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  • Writer's pictureDr. Tarra Bates-Duford

Families Struggling with a Decompensating Member

Too often when those struggling with mental illness begin to mentally decompensate families of the mentally ill are faced with the challenges of understanding and coping with their loved one’s decline. For many families coping with the mental health problems of a loved can be extremely stressful and overwhelming. Families often experience several different and conflicting emotions; such as, why is this happening now? Why won’t he or she just take their meds or go see a doctor? Why are they so weak? What can we do to help? How can they help? Why won’t the person try to help themselves? Should the family get involved or intervene? Where can we go to get our family member needs? What will people think about our family if he or she doesn’t get help?

Family members’ response to the mental decompensation of a member can vary in type and intensity. Typically, during early onset symptoms of decompensation there are several warning signs that include but are not limited to:

  • Irritable mood/affect

  • Depression

  • Socially isolating behaviors

  • Changes in sleep and appetite

  • Confused thinking or reduced ability to concentrate

  • Excessive fears or worries, or extreme feelings of guilt

  • Significant tiredness, low energy or problems sleeping

  • Detachment from reality (delusions), paranoia or hallucinations

  • Inability to cope with daily problems or stress

  • Trouble understanding and relating to situations and to people

  • Alcohol or drug abuse

  • Sex drive changes

  • Hostile or violent behavior

  • Suicidal thinking

You can help your friends or family members by educating yourself about his or her mental health condition as well as recognizing the early signs of mental health decompensation, i.e., changes in behavior and mood. Unfortunately, the reality is that most families are poorly equipped to personally help a family member or loved one who is struggling with mental health decompensation as there is often little understanding about the disorder. Due to the emotional connection and the presence of highly charged and conflicting feelings objectivity can be difficult for friends and family to attain. The other barrier is simply one of lacking the skills to talk with the person or offer guidance about what help is available and where it can be found.

Fortunately, once effective treatment has been located and secured many families can be brought together, many times stronger than before. Once effective treatment begins, it is important for family members to get involved and remain consistent in the therapeutic process of the sufferer. Family members also have the option to seek treatment on their own to deal with their feelings and emotions apart from that of the sufferer. Through the process of treatment and dealing with the sufferers’ mental health issues families have been able to grow both stronger and healthier.


Lily was diagnosed with schizophrenia 6 years ago. For the most part she has been able to live independently, i.e., work, rent and apartment, pay her own bills, etc. However, for the last 3 months her behavior has become increasingly erratic, she is becoming increasingly paranoid and suspicious of others, she no longer sleeps throughout the night as she is waking up multiple times, her appearance is no longer neat and clean in appearance but dirty and disheveled, and she rarely eats. When family members come to Lily’s home to visit her they find her apartment dirty, she is no longer able to carry on a coherent conversation, and she is often seen appearing to talk to herself. It should be noted at this time Lily does not present as an active threat to self or others. Should Lily’s family wait to see if her symptoms get worse? Is there something they can do now to help Lily or let Lily address the issues on her own?

#mentalillness #family #Symptoms #Decompensation

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