- It's also difficult to be with them when you're exhausted from caring for someone.
- It's deeply exhausting, frustrating, and frightening to try to help those who don't want help. It's out of your hands, and it's out of your authority.
- People have a natural desire to exert control over various aspects of their lives.
It’s difficult to watch a loved one suffer. It’s fair and customary to wish to make things better for our dear ones. It’s also difficult to be with them when you’re exhausted from caring for someone. Something has to change soon, or else you won’t be able to take it any longer.
It’s deeply exhausting, frustrating, and frightening to try to help those who don’t want help. It’s out of your hands, and it’s out of your authority.
People have a natural desire to exert control over various aspects of their lives. This applies to both you and your family members. When we push too hard, the other person is more likely to pull back or double down on assuming charge of their own living. Consider a time when you decided to make a change, such as losing weight or eating healthier. The more people inquire about our eating habits or whether we exercised that day, the more annoyed we become… and the more likely we are to resist making healthy decisions.
Striving in recovery is a normal part of the process. It’s beneficial to use these encounters as learning opportunities. It’s also time-consuming and messy. Sometimes good decisions are made, and other times bad decisions are made. But, with the correct help, we should be able to get to where we need to be.
When working with a loved one who refuses to help, keep the following points in mind: (source: NIMH, 2024)
Pay attention and validate
It doesn’t harm to just listen if your relationship seems fragile. Inquire about their situation and simply repeat what they say. Assist them in feeling heard. You can ask, “How are you doing?” and respond, “Yeah, that seems difficult or amazing.” People find it difficult to act unless they feel understood and accepted.
Interrogate
Inquire about your loved one’s desires! You can’t force someone to do something they don’t want to do. But you can figure out what they really want and work with them to achieve their objectives in a way that you can agree on. You can also inquire how they think about the item you want them to do if they are receptive to it. A typical example is a medication. “How do you feel after taking that drug?” It’s acceptable if people wouldn’t want to take medicine that makes them feel worse because dealing with adverse effects like vomiting or weight gain is challenging. (source: APA, 2023)
Refrain from offering solutions or advice.
There is a time and place for counsel, and that is when someone asks for it. Lean toward support if they haven’t asked. You could even agree with them at times: “Yes, this mental disease stinks, but so does medication.” People’s defenses come down when they are given the opportunity to be heard, and they are more open to discourse.
Investigate options together and look into various possibilities
If someone says, “I don’t want to do this,” you’re likely to make things more difficult for yourself (and them) by insisting on doing it. “All OK,” you could say. Let’s not do that…what do you want to do instead?” Don’t use those phrases straight away if you’re not sure or ready to talk about mental illness. Career, life, relationships, stress, and sleep are all good places to start. Something else—and then take up the subject of “mental illness” afterward. (source: SAMHSA, 2024 (FindTreatment))
Take care of yourself and seek out your own sources of assistance.
We can’t help people unless we’re in good shape ourselves. When we’re exhausted and frustrated, it’s difficult to be patient. Look for all those who are caring for others. Find someone with whom you can express and who will make you feel better. Having other people to speak to can also assist you in determining when and how to push, as well as when and how to cut loose.
Finally, if someone truly refuses to help, coercion may be an option… However, it does not appear to operate very effectively. When we compel individuals to do things we don’t want them to do, it frequently results in bickering and animosity. Allowing others to make their own decisions, even if those decisions are bad and cause more grief, does not make you (as their friend, family, or other loved one) a failure.
It can be tough to support someone you believe needs help, especially if they are unwilling to get help. If a person is legally an adult, it is up to them to seek therapy and accept care, unless they meet the conditions for involuntary admission to a mental health facility under the Mental Health Act.
There are several ways you may support someone who is suffering from a mental illness or condition and motivate them to seek help and therapy. (source: NAMI, 2024 (Crisis Guide))
Some strategies for assisting someone who may be suffering from a mental illness include:
- Find a convenient moment to speak with the person about your concerns and assure them that you are on their side.
- Discuss the changes in behavior you’ve seen with the person in a considerate manner (try avoiding accusing and blaming the person)
- Try to be as compassionate as possible when it comes to how the person may be feeling about getting help.
