Ask a Psychologist: Coping with a Family Member’s Mental Illness

You can't fix everything at once

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Q:

I’m getting married in around two months, and I am worried that my feelings will spoil the wedding day, for myself and for everyone else. Also, I’m seven weeks pregnant, which casts an extra spotlight on to my worries. In basic terms, my worry is about my father and my own anger and resentment towards him. He’s not abusive; he’s not a drunk; he’s still married to my mum. I know he loves me. He has, however, quit. Quit on living a healthy, rewarding life. He has no hobbies, no interests, no friends. He refuses to support my mum in attending family social events such as weddings or funerals. He sleeps for four hours each afternoon, longer on Christmas, so we don’t spend much time with him. When he is in the same room as us he will sit in silence and stare at us, not engaging in conversation. He doesn’t work. He took early retirement and it seems like money is pretty short.

I know he has been diagnosed with depression, and takes medication for it. I have also had bouts of this in the past, and my overwhelming feeling when I am down is to get better, to improve myself, so I don’t let myself or others down. He doesn’t seem interested in learning, or engaging, or anything.

I am trying to accept that he won’t change. My mother and brother seem to have come to terms with this more than I have, and don’t have the expectation I have around who I want, and perhaps, need him to be. I’d like a dad who has friends, who engages with the world, who challenges me to work harder, to achieve. Instead of a role model, I feel I have a figure in my life who only highlights the worst parts of my own personality.

I am getting married in a tiny ceremony, just mine and my fiancé’s parents will be there, which will only throw his nature into sharper relief. I worry that the day will be spoilt by my own anger towards him. I’m also worried that as a grandfather, will he be a good example to my child?

Again, I know he will not change. We shy away from any confrontation in our family, so direct talk will not work. Does anyone have any advice about how I should go about changing/forgiving so I’m more comfortable with this situation, for my wedding, and for the future?

Thanks,

Looking for Answers

A: Dear Looking For Answers,

Coping with mental illness (one’s own or a family member’s) can be difficult as it is, and as I wrote about last month, adding life transitions into the mix does not usually make things easier. You’re managing a lot right now. Fortunately, you know what’s important to you, and you’re also very aware of your thoughts and feelings. These strengths will serve you well in navigating your concerns.

As Meg points out in her book, people’s personalities and problems don’t change just because there’s a wedding going on. In fact, it’s very normal for weddings to bring out people’s vulnerabilities and less ideal characteristics. And you’re right that we ultimately can’t directly change other people. But, we do have a great deal of control over ourselves, in that we can choose how we think about things, and how we go about doing them.

To help answer your question about family relationships, I spoke with my colleague, Hinda Winawer, LCSW, past president of the American Family Therapy Academy, faculty member at New York City’s Ackerman Institute for the Family, and co-founder of both the Princeton Family Institute and the Center for Family, Community, and Social Justice. “Your insight puts you at an advantage,” notes Winawer. “You’re already steps ahead, in that you see that your anger is what may get in the way on your wedding day.” In other words, how you’re thinking and feeling about your relationship with your father may actually be more problematic than the relationship itself. Changing your perspective may allow you to enjoy the planning process, and your wedding, a lot more.

You may be ignoring strengths about your relationship with your father in the midst of this stressful transition and his mental illness. “You probably wouldn’t feel this kind of disappointment if you hadn’t already shared something valuable in the past,” Winawer suggests. “What things have you loved about your father? What fond memories do you have together? There is a generic pressure for everything to be perfect for the wedding, but major life transitions can be very difficult. They can be surprising and disappointing, positively and negatively. What kind of lens can you bring to your wedding that will help you to move forward in a different way?”

Another important thing to keep in mind is that you cannot take everything on at once. Weddings and pregnancies often bring issues to the surface, but you can’t solve everything during the planning process, nor can you solve everything alone. Right now is the time to make sure you’re taking care of yourself, and to notice and accept, but not fix, concerns about family members and relationships. Weddings and pregnancies also create a lot of pressure around family relationships and appearances, and it can be hard to manage negative thoughts about what other people may be thinking. Individual therapy can be really helpful in stressful times like these, both to make sure you’re taking care of yourself and coping in a healthy way, and also to gain insight into how to approach things differently. The Psychology Today directory is a good place to start to find a therapist.

As for longer-term things to think about, your dad has also been managing a lot: serious symptoms of depression, as well as an adjustment to aging, retirement, and changing family dynamics. Has he truly quit, or has everyone else given up on him? Depression can be very serious, but it is also relatively common. With the right treatments and support, symptoms can be effectively managed, and families and patients really can feel better. It sounds like you and your family have made multiple attempts to reach out to your father. But there may be other ways to engage him and to help your family move forward. Have you, your partner, or your family members spoken with your father’s psychiatrist, therapist, or other physician? Have you gotten a second opinion on his diagnosis and treatment? Conversations with providers, although emotionally challenging, can help you to feel supported. They can also bring to light other ways that you can help. Have you looked into resources for families of people with mental illness, or tried support groups or family therapy? If yes, then maybe acceptance is the way to move forward. If not, these could be strategies to consider to get unstuck.

Family therapy helps family members to understand their roles in the family system. Family therapists incorporate a family’s strengths to teach family members how to break unsatisfying patterns, and how to learn more effective ways of communicating. Winawer, who has significant experience working with families of people with serious mental illness, suggests meeting with an experienced, trained family therapist who works with adult children and their families. “It’s important to sit down as a family and talk about transitioning into a group of adults,” recommends Winawer. You can also read more on the Princeton Family Institute’s blog about the impact of transitions on a family, and about how to begin therapy.

The important thing to remember is that you can choose how to think about all of this, including considering what you can and can’t change. Also, you’re not in it alone—you have resources to help you, and many families have overcome obstacles like these. Last, you’re creating a beautiful new family with your partner. And that marriage is the most important thing.

DISCLAIMER: The information provided in Ask a Psychologist is intended by Dr. Brofman and APW to serve as general advice and guidance for all readers. The advice herein does not constitute a clinical recommendation or relationship, and Dr. Brofman and quoted mental health professionals do not take clinical responsibility for this information. Ask a Psychologist does not take the place of a confidential clinical consultation with a trained mental health professional.

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