Something to think about

Triedntrue

Well-Known Member
How do we establish behavioral guidelines for a grown child who suffers from mental illness? Should our boundaries be the same as those we'd set up with any other child? Or do special considerations apply in a situation like this?

A great deal depends on the kind of mental illness you are talking about. A wide variety of conditions get lumped together under that general heading, including everything from mild depression to schizophrenia. Obviously, an individual who merely has trouble sleeping at night due to anxiety has to be handled in one way, and a person who suffers from delusions or dissociative personality disorder in quite another.

On the whole, it would be fair to say that someone who struggles with mental disease in any form needs more boundaries, not less, than the average person. By definition, a mental disability distorts an individual's perception of reality in some way. Since this is true, it stands to reason that he will require extra guidance, very specific limitations, and a lot more structure than most young adults. Because of this, those who live with or interact with him on a regular basis should expect to spend a significant amount of time and energy communicating those guidelines and boundaries in a way he can understand.

As you're probably aware, anybody who suffers from a serious mental illness – for example, schizophrenia or bipolar disorder – should be receiving treatment from qualified medical and psychiatric professionals. This will almost certainly involve some type of drug therapy. If that's the situation in your family, your first concern is to make sure that your adult child is taking his medication faithfully.

If he is unwilling to follow the regimen prescribed by his doctors, you will have to proceed with extreme caution. Sit down with the rest of the family, possibly in the presence of a professional counselor. Agree to govern your interactions with him by means of some strict boundaries and guidelines. For instance, you might tell your child, "If you refuse to take your medication, we can't permit you to spend time in our home," or "Until you decide to cooperate with the doctors, we won't be sending any more financial support." It may sound harsh, but it's a question of self-protection. Besides, there isn't much you can do for him if he isn't willing to go along with the program.

If he is receiving the treatment he needs, or if the illness from which he's suffering is less severe, go ahead and assess the situation with an eye to the best interests of everyone concerned. Then set your boundaries accordingly. The goal here is to preserve healthy relationships. If you want your interactions with your child to remain friendly, you need to be direct and diligent about protecting your time, your privacy, and your health from unjustified intrusions.

As you go through this process, remember that it's easy for parents in your position to blame themselves for their child's difficulties. If you allow yourself to feel guilty, you will quickly fall into the trap of enabling your adult child to manipulate your feelings. There isn't any reason in the world why a young adult struggling with depression, anxiety, neurosis, or even bipolar disorder should not be given responsibilities similar to others their age. No doing so can prevent their progress toward healthy independence. Remember, each and every one of us has hurdles to overcome in one way or another, not just those who are labeled "mentally ill." We all need to learn how to trust in God and make our own way in the world despite our limitations. So in mapping out your strategy, make key decisions on the basis of prayer and careful, rational thought, not emotion.

If you'd like to discuss these ideas at greater length with a member of our staff, feel free to call Focus on the Family's Counseling department
 

Triedntrue

Well-Known Member
Another one to think about

friendships and relationships have boundaries and you are overstepping ours. Your actions cost me at least one interview and who knows what else because people couldn’t leave me a message. Do not call me more than once a day. If you do, I will call the phone company and have your number blocked.”

*I have an adult relative who lives with me. He does nothing but idle, won’t take his medication, won’t go to the doctors, and won’t get a job.

ex. “I am willing to help you if you are willing to help yourself. This isn’t a hotel and you’ll never get well unless you actually do something about it. So you can start making an effort to take your medications, visit your doctor, and (if capable) get at least a part-time job; or you’re going to have to find another place to live.”

*I have a loved one who is verbally and/or physically abusive while they are unwell.

ex. “Mental illness is no excuse for being abusive and will not be tolerated. If you persist on being verbally abusive, I will remove myself from the situation. If you persist, I will remove you from my life and get a restraining order if I have to. If I feel like I’m in danger, you hurt me, or you threat to kill yourself or me; I will notify authorities.”

As you can see, each one is very clear and concise in approach. It puts the choice in the hands of the mentally ill person. That way when they come around to blame you (and they will), you can point back at it and say “I gave you a choice and you made it. This was your decision.” The goal is to try and break through the mental illness to the rational part of their brain. A mood disorder unwell thought process is very similar to a tsunami. The further it is allowed to go, the bigger and harder to stop it becomes. There has to be something solid in the way to break up that wave (or thought process). By introducing such harsh measures with clear repercussions, we are hopefully putting sturdy walls in the path of the wave.

Reintegrating such a person into your life should be handled the same way. “I’ll let you move back in, but you must maintain your medication and go to your doctor. If you do not- then you’ll have to find another place to live. Entirely your choice.”

