“Are they a threat to themselves or others?”
It’s the question you will be asked if you are trying to get help (through involuntary commitment) for a loved one with a mental illness. And in many states, provinces and countries around the world, it’s your answer to that question that will determine whether help will be forthcoming or not.
For a person’s illness to progress to the stage of potentially harming themselves or others is very serious and obviously not desirable, yet the flip side of that coin is that if someone hasn’t reached that stage, and won’t voluntarily accept treatment, there is little a family member can do. It can be an excruciatingly difficult and heart-wrenching position to be in, as I learned some years ago.
The symptoms of my mother’s mental illness started when she was in her late teens. She received her first treatment for schizophrenia when she was 73. See, her primary symptom was paranoia. How do you get a super-duper paranoid person to accept that you’re acting in their best interest when you prod them to seek mental health help? As Wayne Campbell says in the very worthy 1992 film Wayne’s World, “It might happen. Yeah, and monkeys might fly out of my butt.”
Recently, the family doctor who treated my mother for many years said Mum was the most difficult patient she’s ever had, and she felt terrible because she wasn’t able to help her. She tried, I tried, my sister tried. And then we gave up and went about looking after ourselves, which is what you have to do once you’ve spent all the energy and resources you’ve got and find yourself no further down the road.
I also talked with a woman recently whose mother has schizo-affective disorder. Her mum was in her 60s when she was finally treated, but it was only after she’d taken an axe to their dining room furniture and started setting fires in the back yard. She’s now under court order to take her medication, but still doesn’t believe she has a mental illness.
Mental illness can go untreated for a lifetime.
There are reasons behind the laws: individual freedoms require protection and people have a right to refuse treatment, for any disease. Unfortunately, the reality is that family members end up having to stand by as loved ones end up in marginalized living conditions or even homeless on the streets. It’s estimated that one-third of the homeless population in the United States have an untreated mental illness.
I don’t want to discourage anybody from trying to help their loved ones who have a mental illness. Yes, absolutely, educate yourself about the laws and options in your home state or province. Work with the resources that are available to you. Have a plan. And if none of that works? Well, then you may need to set some boundaries in your relationship and take care of yourself. Do not feel guilty about it. Really, there’s no point in two people (or more) being sick from the situation, instead of one.
If you have to temporarily or permanently let go of a relationship with someone you love dearly, you’ll likely find yourself grieving the loss. Here is a recent article by Jennifer Boykin with some thoughts on the journey of moving through tragedy/grief and coming out stronger.
Incidentally, at age 73, when my mum finally received treatment for her mental illness, it was because she developed dementia on top of the schizophrenia. She was committed because she couldn’t remember how to access her money to buy herself food, not because she was violent. If the dementia hadn’t come along, she’d probably still be holed up in her apartment with the closed blinds and the triple-locked door, and we’d still be estranged.
I’m grateful she’s finally receiving help, but I can’t lay claim to any credit for that outcome. The bonus is that it gave me an opportunity to help out with her care, although my butter cookie contribution may be as much to blame as the anti-psychotic medication for her recent weight gain. Because I’ve spent the previous years making sure my own mental and emotional health were in order, I’m able to participate from a place of strength and compassion and with a clear head and heart. There’s a good reason why the safety videos on airplanes tell you to put the oxygen mask on yourself before attempting to help others.
You have written a warm, touching, and poignant blog about a situation that faces so many in life. It’s never easy. There are no solutions. But, in the end, the human spirit always endures and prevails.
Thank you so much, Caleb. And the endurance of the human spirit never fails to amaze me when I read stories of people’s plights around the world.
Thank you for sharing your life experience. People need to learn from it. I also thank you for the sharing the link to the other post: Broken Open to Greatness.
Hi Carolyn! Thank you for stopping by. Yes, I thought that other post — Broken Open to Greatness — was quite helpful, too. I can never get too many ‘reminders’ on good ways to reframe my thoughts.
Thank you for writing this article. The same situation holds true for illegal drug use. My son was addicted to Meth and we went through many of the same problems. After several detox programs that did no good, we cut off all contact. We are the lucky ones. After years of abuse, he kicked the habit himself and is drug free after seven years.
The hardest part was saving ourselves and the guilt. We discovered, you can’t let them drive you crazy or there will be two crazy people.
Stephanie, thank you for sharing your experience. I know someone who went through the same thing as you with their daughter. It’s a very difficult situation, and I’m so glad your son is doing well.
