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Caregiving and living with those who have mental illness

Greg Smith, MD
Patient
January 12, 2011
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Your mother has been up all night.

She has Alzheimer’s Disease and now it has progressed to that inevitable stage of the dementing process where she is paranoid, agitated, and confused. She fidgets and paces and walks all day. She gets out of bed multiple times each night. She has gone out the door into the back yard and tried to escape to the street, wearing only her night clothes. Sometimes she doesn’t even know who you are, but you are solely responsible for her ongoing care. You are losing weight, not sleeping well yourself, not able to concentrate, have no interest in your hobbies, and are thinking that it would be easier if both you and your mother died and this was all over.

Your son used to be a strapping, handsome lad with tousled brown hair, deep brown eyes and a quick, winning smile. At nineteen, he won a scholarship, was making good grades his first year in college, and had many friends. Now, he is back home with you. He quit studying, thought his professors were all out to see him fail, and alienated all his friends. He sleeps all day and plays video games all night. His face is sallow, his clothes hang on him, and he drinks too much. He tells you that the end of the world is coming soon. The voices in his head have told him so.

Your spouse is getting worse. The daily six pack of beer has turned into a case. You suspect he is buying marijuana or maybe even cocaine downtown, something he has never done before. His mood is erratic, swinging from angry and mean to insanely happy about everything. He has started fifteen different grandiose projects that will change the world, but can’t manage to take out the trash. He hasn’t hit you yet, but the arguments are more heated and they come much more often than they used to. You knew about his illness when you married him, but this is much worse than you bargained for. You’re frightened, and you wonder if you need to cut your losses and get out. You’ve made a call to a local shelter for battered women, and you’ve hidden a packed suitcase in the closet. If it happens again …

Do any of these scenarios ring a bell? Are you or someone you know a survivor, a caregiver, a person who lives with someone who suffers from some kind of mental illness every day? If so, you may be at risk. Your own mental health, physical health, and well being may be in jeopardy. If you are depressed, feeling suicidal, not sleeping or eating, missing days at work, or just feeling like you’re close to giving up, what can you do? There is help.

Your own family doctor can be a great asset. See him or her and ask for help in finding resources, local meetings or support groups, or even for help in treating your own depression or anxiety that commonly comes from the stress of being a caregiver.

Clergy can also be helpful. If your spiritual tank has run dry, speak with a trusted priest or pastor or minister who can listen to your concerns and guide you in the right direction.

Counselors, therapists, psychologists and psychiatrists may also be able to help if the stress of caring for someone you love has lead to your own mental health issues. This is not uncommon, and it is certainly nothing to be ashamed of. Seek help for yourself so that you may continue to provide the support for your loved one. You can’t help someone else if you’re hurting and broken yourself.

Caregiving and living with those who have dementing illnesses, mental health problems and substance abuse or dependence are hard work. Sometimes love and good intentions are not enough. Sometimes you need help yourself.

If you need it, get it.

Today, please.

Greg Smith is a psychiatrist who blogs at Shrink Rapping.

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Caregiving and living with those who have mental illness
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