To all the friends, parents, supporters, and loved ones of those with mental illnesses like Depression and Bipolar Disorder- I know that many of you want to understand and help your loved one. The fact of the matter is, the only person that can truly help your loved is them. They are the one that needs to go to the doctor, take their medications, monitor their moods, and most importantly- realize there is a problem in the first place. The greatest way to help these people is to force them to realize that their way of conducting life, their way of thinking is damaging. The sooner, the better- which is why I advocate strong measures even early in the process. It could be the difference between lost months and lost decades.

Yes, it’s probably going to be difficult for you to establish limits and stick to them. Even if they storm away and you end up separating from that person for awhile; you are actually still helping them. At some point their brain is going to hit rational thought processes again and think about those circumstances. It may very well contribute to their moment of clarity even if you haven’t heard from them in months.

Unfortunately, there are people that can’t or won’t help themselves either. These people will draw you to the bottom like an anchor. They will drain you of all of your emotional energy and bring the chaos of their lives into yours. It’s one thing to be there for someone who is trying to get themselves together; it’s another to be constantly victimized or treated badly by someone who is just fine with it. Look at the entire picture of the situation. Is this person trying to help themselves? If the answer is no- put distance between you if the person is damaging.

Many people with mood disorders and mental illnesses can reach a point of management and live a mostly normal life. Unfortunately, getting the person to realize that and fight for it is often an extremely difficult road. It can take years of suffering and loss before that person realizes they have to be the one to take control.
 

Deni D

Life isn't about waiting for the storm to pass.
Staff member
I agree wholeheartedly. My son's dad told me when he was hypomanic he still knew he wasn't acting right. I keep holding onto that and keep holding onto my boundaries, for my sake and for my son's sake.
 

newstart

Well-Known Member
How do we establish behavioral guidelines for a grown child who suffers from mental illness? Should our boundaries be the same as those we'd set up with any other child? Or do special considerations apply in a situation like this?

A great deal depends on the kind of mental illness you are talking about. A wide variety of conditions get lumped together under that general heading, including everything from mild depression to schizophrenia. Obviously, an individual who merely has trouble sleeping at night due to anxiety has to be handled in one way, and a person who suffers from delusions or dissociative personality disorder in quite another.

On the whole, it would be fair to say that someone who struggles with mental disease in any form needs more boundaries, not less, than the average person. By definition, a mental disability distorts an individual's perception of reality in some way. Since this is true, it stands to reason that he will require extra guidance, very specific limitations, and a lot more structure than most young adults. Because of this, those who live with or interact with him on a regular basis should expect to spend a significant amount of time and energy communicating those guidelines and boundaries in a way he can understand.

As you're probably aware, anybody who suffers from a serious mental illness – for example, schizophrenia or bipolar disorder – should be receiving treatment from qualified medical and psychiatric professionals. This will almost certainly involve some type of drug therapy. If that's the situation in your family, your first concern is to make sure that your adult child is taking his medication faithfully.

If he is unwilling to follow the regimen prescribed by his doctors, you will have to proceed with extreme caution. Sit down with the rest of the family, possibly in the presence of a professional counselor. Agree to govern your interactions with him by means of some strict boundaries and guidelines. For instance, you might tell your child, "If you refuse to take your medication, we can't permit you to spend time in our home," or "Until you decide to cooperate with the doctors, we won't be sending any more financial support." It may sound harsh, but it's a question of self-protection. Besides, there isn't much you can do for him if he isn't willing to go along with the program.

If he is receiving the treatment he needs, or if the illness from which he's suffering is less severe, go ahead and assess the situation with an eye to the best interests of everyone concerned. Then set your boundaries accordingly. The goal here is to preserve healthy relationships. If you want your interactions with your child to remain friendly, you need to be direct and diligent about protecting your time, your privacy, and your health from unjustified intrusions.

As you go through this process, remember that it's easy for parents in your position to blame themselves for their child's difficulties. If you allow yourself to feel guilty, you will quickly fall into the trap of enabling your adult child to manipulate your feelings. There isn't any reason in the world why a young adult struggling with depression, anxiety, neurosis, or even bipolar disorder should not be given responsibilities similar to others their age. No doing so can prevent their progress toward healthy independence. Remember, each and every one of us has hurdles to overcome in one way or another, not just those who are labeled "mentally ill." We all need to learn how to trust in God and make our own way in the world despite our limitations. So in mapping out your strategy, make key decisions on the basis of prayer and careful, rational thought, not emotion.

If you'd like to discuss these ideas at greater length with a member of our staff, feel free to call Focus on the Family's Counseling department

Tired mama, Thank you for posting this great information. Much to think about and much to take action from. Yes, we each have hurdles to overcome, each and everyone of us. We have to remember that there are many severely mentally ill people that are living good fruitful lives, they have made their mind up to move forward and do everything in their power to keep things balanced.
 
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