Mental Illness in My Own Family

One of the hardest things to accept has been the loss of my son to a mental disorder. I remember the day 30 years ago, the day he was born planning his life. I picked out the preschool he would attend, elementary, middle, high school and college with no thought that his path was chosen and I would be the one and other family members adjusting to the changes that were going to affect all of our lives.

I remember thinking and feeling what an angel,

he looked like, rosy cheeks, blue eyes, and brown hair. The perfect child; as infant always smiling, watching observing and being content. He responded to cuddling, kisses from everyone, children and adults with smiles; as he grew the most cooperative, mellow, observant and accommodating child to everyone who came in his presence. I had no idea the changes that were waiting in his future and the devastating effects his illness would play on the family's future.

I was blindsided by his deteriorating behavior towards me and I wondered would I be able to manage the challenges that are not part of normal/regular parenting. This was an eye-opener and a glimpse of what was to come. Two years prior to the decline in his behavior; it started in middle school: skipping classes and being truant to class regularly and lastly not attending his middle school graduation.

I remember looking and searching for him the entire day only to discover he was at a classmate's house smoking marijuana. His delinquent behavior from that moment increased to almost daily defiance. I was at a loss on what to do! The next move was to seek out counseling services but to no avail.

He refused to participate and only resisted my efforts to help him. At that point, I chose to help myself and practice self-care in an effort to deal with the issues to come so I attended counseling to learn coping skills to maintain my own emotional and mental stability.

Without therapy, I don't believe I would have been able to maintain and navigate the challenges that come with parenting a mentally unwell adolescent. My story does not end here and this is only the beginning in a series of articles....

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Danisha McCrary, AMFT knows first-hand how difficult it is to love someone with a chronic mental illness. She has worked with many families that were struggling with issues of substance abuse, homelessness, mental disorders and traumatic events. As a counselor, Danisha assist families to overcome the obstacles that prevent healing, teach people how to manage crisis situations, and find new healthy ways to cope in life. Danisha is fond of saying, “that we all can use a little bit of help from time to time, even me.” If you want to work with Danisha give our office a call.

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By: Danisha McCrary, AMFT

I found my passion for working with children, teens and families when I was a Social Worker for Child Protective Services. These families were struggling with issues of substance abuse, homelessness, mental disorders and traumatic events. As a counselor, I desire to assist families to overcome the obstacles that prevent healing, help manage stressful life events and find new healthy directions in life.

I am fond of saying, “we all can use a little bit of help from time to time, even me.”

 I believe people and families can develop the coping skills needed for healthier relationships. Nobody wants to feel sad, depressed, angry or anxious. I have seen plenty of people get better and enjoy their lives and families again. I believe in hope.

My specialty is working with people from age 5 to 80 who experience depression, low self-esteem, anxiety, feeling stuck, or just can’t find the joy in life anymore.  

I have found children and families can be resilient by participating in therapy and learning the skills needed to recover and manage their life struggles. My priority is to find the best therapeutic model to assist you and your family in healing and developing a healthy relationship. Because we all deserve to feel good about ourselves and have loving and caring friends and family.

Anticipatory Grief

Grief and loss doesn't start after your loved one has died. It begins when the realization becomes real that their death is approaching, whether far in the future from a long-term illness, or when a death occurs with little notice. In the ER, the ICU, at home… when that realization happens grief begins. It’s called “anticipatory grief” but, in reality, it’s grief, with all its emotion and sadness.

In the time before death occurs, there are things that need to be considered, both from the loved one’s perspective and to address your concerns. This will address the dying person’s needs. I’ll follow it with a blog about your needs as you support your loved one.

What Does A Dying Person Need at that point?

·       The need to “settle up” with the people so as to die in peace, with them and with myself.

Settling up emotional accounts

All of us have unfinished business left over from our years on Earth. Approaching death is the last time to make amends, check in, or say the things that have been left unsaid.

If someone can’t be reached, letters can be left, and even dictated. Elaborate isn't necessary. Peace for the person dying is.

·       An advocate for their end of life decisions

End of life decisions need to be written well in advance of the dying process. They aren't valid if you aren't of sound mind without a doubt.

Enforcing a living will or other decision making documents can be difficult if there is division in the family.

It’s hard to not provide hydration of nutrition if it’s been days or weeks. Someone has to ensure the dying person’s wishes are followed. That may have to be you.

·       The environment the dying person desires

Some people are extroverts, even when dying. Some are private, even if the family wants access. The dying person should have the kind of environment they lived with and following their wishes. And someone has to ensure it happens.

Things to consider:

•  music 
•   TV or movies
•   Bedroom or living room 
•   Home or hospital
•  Family 
•   Friends
•  Pets
•  Spiritual folks
• Lighting
•   Scents

·       A safe space to talk or a safe person to talk to about death

Family and friends are often reluctant to face up to the reality of the terminal illness and death: even if they are not, their experience is not the experience of the dying person. If they are still capable of talking, they may need someone to talk to about their fears and terrors, hopes and vulnerability. It may not be family. It may be a nurse, a friend… it’s up to the person who needs to do the talking. They don’t need their decision to create conflict. It’s their decision.

·       Spiritual support- or NO spiritual support.

Some find it comforting. Some find it presumptuous to assume they need spiritual support. Some do not have a faith they rely upon or believe. The dying person needs, and deserves, to have their needs followed at this point. If family needs to listen to religious music, say prayers, light incense… no matter- if it’s not something the patient wanted or participated in, it belongs outside the door. It’s the patient’s death- nobody else’s.

·       Pain management/comfort measures

A dying person deserves to have pain and discomfort resolved. They may not be able to tell you what they are feeling, but their body can to some degree. Blood pressure, fever, grimacing, tightened muscles, low oxygen saturation, irregular breathing. Those and so many more are indicators of the patient’s body being uncomfortable. Can you fix the breathing? Probably not. But you can add oxygen. You can administer pain medications and anxiety meds through sublingual administration. You can add a subQ IV to administer meds without adding fluids that could create respiratory distress. You can massage. Make the bed softer. Use a cool washcloth. Turn on a fan. Add a blanket.

Families tend to be especially distressed about morphine and other meds. They are not going to kill a dying person. They make the muscles relax so breathing is less stressed. They relieve pain. If your loved one has asked for comfort measures, they don’t want to die in pain. Allow the medical professionals to guide you. Ask questions.

·       Food? Fluids?

At the end of life, the body has a process of its own as the systems shut down. It no longer needs food. It doesn't thirst. The mouth may need moistening. Oral care is still necessary. But if a dying person says they don’t want food or fluids- believe them. It’s hard to watch. You are still hungry. You are still thirsty. They are not. Honor their body and their needs. Forcing fluids can cause choking and even pneumonia, hastening death.

·       Visions supported

Many people who are dying will report that they are seeing loved ones who died before now, or angels.  Don’t question or deny that. There have been studies that say they may be caused by hypoxia or changes in brain chemistry. The studies, however, cannot include dying people. We don’t know this experience. We do know it’s common and brings comfort. Tell them you are glad they are there.

o   Your voice

The last sense to die is hearing. If your loved one would want you there, talk to them. To the end.  

o   Permission

This is most likely the hardest of all. No matter the disease or the pain, very few of us really want our loved one to really die. The fact is they are going to die. Tell them it’s ok. Tell them you’ll be ok; you’ll take care of business they left behind; you’ll carry their memory. Tell them what you will miss most and how much you loved them. But tell them they can go.

It’s not easy to sit while someone you love is dying. It’s a gift if you can.