I had a long conversation with a family member yesterday. She's entering a graduate program that will keep her far away from home for a few years and she feels guilty. Her mother is mentally ill.
Guilt seems to haunt many of the family members of those with psychological disorders. We feel guilty for not giving up more of our time to help care for them. We feel guilty for not being able to solve their problems. And worse, we often feel guilty, thinking we contributed to the problems to begin with.
In this particular case, the young woman's mother had been diagnosed with Bipolar Disorder while in her 20s. For years it was managed well with Lithium, then later with a cocktail of several drugs. While there were periodic episodes of depression and extreme manic behavior when she convinced herself that she was cured and didn't need her medication, for the most part, she was able to raise her children and thrive at a job she loved.
One day, after deciding she could stop taking her meds, she went manic again. This time, she took her daughter out of school and hit the road. Not long into the trip she abandoned her young daughter in a motel and continued on her manic binge until she was ultimately arrested by the police and placed in a psychiatric institution. Fortunately, a very wise psychiatrist explained to her that her condition was physical, a chemical imbalance in the brain, and that she would have to be on medication for the rest of her life. There was no cure but the condition could be managed. Family members and social services made it clear to her that she would lose custody of her daughter if such an incident ever occurred again and this resonated for her. Over the next several years, she stayed on her medication and worked tirelessly towards doing the best job she could to raise her daughter.
But life is change and her daughter grew up. Her daughter started spending more and more time with friends as teenagers are wont to do. Unbeknownst to her daughter and family members, she quit going to work. She pretended to, fooling everyone. As graduation approached, she had a complete psychotic break, losing all touch with reality. This was no longer Bipolar Disorder.
She was hospitalized for several months and then moved into a care home, a place where trained nursing staff could ensure that she took her medications and could recognize signs of impending crises. Her daughter went to college nearby but then took an internship on the other side of the country, promising to return to care for her mother and feeling both guilty and relieved that she could get away from the situation.
So back to yesterday's conversation: it started off about the unique opportunities of the particular graduate program she's chosen, then quickly moved to guilt about not being there for her mother. She believed that if she could be there, perhaps she could make a difference.
We discussed the fact that her mother experiences a different reality, and our ideas of logic don't make sense to her. She hears voices, is convinced that she's responsible for all the problems in the world. She'll see a television program on tainted water and will ask to be arrested because she's at fault. She doesn't believe that her daughter is living far away, even when shown the documentation. And yet, the daughter believes that she could make a difference if she were there.
We talked about the fact that like the Bipolar Disorder, the psychosis her mother suffers from is incurable with current psychiatric techniques/medications. It's somewhat manageable, but the medication and therapies don't bring her a normal life. Her daughter's presence won't change the incurable physical aspect of her disease.
And then it came out. She believes she caused her mother's mental illness. Because she grew up and graduated from High School, her mother lost her reason to remain sane. It's her fault that her mother had the psychotic break and is now in the state she's in.
And maybe it is her fault.
But was there anything she could have done to avoid it? No.
The reality is that she had to grow up. She didn't have a choice in that. Whether her growing up was a fault or not, time and genetics guaranteed that the break would have occurred at some point.
It's a terrible thing that her mother suffers from this debilitating mental illness. But it's just as terrible that her daughter suffers from such guilt. You and I know that it's not her fault. Blame it on genetics.
If you don't have much experience with people who are severely mentally ill, it's easy to think that cures are possible. The right medication, the right therapies, there's got to be a way.
But after you've lived with it for a while, after you've outgrown the arrogance that makes you think that you have the power to fix it, you come to realize that people in this state don't think like we do. Their perception of reality is completely different. Their logic is not a logic we can understand. Their brains are wired differently.
Maybe someday, science will invent a machine that can scan the brain and see these broken or mis-wired circuits. Maybe someday, they'll figure out how to fix them. In the meantime, we need to understand our limitations and understand that as family members or friends, we can help manage, but we, ourselves, can't fix something that's this badly broken.
