Sunday, November 18, 2012

Five Things I Wish I'd Known When a Loved One Was Diagnosed With a Mental Illness

1.  The diagnosis is difficult.

We don't yet diagnose mental illness with real lab or blood tests. Virtually everyone has the experience of the diagnosis changing from doctor to doctor.  And many people have more than one diagnosed disorder. Dual diagnosis of mental illness and an addiction are particularly common. Up to 80 percent of the people with bipolar disorder have an alcohol/drug addiction.

2.  It's hard to get help. 

You face long waiting lists for psychiatrists and case managers.  The rules generally are that you have to be assigned help when you leave the hospital unless, of course, you have private insurance. That can mean you are looking at waiting lists of as long as eight months.  If you are in that situation, look for a psychiatrist who doesn't take insurance. You'll have to pay some money, but you'll be able to get in faster. You also can look for psychiatric nurse-practitioners to get faster help. In some cases, family doctors are comfortable prescribing medication, but often they are not, particularly for schizophrenia. If you are in an emergency situation, need to get a prescription and can't get an appointment, your only options may be a hospital emergency room or Netcare, a psychiatric emergency service. And, you're right, that's expensive and doesn't make sense.

3. One aspect of mental illness is lack of insight.  And the medications do have bad side effects. So it's really challenging to get people to take their medicine.

The ill person often doesn't see himself as ill, which makes it hard to get him to stay on medication or go to therapy.When the medication has bad side effects, that's doesn't help either.  One-half of people with serious mental illnesses don't take their medicine.

4. You have to find a friend who understands the system.

Make friends with social workers through Mental Health America or NAMI support groups so you can learn how the system works ... at least, for this month. These social workers, who are assigned to the groups that meet at community mental health centers, can make phone calls for you and tell you what to do.

5.  This is a marathon, not a sprint. 

This is going to go on for a decade or two or three.  You must adjust your response and the pace at which you work so that you maintain your own strength and sanity. Do everything possible to prevent the unpredictability of the situation from making your own life disorganized and chaotic. Figure out your own limits. Find ways to bring joy into your life.

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