It comes slowly. A friend or member of your family stars acting a little bit “off.” You might ask them about it at first. They may dismiss your concerns. You might even dismiss your own concerns. It’s more comfortable to ignore than to investigate; after all, you’ve got your own life to live! Besides, everyone has a bad day now and again. The odd behavior then becomes more frequent. You might worry about what’s going on with that person, and you might discuss it with someone else who knows the person well. If they aren’t concerned, then you can stop worrying for a little bit longer. Maybe other members of the family are concerned too; you wonder if it could be “just stress.” It could be drinking or drugs. Oftentimes when these concerns are broached with the individual, the reaction is brusque. Yet maybe professional help is warranted. And though there may be resistance, when confronted with a description of the concerns and odd behaviors, the person might be convinced that it is time to seek help.
This family member who is acting “off” is typically between the ages of 18 and 25, a phase of life that comes with a good amount of stress. Consider the fact that the brain’s prefrontal cortex, which controls executive function, is not fully developed until approximately age 25. People in this age group are expected to leave home, function independently, succeed in college or in a job, and manage finances. Love interests can dominate the individual’s mind, and losses in love can be devastating. Especially when significant adults do little to prepare youths for these big transitions, early adulthood can be a tough part of life to negotiate. Drugs and alcohol, often easy to access, can exacerbate other problems, including increased likelihood of developing certain mental illness. Signs that may be concerning include persistent depressed and irritable moods, becoming reclusive, having manic episodes, and developing panic attacks or delusions. Most of the time, mental illness is not considered as a possible root of odd or eccentric behavior in young adults. Yet this is the time of life when it is most likely to appear. It is a sensitive topic, because sometimes odd behavior is stress-related and temporary. It may seem intrusive and inappropriate to pry. It is uncomfortable to ask personal questions or recommend counseling to an individual who is behaving unpredictably. Yet failing to bring it up carries risks as well.
Should the individual go for a clinical assessment and wind up with a diagnosis of a severe mental illness like bipolar disorder or schizophrenia, there can be a real sense of shock and dismay that ricochets through the family system. The individual is likely to be afraid and extremely disconcerted as they learn about the new label and treatment options, side effects, and prognosis. Even if they can fully process the information they are presented with, suddenly life’s possibilities seem much dimmer. Family members feel a sense of loss and they wonder about the implications. Friends become unsure of how to act, and they may be reluctant to come around at all. Though their friend is still the same person, the new label makes that person seem suddenly dangerous and unpredictable. Stigma is real, and despite some progress it still affects people’s lives!
So what do you do? You might think of it very differently than a physical illness, and it is different. If a friend or family member develops diabetes, it is easier to trace the epidemiology. Treatment is more clear-cut, and people can understand it. Mental illness is not so simple. Yet there are some simple, human things that you can do if someone in your life is dealing with a mental illness.
First and foremost, be there. Let the person know that you care, you are not afraid, and are willing to talk about it. You can be an encourager, but try to avoid being coercive, as in asking questions like “did you take your meds?” Treat your friend like the adult that he or she is, and be engaging. Have empathy, but avoid taking pity. People with mental illnesses are usually quite capable of maintaining healthy relationships, and can greatly benefit from them. And remember, your friend is not a diagnosis. In other words, it’s “my friend Jill,” and not “my bipolar friend Jill.” Finally, you can advocate for your friend and others with mental illness. This can be done in big ways and small. Educate yourself about the disorder. NAMI of Hamilton County is a terrific resource for this, and provides many ways to learn and be a part of a supportive community for all those living with mental illness. You could donate money to NAMI or other organizations that provide counseling and other services for people with mental illnesses and their families. And point it out when you notice people making false claims that further entrench stigma among the public. Kids sometimes mockingly call one another “bipolar” when someone is perceived to act erratically. If you hear this, gently correct the child and explain why it is damaging to use that word as a slur. If you see a TV program that reinforces the stereotype that people with schizophrenia are violent and dangerous, write a quick letter objecting to the propagation of this harmful myth.
Many people experience mental illness sometime during their life, and most people’s lives are touched by it in some way. People who are well-educated on these matters can help by being kind, encouraging, and unafraid advocates.