You make some important points. How hard it is to get treatment for someone who is paranoid, how mental health can be untreated for a lifetime, and how family members have to be sure they are taking care of themselves! Great post, i cannot wait to read the book about your mom.
Thank you, Jodi! xo
Laura, I so admire the honesty of this post and I so admire you. This is such important information. Thank you so very much for sharing your story and your mother’s story. I shall RT this often.
Jo-Anne, when I get such wonderful support from people like you, it feels good to share my story! Thank you, thank you, thank you.
My respect just keeps growing for you Laura. xo
Cyber hugs, Kendall. Thank you.
A sincere account of the flip side of treating someone with mental illness. It’s difficult for family to just watch a loved one decline while s/he refuses – or feels incapable of – seeking treatment. From what I understand, it’s often the illness that makes a person refuse help – it’s a vicious cycle. I came to that same conclusion a few months ago, as your perspective is applicable to all illnesses and conditions, not just mental illness. Thank you for posting such an insightful and honest article. As a caregiver to 2 family members & a mother to a teen daughter, I have to take care of myself… and I do!
Yes, agreed, it really is applicable across the spectrum of illnesses. Thank you for your comment, Lynn. I stopped by your CaregivingCafe.com web site and it looks like a very good resource. And I’m glad to hear you’re practicing self-care given that you’re a busy caregiver yourself!
Very important points here, Laura. Great post! Having been caregiver for both aging, sickly parents and a difficult spouse, I can testify how hard it is to see to your own well-being. Usually, it all falls to one person in the family because everyone else is so willing to turn a blind eye. From a poem I once wrote:
“when we find
what is actually required
to serve the hurting,
it’s too high a price
and beautiful excuses are
available, darlings,
in such ugly
abundance”
Thanks, Jo. I’m so very fortunate to have a sister who is a partner in all the family matters. It almost works better because it’s just the two of us. I have a friend who has five siblings and there’s a lot of conflict over the caregiving. And thank you for including part of your poem. I can only imagine what you were facing when you wrote it. xo
The similarities of the situation you describe and that of having family members suffering from some sort of addiction are extremely similar. Coming to grips with the concept that you can’t truly help someone who won’t admit they have a problem is, for me, the most difficult part of the whole scenario.
Hi Tim! Thank you for stopping by. I agree. And I also found it was hard to dispense of the feeling of “well if I was worthy and good enough, they would get help because they must know how important it is to me.” But really, when someone is in the irrational grip of illness or addiction, they don’t understand or accept the external impact they’re having, either.
Wow. What a great honest post. It so well describes what many of us go through when dealing with an issue like this. Whether it be a parent, spouse or child, it’s so hard to deal with, and harder still to not feel guilty and take blame on oneself.
Thank you, Lee. I appreciate your comment. Hopefully you haven’t had to go through toooooo much of it yourself.
This is a lovely and touching article. I’ve spent the last five years in the position of the mental health professional who has to tell the family members that their loved one doesn’t meet that criteria for involuntary treatment. Sometimes I’ve thought the law is right to protect the individual with mental illness from being forced into treatment. At other times it has been absolutely heartbreaking and seemed deeply wrong. And, unfortunately, I think you’re right that sometimes all you can do is create a boundary and step away in order to protect yourself and the rest of the family. Thanks for writing this.
Kerry, thank you for the work that you do. Wow, you must find yourself in some terribly difficult and emotional situations, and I hope you receive grace and respect when you have to deliver information that isn’t what the families wanted to hear. I’m glad you stopped by to read, and I look forward to seeing your book come out next year.
The oxygen mask analogy is very relevant and it applies not only to this topic but also to finances and other aspects of the family unit. Those that have the decision-making power in the family and provide for its support have to take care of themselves first, because if they go the family goes. It’s a tough situation but sometimes it is often “do or die.”
Yes, true enough, Rolando. Thank you for your comment.
What perfect words, Jo, what beautiful, perfect words…
I concur!
I have a friend who went undiagnosed for years. Finally, she found medical attention that gave her an answer and today she leads a good life and acts as a advocate for teaching others about bipolar disease and its treatment. I might add, the Canadian system is remarkable in helping those with mental diseases – so humane and practical.
I’m glad your friend received help, Christina. Speaking of good systems, when I spoke with my mum’s nursing school roommate, she mentioned Margaret Trudeau, who has bipolar. In Trudeau’s book, she wrote that it was her belief that in order for a person with a mental illness to successfully manage it, they needed to have one consistent advocate/medical professional in their life over the long haul. I think there’s some truth to that. Bouncing around through different doors and doctors leads to so much fragmentation in treatment and support. I don’t know how the Canadian system is doing with regards to coordination between its different agencies, but I’ve heard that that’s a challenge area.