All we can do is the best we can. We need to live our lives too. And, we shouldn't feel guilty that we can't do more.
Guilt seems to haunt many of the family members of those with psychological disorders. We feel guilty for not giving up more of our time to help care for them. We feel guilty for not being able to solve their problems. And worse, we often feel guilty, thinking we contributed to the problems to begin with.
In this particular case, the young woman's mother had been diagnosed with Bipolar Disorder while in her 20s. For years it was managed well with Lithium, then later with a cocktail of several drugs. While there were periodic episodes of depression and extreme manic behavior when she convinced herself that she was cured and didn't need her medication, for the most part, she was able to raise her children and thrive at a job she loved.
One day, after deciding she could stop taking her meds, she went manic again. This time, she took her daughter out of school and hit the road. Not long into the trip she abandoned her young daughter in a motel and continued on her manic binge until she was ultimately arrested by the police and placed in a psychiatric institution. Fortunately, a very wise psychiatrist explained to her that her condition was physical, a chemical imbalance in the brain, and that she would have to be on medication for the rest of her life. There was no cure but the condition could be managed. Family members and social services made it clear to her that she would lose custody of her daughter if such an incident ever occurred again and this resonated for her. Over the next several years, she stayed on her medication and worked tirelessly towards doing the best job she could to raise her daughter.
But life is change and her daughter grew up. Her daughter started spending more and more time with friends as teenagers are wont to do. Unbeknownst to her daughter and family members, she quit going to work. She pretended to, fooling everyone. As graduation approached, she had a complete psychotic break, losing all touch with reality. This was no longer Bipolar Disorder.
She was hospitalized for several months and then moved into a care home, a place where trained nursing staff could ensure that she took her medications and could recognize signs of impending crises. Her daughter went to college nearby but then took an internship on the other side of the country, promising to return to care for her mother and feeling both guilty and relieved that she could get away from the situation.
So back to yesterday's conversation: it started off about the unique opportunities of the particular graduate program she's chosen, then quickly moved to guilt about not being there for her mother. She believed that if she could be there, perhaps she could make a difference.
We discussed the fact that her mother experiences a different reality, and our ideas of logic don't make sense to her. She hears voices, is convinced that she's responsible for all the problems in the world. She'll see a television program on tainted water and will ask to be arrested because she's at fault. She doesn't believe that her daughter is living far away, even when shown the documentation. And yet, the daughter believes that she could make a difference if she were there.
We talked about the fact that like the Bipolar Disorder, the psychosis her mother suffers from is incurable with current psychiatric techniques/medications. It's somewhat manageable, but the medication and therapies don't bring her a normal life. Her daughter's presence won't change the incurable physical aspect of her disease.
And then it came out. She believes she caused her mother's mental illness. Because she grew up and graduated from High School, her mother lost her reason to remain sane. It's her fault that her mother had the psychotic break and is now in the state she's in.
And maybe it is her fault.
But was there anything she could have done to avoid it? No.
The reality is that she had to grow up. She didn't have a choice in that. Whether her growing up was a fault or not, time and genetics guaranteed that the break would have occurred at some point.
It's a terrible thing that her mother suffers from this debilitating mental illness. But it's just as terrible that her daughter suffers from such guilt. You and I know that it's not her fault. Blame it on genetics.
If you don't have much experience with people who are severely mentally ill, it's easy to think that cures are possible. The right medication, the right therapies, there's got to be a way.
But after you've lived with it for a while, after you've outgrown the arrogance that makes you think that you have the power to fix it, you come to realize that people in this state don't think like we do. Their perception of reality is completely different. Their logic is not a logic we can understand. Their brains are wired differently.
Maybe someday, science will invent a machine that can scan the brain and see these broken or mis-wired circuits. Maybe someday, they'll figure out how to fix them. In the meantime, we need to understand our limitations and understand that as family members or friends, we can help manage, but we, ourselves, can't fix something that's this badly broken.
All we can do is the best we can. We need to live our lives too. And, we shouldn't feel guilty that we can't do more.
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