When I made the decision to write the first blog post about my experiences dealing with mental illness, I thought that single blog post would be the alpha and the omega – my beginning and my end.  I also thought that I would be able to maintain my plan to post one new blog entry every Sunday morning.  Well, while writing about my family and mental health, I remembered the multi-faceted and multi-layered complex nature of mental illness.  That fact, along with the critical need of villagers in crisis, mandated more sharing of my story.  It dictated an urgent requirement to deliver help to an audience in need.  Writing about mental illness was helping me and the pinned up desire to help others pressed to be unleashed from my heart and my soul.  I aimed to enable myself and empower others to find a way to unravel the tangled web of emotions, events, and diagnoses that define mental illness.  Hence, that blog was my alpha and there will likely be many more before I write the omega.

I have read and reread my blog in an effort to decide just how many topics of discussion existed in the alpha post.  It was interesting to examine how I dealt with the varied topics related to my sister’s mental illness for many years, but how sharing the story with the world stirred up some old, quieted emotions.  Sharing, with my outside voice, made me cry, but not in a pitiful, sorrowful way.  I cried tears of remorse and compassion for my sister and other families of those with a mental health diagnosis who found themselves, like my family, hijacked by an unexpected assailant preying on the unarmed, the unprepared, and the often unevenly matched.  Mental illness swarms the innocent victims, families, friends, and loved ones without warning and steals their present moments of calm replacing them with extreme, undefinable and unimaginable chaos.  Mental illness forces the subjects to ponder their past and how their decisions and habits “caused” their present condition while planting seeds of fear of the future.  My experience was watching the instantaneous evaluation of not only my sister’s psyche, but also her social practices, her childhood behaviors, her history of injuries and/or trauma, her friendships, her career and educational pursuits, and her family.  In sorting out my sister’s illness and trying to help determine the how and the why, the family went through a strip search of a sort, individually and collectively.

Now as I look at this situation through more mature lenses, I see that the challenge was how to explore every aspect of my sister’s life without judgment, guilt, shame, regret, or abrupt adjustments that might cause the unit to derail.  The challenge was how to prevent isolation of the individuals and how to encourage open dialogue among people who were all in shock by the sudden onset of the break.  As a child in the midst of this type of chaos, I found myself often the most capable and clear voice.  That truth frustrated me for years, but now I believe it was our truth because my thoughts and understanding were not tainted by life experiences.  I didn’t know enough to be afraid of anything I heard about experiences of others or the possibilities presented by health care professionals.  I didn’t have the fear of failing my child if I made the wrong decision related to her care or the guilt or fear that something I said or did in the past “caused” the illness and therefore the break.  My thoughts were pure and solely based in my journey from the tremors to the quake.  There was something about not feeling responsible that made me the perfect authority to speak directly to that voice within her when I felt a tremor.  Surviving those hours in the house, as I held on for dear life, empowered me to stand up to the voices that now found residency in my house through her.  I was empowered to stand whenever those voices frightened my older family members or manipulated them with guilt or pain.

I know that my comments make me sound like a very strong and mature eleven-year-old kid.  I was mature for my age; however, the truth was some of my strength and need to speak emerged from a place of anger and resentment.  I was angry that my childhood was gone and that I had become like “Cinderella” (or at least that’s how I felt).  Instantly, I was tasked with ALL of the chores because any other option that included asking or demanding my sister perform a chore might “put too much pressure on her” and cause another break.  My parents dared not ask her to empty her ashtrays or wash her dirty dishes or take her shoes to her room or clean the tub after her baths and most certainly there would be no ask for her to help me cut the grass. This approach by my parents only fed my sister’s huge ego that thrived on attention and submission of others to her will.  As a result, she began to believe that I was born, not to assist, but to serve.  She figured out quickly that she could tattle on me and receive pity from Mama and Daddy to will the results she wanted.  To me she was a master puppeteer.  My husband once called her “a master chess player.”  These types of manipulative calls coupled with the empathetic responses by my parents motivated the “baby sister” to begin the process of sorting out the line that separated the mental illness symptoms from the innate personality traits of my sister.

