On Your Mind: Dealing with a parent’s mental illness

on your mindNOTE: The question below reached us through our “online hotline” button which lets anyone send a question to a local counselor at Ozark Guidance — in a completely anonymous way. The email comes in with no email address and no identifying information. We set it up this way so women would feel free to write about anything on their mind.

I have a mentally ill, but thus far undiagnosed, mother. It is becoming increasingly difficult for me to be around her because of her insistence on continuously talking about her paranoia and delusions/hallucinations. I already struggle with feelings of anxiety and depression, and while I want to be a part of my mother’s life, I am finding that my own problems are exacerbated during and after contact with her. What is the best approach to dealing with this issue?

Response by Libby Bier, MA, NCC, LPC, LADAC

Thank you so much for taking time to submit this question. You might be surprised to learn how many  have similar struggles. You raise several important issues including diagnosis and treatment for your mother, as well as care for yourself and the impact her illness is having on your relationship.

Before I address these, I want to start off by saying that if any of your mother’s symptoms put her or anyone else in danger, she may need to go to the hospital. If the danger is immediate, call 911. (Once she’s in treatment, there may be some other options you can explore with the treatment team that can help with accessing care.)

Let’s start with you, though, and first look at the importance of self-care. You mentioned you already struggle with your own anxiety and depression. An important component to addressing your mother’s issues is making sure you’re in a good place yourself. Are you familiar with coping strategies for yourself such as relaxation, positive thinking, healthy support systems, and setting limits or boundaries? Are you taking care of yourself by sleep bedtaking care of the basics: relaxation, exercise, diet, sleep, and spending time with others who aren’t caught up in this challenging situation? If you are and it’s not working, have you looked into treatment for yourself?

When you’re doing all of this for yourself, then you’re better equipped to begin addressing the concerns you have for your mom. This will also improve your ability to be in a relationship with someone who may need some ongoing support to manage potential psychotic symptoms. I say “psychotic symptoms” rather than a specific mental health disorder because there are many reasons as to why someone may have paranoia, delusions and hallucinations.

This leads to diagnosis and treatment. A lot of information is needed to determine if someone is psychotic due to a mental disorder or if there’s some underlying medical issue. A good first step in getting your mother care is a medical evaluation by a primary care provider. It’s ideal if it can be someone with whom she already has a trusted relationship (to help with any reluctance or paranoia on her part). If no underlying medical issues are found, then being evaluated by a mental health care professional would be important.

It’s really important for whoever is working with your mom to have a complete picture of how her symptoms are affecting her functioning. This will help with diagnosis and the development of a plan of care.

Research tells us that many people are not even aware they have mental health symptoms. This can make it really frustrating when the person does not believe they need help and can put additional strain on the relationship. Sometimes it’s not helpful to challenge the delusions or hallucinations while you’re trying to first connect her with treatment. The insight that she is experiencing symptoms of an illness may not come until she has been in care for some time. Even as a professional, I have to sometimes remind myself to not take it personally when someone becomes agitated or mistrustful. This helps take the pressure and focus off of me or the individual and instead puts emphasis on them and recovery.

To summarize, here are your next steps:

1. Take care of yourself so you can be there for mom (the commonly used analogy is that if you are flying, the pre-flight instructions always include putting the oxygen mask on yourself before taking care of others around you).

2. Work with mom to connect with primary care and, if necessary, mental health care.

3. Try not to take mom’s behavior personally. It sure can feel personal, and some of the things people do when they’re sick can even seem like an attack. But remember, these are not things mom would be doing if she were feeling better.

One last thing to remember about this is it may not be possible to immediately “force” mom into getting help, (hence all the talk about taking care of yourself). There are some steps that can be taken if there is danger to self or others or if there’s some long-term impairment that prevents her from taking care of herself. However, delusions and hallucinations are not always, by themselves, enough to secure care for someone against their will.

I hope this has been helpful. If after your mom has seen a primary care provider, it’s determined that she  needs a mental health care provider, the staff at Ozark Guidance would be happy to assist with an evaluation to determine what services are needed and to connect her with resources within our agency and in the community.

