Caregiver's Challenge when a Mental Health Crisis Occur - Podcast 12/20/22
Welcome to the Mind Wise podcast about mental health, wellness, holistic health care, and topics of interest. I am Ron parks, MPH, MD, writer, and teacher consultant. And your host today.
Ron: Parents or caregivers can find themselves in uncharted waterers very easily. Many get caught unprepared when a mental illness affects the loved one, a spouse, a child, or significant other. The person now disabled rapidly or slowly becomes dependent on a caregiver's help and support in management. The dissent into illness and dysfunction caused by mental disorders calls on the extreme resourcefulness of the one beset with the unimaginable level of additional responsibility.
When, whether a mental illness or when a relative, child, or parent [ develops any illness or disability that requires a responsible person. To be in charge or accept some level of care or administrative duties for the significant other. The challenge can being can seem daunting or impossible at times.
The situation may be any unanticipated disruption to the family and relationship as a development of a mental illness, dementia of a loved one, a devastating medical disease, or an injury from an accident. The responsible person must assume a heightened supervisor and care-related responsibility for the significant other when wall one is developing an illness and becoming disabled; the person aligned to be a caregiver can want the troubled person to fend for themselves or survive with whatever resources they have or that are available.
To be the responsible one where the caregiver can be a difficult-to-bear burden for another, a waiver of love that gives some level of personal gratification. Some go into denial, avoiding the feelings of responsibility, and look for others to be the caregiver or assume responsibility. Frustration is high when the person wanting to be responsible for another cannot control the circumstances, as trying to help a relative with an ongoing substance abuse problem with the needed resources not available to address the issue or needs.
A family member or significant other may develop one of the many types of mental illnesses, which is incapacitating and debilitating and requires help managing day-to-day activities or supervision. When a family member with severe schizophrenia becomes unmanageable or a danger to others and needs more secure, higher-level care than can be offered in a home or a community service hospital, residential treatment may be required.
There can be trouble with resource issues
A dilemma with support, therapy, or educational resources sometimes exists, even when available. When the ill person rejects or won't avail themselves to use a service that could have been helpful. Still, those in need may have refused or not fully complied with services where the appropriate needed services were unavailable.
Often there's a lot of guilt and remorse about not having done enough for the one you felt responsible for. The feelings are hard to avoid, even though the best possible was tried or offered. A friend, a neighbor, recently wrote an outstanding autobiography and educational resource for people unfamiliar with the travails of having a family member affected by a mental illness and struggling to cope and find recourses is a heartfelt and captivating story of the struggle and anguish of a family caught in the grips of unforeseen challenges of a family member developing schizophrenia with courage in facing the realities and growing demands. They meet the challenge as told in this beautiful written personal story of love and compassion. The book Two hearts on a Rocky Road by Roselyn Katz. That's r o s e l y n n, last name Katz, k a t z. And you can look [00:05:00] for this on Amazon, where it is published.
A young find psychiatrist finds understanding and perspective
While in my psychiatry training, I cared for people with schizophrenic-like illnesses in some hospitals or residential care settings. Their illnesses had a mixture of symptoms, including an auditory hallucination of sounds as hearing voices or visual hallucinations, which we later learned were more apt to be from other types of brain illness or related conditioners. Often the person would be caught up in unrealistic or delusional ideas, which seems like they fully accepted their fantasy beliefs or inner narrative, the story in their head, which they sometimes were fearful for.
The higher functioning with their thoughts and behavior might have fixed paranoid delusions when they would accept the reality of their delusional war. Again, inner narrative or story such as that the government or police were after them, or that there was some sinister pot against them or some other imagined belief, which was very real to them.
Before medication, people with these more severe conditions would be locked away in the history of psychiatry. In institutions with the advent of medicine and better management of symptoms, people could go home, supervise, and have lesser restrictor living situations. There was increased availability of residential or halfway houses.
Where the needed management occurred at the state’s expense, the families, sometimes insurance companies, or some combination. The medicines were never a complete cure for the condition, but medications made the symptoms more manageable for the person themselves or the caretakers. Drugs help decrease their active psychotic symptoms such as delusions or hallucinations, reduce their anxiety, and often their dangerous acting out behavior.
The teaching for us in training was that schizophrenia was a rather chronic illness for most it could get worse with time or remain a highly debilitating illness, manageable with medications when there was a need for a higher level of care. Residential housing provided supervision with medication.
A return home was made possible with the medications and management as required by a significant other or the parents. There were many challenges in my early practice year, working early in community mental health or in programs connected to the hospital or private practice. One of the most challenging things for me was seeing a young adult and seeing the early signs of a schizophrenic-like condition. Though it could occur at different ages, it seemed typical when growing into young adulthood and being up against more stressful life demands. I remember several young men and women entering college or a new job with all its challenges, and then they began developing symptoms.
When dysfunctional mentation or behaviors appeared and the person came into my office for evaluation, or I saw them in a hospital setting, It was quite challenging for me. [00:09:00] When I saw the person for the first time and recognized the telltale signs of schizophrenia, it was tough to tell the parents as I knew how frightening and devastating it would be.
They would need to come to terms with the possibility that their child or loved one, with the stoppage of their development and onset of the odd behavior and cognitive difficulties, potentially had a schizophrenic illness. When I saw the parents, they understood something was majorly amiss. Still, they hoped it would be a treatable condition that would return the person to everyday life and responsibilities.
When I had to share my observation opinion, it was overwhelming for the parents and myself in my early years of training. I remember being so distraught that I felt like crying, and I think I ended up embracing the parents and crying with them occasionally. I now have a much larger perspective and acceptance that many things could occur in one's lifetime to which one has to adapt. I now know and have a much larger perspective and acceptance that many things could occur in one's lifetime to which one has to adapt.
