Mental health issues. Am I being unsympathetic?

I'd like to make a suggestion. How about we stop focussing so totally on the depressed person in the family and think about what life is like for those living with and around them? All this 'you mustn't do or say anything or you'll upset us, you must let us spend our entire lives in our rooms doing what we want' just makes people with MH issues seem selfish and sometimes controlling and abusive. But if they're living in a family or a community, the effect of their illness can spread a lot further.

My bi-polar friend Kathy used to have manic periods when she was horrible and threatening to those who cared about her, and each time she recovered she would give us flowers and apologise because, as she would say, having MH issues didn't mean you were allowed to be a c**t.

How tyrannical that sounds. Do what I say. Empathise, damn you! Give me what I want, don't question. Be here for me when I want you and don't bother me when I don't. Cook for me. Do my laundry for me. Give me money.

You can't treat others as your servants.

As my bi-polar friend Kathy said, having poor mental health doesn't give you a free pass to be a c**t.

Completely agree with you @pattihews . If affects so many people and it's just not a case of ignore it and get on with your life.

The parents of the person I am thinking of can't go on holiday - he won't come, they can't leave him alone. They can't have days out even as he wants them around. Can't go to family events like weddings or funerals as a couple, one has to go and the other has to stay at home. Their finances are impacted by having to feed/clothe another adult. They have huge levels of worry about what happens when they die. They have huge stress/guilt through walking on eggshells constantly in their own home, worried about saying or doing something which sets off the adult or makes them threaten suicide (again).

It's shit. Yes shit for the person who is unwell but equally shit for people around them. On one hand they are definitely enabling the behaviour but on the other they are unable to force an adult into trying to take initial steps to get better. And don't want to, because if said adult even hears the phrase "maybe a GP appointment is start" from a parent, they threaten suicide.

So everyone's sort of stuck in this half-life limbo, and posters seriously think the best solution is just to let them get on with it?

This is what my friend is enduring, too. She's had to negotiate one night a week to attend the group where I met her. Otherwise, apart from work, they demand she's there for them. It's abusive and when you're talking about an adult old enough to be responsible for his own behaviour it's unacceptable.

All these things are disorders, and not chosen. And you have to work at improving all of them. Doing the prescribed exercises can have a huge impact on how fast and how fully one recovers from a broken leg or other injury. And it can be quite tough-physiotherapists are sometimes flippantly referred to as 'physio-terrorists'. But it's necessary. Diabetes may require medication, including children regularly injecting themselves from a young age; and dietary and lifestyle adjustments, in order to lead a normal life and to avoid dying young. Some (certainly not all) people with Type 2 can virtually cure themselves through diet and exercise.

I know people who are more disabled than they need be, because they wouldn't do the exercises advised for them after an injury or operation. I knew someone who died because she consistently ignored advice about diet for controlling her diabetes. The need for effort by patients as well as doctors applies to physical as well as mental health.

If people with mental health problems refuse to seek or accept medical help or if they engage in harmful forms of self-medication through alcohol or drugs, then, yes, they are partly responsible for their failure to make progress, just like a person with heart disease who eats unhealthily and won't take prescribed medication. But it's not the case that someone with mental (or physical) health problems can just cure themselves if others are sufficiently harsh with them!

I don't think anyone's suggesting being harsh to those with mental health problems, but as you say they are something to be worked at.

But the same is the case for families who have to care long-term for a family member with dementia or severe learning difficulties. It can often bring family members to breaking point. But it can't be cured by giving the person a metaphorical kick.

I don't minimize the effects on family members. There are reasons why people with severe mental health problems used commonly to be placed in 'asylums'. Care in the community has many advantages over automatic institutionalization, but it does often increase the burden on families. We should perhaps be thinking of ways in which additional help can be provided, in terms of day centres, sheltered work, home help and respite care. And yes, it would cost the taxpayer more (volunteers may do some of the work, but there are never enough); and yes, there may be competition for social care resources between elderly people with physical frailty and/or dementia, and younger people with mental health problems. But if we really wish to relieve the burden on families, we need to look in this direction, rather than taking an attitude that the people with mental health problems are just spoilt brats who could stop being mentally ill if they weren't pampered.

You twist what I and others are saying. We don't think 'people with mental health problems are just spoilt brats who could stop being mentally ill if they weren't pampered' and it feels quite malicious that you should choose to interpret me that way. And simplistic.

We see complex patterns of behaviour and emotional and physical dependency that may be impeding the efficacy of treatment and respite/ recovery/ improvement. We see a number of people being adversely affected by the needs of a loved one.

