Everyone agrees with the huge role of the family in the life of any person. When asked what a family is, everyone answers differently. The following definitions are often given: “a family is a group of people living together and leading a joint household”; “Cell of society, a form of organization of everyday life”; “Relatives living together with a common budget”, еес. Any of them is correct and each reflects certain conditions of the family’s existence, its characteristics. And at the same time, everyone agrees with this definition: “a family is a socio-cultural system of an adult and one or more adults or children, bound by the obligation to support each other emotionally and physically and united in time, space and economically.”
Family functions are spheres of family life that are directly related to meeting the needs of its members – emotional, spiritual, social, household, medical, etc. Some of these functions remain unchanged throughout its existence, and some change over time.
The family encounters the disease earlier than the doctor – even at the stage of pre-symptoms and the first, so-called latent, unclear symptoms. The reaction to the onset of the disease depends on the severity and speed of its development, perceptions of it and prejudices. In acute – sudden onset, the period of uncertainty in terms of establishing a diagnosis is small. With its slow development, this period, which is very disturbing to loved ones, can stretch for months or even years. For the first phase, anxiety, concern, rushing in search of the most competent medical assistance are typical, although hostile attitude towards doctors, accusation of bias and inattention is possible.
The moment of receiving information about the presence of a mental disorder is often the most difficult for a family and is most often perceived as a bereavement. For this period, the most characteristic reactions are disbelief, denial, shock, guilt (“not saved”). At this stage, she needs objective information from specialists, in which the nature and characteristics of the disease must be clearly presented. At the very beginning of the disease, the duration of its treatment and the prognosis are still unclear. However, already at this stage, the family should know the symptoms of the disease, its possible causes and the goals of treatment.
Treatment for mental illness is usually long-term. At this stage, it is important that the responsibility for implementing the recommendations is shared between the doctor, the patient and his/her family. Long-term treatment of the patient requires a restructuring of the way of life and the redistribution of roles in the family. Relatives may develop depression, alcohol and drug abuse, and often need the help of a psychotherapist or psychiatrist too.
Questions to ask specialists and yourself
During the treatment period, relatives, like the patients themselves, should ask the specialists:
- how will drug therapy benefit?
- what are its side effects?
- why is this particular drug chosen?
- will I have to take this medicine all my life?
- are there other drugs available to help if the prescribed one is ineffective?
- what signs (symptoms) indicate that the dose of the drug needs to be changed?
- what happens if the patient stops taking the medicine?
- is there any literature on this medicine?
- will psychotherapy help the patient?
It takes time to accept the illness of a loved one, go through denial, anger, sadness and depression, and learn to live with a mentally ill relative. Usually, this period is quite long. There is information that it is generally 12 months, but this is only an average; in life, however, it often lasts for years. Nevertheless, in this difficult time, relatives of patients need to learn to take care of themselves, to economically expend energy – after all, their life is like a marathon.
Ideally, during this period, the patient takes a place in the family and society corresponding to his or her capabilities, and family members work out models of communication with him/her, which are constantly being improved. However, for relatives of the patient, this process is very difficult due to the unpredictability of the development of symptoms of the disease and changes in their severity.
For relatives, in conditions of constant emotional overload from contacts with a mentally ill family member, it seems impossible to keep their own plans for the future. But the more complex these plans are, the greater the effort must be to achieve them. During this period, family members should consider the following questions:
- how does the disease affect each family member?
- how should I talk to each other about the disease?
- how will I have to change my life?
- what will life be like when the patient gets better?
- are family members encouraging the patient to remain in the patient role for as long as possible?
- what kind of help does the family expect (psychotherapeutic, psychological, patient care, social support, etc.)?
Help in overcoming illness
Until now, many families, as well as a significant proportion of mental health professionals, consider drug treatment to be the mainstay of the management of patients with schizophrenia and other serious mental illnesses. Therefore, in both areas, it is widely believed that the solution to the problem lies in the correct selection of drugs. However, the modern approach to the treatment of mental and behavioral disorders involves a balanced combination of its three main components: pharmacotherapy (drugs), psychotherapy and psychosocial rehabilitation. The best results are achieved when the patient and his/her immediate environment are not passive participants in the difficult healing process, but active partners in providing assistance along with professionals.
The conditions for the formation of partnerships are:
- the presence of the patient and his/her closest relatives of knowledge about the nature of mental illness and their treatment, style of communication and behavior in the family;
- skills in solving problems specific to certain diseases;
- possession of ways to control the symptoms of the disease.
In most families, such knowledge and skills are minimal, and it is unrealistic to require their acquisition on their own. Relatives of patients should have access to the information they need, as well as the ability to communicate with each other to share experiences that reflect their successes and failures, and to develop solutions to the most common problems.
Recommendations for family members
- There is no need to rush. The recovery process can take a long time. Getting more rest is very important;
- Keep calm. Excessive enthusiasm is normal. Try to temper it. Showing disagreement is also normal. Try to take this calmly as well;
- Let each other rest: everyone needs a break. You are tired of something – that’s okay. It’s also okay to say no sometimes;
- Set limits. Everyone should know the rules. A few simple rules can put everything in its place;
- Don’t think about what you cannot change. Something needs to be left as is. Pay attention to violent behavior;
- Express yourself in a simpler way. Say what you intend to say, clearly, calmly, confidently;
- Follow your doctor’s orders. It is necessary to take medications as prescribed by the doctor, and only those that he prescribed;
- Do your business as usual. Restore your normal household chores. Keep in touch with your family and friends;
- No drugs or alcoholic beverages: they aggravate the symptoms of the disease;
- Pay attention to any changes in the health of a loved one, record them. Consult your doctor;
- Solve problems step by step. Make changes gradually;
- Work on one thing. Reduce expectations temporarily. Use your own characteristics and impressions of the state of the loved one. Compare the results of the current and the previous month.
A few more points that you should pay attention to
The burden of illness and its painful influence on the patient and his/her family can be mitigated if:
- the disease is recognized as such;
- all interested parties received the necessary information about the disease and its treatment;
- drug therapy is carried out sequentially;
- medical supervision is carried out regularly;
- the family managed to avoid isolation.
These recommendations are in fact models of behavior with the patient. It is important that they take into account the biological, psychological and social components of mental illness. They help to maintain a calm atmosphere in the family, are aimed at reducing stress among family members and help prevent disease recurrence.