What Should I do?

* If your loved one is in crisis or in danger, please call 911

What should I do is the most common thought we have when a loved one is in the midst of a mental health struggle, or on the cusp of one.

My family member’s behaviour is concerning. What should I do?

Often times our family member displays concerning behaviour, but we aren’t sure how to describe it to our doctor. I could say that he was depressed, but how do I know the difference between a few bad days and something worse?

We aren’t therapists or professionals, so trying to understand it can be overwhelming. Also, trying to describe it to someone may come across as confusing, or you don’t really know what you are talking about.

Here is the thing: If your loved one’s behaviour has caused you to become concerned, then they might be struggling. Perhaps it is a repeated pattern of behaviour that is not in line with their usual routine, and has caused you to be more aware of their actions than normal.

For me, I noticed my partner’s mood had started to shift from being more involved, to staying more at home and quieter, even moodier and sad. It was at that point I suggested we speak to our doctor.

Ask some questions when considering whether something has changed:

• Has your loved one become withdrawn from things that have made them otherwise happy and fulfilled?
• Have you noticed sleep pattern changes?
• Have you noticed that they are not taking care of themselves, such as bathing, changing clothes, washing their hair
• Are they speaking in a concerned manner, i.e. that they have no future, they are sad

Again, if any behaviour that might seem like they are looking to harm themselves, please call 911 immediately

How do I approach the topic with my loved one?

Before you even begin a conversation, there are a few things to keep in mind:

1. Pick a time when there are no distractions. Don’t bring up the subject when you are in the car driving somewhere and the kids are in the backseat demanding your attention. Don’t approach them when they have just returned home from work, or look tired and stressed, and do not start talking about the subject if you are in the presence of other people. This should be a private conversation, away from others. Don’t start a conversation when you know you need to leave or be somewhere shortly – try to find time when you have a good window of time to talk.
   
2. Choose a place that is comfortable: This is a stressful conversation, and approaching the topic while waiting in line at the grocery store, or while driving to work in the morning is probably not ideal. Choose a room that is comfortable and safe, not where you loved one will feel anxious or antsy.
   
3. Ask them if they can talk: Don’t walk into the conversation demanding that they listen to you. You run the risk of it coming across as accusatory. Instead, there are several ways that you can approach this topic with them in a gentle and compassionate way. Here is a good place to start:

When you enter the conversation, enter with empathy and express your emotions appropriately. You do not want this conversation to come across as an attack, so stay away from “listing” off behaviours. Keep in mind the following:

1. Use “I” instead of “you” when focusing on your loved ones struggle. “I am worried about you, because you haven’t been sleeping well.”
   
2. Avoid using aggressive language such as “your behaviour is crazy” or “I’m so frustrated with you.”
   
3. Be aware of your body language: if you are crossing your arms or pacing while your loved one is sitting, this could seem threatening or intimidating.
   
4. Do not “blame” your loved one. Telling them that they are at fault for the situation you are in can be hurtful. We all want our loved ones to be healthier, but we also have to understand that mental health is not always something we can avoid, such as psychosis or a depressive episode. We need to remember to approach the conversation with compassion and care.
   
5. Do not diagnose the problem. For example, avoid saying things like “you are manic, or you are depressed.” We aren’t professionals and receiving a diagnosis entails much more than just an observation – a team of mental health professionals will do a thorough assessment.
   
6. Do not become defensive if your partner is not receptive to your concerns right away. Perhaps they are embarrassed, or scared themselves. Be aware if your loved one looks uncomfortable and wants to end the conversation. Do not force your partner to continue with the conversation if they want to leave or stop talking.

What if my loved one is experiencing delusional thinking, or having a psychotic episode? How do I speak to them? Here’s the thing: at that moment.. it’s their reality. “If someone is experiencing reality in a very different way from people around them, they may not realize or agree that seeking help could be useful for them.” (Mind).

In these cases, more help might be required. I found myself in this situation and was unable to properly communicate with my partner. That’s when I reached out to COAST – a crisis line who provided advice, and also came to our home to provide help for my husband.

Not sure where you should go for some guidance? I put together a list of helpful contacts here in Hamilton that I hope will help you.

References and resources:
How to Encourage Someone to Seek Mental Health Support

Starting a conversation with someone about their mental health

CAMH When a family member chooses not to seek help