Different mental illnesses can happen to anyone related to various reasons and situations. When a disease or problem develops, the person must rely on their deepest resourcefulness, coping skills, and external support, such as friends and families in the support system. Unfortunately, there are currently great difficulties and limitations to the mental health system, which is added to what parents must negotiate and go through to get the help and support they need. The lack of services makes it more difficult and a burden for the individual responsible for a mental illness; the challenge and toll on caregivers can be significant. The emotional crisis for the parents of all involved with a mental illness more suddenly becomes apparent in an emotional and intense situation for most.
When the onset of the mental illness or health condition is gradual, the person and family have more time to repair and adapt to the needs, acceptance of reality, and coming challenges. According to the Mayo Clinic, about a third of adults in the United States provide care to other adults because of the aging population. The number of caregivers would be much higher if statistics included all the ill or disabled spouses, partners, or disabled children. Most caregivers are not healthcare professionals and are trained to be so.
Some signs of caretaker exhaustion, stress, and risk of ill health are feeling inundated or constantly anxious and tired. Sleeping either too much or too little. Changing weight, gaining too much weight, or losing too much weight, becoming quickly annoyed and angry, losing enthusiasm for things you used to appreciate and feeling depressed, having recurrent headaches, body aches, or other physical issues. Misusing alcohol or medications can be a problem, including prescriptions, experiencing constant worry, depressed feelings or nervousness, and finally, being unable to get enough rest, exercise, or new nutritional food. In other words, feeling all these things and not being able to take care of yourself or not taking care of yourself
As a young medical student, student, I remember being mentored by a seasoned neurosurgery resident who had been a fighter pilot during the war and had often been in life-and-death situations late one night. I followed him into the emergency room as I was under his supervision as a medical student. We saw an ambulance bring a child in from an accident while riding his bike when he was hit by a car.
He was followed into the emergency room by his parents. The neurosurgeon resident I shadowed was well accustomed to the trauma of life and death from his being a fighter pilot in a war zone. He consoled the parents in a calm, collected, and empathetic way and delivered the tragic news that the son had died in the accident. However, they were anticipating the worst; death was beyond anything they had expected.
I was like an observer, a bystander, but struck by the gravity and amenity of the situation. It became one of the many experiences that brought me through the reality of the unexpected trauma and loss experience to can happen to anyone. It was part of my learning and acceptance of our limitations in doing or controlling things that we can only strive to do our best to be aware, learn, and be helpful.
In our Life journal journey, and at least we can only do the best we can with our limitations to control and manage. Meeting my mother's cousin, a Holocaust survivor, likewise brought me to the greater reality of how traumatic changes and loss occur and can call on our deepest survival instincts and resourcefulness to meet the challenge.
When the unforeseen happens, there is a companion article to this called Schizophrenia, The Stigma Reality, and Hope. It likewise is on my blog website, www.inmindwise.com.
Schizophrenia is a severe mental illness and a potentially debilitating disease that affects how a person thinks, feels, functions, and behaves. It can cause psychosis and lead to disability that may affect functioning in multiple areas, including personal, family, social, educational, and occupational activities.
About one in three people that develop schizophrenia will recover fully when effective care options are available. Support for funding research services will require as many advocates and public-minded servants as possible. I should comment that the statistics cited that a third will fully recover is probably skewed because many people who are first seen with psychotic symptoms are misdiagnosed. With further evaluation, their symptoms are from other causes
While currently, there are no definitive cures for schizophrenia, a minority with treatments will go into complete remission. Effective treatments are available to help manage symptoms and improve the quality of life for most others with the illness.
With proper support and repeat treatment, people with schizophrenia can improve and live more independently and productively. More awareness about schizophrenia, its causes, symptoms, diagnosis, and treatment options will increase the understanding and support for this underserved community and their difficulties with the debilitating illness or other mental illnesses. Hopefully, it will lead to less stigma, discrimination, and violation of the human rights of those affected by these illnesses.
When being a caregiver for someone with a mental illness or schizophrenia, recognize the challenge and accept help from others, friends, or family members. Please acknowledge that we all have limitations, and it's impossible to do everything.
Bypass the feelings of guilt and overwhelm and do your best with the limitation or resources or your capabilities and accept or get help. Find and use community resources when available.
Choose available goals that are doable. You can do things like divide large tasks and smaller ones you can do one at a time.
If you're good at ranking things, making lists create a daily plan, you need to begin saying no to things. Begin declining requests that are draining and not socially supportive of you. Find out about caregiving resources in your area. Many communities have supportive services for transportation, meal delivery, or cleaning services.
Take part in a support group that can provide support and motivation that helps with problem-solving for complicated predicaments. Take the time to connect with non-judgmental family and friends who can be emotionally supportive. Schedule some time each week to interact with problem-solving with friends or a companion.
Take care of your critical health needs by getting a good sleep routine. The proper amount of restorative sleep. Make time for active movement and exercise daily to support your well-being daily and health. Follow the best nutritional guidelines. Eat regularly and make the best food choices. If you have difficulties sleeping, check with your healthcare providers. Have a list of support, resources, services, and your doctor or community health professionals.
You can call when you feel things are getting overwhelming or outta control. Check out the resources available with the full article, which you can again find at www.inmindwise.com.
Thank you, and hopefully, you'll find this article helpful. And again, if you are a caregiver, do the best you can, but accept any help or resources that might be available.
I appreciate your interest. Please share with others. Subscribe to my Substack newsletter and podcast at www.inmindwise.com. All content in this podcast is created and published for educational purposes only, is not intended to be a substitute for professional medical advice, and should not be relied on for medical decisions. Always seek your healthcare provider's guidance regarding medical or mental health conditions. Thank you.