It goes without saying that there needs to be much, more more support for people trapped in caring situations with family members who need constant care for whatever reason. With my feminist hat on, I particularly want to see women relieved of the expectation of caring — because it's so often the mothers and daughters who are assumed able and willing to do the work.

My father had two long periods of clinical depression which made family life extremely difficult and left all of us scarred. I've been really clear with my partners that I don't expect them to look after me should I turn out to have inherited his depressive disposition. Fortunately I don't seem to have done so. I loved my dad but I wouldn't want to inflict on anyone else what we went through with him. My partner and I have both agreed that if either of us develops dementia the other is absolutely free to walk away and enjoy their final years without guilt or regret.

YANBU, there is an element of enabling. A few PP have made the point about young males just hiding in their rooms on game consoles.
If all of your needs are being met, as in someone paying bills, feeding you, cleaning your clothing/room, why would you try to change that?
If someone threatens suicide if you even suggest maybe getting out the house, then the worst thing you can do is pander to that. They need help in how to deal with the feeling surrounding leaving the house. Feeling suicidal about minor things is a miserable way to live, and should be something that help is sought for.

YABU - this isn't as simple as just getting yourself together. They're aren't choosing to feel how they do. Mental illness isn't looked at as being as debilitating as physical, but it is. It's like telling someone paralysed to walk. They can't.

I think posters might be mistaking:
Someone has depression - i feel empathy for them - i feel empathy for their families - i notice destructive behaviours - i notice a lack of engaging with trying to get better - i notice the impact on the family - i have my own knowledge/experience of mental health issues and recovery - i am aware of enablement behaviours - i am aware of unhealthy family dynamics - i am aware of the patriarchy and how it seeps into things like health & caring dynamics - i am not under unhelpful and damaging misunderstandings that a lot of people who become mental health 'aware' fall into such as:

• 'people with mental health issues cease to have any negative personality traits or behaviours the minute they get sick'
• 'the illness itself and how an individual person deals with that illness are the same thing and no individual in the history of time has ever had any influence or control on how severely it affects them'
• 'The lived experience (& studies) of literally thousands of people with depression who talk about how improving diet and exercise and other things helped literally do not exist or their depression must have not been that bad'
• 'any observation that someone is treating others badly as a result of their own handling of depression means you have no understanding of mental health and are evil'
• 'depression is always always aways so severe you lie catatonic in bed incapable of feeding yourself how dare you suggest someone might be capable of going outside??'

Yes, you get it @KILM.

We are a very plain-speaking Northern family and I don’t understand how supporting someone with MH issues came to mean – tiptoeing around them / never challenging them / never speaking your mind for fear of what they might do. It’s a strange claustrophobic situation and I don’t know what to do for the best.

Lol. Plain speaking. In my experience people say ‘that’s just how I am, I speak plainly’ when they want to be rude. With your attitude, which they’ll know, you won’t be privy to what’s happening for these young men. They and their closest family/friends will rightly guard them from people like you and you desire to ‘help’. We’ve got one like you in the family, offering ‘advice’ to someone, asking their ‘helpful‘ questions, just ‘making conversation’. It’s not just conversation, the tone underneath is like your posts here. ‘I don’t understaaaaaaand’. 🙄 They’re clueless, partly because they don’t understand depression/anxiety generally and partly because they’re told very little because of their attitude. Beak out beaky as my aunt says. You’re on the outside for a reason. You’re posts are extremely similar to conversations I’ve had with with this person in my family, very unpleasant just underneath the surface.

As a life long anxiety and depression sufferer, I find it incredulous that in this day and age, with so many mental health awareness campaigns etc, that non sufferers still can not grasp how debilitating poor mental health is.
It is a disease, not one you can easily see but it’s there regardless, eating away at a persons world in the insidious way in which it works.
To someone who has always had good mental health it’s hard to understand why someone with depression acts or looks the way they do but it’s not as simple as picking yourself up and dusting yourself down, it just does not work that way.
My MIL never suffered from bad mental health, she always thought you could talk yourself out of it with a little pep talk. She thought if you lived in a nice house, with a good partner etc there is no way depression would be a thing.
You wouldn’t dream of telling someone with a disability to get themselves out of their wheelchair and walk because you know they couldn’t so why would you think someone crippled with poor mental health would be able to just snap themselves out of things by doing the things that ‘normal’ people are doing.

Again that "snap out of it" phrase which none of us who are actually in the situation have ever used.

There is a whole range of intervention and approaches between "snap out of it" and "never mention this ever and accept that the person concerned is ill, never going to get better ever, do not seek treatment, support unconditionally irrespective of the impact on everyone else".

