Watching the moving drama “Broken” on BBC recently, I was reminded of how tough it is for people looking after someone they love with emotional or mental health problems.  How difficult it is to watch someone suffering, their personality changing or disappearing, no longer being the person they recognise.  Not knowing what to say, how to help or what to do.

I felt an affinity with the priest, portrayed by Sean Bean, as he struggled to overcome his own demons in order to reach those in need of his help, whose parishioners taught him more about how to care in the darkest times than his profession could.

When someone we know is suffering or is experiencing a tragedy, we fear saying the wrong thing, saying or doing something that will make things worse, whilst also worrying that not doing or saying anything means we don’t care.  We are left in a bind that is hard to break out of without having to take a leap of faith and hoping that what we do will be received as intended.  In most cases, being honest and acknowledging that bind along with the intention to show care is all that’s needed for the other person to feel cared about.  I think Sean Bean’s character felt bound, at times, by his need to maintain his position in the Church, then was humbled by others who found a way to cut through the detritus of professional responsibility to reach the hearts of others.

But what about when the person we love does not acknowledge anything is wrong, or that it is as significant as we think it is?  There’s more at stake than worrying about saying the wrong thing then.  We question “is it me?”, “am I the one with the problem?”, “am I going mad here?”.  We also want to convince ourselves that it is just a temporary blip, that they will get over it soon, after a nice holiday, a night out with the girls/boys, once that big project at work is finished or the exams are over.  We spend hours thinking about what might be wrong, and working out how we can fix it for them, make things better, shoulder more of the load.  Only to find that it makes little or no difference, and we can end up in the firing line of their anger and frustration.

No one wants to think that they are not well or are suffering in some way.  So, to have a partner, parent, friend or colleague suggest that’s the case can be very painful and humiliating.  You’d think I’d be a bit of an expert at breaking the news to people I love given how many poorly people I have worked with over the years, but it’s really no easier knowing what I’d say as a professional, after all, my loved ones don’t want a relationship with the Psychologist, they want me, with all my quirks and failings.

In the past I have tried to be subtle, so subtle they have ended up none the wiser.  Or I have danced around the subject and ended up with a lovely intellectual discussion that I can only hope might have sown a seed or two.  Other times I have used myself as a case in point, and come away thinking I really ought to book myself an appointment to see someone!!!  Then again, I have blurted it out in the middle of an argument when no one is going to hear a loving, compassionate message in “you really need to get yourself some help!!!” Hm.  Not my finest moments.  There is something about telling someone we love that they aren’t themselves at the moment and would benefit from some help that creates a lonely place in ourselves.  It’s the fear that we will humiliate them and make them feel worse, and how they will respond as a result that holds us back.

We may have fantasies that they will kill themselves, we may have had experience of them lashing out and taking their shame out on us or others, we may worry that they will leave us, denigrate us or blame us in some way, then the shame will be ours and not theirs.

But all the time we are living with the impact of their difficulties and feeling more and more cut off from the person they once were.

It’s horrible to be treading on eggshells, hyper-vigilant to any change of mood, unsure of whether to try to carry on as normal or do something different.  This tension can then create emotional difficulties in the carer as well, such as feelings of helplessness, anxiety, suppressed anger and guilt, which in turn can come out as physical health problems like IBS, hypertension, back pain, headaches etc.

It is hard to remember during such times that no one is intentionally making this happen, no one is setting out to hurt the other, but so often this is how people can be left feeling.  A lot has been said in the media recently about the very common tendency for people with emotional problems to be told to pull themselves together, which is usually said out of frustration that nothing is changing or getting better.  Having exhausted all of our strategies and resources, we can become exasperated and start to believe that the person we love does not want to do anything about the problem and is therefore somehow deliberately inflicted their misery on others.  Neither person wants this to be happening but the nature of mental health problems means it is difficult to find the energy, motivation and courage to face the problem head on and do something about it.

So, what can be done to make sure we stay ok as the other person is suffering?  Here are a few suggestions:

1. Make sure we have a few other people that we feel we can trust to talk to about this.  This support network can include friends and family, but sometimes it is better to have people who are outside of the situation entirely such as a GP, colleague, counsellor, religious leader, teacher, etc.

2. Maintain a hobby that enables us to find some time and space to ourselves in order to relax.

3. Look after our physical health by eating regularly (even if the other person is not eating), getting a fair amount of sleep (sometimes this has to be snatched in bursts if sleep difficulties are an issue), take a shower or bath and spend that time just focusing on the temperature of the water, the way the light catches on the water, and the different smells and sounds that come with the experience.

4. Keep a diary or find a way of being able to express our feelings without them coming out in an argument, for example some people find writing poetry or finding a private place to have a good old rant very helpful.  I have been known to mutter things into the washing machine as I load it up.

5. If it is possible to have a discussion about what is going on, then focus on how we will help each other to manage the situation, give each other permission to have a bit of space without guilt or fear of anything bad happening, and acknowledge that we’re both going through a tough time.

6. Avoid unhealthy or unhelpful things like alcohol, however tempting it is to get some short term relief from the distress and tension we are carrying around inside us.

7. If there is the opportunity to go to a relaxation class, like yoga, pilates, mindfulness, art, craft or music, then take it.

8. These are some general suggestions, that I hope will help to spark some more specific ideas that are personal to you.  Above all, please remember that to care for someone else we must first have taken care of ourselves, which we can do with the help of others.

Here are some links to organisations that might be of help:

http://www.mind.org.uk

http://www.nhs.uk/carersdirect

http://www.carerssupport.org.uk

http://www.rethink.org