When Someone You Love has Chronic Mental Illness

What if you have an adult son, daughter, parent or sibling who has serious mental illness? How can you help? How can you get them help? What is your role? How do you deal with your own feelings of loss, sadness, anger, frustration, worry or helplessness? How do you set some limits?

You may notice self-destructive behaviors, racing thoughts, delusions, hallucinations, or other breaks with reality. You might be aware of rapidly cycling moods in your loved one, or angry rants.

If your relative is under 18 years old, parents can intervene, and get a psychological evaluation. Your family member may be helped by medication and counseling. Parents have the legal right to seek mental health assessment for a minor child.

After age 18, the situation becomes much more difficult. The individual themselves has to be willing to get treatment unless they meet the specific criteria for involuntary hospitalization, which are: danger to self, danger to others or gravely disabled.

As a family member, it is essential that you get informed about mental health/chronic mental illness and get support for yourself. One of the best ways to do both is to contact the National Alliance on Mental Illness at www.nami.org  In many areas of the United States there is a local chapter of NAMI which offers information, support groups, lectures and more. In Orange County, California where I have my counseling practice, the local chapter can be reached at www.namioc.org/
Getting to know other families who are also dealing with a family member with severe mental illness, like schizophrenia, personality disorders and untreated bipolar disorder can be incredibly helpful.

Another valuable resource is your local Mental Health Association, which can help you identify local resources for a family member you are concerned about. In Orange County, our local chapter can be contacted at www.mhaoc.org/  If you live elsewhere in the US, contact the Mental Health America national office at mentalhealthamerica.net and they will put you in touch with your local MHA office.

If your family member has a personality disorder, be aware that many people who have this diagnosis do not see themselves as having a problem and will probably blame others and be reluctant to get help. There are different types of personality disorders, including narcissistic, borderline, paranoid, schizoid, schizotypal, antisocial, histrionic, avoidant, dependent, and obsessive-compulsive. All personality disorders are an enduring pattern of inner experience and behavior that varies far from what we normally expect. Most are difficult to treat, especially if the individual does not acknowledge their situation.

Family members need support in learning the best ways to help the mentally ill member, as well as how to set reasonable boundaries and limits for your own self-protection. For example, if you have an adult son or daughter who refuses to get help, but does not meet the strict criteria for involuntary hospitalization, you will need to sort through what your role will be. Perhaps you can see them and be emotionally supportive, but set limits that you will not accept physical, emotional or verbal abuse. It might be that you can help the grandchildren. You might be willing to help with the cost of some treatment, depending on your circumstances. You might be able to see them in limited amounts and provide emotional support, but not have them live with you.

A family therapist can help you learn not be codependent, and sort out how you can help and how you can  take care of yourself as well. Many people with chronic mental illness won't consistently take their prescribed medication or participate in talk therapy. As a family member who cares you won't be able to fix everything for another adult. Figuring out what you can do to help, and what is beyond your limits is key.

Why do Marriages Last Better In New Jersey?

In the October 14th edition of The New York Times, I found an article in the wedding section with some interesting demographic data about staying married. Recently, the Census Bureau released its 2011 American Community survey, showing New Jersey ranking last among the states for its percentage of residents age 18 and older who are divorced.

A different study by Philip Cohen, a professor of sociology at the University of Maryland looked at the states with the lowest of divorces the previous year compared with their populations, finding these states to be Delaware, Massachusetts, New Jersey, New York, and North Dakota. All of these states had rates of divorce about 6-7% per 1,000 people, compared to 31 states that have above a 10% rate.

The Director of the National Center for Family and Marriage Research at Bowling Green State University in Ohio, Susan Brown, suggests that the data about less divorce in New Jersey has a lot to do with the demographic trends for first marriage there. Long-term marriages are more likely when couples marry later, have a higher level of education, and are more financially stable. In New Jersey, it seems that more people are delaying marriage until they are more ready for it and have fewer risk factors for divorce.

According to American Community’s 2011 survey, 23% of Americans married that year were between 18 and 24 years old. In New Jersey, only 13% of newlyweds were that young. The same survey found that of people 31% of Americans married in 2011 had a bachelor's degree or higher education. In New Jersey, this figure was 42%.

Public Policy professor Andrew Cherlin from Johns Hopkins notes that the divorce rates tend to be lower in the northeastern states because of this trend to marry later and at a higher educational level.

Recessions tend to have a mixed effect on the rates of divorce. While job loss, unemployment, bankruptcy, foreclosure and other economic instability are bad stress for couples, it may be that some couples do not separate or divorce because they cannot afford the additional expense of setting up and maintaining two households, plus legal costs.

Other writers wonder if other factors make divorce in New Jersey less likely. There are many foreign-born residents, which may reduce divorce rates. Unemployment is not as high in New Jersey as some other states. Perhaps the stress and impact of Hurricane Sandy will impact the next set of divorce statistics. Some question whether married people in New Jersey have a lower happiness set-point than those in other areas, or if they are settling.

At the very least, these national statistics about trends in marriage and divorce give us an interesting dialogue about that factors that make splitting up less likely. For my own daughters, and all the young people I work with in counseling, I still hope you will take your time. Don't partner too early. Finish your education and get financially stable on your own if possible before taking on the huge commitments of marriage and family. Be sure to get some pre-marital counseling so you know how you will deal with decisions, religion, parenting, finances, family, and sex.

Your core self isn't truly developed until close to age 30, so if you marry before then, it's anybody's guess if you will still be a fit with your partner later on. Give yourself the best chance at marital happiness and success that you can, because there are plenty of challenges you can't control in life.