Break Down: Why People With Mental Illness Act That Way

Patience is one of the best byproducts of having children with special needs.  And I have plenty of it ... except, I've discovered, for parents who exhibit no compassion for their adult children with mental illness.

NAMI's Family-to-Family class is a great help in that arena. This course on mental illness for families dealing with it is a must. Families learn about mental illness, and, just as important, find out that the terrible behaviors that they see at their house are happening at everyone else's house as well.

For me, the most effective class was called "Inside Mental Illness: An Empathy Workshop." We learned that any serious illness ... from cancer to heart disease and everything in between ... causes a psychological impact. The trauma is two-fold:

• You lose forever the "magical belief" that you are exempt from harm.
• You lose a predictable, dependable future.

When the serious illness is schizophrenia, bipolar disorder or another major mental illness, this psychological trauma is even more debilitating. Even when the illness is under control, those who suffer from it rarely get to enjoy things that we take for granted.  Often they have lost the ability to be component and successful in jobs, marriages, parenting and friendships. This is called "life constriction."

The resulting trauma sets up a process in which the "core self" must be protected at all costs. The resulting  behaviors don't make a lot of sense to family members and onlookers, but they are often coping strategies. They are the direct result of an effort to maintain some dignity and self-respect in the face of continual failure, disappointment, shame and stigma.

Here are some of the behaviors you can expect to see:

• Denial (refusing to acknowledging having the illness)
• Refusing medication
• Self-absorption
• Irritability
• Haughtiness
• Controlling and manipulation
• Anger and attack
• Rejections of friends and family
• Blaming others and defensiveness
• Drug and alcohol abuse
• Doing nothing
• Resisting change
• Refusing mental health services
• Apathy
• Bargaining
• Suspicion
• Withdrawal
• Dependency and envy
• Running away
• Quitting a job
• Abusive criticism of others
• Sleeping 
• Refusal to discuss the situation 

These defensive coping strategies make things worse.  Of course, they do. But they do provide the person with the illness with a temporary psychological refuge when their feelings about their core self are hitting bottom.  And honestly, in all my years of working with parents of the mentally ill,  I've seen plenty of them doing the same things from time to time. I've even done some of it myself.

We'll talk more about how to deal with this in the next post.