Mentally ill have responsibility to care for selves

My husband and I have a 24-year-old daughter diagnosed at 5 as ADHD, later, OCD, and now it is thought that she is bipolar. She has never had good relationships with friends, boyfriends or us. I worry daily for her. She cannot hold down a job because of the things she says and does. She has no drive and feels defeated and (destined) to be a failure. My husband is 79 and retired with only Social Security and I am 61 and work as an independent contractor in a travel (agency), which means the only salary I bring in is what I do on my own. (My daughter) needs blood work, but refuses to have it done as she is afraid of needles. Every day, I pray to God for a change, but my prayers have not been answered. We have been to family counseling and she has seen therapists and psychiatrists most of her life, with little success. She needs help. I feel such despair for her and am concerned about her life.

-- G.D., Las Vegas

A family member with chronic mental health issues can turn an otherwise happy, functional family upside down. It can estrange loved ones. It can erode and destroy marriages. It can affect your health. The stress, the worry, the conflict, the expense, the helplessness, the stigma -- truly, it can tear you from limb to limb.

Many people who suffer from chronic mental illness can and do find their way to functional and even thriving lives. What these people have in common is that they take their illness seriously, and avail themselves faithfully to therapy, support groups, family intervention, medication and other such resources that combine to help manage the illness and ameliorate the symptoms.

But, commonly, the bane of us mental health professionals is the frequency with which mental health patients will not consistently avail themselves to medical/social resources. A dark joke that makes the rounds among my colleagues is that the diagnostic criterion for bipolar disorder should include "won't stay on his/her meds." It's very frustrating.

I encourage you, as you continue to look for help for your daughter, to make a new priority of finding help for yourself, your husband and any other people obliged to manage these circumstances. Here's a quick list:

* Southern Nevada Adult Mental Health Services, 486-6000.

* The Path Program, 657-0123, www.pathprogram.samhsa.gov.

* NAMI-Nevada, 322-1346, www.nami-nevada.org.

* Depression & Bi-Polar Support Alliance for Southern Nevada, 255-4003.

I know a mother whose son suffers with paranoid schizophrenia. After years of angst and chaos, this mother surrendered. She accepted that, not only was she largely helpless to help, but that so often her attempts to help quickly became part of the problem. So she changed the equation. Instead of "What does my son need?" she began to ask, "What must I accept ... and, having thus surrendered, what do I need to do to have integrity in myself?"

So, she told him he couldn't live in her home. Today, he is homeless in another state. He lives in his car. The only medication with which he is faithful is marijuana. He bathes once a week. She never knows when she'll hear from him. When he does call, it's invariably to ask for money.

Occasionally, she travels to see him. Not for him, but for herself. She buys him a few meals, buys him some clothing. She bought him a cell phone, again, not for him but for her. All that she does today is first a gift to herself, so that she can look in the mirror and say I am doing all that can be done to love and honor my boy.

Don't get me wrong. This woman will die with a part of her heart broken. But I count it as courageous that she surrendered to her broken heart and decided to live the life that was hers to live despite that loss.

G.D., you say you pray to God for change. So did this mother. And the change that God required of her was a change in herself. Today, this mother tells me that, every day, she surrenders her son to the care of God. She has found serenity in accepting her limits, doing the grief that a mother must do, and claiming a productive and meaningful life for herself.

If you paddle your boat out to save a drowning man and that man proceeds to get into your boat and behave in ways that threaten to drown you and others in the boat, sometimes you must face the terrible choice of throwing that man back in the ocean.

People who need rescue are not without responsibilities to participate faithfully in their own rescue.

Originally published in View News, Dec. 15, 2009.