When mental illness enters the family | Dr. Lloyd Sederer | TEDxAlbany

Transcriber: Katarina Ericson Reviewer: Denise RQ Thanks for joining me. We are here together because we share a common interest and concern: helping a loved one with a

mental

illness

get the kind of care that will make a difference in her life and the lives of her

family

. I'm referring to a

family

member like John, who was 16

when

he started falling behind in school. He stopped seeing his friends, he quit soccer where he had been a star, he started spending countless hours in his room, refusing to come out. His parents could smell the marijuana and could hear him in the middle of the night, screaming at God knows what.

I am referring to a family member like Irene, married and mother of two teenage daughters, who began to miss work, despite having always been a reliable and hard-working person. Her family was worried, they were worried about her, they were worried about her income because her husband was disabled and they were worried about her losing her job. But she had a hard time concentrating, even the smallest things were very difficult for her and she often said: "I can't do this, I feel hopeless, I don't know if I can go on." I'm talking about a man like Roberto, who is 69 years old and has long-standing problems with high blood pressure and diabetes, and who suffered a heart attack a few years before.

But for him, it was his depression that prevented her from addressing his medical problems and put him at greater risk of progression of those physical problems and, potentially, suffering another heart attack. Families sense it, they sense deep down that something is happening, that there may be a

mental

illness

and they ask themselves: "What are the traffic signs?" 'What are the characteristics of mental illness?' There are two; There are symptoms and time. Symptoms of mental illness present themselves in three ways: there are problems with mood, problems with thinking, and problems with behavior. A person's mood may drop, they may be tearful, cry and feel hopeless, they may be irritable or angry.

The thinking changes. They may have trouble putting one thought after another, their thoughts are confusing or spicy, they may become suspicious and even downright paranoid. Your ideas may not make any sense. They may also have problems with their behavior, their behavior becomes noticeably different, there may be dramatic changes in their sleep and eating patterns, and they may stay awake all night. They may eat very little, behave strangely, become isolated, suspicious, or even sometimes so paranoid that they talk to themselves. These are the symptoms of a mental illness; mood symptoms, thinking problems, behavioral problems and the second characteristic is that they persist.

It's not a matter of them lasting a few days, they last weeks and months, and someone needs to be truly considered sick and they don't get better on their own. There is one more thing, another feature that families should take into account: safety. Is there a time

when

the family is concerned that a person's life, being a risk to themselves or someone else, is a hallmark of a mental illness that must rise to the top? And even when it seems so obvious, many families can find it difficult to trust what they see. Perhaps they have never experienced this before, or the implications may be too much to bear, which is why I encourage families to write down what they see, what they observe, not what they feel, what they observe.

Things like "He spent the weekend in bed," "He misses school every day," "He's late for work," "He bites his food," "His clothes fall off." Write them down and then think: "Who else is observing the same thing as me?" Because that's another person you can go to and say, "This is what I'm seeing, are you seeing the same thing?" Because that is a way to validate, to gain confidence, that what you are seeing is really happening. And that will be important when the time comes to talk to your loved one about these issues, if they don't bring it up themselves, and many don't.

They may be ashamed, they may not want to be a burden, or the illness may often prevent them from recognizing that they have these problems. So who else can you turn to, who else can validate it? This will also be helpful if you have the opportunity to go to a doctor's appointment with your loved one, because it will be able to provide you with information that your loved one probably won't give you. So if there really is mental illness in your family, I want to offer you four messages, four ways you can turn these problems into solutions.

First, don't do it alone. Secondly, don't get into fights. Third, learn how the mental health system works, know its rules and how to bend them. And fourth, remember that you are in more of a marathon than a sprint. Each of these in turn. First, don't do it alone. Don't do it alone. There are people and places to turn to. Since more than one in five people in this country suffer from mental illness each year, that is, adults and adolescents, that means there are many other people who are experiencing what their family is experiencing or has experienced.

So think, who can you turn to? For many families it will be a doctor or a clergyman, someone who has known their family, their loved one. Every day, doctors and clergy have families in their offices seeking help, families in crisis. They are a place to go. Sometimes other families have spoken, they've had a depression problem, they've had an addiction problem, they've had a trauma problem. They can be friends, they can be relatives, they can be people you know at work, other families or other places and people to turn to. Sometimes a school counselor reaches out to a family and is a good person to turn to.

Many companies have what are called employee assistance programs. These are confidential programs that provide counseling, that provide information on where to go. I almost always encourage families to go to NAMI and consult with them. N-A-M-I, The National Alliance on Mental Illness. This is a volunteer organization that has been around for decades. Hundreds of thousands of family members, across the country, who have been through this themselves and who have been trained, they have been trained to provide information, referrals, they do it over the phone, they do it in person, many NAMI Chapters Provide educational groups nights called Family to Family.

