?
Family health can be maintained by building on both internal and external strengths.
1. Build Internal Strengths
Several qualities are found in strong families. Aim to build these before a crisis occurs, if you can. Remember that all families do have strengths, even if it doesn’t feel like it right now.
There are six characteristics found in strong families:
- Appreciation and Affection – Demonstrate your caring, liking and respect for one another. Small acts of appreciation or affection can go a long way. A hug, smile, shared joke or simple thank you are easy to offer to each other.
- Positive Communication – It can be easy for conversations to start to focus on problems or stressors. Be sure to also talk about the positives in your family and offer each other support. Acknowledge that each person in the family may experience the impact of the illness differently. Validate efforts being made to manage this impact. Avoid playing the blame game!
- Adaptability – Grow your family’s ability to adapt by being flexible and open to change. Often one person becomes the primary caregiver or support person for the ill family member. Share this role as much as possible. Seek outside help if needed, to find new ways of responding to the impact of the illness.
- Time Together – Having family rituals and routines will help build unity. This could be regular family dinners, family fun night, or retelling favourite family stories. What is important is that you are doing something together. If possible, these family events should include the family member who lives with the illness.
- Spiritual Well-Being – Even if you do not have a religious faith or spirituality, your family can seek and find meaning in shared values such as compassion, or altruism. You may feel a sense of oneness with other families who have similar experiences, or hope for the future. Many families I know have become advocates within the mental health system, or volunteer at mental health support organizations.
- Commitment – This one can be difficult if your family does not have trust in each other. However, it can be developed by being dependable and reliable, and practicing honesty (with kindness!).
I recommend you have a Family Action Plan. This is a detailed plan that includes strategies to build these six healthy characteristics. Your plan should also list who your support people are, how to respond to symptoms and what to do in a crisis. If possible, enlist the ill family member in identifying symptoms and signs that early intervention is needed, and a plan for what to do. Also include a plan for everyone’s safety if suicide or aggression are expected issues, and a plan for your own self-care.
2. Build External Strengths
The biggest factor in families’ ability to cope with mental illness is Social Support.
- Reach out to family and friends – let them know that you are dealing with an illness in the family, and what kind of support you need from them. Tell them what would be most helpful for them to do for you right now.
- Determine who needs to know what – it’s not always necessary to say what the illness is exactly, only how it is affecting you. One father I know says his son has a disability. Another family freely tells people their mother lives with depression. Share to the extent that you feel comfortable and also be respectful of your ill family member, who may have concerns about their personal privacy. This can be a delicate balance between breaking out of isolation and not oversharing details that your family member may wish to keep private. If you share your own emotions and needs, rather than talking about the ill person, you can often elicit support without needing to go into details.
- Find a formal support group – there are many supports available; the trick is finding them. Local self-help organizations will usually offer family supports or programs such as Strengthening Families Together.
You can also look for online support. Here are a few sites that I like to recommend:
List of groups in the USA
Mental Health America
It can be challenging to change longstanding ways of interacting in a family. If your family finds it too hard to develop these new patterns on their own, you can ask for help from a qualified family therapist or consultant. This does not mean your family is “dysfunctional”! It is, in fact, part of adaptability to be willing to seek help when your own efforts are not working.
Look for a therapist or consultant who has professional credentials. A list of family therapists can be found at the Association for Marriage and Family Therapists:
In the USA
Other qualified family consultants may be advanced practice registered nurses, social workers, psychologists or other professionals with training and experience in family dynamics and mental health.
You can be a strong family despite the challenges of a serious mental illness!