As a psychiatrist treating patients hospitalized with mental illness, I go through this scene quite often: anxious parents (who sometimes fly in from out of town) meeting with the treatment team to discuss their child’s illness, treatment, and prognosis (our technical term for prospects.)
These parents come from different cultural, social and economic backgrounds, but they all share the same two things: Unconditional love for their child, and much anxiety about what the future will be like for them.
Parenting is no easy task. Parents must simultaneously provide nurturing and structure. They must create a supportive environment that allows their offspring to grow and blossom and yet set boundaries that help them become well adjusted adults. Now imagine, just when these parents think they are out of the woods, life throws in a curve-ball.
Severe and persistent mental illness usually develops in late adolescence or early adulthood; a time when children may be graduating high school; leaving home for college, or getting their first job. For the parents who meet with me, there are new questions and new fears: will their child fulfill their potential? Will they graduate, hold a job, raise a family?
Here is what I tell them:
1. “Mental illness is a matter of fact.” Don’t waste time blaming yourself or others. Severe mental illness, including schizophrenia, bipolar, depression, and substance abuse, results from biological changes to the brain. This has been well studied, and as we learn more and more about what causes mental illness and what happens in the brain of people who suffer from it, we also find new treatments. New approaches emerged over the last few years, some of them quite unexpected, including new drugs and new interventions (transcranial magnetic stimulation, and vagus nerve stimulation, to name a few). So many options allow doctors like me to tailor treatment to each individual and to minimize adverse outcomes.
2. No man is an island, no family is alone. Research shows that having a strong support system improves outcomes. Support systems include not only family and friends, but counselors at school, a therapist, and a doctor who you trust. From nationwide groups like the National Alliance on Mental Illness (NAMI), to local ones, help and support is available.
Reach out; inform yourself, your child and the rest of the family. Share your experiences and learn from others, and, don’t forget: Talk with your psychiatrist, and ask questions.
3. Know your options and resources. If your child becomes destructive towards others or themselves, you are not powerless. Hospitalization might be necessary, providing a safe, supervised environment. In case they are unable to make that decision on their own, Florida’s Baker Act Law allows families to obtain a court order for evaluation and/or treatment. If your child has trouble keeping up with their medication every day, you can ask the doctor about a long-acting drug (usually once a month injection) that may facilitate compliance to treatment and allow them to fulfill their goals.
4. Understand that this may be a life-long illness. Severe mental illness is chronic and recurring. There are good days and bad days. There may be re-hospitalizations and relapses. These fluctuations do not mean “failure”. Instead, they reflect the natural course of the illness as it progresses through life changes. Look at the big picture: Is your child moving in the right direction overall?
This may mean conquering another semester in school or receiving a promotion at work, or even starting and keeping a long-term relationship. Sometimes parents need to help their children adjust the course (less credits for a semester, seeking a work environment that is less stressful). Celebrate the milestones instead of focusing on the setbacks.
5. Last, but certainly not least, keep faith and hope! I have seen many young clients rise above their mental illness and accomplish much. Even with residual symptoms and occasional hospitalizations, they reached significant milestones. I have been privileged to share some of those moments. I have been invited to graduation parties, weddings, and baby showers. I have met new spouses, cheered over promotions and helped them find a provider when they needed to move on to better things elsewhere. I have been humbled by what they have achieved, in spite of their mental illness. I hope that widespread consumer advocacy continues to push for more access and affordable treatment. Research has shown that early detection and treatment of mental illness successfully improves the outcome for individuals since mental illness is most responsive to treatment in its early stages.
We are doing our part at Apalachee Center by expanding existing services, training our staff, and joining forces with other agencies in the community (Bond Community Health Center, DISC Village, etc.) to facilitate access and to provide a broad range of individualized services to each patient. Please let us know how we can help.
by Dr. Ludmila De Faria
Chief Medical Officer at Apalachee Center