- Offer to accompany the person to a doctor’s office as a first step in obtaining assistance.
- Learn about mental disorders and the types of specialists who can assist you.
- Make a strategy for what you’ll do if the person’s behavior worsens to the point where they’re a risk to themselves or others.
If your loved one is refusing to take medicine or take treatment for schizophrenia and their episodes are getting worse, it’s essential to get help. It can be tough to force someone with a mental illness to seek treatment, both legally and emotionally, but if a loved one becomes threatening, family members and friends may need to call the police to transport the individual to the hospital, as per NAMI.
For most states, assisted outpatient treatment (sometimes referred to as outpatient commitment) is provided. It requires people to participate in their therapy and gives the state the ability to transport them to a treatment facility if they refuse to do so on their own. Local NAMI chapters may be able to provide you with information about doctors or outreach agencies in your area who can assist you.
Friends and family should be on the alert for indicators of relapse, such as new delusions, hallucinations, suicidal impulses, social disengagement, disorganized thinking, and difficulties speaking, which frequently indicate that the person has ceased taking medicine. (source: NHS, 2023)
It’s time to call the doctor if relatives or friends notice that the individual spends a lot of time alone or refuses to do things that they once enjoyed. It’s critical to spot behavioral changes earlier on during a psychotic break from reality, which can have fatal repercussions.
Estimates vary, but according to a study published in the journal Schizophrenia Research and Treatment in 2016, individuals with schizophrenia are 6 times more likely than those without the disorder to attempt suicide.
Once your loved one starts to feel better, strive to strike a balance between doing too much for them and doing too little. The goal is to assist them in gaining the confidence and independence necessary to care for themselves.
Consider what you can do to make their lives easier. Can you go to the gym with them, assist them in finding a volunteer or part-time work, have lunch with them, or attend church with them? People with schizophrenia benefit greatly from this type of assistance. (source: CDC, 2024 (Caregiving))
Having a loved one who suffers from bipolar disorder can be difficult, especially when that individual refuses to seek treatment. They may resist care for a variety of reasons, including an inability to recognize that they have a problem. Without expert help, this highly dangerous mental condition that causes despair and mania cannot be handled. Family and friends must push and do everything they can to make sure that a dear one with bipolar disorder receives the assistance they require.
Listen and offer assistance.
If someone refuses to be treated, fight the desire to leave. Because this is someone you care about, continue to help them as long as it is in your best interests. Pay attention to what they’ve not been able to say about treatment and why they are refusing it. You might discover that if you just sit back and listen, your loved one will open up to give you some hints that will help you push therapy through more efficiently.
Simply listening attentively to the people you care about can disclose some genuine, but manageable, therapy hurdles. Fear of stigma, failure to accept the title of mental illness, reluctance to take medications, negative experiences with previous treatment, and concerns about being unable to work or attend school are all genuine issues that may be reasoned with and worked around. (source: NIDA, 2022 (Treatment))
Outline the benefits and make a plan.
You can engage and have a meaningful talk with your loved ones as long as they are still capable of having a sensible conversation regarding treatment. Discuss the potential advantages of treatment. For instance, if your loved one is having difficulty leading the life they desire, discuss how treatment can assist them in making adjustments and setting and achieving objectives.
Concentrate on the aspects of their lives that they dislike. Perhaps your loved one is having difficulties keeping a long-term relationship or holding a rewarding work. Discuss how untreated bipolar disorder is likely preventing you from having a stable relationship and a fulfilling career.
Encourage the Use of Residential Treatment
Bipolar disorder is a complex illness that affects all aspects of a person’s life and necessitates time to adjust to and benefit from treatment and medication. Outpatient care can be beneficial, but for your loved one’s best results, insist on residential care. Residential treatment will allow them to concentrate on learning to live well with this chronic condition in a secure and safe environment. (source: APA, 2019 (MI))
There are a few things that a residential treatment program can give that outpatient treatment can’t:
- A multidisciplinary team with competence in a variety of fields
- Various therapies are available.