NAMI is a fantastic resource and it's free. The thing is, you don't have to do it alone, there are people and places to go to. This has been learned with every persistent illness, be it heart disease, colitis, diabetes, Parkinson's, cancer, there is no need to go it alone, there are people and places to turn to. Secondly, don't get into fights. This may be the most difficult recipe of all. Because you've tried reason, you've tried persuasion, you've been patient and it's just not working. And you are worried; You see that your loved one is getting worse, you wonder what is going to happen, you know that time is not on your side.

So what do we all do at that time? We amplify our voice, we speak louder, we start pushing, we start yelling. But what does that do? It invokes an equal and opposite reaction. A fight starts, someone goes even deeper. There are alternatives to fighting, there is listening and influence. Listening. I believe that all behavior has a purpose. We may simply not understand what that purpose is. For Irene, the mother I mentioned, why does she avoid working? She knows very well that the family needs the money. She also knows that she could lose her job. What is it that overrides that, that makes her stay home despite that?

Listening, asking, that's how we discover it. John, the teenager who smokes marijuana. What does that marijuana do for him? How is it serving you? Do you find it useful, just like locking yourself in the room? These are not good solutions, but they are the solutions that someone has come up with so far. Listening is the way to take the side of someone you love and see if there isn't a way to find a better way, because God knows these behaviors aren't working. But if listening is not enough, then there is influence. I think that in all families it is a two-way street.

You give and you receive, and you get by giving. It is obtained by giving. Then I ask families: "What support are you providing to your family member?" Is it a place to stay, is it money, is it a car, is it a phone? It doesn't matter. Whatever it is, that's what you have to deal with, say you get, and there's something, it's a conditional get. It's about saying, "This is what we offer, and in return, we want you to do something that matters to you, something that will help you get better, like going to an appointment, getting treatment, doing the hard work of recovery, taking care of yourself." ". "It's always in your best interest, that's where influence is used, to help someone do something that will make a difference for them.

There are alternatives to fighting, listening and taking advantage is not the same as being disengaged; in fact, it is being more committed, in a more difficult but more effective way than getting into a fight. Don't get into a fight Third, learn how the mental health system works, know its rules and how to bend them. , the mental health system in this country is too broken. Families will find this out sooner rather than later, and that means they will have to learn to be vocal advocates for their loved ones and themselves. They will need to learn what the rules are and how. rape them.

I have seen families with a child who is in college and the child stops going to class, has a serious medical problem or a disciplinary action and they don't know anything about school. I have seen many families with a loved one get sick every time. more, deteriorating, isolating, using drugs, hoarding pills, and maybe even hiding a gun. And the family tries to contact the caregivers, tries to call the doctor, tries to call the clinic, and what do they hear? "I'm sorry, I can't talk to you without permission." That's the Federal Privacy Act, this HIPA, it's called HIPA, H-I-P-A, it's a HIPA mantra that doctors are taught.

That's a rule you need to know because it's a rule you need to bend. You should call a doctor and say, "Wait! Don't hang up on me." "I know you may not be able to give me information, but there is no prohibition that stops you from listening, and you need to know what is happening at home, you need to know what will make a difference with your patient or a member of your family." "This isn't fair, it's certainly not fun, but being a vocal advocate has become a necessary part of healthcare, in general, and mental health in particular.

Fourth, remember that you're in more of a marathon than a sprint. Few illnesses, physical or mental, come and go in a matter of weeks, most persist. And there are problems along the way, there are delays in appointments, there are questions about the quality of the appointment. treatment. Is it good enough? Is it working? Is it enough? And then a loved one may stop going to appointments or stop doing the hard work of recovery. Recovery is not a straight line. Then there are setbacks, which test the morale and determination of everyone involved. That's why another way of saying this is never give up.

Experienced doctors are not good at predicting when someone is going to turn the corner, when they are going to start getting better. We know it happens, we see it all the time, but we don't know when. So never giving up is a way to stay the course, because people recover, people make lives with illnesses, lives that they find rewarding, but it means staying the course, it means never giving up, you're in more of a marathon than a sprint. So my four messages to families that mental illness has entered are: don't do it alone, don't get into fights, learn how the mental health system works, learn its rules and how to break them, and fourth, remember: Don't give up, you're in more of a marathon than a sprint.

Recovery is possible, people live with illnesses, with work, with relationships, with lives of contribution that they can be proud of. There are many people like that, but they may simply not step forward. They may worry about stigma, doubt their own achievements, or simply want to put the past behind them. Many people recover, but it is not visible, people do improve, but it takes good treatment, hard work, support, support, support. It requires the color of time and means keeping hope alive. Thank you. (Applause)