Thank you for reading, Christina!
Laura, I cannot imagine how heart-wrenching this life experience has been for you. I’m glad to hear that she’s getting help — whether she truly wants it or not. And I love your comment about the oxygen mask. How true. You have to take care of yourself, even if it means distancing yourself from those you love. Wonderful post.
Thank you, Diane. Hugs to you.
From the bottom of my heart, thank you for posting this. My mom has exhibited symptoms of mental illness her whole life and ended up drinking to cope. Any symptoms of mental illness are now masked with alcoholism & she is written off as a drunk. We are cuurently estranged as my younger sister is showing the same symptoms but my mother’s paranoia and her attachment to her is stopping her from getting the help she needs. I hung out as long as I could but now I’m afraid of what my relationship with them is doing to my marriage & daughter. I also live in fear that the illness will eventually descend upon me. If I have a bad day I question my own mental health. Just wondering where you find support, if there are any online groups or books you recommend.
Thank you again.
Sarah, first off, I am sending love to you — wherever you are, state or province, it will find you!
Whatever decisions you make about your relationship with your mom and sister, continue to hold love and compassion for them in your heart and go forward from there. You may be estranged, but they’ll always be in your heart. I’m sorry to hear that your mom hasn’t received help, and I understand how difficult it is to be in your shoes, trying to hang in there, like you said. And I’ve definitely had days where I ‘checked myself’ for symptoms like my mum’s!
Finding the right support is incredibly important and I’m glad you’re looking into that. I’ve been lucky to have a very supportive older sister, good friends, and now a supportive husband. I worked with professional therapists for years (and even took my mum to a session with me back in 1992 so that my therapist could see what I was dealing with). I’ve found therapy/counseling to be a giant help. Life changing, actually! I’ve not used any online support groups or in-person groups, but many organizations have them (here’s a web page with some resources: http://www.mentalhealthamerica.net/go/find_support_group). That’s just a personal preference of mine, though — to talk to someone one-on-one and face-to-face. I do read some good blogs and web sites. Two are http://www.healthyplace.com/ and http://healnowandforever.net/ (this is Jodi Aman’s site, who commented just above). I also try to use techniques like meditation and mindfulness breathing to help me stay in the present and not fret too much about the past or future. The books that I’ve read that have been most helpful are focused on the same type of thing — staying present, giving grace to yourself, self-acceptance, self-love.
I hope that you’re able to find the support you need as you travel this journey. And don’t forget to give yourself credit for the incredible strength and resilience that have carried you this far. Wishing you the best.
Even when treatment can be given early on to someone with mental illness, the highs and lows of finding just the right dose of medication can be as bad as the illness itself. My bipolar mother has been hospitalized nearly 20 times over the course of 38 years (starting in 1974 two years before I was born) Even without being admitted to the hospital in a long time, she often has bad spells as she cycles through severve emotions when life throws a curve ball her way. It’s a long story and one I come to terms with each and every day of my life. Thank you so much so sharing some of your story.
And thank you for sharing some of your story, Jeri. That’s a side of the story that I would like to write about as well — the ups and downs of treatment over the years. Medication effectiveness changes as people’s chemistry changes and just being on medication and having psychiatric support doesn’t ensure a smooth ride. Mental illness is terribly difficult to live with and around, yet affects more and more as the years go by. I hope that continued research helps to uncover some ways to have more effective treatment the earlier it is caught, etc. etc. Thank you for your support on this journey, Jeri, and I hope I can reciprocate.
Sadly, we ask people who are incapable of making logical decisions to make good decisions regarding their health care. If they could make logical decisions, they wouldn’t be mentally ill. I hope the day will come that family members will be able to help choose their treatment even when they resist it, which they almost always do. The only time my mother ever had help is when she was committed. Nice post, Laura!
Very true, Mary. I understand the need to protect individual rights, but I think there must be a way to come up with assessment criteria that forces people to accept help outside of the criteria that they’re “a physical threat to themselves or others.” So many people are living marginal and diminished lives because they won’t accept treatment.
People often take their mind for granted. They don’t understand how everything they are, do, feel, and believe in is nothing but electrical signals and the biochemical changes they induce on a vast array of networked cells. And like you mentioned Laura, this network and its set points change with time. The chemistry of the brain when you are 20 years old is different from that at 40, and 60. Modifications in this network can alter a person’s personality, beliefs, emotions, etc. It is really amazing that we are able to treat anything at all by such crude methods as administering a handful of chemicals to someone.