Therapists at Ozark Guidance would be happy to answer your questions and read what’s on your mind. Click the butterfly icon below to fill out an anonymous submission form with your question or concern. The form contains NO identifying information and is designed to give local women an online place to share concerns with a person qualified to offer feedback.

Disclaimer: This RESPONSE does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on nwaMotherlode or Ozark Guidance websites.

On Your Mind: Introducing a boyfriend to the kids

on your mind
I’m a single mom who is dating again and the relationship is getting serious. I think it’s time for my boyfriend to meet my kids. How can I make this process as easy for the kids as possible? They are still very close to their dad and I don’t want them to think I am trying to replace him.

Response by Patrick Henry, LMFT, LPC

Introducing kids to a new partner is exciting for some while very anxiety-producing for others. Still others dive right in without a good strategy and with little/no planning, which is not ideal. Planning, patience, and preparation can go a long way in setting your partner and kids up for success with each other and may have a ripple effect—setting the kids’ dad up for a positive response, too.

Here are some guidelines/ideas that frequently come up in the literature on blended families and introductions that I can strongly agree with based on my own experience in helping families.

Relax

Breathe. Your kids’ level of anxiety and regulation comes from you setting the example. It will help if you don’t have too many expectations. Unrealistic expectations are sure to set you up for frustration.

I’ve seen too many parents who have an idea in mind for how things should go or a timeline for how quickly they should see a relationship develop between their kids and new partner. Don’t add this extra pressure or you may sabotage your own best efforts. Your kids are going to think and feel whatever they think and feel. Respect this. Don’t freak out if they don’t like him, have reservations, or don’t interact too much the first time they meet him. Relationships aren’t created in a day. Be okay with that.

Do something together

Do something fun/interesting together when your kids meet him for the first time. Kids don’t want to sit around in the living room answering a bunch of questions for someone they don’t know. Awkward. Instead, go cartoon family stick figuresomewhere and do something….fun! This is similar to “breaking the ice” when you’re with a group of people you don’t know for the first time and the group leader gives you some kind of game/activity—usually referred to as an ice breaker.

With your kids and partner, you’ll want to go do something more natural that you expect your kids will enjoy. For example, go bowling or hiking (again, the key is that you can reliably predict or know it’s something your kids will like doing). This will help them feel safe and they will be comfortable to be themselves and engage in conversation in a more natural and genuine way. Avoid going somewhere you used to go together as a family with their dad.

Go slow

You can’t force a relationship. You cannot make your kids like, love, or bond with your new boyfriend. You can give them opportunities to connect. You can plan times together, and you don’t have to run this by your kids every time…..but don’t include your new boyfriend in everything you do.

They still want time with just their mom and they don’t want to share you all the time. It’s okay to decide that you are all going to spend the day together….but not every day. You can respectfully decide the schedule but you have to let the kids set the pace for the development of the relationship, and this can be a great time to teach and allow your kids to do some healthy boundary setting.

Reassurance that replacement is not the goal

You’re very interested in moving forward with this new person while your kids may still be grieving the loss of the original family unit. You’re highly interested in this new relationship. Your kids are highly interested in maintaining their current relationships—with you and their dad. Reassure them by telling them that their dad cannot be replaced. Your boyfriend is not working towards this end. Back this up by doing what you can to support and encourage their relationships with their father.

If you and their father co-parent and have open communication about parenting issues and your kids see you working together, this will also help in them accepting your new boyfriend as he will be safe — not a threat.

Be the parent; Don’t under-function

I’ve heard it said many times that Rules – Relationship =Rebellion. The most successful families I work with are those in which the parents have a strong bond/relationship/connection with their children. These parents have a far easier time setting limits and boundaries, communicating expectations, and gaining child cooperation overall. The relationship acts as a contextual backdrop and, because the relationship is there, the rules and expectations can be heard, tolerated and followed.

caution-943376_640I have too frequently seen mothers introduce their new boyfriend to her kids and, within a short time, he is giving many or most of the orders, commands, and directives as well as handling discipline. This is not his job.  You should not give him this job or let him assume this job. That is your job. You handle the expectations and the discipline. He needs to work on the relationships. He doesn’t have the relationship with your kids needed to back up the expectations and you will likely get resistance and the dreaded “You’re not my dad, you can’t tell me what to do.”