- Medical care is available 24 hours a day, 7 days a week.
- Treatment programs that are tailored to the individual
- Support services and alternative treatments
- Training in life and work skills
- Services for aftercare
When is it time for mental health intervention?
When someone you care about refuses treatment, their mental health difficulties are causing major problems, or they refuse to recognize or admit that they have bipolar disorder, a stronger push may be necessary. Interventions are well-known and successful in the treatment of substance abuse disorders. Family and friends gather to express their support while also insisting on treatment. If the individual refuses, there may be repercussions, such as the loss of financial support.
There are some hazards involved with attempting an intervention. It’s essential to design, practice, and implement this method with the help of a mental health expert. An intervention for a mental condition such as bipolar disorder is more dangerous than one for an addict. Be cautious and ready for denial, hostility, and even aggression. Make a plan and don’t attempt to achieve this without professional help. (source: NICE, 2022)
Is Hospitalization Always Required?
Making the option to enter into an involuntary commitment is a difficult one. Adults, in general, have the legal right to refuse any treatment. And taking away someone’s right to refuse medical treatment is a serious decision. There are, however, exceptions. These are usually reserved for situations in which the individual is suspected of causing harm to himself or others.
One of the most common reasons you may need to seek emergency treatment for a loved one is suicide. It’s worth it if involuntary commitment saves their lives. Of course, hospitalization for the purpose of stabilization is not the same as treatment. Treatment for bipolar disorder cannot be pushed because it necessitates the patient’s commitment and time. However, in some emergency situations, treatment may begin with hospitalization.
The kindest and most accepting thing you can do is accept and love someone who refuses to live. (source: 988 Lifeline, 2024)
Acknowledge them for who and what they are, pay heed to them when they want to talk, and show them that you care by not attempting to change them, or telling them that you have the solution they seek or shocking them into becoming real. Ask them questions – it might be about basic, daily topics like what they like to eat or what they would do if finances were no barrier. Perhaps they’d go on a mission to Mars, get a crypto mining rig, embark on a world tour, become a professional athlete or entertainer, or learn to play a musical instrument.
Give people a reason to live by giving them a purpose to live. Let that friend know why they are so important in your life. Remind them of what has happened in their lives and what might be treasured. If you don’t suffer from depression, it’s nearly hard for you to grasp why someone wouldn’t want to live, but it’s critical that you strive to understand and demonstrate why you want to understand.
They must understand that you wish to have them on this earth with you. Staying alive may appear to be straightforward, yet there are incomprehensible complications that people require assistance to comprehend. Be a good friend, be there for them, understand their grief, and share your delight.
When you’re depressed, it’s easy to forget that anyone cares, wants, or even thinks about you. It doesn’t have to be difficult to make you feel like life isn’t worth living. Everyone, regardless of their mental health, needs to be reminded of the value of life. You are adored, and others require your affection. In times of adversity, be the person you most needed.
The Article
References
- World Health Organization. (n.d.). Mental health: Strengthening our response. World Health Organization. [who.int]
- National Institute of Mental Health. (n.d.). Help for mental illnesses. National Institute of Mental Health. [nimh.nih.gov]
- Substance Abuse and Mental Health Services Administration. (n.d.). National helpline. Substance Abuse and Mental Health Services Administration. [samhsa.gov]
- National Institute on Drug Abuse. (n.d.). Principles of drug addiction treatment: A research-based guide (3rd ed.). National Institute on Drug Abuse. [nida.nih.gov]
- MedlinePlus. (n.d.). Mental health. MedlinePlus. [medlineplus.gov]
- American Psychiatric Association. (n.d.). What is psychotherapy? American Psychiatric Association. [psychiatry.org]
- National Institute for Health and Care Excellence. (n.d.). Self-harm: Assessment, management and preventing recurrence. NICE. [nice.org.uk]
- Cochrane. (n.d.). Motivational interviewing for substance abuse. Cochrane Library. [cochranelibrary.com]
- National Center for Biotechnology Information. (n.d.). Motivational interviewing. In StatPearls. StatPearls Publishing. [ncbi.nlm.nih.gov]
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