And who’s not to say that a person’s brain chemistry changes daily? At this point, there’s very little that’s scientific about the treatment of mental illness, so it is amazing that there are some stunning successes. And then for others, medication doesn’t work well at all. Thanks for reading, Rolando.
Wow! It’s been a very very long time since I have seen your mum. Thank you for sharing the picture!
Even though my uncle was committed at an early age, it did take different treatments, medication and more time committed before he had the proper diagnoses & treatment. Luckily he had a social worker who was his advocate.
The advocacy part is soooo important. I’m glad your uncle had someone who worked with him over the years. My mum always refused that help — they’d go to her door and she wouldn’t open it, and beyond that attempt, there wasn’t much else that could be done.
My mum has put on a few pounds (okay, 35 pounds) from her anti-psychotic meds, but she’s such a cutey now!
your mom looks wonderful! I just want to give her a big hug!
Aw, thanks. I’ll gladly do that for you next time I see her. 🙂
Thanks Laura for your great article. I have had a mother who all her life has had untreated mental illness. I am 52 and her mental issues are still front and center. It is so hard to deal with. When someone has cancer or heart condition they seek help and get treatment. My mother will have no part of it. It is the other peoples fault.
I just went to visit her with my two kids and it was a nightmare. I pray and I am looking for ways to help me deal with this.
Always nice to meet another Laura — there are too few of us in the world! Thank you for sharing your story and I’m sorry it’s not going better for you and your family. There really is little one can do when the person won’t accept help or treatment. I paid extra attention to building a strong support network around me, and waited for a change in the situation that would precipitate her receipt of treatment (unfortunately, that was the onset of dementia, but she’s still in a better place than she was before, in my opinion). I hope that something changes to bring about some improvement for you and your mother, and in the meantime, give yourself a pat on the back (or maybe a spa day) for having made it this far!
Laura, beautiful, meaningful post.
Thank you, Marlena. And thanks for reading.
Wow – what a journey. Mine is the opposite. I am so mentally ill and have known it all my life, but I just can’t get the proper help. Canada’s health system has much to be desired. No beds, no long tern in patient care. I am acutely aware that I am sick. You are a good daughter. I wish I had a mother who would fight for me. You are a soft place to land, I can tell, but that’s no runner prize for life without traditional mothering.
I’m so very sorry to hear that you’ve been unable to get the help you’re seeking, and I admire your forthrightness. Thank you for your kind words and your comment, and I hope that some good resources come available to you soon. The bed shortage issue is present here in the U.S. as well, it seems that things swung too far in the direction of outpatient care when that movement started in the late 1950s/early 1960s. Best to you.
I just can’t go around apologizing for my mother’s inappropriate behaviour any more. And now I see the light. She is ill – and I have worked around it – protected it – excused it.
She has breast cancer and I am caring for her now and she asked why I don’t get home care. I said “because they would quit after the first day – because of the way you treat people”. When I said that… I finely understood what I was dealing with. I am grieving for the loss of someone who maybe never existed in the first place.
Bonnie, you’re an incredibly strong person to be caring for your mother despite her behavior and mistreatment. You absolutely don’t need to apologize for her behavior. The way she acts toward others is no reflection of you and your character. And working through this kind of realization is very much like a grieving process, so be kind to yourself throughout. Thank you for sharing your situation, and I wish you the very best. xo
Thank you, it’s now 2021 and this morning I just found your blog. Are you still writing it. My now 35 year old son suffers from undiagnosed mental illness in addition to drug addition. He is a wonderful young man who is now homeless and I grieve for the son who is no longer apart of my life. It’s been difficult trying let go and not feel guilty.
Mary Ellen, I’m very sorry to hear this. It must be so painful. Those two things together — mental illness and addiction — make it a tough road in every sense: for treatment, for recovery, for relationships. I hope you’re able to access the support you need to help you through this, because you shouldn’t have to go through it alone. It’s a big thing. And I really applaud you for setting the necessary boundaries to maintain your own health.
I’m not writing on the blog much anymore, no. I’m still writing, but mainly for other places and publications now.
I’m sending you healing energy and love for 2021. I sincerely hope that things improve for your son, and I think that when/if he turns a corner and a solid opportunity comes up for you to see him again and offer help or support in some way, you will know. Until then, please take care of yourself. – Laura xo