It seemed that I was often the only one in the house who could exercise objectivity and clarity of thought where she was concerned.  Again, my innocence and the natural bend of the sibling rivalry made me perfect for the role.  I can remember my mother becoming especially aggravated with me for forcing some issues with my sister and not just “keeping peace.”  I remember once when Mama told me to clean up the den and I decided to deliver all of the dirty dishes left in the den by my sister as well as the ashtray filled to the brim with butts from the Virginia Slim Menthol’s she smoked to her bedroom dresser.  She plead with my mother to make me take the dishes to the kitchen and empty the ashtray.  I refused.  It seemed like a minor request to my mom, but it was my belief that she could have walked each item to kitchen every time walked to the kitchen to grab another treat or drink just as easily as I could have walked ALL of them there at one time.  I am not sure to this day who actually got those dirty dishes to the kitchen and I honestly cared less who emptied the ashtray since I was allergic to nicotine and cigarette smoke.  Although the health care providers were rarely speaking to me directly during my childhood, I listened as my parents recapped and debriefed after their sessions with therapists and social workers.  I heard them say that they had been advised to “set firm boundaries for her”, “give her responsibilities,” make her “accountable” for those responsibilities, for herself and her decisions.  Discussions about my resistance always included me reminding my parents about the advice of the professionals and of course it was my position that my juvenile and arguably rebellious behaviors supported those recommendations.

My personal experiences have shown that like a child in early stages of development, families at the birth of a mental health crisis are in the infancy of a developmental process with no foreseeable end date.  Each family member must trust the village of health professionals like the toddler trusting the grown ups guiding their first steps with outstretched arms.  I think the challenge for those learning to live with this new diagnosis is that the health professionals are strangers, not loving, familiar faces like those in the toddler analogy.  Thus, the unit, individually or collectively, resists the advice of those with more expertise in the field.  They sometimes begin a series of experimental efforts based in emotion, instinct, and sometimes religious practices that can hinder or interfere with the medical treatments and counseling already implemented.  In my opinion, every person or family in a mental health crisis needs the supervision of trained health care providers.  It is also my opinion that it is equally important for the family to have access to that health care team.  Within the family unit or non-medial support team, there must be at least one objective voice willing to be the project manager of what I will call “the tough love team.”  I was the project manager of the tough love team for my family starting at age eleven and I continued to serve in that capacity for the next three decades.  If you are that person for your family, you, like I, probably expect to be the target of your mentally ill family member’s rants and venting.  I hope that you will find, as I did, that the village will respect your role and your consistency.  Respect, in this context, feels more like a remarkably heavy load weighing down your body.  You will be surprised about the challenges of the co-dependency relationships that also form and add to the already heavy load.  It doesn’t feel as honorable or heroic as it sounds, but your role is valuable and necessary.  The village and the person battling the illness will call upon you to bring calm and order to the chaos more often than you can imagine or desire.  Be strong. Be consistent. Be informed. Take deep breaths often.  Have a short memory in the management of the rants and manic behaviors.  Forgive the targeted behaviors and manipulative actions while remaining objective in the decisions you will make aimed to keep your loved one healthy and safe.  Finally, I recommend that you build a good relationship with at least one mental health care provider who can support your efforts to support their plan of care for the person you are working so hard to help discover how to manage and master the illness.

Find people and practices to encourage yourself in this process of caring for and supporting your loved one.  Find positive, healthy ways to empower yourself to stay the course.  Surround yourself with folks who can enlighten you about how to support your loved one and how to maintain your own emotional, physical, and mental stability.  I lived in the shadows of my sister’s illness for most of my life.  My life as a SisterintheShadow of mental illness is no more and I pray that my decision to speak about my experiences with my outside voice will encourage, empower, and enlighten someone else in the shadows of a mental health challenge.