The National Institute of Mental Health (NIMH) states that 1 in 6 Americans, or 46.6 million of us, struggle with mental health problems. These range from mild depression and anxiety to crippling mental illnesses that prevents work or even self-care. More than 30% of households are home to an individual with mental illness. While mental healthcare has, and for good reason, historically focused on the person with mental health problems, family members and caretakers bear a heavy burden. In fact, more than 35% of all family members of a mentally ill person report negative side effects, which damage their own mental health. These range from smaller social circles to increased stress and, in severe cases, even trauma.
If your loved one is struggling with mental illness, it’s important that they get help. It’s equally important that the people around them manage their own mental health, set boundaries, and ensure they have the space to get help before stress and trauma harm their own mental health. Understanding the impacts of mental health on loved ones is crucial to making good choices and setting boundaries for yourself and for others.
Mental Illness Requires Emotional Labor
Living with someone who is mentally ill typically requires considerable emotional investment on the part of others in the household. While this labor typically falls on parents, spouses, and children, it’s felt by anyone living with someone who is mentally ill. While most people living with a mentally ill person are more than willing to sacrifice emotional stability, time, and patience to managing and helping someone manage turbulent emotions, depression, anxiety, or schizophrenia, these things take a toll.
This is also, critically, where many people are less able to rely on their own support networks. Social stigma, lack of knowledge, and poor mental health literacy affect how and when people can talk about mental illness. When people reach out to friends and family members to vent or talk about difficulty dealing with a loved one with mental illness, they do not get the same support, sympathy, and offers of help like they would if that person were physically sick. Instead, family members are likely to receive dismissal, encouragements to drop the person, and to have to deal with stigma. This can result in more exhaustion, as they have to do work at home and where they would normally go to deal with stress.
Stress and Emotional Distress
Watching a loved one struggle is emotionally stressful and distressing. This holds true whether it’s watching someone struggle with school or work, or dealing with outburst, suicidal ideation, or mania. A loved one’s actions and behavior while mentally ill can be incredibly traumatic to people who care about them. Unfortunately, there’s little those same people can do to offer support or assistance.
Lack of Education Impacts Actions
Most people know very little about mental illness. When a loved one is diagnosed, they either learn and adapt or eventually cut themselves out. The people around them often also know very little. Both result in a situation where anyone with a loved one facing mental health problems must educate themselves in order to even fully understand what is going on. This adds an extra burden of stress, misunderstanding, and emotional difficulty. For example, if you aren’t aware of why someone is acting in a certain way, it’s easy to take it as a personal attack, as a choice, or to approach it in the wrong way. People living with someone who is mentally ill have to understand how and why behavior and episodes work in order to manage those episodes. Taking time to research and learn about mental illness is necessary, but it’s another responsibility for people who are often facing added responsibility as caretakers and providers.
Some resources might include books like, “When Someone You Love Is Depressed”, by Rosen and Amador, “Boundaries”, by Cloud and Townsend, “The Enabler: When Helping Hurts the Ones You Love”, by Angelyn Miller and “I Am Not Sick, I Don’t Need Help”, by Xavier Amador. Similarly, seeking out therapy, family therapy, and assistance from organizations like the National Association of Mental Illness (NAMI), can help.
Family members who become mentally ill, whether chronic or not, often put a sudden and unexpected socioeconomic burden on family members. Individuals struggling with stress, anxiety, burnout, and schizophrenic episodes are less and less able to work or to do so in a consistent fashion. Similarly, they are less able to contribute equally or to the same level as a healthy person in the home. This shifts provider roles and caretaker roles off the mentally ill person and onto their caretakers, creating an added burden of stress, financial pressure, and need to produce. For example, if a loved one is paying half the rent and suffer from a burnout, their partner must take over all of the rent. If someone is chronically mentally ill, they are much less likely to be able to contribute for the long-term, putting added financial burden on other members of the household. Socioeconomic pressure is a considerable source of stress and can contribute to developing anxiety, depression, burnout, and in increasing vulnerability to other mental illnesses.
Risks of Mental Illness
Managing stress, trauma, emotional stress, and long-term pain make anyone more vulnerable to mental illness. Individuals caring for family members with mental illness also have to consider enabling and codependency as potential problems. Finally, if the loved one is a blood relative, the caregiver is likely genetically vulnerable to the same mental illnesses. This means that if you’re taking care of someone, it’s critical to also be careful of your own mental health.
Doing so might mean evaluating time and energy spent on a loved one, setting boundaries, or even stepping back. More often, managing mental health risks involves developing mental health literacy, learning coping mechanisms, and learning how to properly evaluate your own mental health.
If you or a loved one is struggling with mental health problems, it’s important to seek out mental health treatment. In most cases, mental health treatment includes a combination of behavioral therapy, stress management, and life skills intended to help the individual manage and cope with symptoms. Medication may also be essential. Mental health treatment may reduce symptoms, help with management, or, in some cases, reduce the severity of the mental illness to the point where the person can cope and function reliably well again. Of course, mental illnesses vary considerably, with some being chronic or long-term, and others fading relatively quickly with treatment.
At the same time, it’s also important to evaluate the mental health and needs of the people around that person. Relationships are complex and someone who has spent a considerable amount of time and effort caring for, providing for, or managing the mood swings of a mentally ill person may need a considerable amount of mental help themselves. This can include cognitive behavioral therapy to recognize and unlearn unhealthy behaviors (such as overinvesting in helping others), coping mechanisms to deal with stress and emotional distress, treatment for trauma or even PTSD, and information on how to set and maintain boundaries.
If you or a loved one is struggling, it’s important to reach out and get help.