Letting this new guy become the disciplinarian will set your boyfriend and kids up for failure. Be the parent. Your boyfriend can back you up and assist with reminders and words like “I heard your mom tell you not to do that” and “I want to remind you what your mom said about that. Can I help you make a better decision?”

Your situation is not easy. But you’re relaxed, patient, and carefully considering your actions. You’re using your head to strategize while also empathetic and understanding. Be confident and good luck!

Therapists at Ozark Guidance would be happy to answer your questions and read what’s on your mind. Click the butterfly icon below to fill out an anonymous submission form with your question or concern. The form contains NO identifying information and is designed to give local women an online place to share concerns with a person qualified to offer feedback.

Disclaimer: This RESPONSE does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on nwaMotherlode or Ozark Guidance websites.

On Your Mind: Old abuse, new baby

on your mindNOTE: The question below reached us through our “online hotline” button which lets anyone send a question to a local counselor at Ozark Guidance — in a completely anonymous way. The email comes in with no email address and no identifying information. We set it up this way so women would feel free to write about anything on their mind.

I’m a new mom to a 3-month-old baby. My husband got upset at me and when I answered back because he was being rude and name calling, he shoved me to the ground in front of our infant son! This is not the first time he has been physical with me. I got up and tried to fight back but he just pinned me to the wall. I’m fed up.

Response by Ozark Guidance Clinical Director Jared Sparks, LCSW, PhD

I’m glad you’re reaching out about this. The verbal and physical abuse you’re describing is not okay. More to the point, from what you’ve shared, you and your baby are in danger.

This can be hard to see when the abuser is someone you care about…and who says he cares about you. However, it’s not only about you and your baby’s immediate safety but also the long-term damage that exposure to this violence can take.

woman-1006102_640What people working in behavioral health and domestic violence have learned over time is that, once there is violence in the home, it is likely to continue and worsen. We’ve also come to understand that witnessing violence in the home (even at a very early age) can result in long-term mental health problems.

It’s really beyond the scope of this blog format to go into depth about this, especially since this feels more like an immediate crisis. The good news is that there is excellent help in this area available to you.

Peace at Home Shelter, provides a 24/7 crisis hotline (Local: 479-442-9811 Toll free: 877-442-9811), and their website has really good information about how to keep yourself safe while getting help.  http://peaceathomeshelter.org/get-help/domestic-violence/

Of course, if you’re in immediate danger, call 911 immediately.

Therapists at Ozark Guidance would be happy to answer your questions and read what’s on your mind. Click the butterfly icon below to fill out an anonymous submission form with your question or concern. The form contains NO identifying information and is designed to give local women an online place to share concerns with a person qualified to offer feedback.

Disclaimer: This RESPONSE does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on nwaMotherlode or Ozark Guidance websites.

On Your Mind: We’re arguing more lately

on your mindMy husband and I have been arguing a lot more than usual lately. The arguments are never physical but I know they are taking a toll on me and the kids, too. What can I do to help break this pattern of arguments that seem to solve nothing? How do you know the difference between normal, healthy arguments and the ones that lead to broken marriages?

Response by Ozark Guidance Clinical Director Jared Sparks, LCSW, PhD

Those are great questions and no doubt ones other readers have. The fact that you’re recognizing that these arguments are not productive may be an indicator that the communication is not entirely healthy. The fact that you’re noticing that this is taking a toll not only on you but also the children also points to the stress the arguments are placing on all of these close relationships.