FamilyTreeBuilder You, personally may not have used the phrase but I can tell you from experience that I’ve had this said to me many times. And I know of many others with poor mental health who have had this said to them. It’s just not a condition which is black and white.

That's not much of an argument, is it Justlooking? You're talking to us here and now and it would seem that most of us have some experience of MH issues, whether individually or as a result of living with someone with MH issues. No one is saying 'snap out of it'.

@KILM well said. I say this is someone who has had some fairly serious mental health issues in my 20s and as someone who has suffered fallout because of an immediate family member with mental health issues behaving in a destructive and unpleasant way. I have immense sympathy with those going through the hell of depression but I dislike the idea of absolving them of all agency and responsibility for their own behaviour. I can understand OP's concerns to be honest

As a life long anxiety and depression sufferer, I find it incredulous that in this day and age, with so many mental health awareness campaigns etc, that non sufferers still can not grasp how debilitating poor mental health is
No, we get it. Some of us have had MH issues or lived with people with MH issues. We know what a horrible experience it is for sufferers — and for those who care for them.

it’s not as simple as picking yourself up and dusting yourself down, it just does not work that way.

We know this. But if you refuse to seek help then you prolong the agony not just for yourself but for everyone around you on whom you depend.

My MIL never suffered from bad mental health, she always thought you could talk yourself out of it with a little pep talk. She thought if you lived in a nice house, with a good partner etc there is no way depression would be a thing

Your MIL is a fool. We are not your MIL.

You wouldn’t dream of telling someone with a disability to get themselves out of their wheelchair and walk because you know they couldn’t so why would you think someone crippled with poor mental health would be able to just snap themselves out of things by doing the things that ‘normal’ people are doing

We don't think anyone just snaps out of anything, but we'd encourage anyone with any illness, physical or mental, to seek help and follow expert advice. I'll speak only for myself when I say I don't want to get trapped in a 24/7 caring situation with all the loss of quality of life that involves if there is treatment that can help you improve your physical/ mental health.

I’m seeing over and over again on this thread what I have experienced in real life- the bar for saying the “right thing” to someone with mental health problems is set impossibly high. Don’t make suggestions, don’t make assumptions, don’t try and have an ordinary conversation about ordinary things because it might be triggering… I think everyone who has a loved one with depression is only too familiar with how difficult and exhausting it is to navigate this without letting your own frustration show. And if you get it wrong, you’re part of the problem. None of us are MH professionals, we’re just people who want to help, but are also struggling.

Unless they’re your own kids , you don’t have the right to ask them anything about their life plans . It’s absolutely none of your business

Don't think you are being insensitive. I agree with PPs that are saying MH does not entitle you to ignore the impact of your illness on others.

I agree OP.

I think there's a fine line between acceptance and... enabling.

It used to be that a mental health problem such as depression was seen as a problem, a deviation from the norm, an illness that could be treated, and there was the expectation that that person would eventually improve.

Now it seems to be viewed as a far more static, unchangeable thing. 'I have depression' or 'I have anxiety' being seen as fixed issues that won't change ever and if you suggest anything to the contrary that's incredibly offensive and shows a lack of understanding.

In some ways comparing physical and mental health issues is helpful, for example the 'if you broke your leg you'd see a doctor, why not for depression?' helps to reduce stigma. But in some ways, as others have highlighted on the thread, it's not so helpful.

However, if you broke your leg and refused to see a doctor and hobbled around crying in pain for years on end people would start to question why you haven't done something about it. It doesn't seem to be the case when it comes to treatable MH problems. The NICE guidelines has a whole range of info on evidence based treatments for depression for example. Not everything works for everyone but I would certainly expect that when someone's depression impacts others, they would take observable steps to try and get better, and it's not insensitive or shocking to say that.

Unfortunately although being depressed is a miserable experience, some of the accoutrements that come with it if you have a family willing to 'support' are quite attractive: not having to go out to work, or study, or do much at all. Being able to just sit around because someone else is paying your bills. It's a fine line between supporting and enabling. Both DH and I have suffered from depression (for him it's episodic and ongoing, I haven't had an episode for a while) but both of us recognise that we owe it to our family to take action when it hits and do things that will help us to get better.

These men that OP speaks about could be getting help, they just don’t tell OP. Who could blame them? She’s sounds ignorant and judgemental, like things would be sorted if she was in charge. 🙄 No one tells that person anything. You humour them, smile and nod and can’t wait for them to go away.

Getting back to having good mental health can be a really slow process, it doesn’t mean people aren’t working in it.