How to Help Your Adult Child if They Have a Mental Illness

Every month I receive emails from parents (just like you perhaps) of adult children who have serious mental illness. You tell me many things, but the one on which you all agree is how painful it is to see your son or daughter in anguish yet at the same time not accept help. She’s angry with you, blames you, yells at you, yet needs your help desperately. You tell me how helpless, how lost and how hopeless you feel. It is a journey of great pain. But there is also great hope. I know. My parents were on this very same journey. For 5 years, I was in and out of the hospital because of psychotic episodes. I not only refused help but refused to accept the diagnosis of bipolar disorder with psychosis and generalized anxiety disorder.

“H.O.P.E.: Hang On Pain Ends” ~ Unknown

There are myriad reasons a person refuses treatment. They can (and for me did) include: denial, anosognosia1 (ie: the inability to recognize you are ill), shame, emotional overwhelm, stigma, lack of access to good treatment, insufficient education about mental illness, fear of change and lack of skills or support to move through change.

But there are steps you as a parent or support person can take, at least initially, if you are facing this situation. The suggestions may help you feel a little less powerless, a little less alone and a little more hopeful.

Know this: change is inevitable, recovery is possible and your adult child can get her life back; maybe not the exact life she had before she got ill, but a life worth living.

"Recovery is a way of living a satisfying, hopeful and contributing life, even with the limitations caused by illness...(it’s developing) new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness." ~ Bill Anthony

I’m not a parent of someone who has a mental illness. But I am someone who saw what my parents went through as I struggled to make sense of my own psychiatric disorders and find my road to recovery. (On this  previous post on my Psychology Today blog my dad offers advice to parents trying to help their adult child. This post describes strategies to help someone with a mental illness who doesn't want help.)

This is not only your adult child’s journey, the entire family embarks on it together. Mental illness becomes a whole family condition – chaotic and frightening. You know this.

But I also know this:

• You can do it. But you can’t do it alone.
• You can’t change your loved one. But things will change.
• Recovery (for the adult child AND family) is possible.

Here are seven suggestions to help make your current difficult situation a little more tenable.

1. Stop the power struggles with (or judgements you have) of your daughter or son. How do you do this? Listen to what your adult child is telling you. Don’t correct her, don’t try to change her or convince her. Just listen. Summarize what you hear her saying. Just because you are listening and reflecting back what she says, does NOT mean you agree with her. It does mean you are doing everything you can to understand her and her experience. Like anyone, someone with mental illness wants to be heard, wants to be understood. And frequently for someone with a mental illness, this doesn’t happen. Really understanding what she is feeling (ie: empathizing) can rebuild trust. It’s not easy. Believe me. But it can build bridges where bridges were previously imploded. Check Dr. Amador’s website and book (I Don’t Need Help! I’m Not Sick) for more instructions on what it means to empathize and actively listen.
2. Remind her (and yourself) you are both on the same team. But don’t just tell her, show her. Show her by working collaboratively: listen without an agenda; partner in decision making, set boundaries when necessary. Telling your adult child what she needs, what she should do, or what YOU know will help her will only make her dig her heels in more. You've probably already experienced this.
3. Recognize you might not be the best person to help her. It may not be fruitful to say you are on the same team. Sometimes there’s too much animosity, so much trust broken (on both sides) that your adult child only sees you (at the moment) as an enemy. Because of the current (yet temporary) volatile nature of the relationship it may be best to find out who, if anyone, she does connect well with. Is there someone who she will listen to; who she does trust or confide in? That person needs to be someone who has her best interest at heart (obviously), not someone who enables her or aggravates the situation. For example, not a person who she drinks with or who encourages her to believe you are an interfering parent. A close friend, a trusted Uncle, a former teacher she admires, are options.
4. Ask your adult child what she needs to feel safe. She may not know. She may not be able or want to calm herself down in order to express what she needs. It may be about helping her learn to calm her anger. Is she willing to go to counselling , not for mental illness but to sort out some life dilemmas; to solve some issues. Even if she blames everyone else for her problems, you can mention counselling can be a place to talk about that. And with that, a good therapist can help her gain insight and learn problem solving skills.
5. Sometimes the only thing left to do (but also the most important) is letting her know you are there and not going anywhere. When or if she wants to reach out, you'll be there, without judgement, with love and curiosity. The most important element for me was to know that my parents, even as I pushed them away, loved me unconditionally, and would be there. They might not like how I was behaving, but I knew they loved who I was. Even as I refused their help there was a part of my consciousness, a part of my soul that heard them, that registered how much they cared. This is true for your son or daughter.
6. Set boundaries. You do not need to nor should you tolerate verbal or physical abuse (nor should your adult child). You may have to say 'I love you. I'm here if you want help, but I will not allow you to berate me (yell at me, swear at me, threaten me etc)'. It might be about giving her space, you taking space or telling her she needs to leave. Always ensure she is safe and not at risk of suicide or harming someone else. If she is at risk, then taking her to the emergency ward (or in the worst case scenario, calling the ambulance or police) will be necessary.

For further excellent strategies watch Dr. Lloyd Sederer’s Chief Medical Officer, NY Office of Mental Health video ‘When mental illness enters the family’. 

1. Don’t do this on your own. Make sure YOU get help. The old airplane emergency adage applies: take care of yourself first, before you help someone else. You are no good to anyone if you are overwhelmed. There are other families willing to help and talk with you. Find a support group for parents of someone with a mental illness. The expertise in those rooms is invaluable, life saving even. Check with your local mental health clinics, your doctor, your community resources and local mental health organizations (DBSA, CMHA, SSC, NAMI)2. These connect you with people who have similar challenges, link you to community resources, and offer you emotional support and encouragement. The resources and support groups are usually offered at no charge.

This path may be long. It may be arduous. But it gets better. It’s not your fault. There is help. There is hope. You are not alone.

Please email me with your own strategies and feedback about my suggestions. I’d like to put them into a future post (anonymously of course, if you wish) because there is strength in numbers and wisdom comes from diverse and multiple perspectives.

? Victoria Maxwell

1. If you’d like more information about anosognosia please watch this video which includes a talk from Dr. Xavier Amador, an expert in the area.
2. Depending on where you are located, check with your local Depression Bipolar Support Alliance (DBSA) or National Alliance on Mental Illness (NAMI) chapter or if you are in Canada: your Canadian Mental Health Association (CMHA) or Schizophrenia Society of Canada (SSC) branch. The SSC helps families dealing with ALL types of mental illness.