My family member is acting strange...
Many people with undiagnosed illnesses do not know that they have an illness and may not believe that they do. If you notice that a friend of family member is acting strange, making accusations or assumptions about their mental health will often make them defensive. With that said, everyone wants to feel like they've been heard and simply listening, asking questions, and having empathy for whatever they may going through in life may be the best answer. While you are not their therapist, starting the conversation and listening to what they have to say may create an opportunity for you to gently suggest that they find more appropriate help if it's needed.
What is a mental health crisis?
Imagine you're shopping with a friend with diabetes and she says her sugar is low. In this situation she realizes so long as she finds some form of sugar, she'll be okay. Unfortunately, on the way to find a restaurant you find yourself stuck in traffic, and you notice your friend has begun sweating perfusely, shaking, and is very confused. You identify that she has gone into diabetic shock and fear for her life so you call 911. A mental health crisis is an emergency situation similar to her shock where the mental status of a person has given you reason to fear for their life or someone else's. You may notice excessive mania, depression, paranoia, or withdrawl during or prior to a crisis.
This is a crisis, what do I do?
Call 911. Learn from our first hand mistakes, you are not exempt from danger in a mental health crisis. While we understand you do not think your loved one would hurt you and probably does not want to hurt you, in a crisis situation their illness may want to and can. Some areas (such as here in Harford County, Maryland) have resources called Crisis Intervention Teams. These officers are police who have undergone extensive training to learn about these brain illnesses and how to mediate a mental health crisis situation efficiently and effectively. Police response can be traumatic for both the person experiencing a crisis and their family, but these officers work to contain the situation respectfully and find the most appropriate form of help for the consumer. For a CIT officer to respond, all you have to do is ask for CIT or Crisis Intervention when you call 911, if an officer is available they will be the first responder.
My loved one was discharged, but I don't think the meds are working.
The first doctor you meet will likely not be the last. Many people navigating the mental health system end up seeing an array of doctors, and recieve a variety of diagnoses before they find a treatment team and medication that is effective for them. Be sure you are happy with your treatment and remember that a second opinion is sometimes life saving. In our experience the most effective doctors have been those who engage in research or an academic setting. Not that private physicians or hospitals don't care, in our experience doctors working with patients partaking in their research seem more invested. Researchers need to learn from their patients and want to see their research succeed just as much as their patients need good care. Insititutions like the University of Maryland and National Institute of Mental Health pay patients who qualify to participate in their research. However, often these studies require a clean criminal background. Whoever you work with, we strongly advise that your loved one sign a disclosure that their doctors may speak with their caregiver about their therapy and treatment foregoing their privacy via the HIPPA rules, and that a patient or caregiver speak with their doctor should there be no change in their cognition or behavior. These simple guidelines keep everyone on the same page, opens the lines between patient, caregiver, and physician, and begins the search for effective treatments.
Should I encourage them to get a job?
Different people respond differently to different illnesses and treatments, but for most people stressors like work, school, and major life events can make their symptoms worse. With that said, some illnesses are more manageable than others. For example, it is more likely for someone who regularly attends therapy sessions and has been managing their major depressive disorder with an effective medication to be able to be successful at work than for someone with treatment resistant schizophrenia or bipolar disorder. Attending work and school is a serious commitment and stress factor that should be considered by their treating phsychiatirst or therapist. Work will be feasible for some people but others may have to undergo rehabilitative therapy before they will be able to hold a job. Job or no job, a good treatment program will keep them working towards better mental health and functionality whether that means finding more effective treatments, keeping journals, learning to identify their stressors, or even taking a college class or completing a job application. Remember that these treatments are work for them and as they move through the phases it is likely they will need a strong support system no matter what.
Tips for Families
Helping someone cope with a mental illness is not always an easy task. Requiring copious stores of empathy, understanding, and forgiveness, coping with a loved one with an illness is sometimes just as difficult as coping with the illness. While a strong support system is key to efficient and successful treatment, it can be difficult to distinguish when tough love is the best medicine. Likewise, balancing other professional, family, and monetary obligations can be stressful when acting as a caregiver for someone with an illness. From finding local resources, making for efficient hospital visits, and navigating "the system" to household and family coping skills as well as working through crisis situations, we've been through it and in many situations have helped others through similar events. Please be aware that we are not licensed mental health professionals, and any significant changes to your loved one's care should only be done after consulting a licensed professional.