Persistence and resilience only come from having been given the chance to work though difficult problems. - Gever Tulley
Living with a loved one who is experiencing negative symptoms of their mental illness can be a challenge, and cause us to loose our cool as well. Depending on how long a loved one has been in a state of agitation we may be feeling overwhelmed and close to burning out, as many times there are stretches of days when a loved one experiences those negative symptoms. Without taking the proper breaks away for regrouping and replenishing our reserves we place ourselves in danger of responding in a manner which can exasperate a situation verses diffuse it. It is best to remind ourselves that our loved one isn’t choosing this behavior, at least not the majority of the time, and that the behavior is the result of the mental illness.
While being there and supporting is our main concern we must also remember our health is also very much a part of our main concern. If we spend too much time under stress it will start to take a toll on our bodies and our minds. So many caregivers wind up in the hospital with secondary patient symptoms as a result of the neglect of their own “self-care”. We don’t always feel like getting dressed and leaving the house, especially after a stint of arguing and negotiating with a loved one who may not want to take their medication or who may be non-compliant.
As a mental health family caregiver we spend a great deal of time, especially in the beginning of our journey with a loved one who is not having much success with the “treatment program” as it takes a while to find one that is effective, navigating the waters of non-compliance. Non compliance means a loved one chooses to no longer take prescribed medication or attend therapy sessions with their psychiatrist or psychologist. A loved one may start to feel better after taking medication and attribute it to them being healed of the illness and stop taking the medication. A loved one may return to self medicating. There are a host of reasons for non-compliance and during the time when we are in the throes of battling with a loved one trying to get them to take medication, go to therapy, or get some rest the reason is the least of our concerns. We just want the tug of war to be over.
One of the most important things to remember is you will never win the argument with a loved one who is experiencing negative symptoms because they are not in a state of being rational. Whatever they are experiencing is very real to them and you telling them it’s not doesn’t make it so.
Our jobs as a mental health family caregiver is to anchor our loved one in reality as they are being pulled in various directions by psychosis, paranoia, mania, or depression. They may not see it’s not the world against them or that everyone thinks they are a burden, and therefore we remind them how much they are loved, and that family and friends are supporting them on the journey and understand how difficult it is for them.
Telling a loved one what they are doing is insensitive and cruel at the moment when they are behaving in an irrational manner only serves to agitate them more. Remind yourself it is not your loved one behaving badly on their own but the illness that is ravaging their mind and body.
When painful and insensitive things are said remember that you have a choice to respond or not respond, to take to heart what was said or to ignore it. Not responding doesn’t mean it doesn’t effect you it does mean you choose how it will affect you if at all. When a loved one stabilizes they are able to reason many times and understand that behavior during a negative symptom may have hurt their family or friends and at that time you need to be honest about how you feel. Sometimes they may wind up with guilt as a result so it’s important to remind them that you love them and understand their behavior is the result of the illness, but at the same time it is important for the loved one to understand their non-compliance effects more than just themselves. Sometimes this is easy and other times it’s not, it depends on your loved one.
What can you do when a loved one is having negative symptoms of their illness?
Make a note of what the behavior(s) are. Be very observant. Listen to what they are saying, watch body language. Be mindful of what makes them calmer if anything at all.
Discuss ways to create spaces for your loved one to go where no one will disturb them should they need time to decompress or deal with the negative emotions they may be experiencing, after the first episode after the diagnosis.
Remind yourself they are not acting out of malice but because they are experiencing symptoms of their illness and are not always able to control their behavior.
Look around to see what could have triggered their behavior or mood change. Be sure to make a note of it. Ask your loved one after they are feeling better what happened just before they got upset. Make a mental note and document it in your journal.
If you are in public see if you can convince your loved one to walk with you, studies have shown walking and listening to your loved one to be an effective method of diffusing negative mood or behavior for them.
Take a pause break by leaving the house, going into another room, or not responding to your loved one.
Speak calmly and let the loved one know you understand they are not feeling well and what would they like for you to do for them.
Don’t agree with irrational thoughts or arguments, only say, “I can understand why you would feel that way.”
Provide an environment that is calming like turning on nature sounds, the sound of a fan, or adjusting the temperature in the house.
Just sit and listen to them.
After the event has passed be sure to replenish your reserves by meditating, taking a long walk or going out to visit friends.
We don’t have control over how a loved one reacts or responds regardless to what we are accused of in the moment of the negative symptom. Don’t internalize the accusations from your loved one. Remember they are not themselves at that moment. Keep a journal so that you can write down what you feel in the event you are not comfortable talking to friends or family about your feelings. Investing in a good therapist or in joining a good caregiver support group.
Remember this is not about perfection but about making it through the day and through the next day , and the next day, and eventually your response becomes immediate and you learn how to help your loved one through those very difficult times.
Most importantly remember violence is never an option. You should never be hit or attacked by a loved one. That is not okay. If you are being hit or intimidated you don’t have to live that way. Ask for help. Leave and find a place of safety if necessary. Never stay in a place where you are being abused.
I am a mental health family caregiver and survivor myself and always willing and able to help you find your way through what can be a very difficult time. I’m not a psych professional but I do have over 4 years in the support of someone with a mental illness, and I have learned to cope with the negative symptoms of depression and anxiety. Drop by our contacts page by clicking here and fill out the contact form, or use the phone number there to call. If you would like assistance with the care demands of your loved one register here for a caregiver course.