The definition of normal is a bit up for grabs. But if you’re both willing to work on better ways of communicating, this can be an opportunity to strengthen your relationship. It does NOT have to lead inevitably to a broken marriage.

breakup-908714_640You mentioned that there has been a recent increase in frequency of the arguments. The reasons for that can be varied. It may point to some new or worsening stressor or change in the environment (good or bad). It can also happen when healthy ways of resolving problems were not learned in the family we grew up in. Over time and in stress, people can fall back on unhealthy communication styles that are more familiar.

To effectively communicate, there have to be some basic skills. To begin with, each person has to know how to listen and relate back their understanding of the issue. However, as you may already know, learning better ways of communicating, while at the same time navigating through difficult family situations, can be really challenging.

In terms of what you can do to break out of negative arguments that don’t solve anything, I would recommend that you find a marriage and family therapist who can guide you. It’s important that, as a family, you set some ground rules about how to discuss these issues before trying to resolve them. This is going to likely include some work on being able to identify early on when these conversations are eliciting strong emotional reactions…before things get out of hand.

It’s going to involve identifying what is absolutely out of bounds in these communications…things like name calling and threatening. Strategies like using “I” statements  rather than “you” can help with this (i.e. “I feel angry” instead of “you make me mad.”) It may include setting limits on the time and space for talking about difficult subjects. There should also be some agreed upon plans for how each of you cope with anger during or after conflict…and respecting each other’s plan.

You were also asking how to tell the difference between healthy and damaging arguments. There is no doubt that all couples do at times argue, and in the heat of things people can say very hurtful things. Having this as a “norm” obviously is not healthy. Having arguments about the same thing without ever generating new solutions or making progress is not healthy. Identifying that you are seeing a change in behavior of your children in response to these arguments is also an indicator. Children can react in a variety of ways including becoming more withdrawn or acting out. Kids will likely pick up on these unhealthy communication styles and use them themselves down the road if they have not already.

It may be cliché, but the fact that you’re noticing a problem is a huge first step. You obviously already have a good foundational awareness and willingness to work for change. Marriage and Family Therapy can build on this and hopefully provide some relief and the potential for you all to grow into a healthier and happier family. Good luck and thank you for the great questions.

Therapists at Ozark Guidance would be happy to answer your questions and read what’s on your mind. Click the butterfly icon below to fill out an anonymous submission form with your question or concern. The form contains NO identifying information and is designed to give local women an online place to share concerns with a person qualified to offer feedback.

Disclaimer: This RESPONSE does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on nwaMotherlode or Ozark Guidance websites.

On Your Mind: Mother trying to help her adult daughter

on your mindNOTE: The question below reached us through our “online hotline” button which lets anyone send a question to a local counselor at Ozark Guidance — in a completely anonymous way. The email comes in with no email address and no identifying information. We set it up this way so women would feel free to write about anything on their mind.

I have a 20 year old daughter that is on the verge of a breakdown. She goes to college, had a recent breakup with a boyfriend, feels alone and has PTSD. I have gotten to the point where I don’t know what to say to her anymore. It’s the same response from her: “I don’t want to live.” She says that I don’t love her (because I don’t know how to fix her).

She has seen a psychologist for 5 years and it’s the same old thing. She talks and nobody listens. She knows all the coping skills and says none are working. Sometimes it feels like she just wants me to feel sorry for her. She is very mad at me because I don’t know what to do. How else can I help her?

By Dr. Jared Sparks, Ozark Guidance Clinical Director

phone 911Thank you for question. Because your daughter is talking about not wanting to live, your question has very serious implications.

For that reason, this response is more directive and shorter than most of the responses shared in this blog. Your daughter is an adult and is ultimately in charge of her own care. However, most medical and mental health providers welcome family involvement when it’s helpful. If there is danger to your daughter or to others, it could be appropriate to share those concerns with your daughter’s psychologist.

If there is immediate danger, you should call 911.

Therapists at Ozark Guidance would be happy to answer your questions and read what’s on your mind. Click the butterfly icon below to fill out an anonymous submission form with your question or concern. The form contains NO identifying information and is designed to give local women an online place to share concerns with a person qualified to offer feedback.

Disclaimer: This RESPONSE does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on nwaMotherlode or Ozark Guidance websites.