People with mental illness do, sometimes, need a push to make things happen, but when do you push a person with a mental illness forward? Obviously, you should never push a person until he or she breaks – and there is a risk of this with those with mental illness because many of us can’t take the same pressures (stress can cause bipolar hypomania, among other things) that other people can. Nevertheless, a supportive push forward can be helpful but do know when to push a person with mental illness.
Pushing a Person with a Mental Illness Who Won’t Get Help
As my readers know, I’m a big proponent of getting help for mental illness. In fact, I would suggest that you can’t get out of a moderate-to-severe mental illness without help. And if the person does have a serious mental illness? Then the kind of help that is needed is medical.
But what if the person won’t get help for his or her mental illness? Then I say push them. No, I don’t mean nag them every day. No, I don’t mean send them daily emails, either. But I do mean making help as attractive an option as you can and make not getting help as unattractive as you can; and have the mental-illness-help conversation over and over until something sticks. It’s up to you as to how frequently this is. It might be once after each crisis or it might be once per month but I say push a person with a mental illness to get help – especially if the mental illness is serious.
And keep in mind, mental illness help might come in stages. The first stage might be to read a book on mental illness. The next might be joining a support group. And it might be only then that the person reaches out to someone medically. This is okay. Anywhere on the path is still on the path.
Pushing a Person with a Mental Illness Who Won’t Adhere to Treatment
Again, my readers know that I think treatment is essential to beating a mental illness – especially a serious one. This may not mean medication; this may mean therapy, exercise, use of a lightbox and so on.
Consider smart ways to help a loved one get back on the mental illness treatment bandwagon:
- Find out why your loved one isn’t adhering to treatment. There are many reasonable reasons a person might be treatment nonadherent.
- Take these concerns seriously. If they are stopping your loved one from continuing treatment, they matter.
- See if you can address the issue(s). This might mean changing doctors or therapists, trying a new treatment or removing other roadblocks.
- Once any possible roadblocks have been removed, then start to facilitate getting treatment. (Such as by picking up prescriptions, driving the person to appointments and so on.)
- If the person still refuses treatment, then really get down to the bottom of why as it sounds like he or she wasn’t honest in step one.
This is the kind of pushing a person with a mental illness needs – loving pushing. Helpful pushing. The kind of pushing that listens to his or her needs and tries to make sure they are met.
Of course this won’t work all the time, put it’s a good blueprint for a starting point. (You may also want to reach my complete article on what to do about medication noncompliance/nonadherence.)
Pushing a Person with a Mental Illness Who Does Nothing
If the person with a mental illness has gotten help and is adhering to treatment but is doing nothing with her or her life, it might be time for another push. A life where you sit on your couch and watch television all day eating bonbons is not much of a life at all and won’t be sustaining or fulfilling, even if it feels like it’s all the person with the mental illness wants to do.
Try to help the person get a job or do some time of other weekly activity. And, again, find out why the person is not doing anything. There may be roadblocks there that you can remove here, too.
A job might be a very part-time job (say, only one day a week) or it might be a volunteer job but a job (in my opinion) is critical in developing self-worth. Try to push the person with the mental illness by offering up job suggestions, looking on Craigslist for jobs that might be appropriate. Get the person’s resume up-to-date.
Other things the person with the mental illness might do includes:
- Art – many of us are creative in some way
- Writing/journaling – I’m not talking anything professional here, just personal writing for enjoyment’s sake
- Joining a social or support group
- Playing a sport – double-positive on this one as it gets a person out of the house and it provides exercise
- Partaking in a hobby
- Chores around the house (Believe it or not contributing to the household can also make a person feel good about his or herself. I might suggest this is an important one to include even alongside others.)
And remember, doing something once a week is better than not doing anything. Start small and move forward building on that in a positive way rather than focusing on the fact that six days a week the person does nothing.
When Not to Push a Person with a Mental Illness
There are times when it’s best not to push a person with a mental illness, however. These might be:
- Right after we’ve already heard you harp on about it. Give us a break, please.
- During a crisis. Crisis management does not include pushing a person to do something they don’t want to do unless absolutely necessary (such as hospitalization – people don’t want it, generally, but sometimes it’s needed).
- When we’re doing the best we can. Look, if someone is trying really hard to live a life including positive activities and trying to keep up with treatment and trying to get better – please don’t further push him or her just because your standards say it’s “not enough.”
- When we’ve just made a positive step, please don’t tell us the step isn’t big enough. Our timetable is our, not yours. If we move forward an inch, it’s as big as your mile, trust me.
Remember, your well-meaning pushing of a person with a mental illness can be harmful if you’re not careful.
After You Push a Person with a Mental Illness and He or She Moves Forward
And do remember this: when we do move forward – thanks to your supportive pushing or not – celebrate our achievement! Like I said, a forward move may be tiny – it may take the form of getting the mail and dealing with it each day; it may take the form of making an appointment with a therapist; it may take the form of keeping the kitchen clean; or it may take the form of volunteering three hours a week – it doesn’t matter. That forward move is an achievement for us. Be positive about it. Celebrate the little things. We need this validation that we’re doing the right thing because it can be very hard (very hard) for us.
Because no matter how you pushed, pulled or dragged us, we still ultimately made the choice to do it and that is a big deal indeed.
Note: People ask me about loved ones who won’t get help all the time and I tell them about this book: You Need Help. It’s a book with many, many strategies designed to convince a loved one to get help. This is not an endorsement by me, but you might find it worth checking out. It’s by a doctor who seems to know his stuff.
Image by Veronica Agullar.
This site has been such a tremendous help for me! My son has been diagnosed as Bipolar II, his therapist and psychiatric NP feel that schizophrenia or schizoaffective are likely. I struggle to understand how best to prepare him for life after high school. We have some special struggles as well. This site- your words – really help me to understand him, to understand what it is he tries to tell me.
I have this problem with my daughter. She often decides her treatments (counseling, meds, etc ) are not helping.
After her last hopitalization for a manic episode, she has declared over and over again that she never wants to have to go to the hospital again.
That turned out to be a big point for me to use to convince her to get and continue to get help.
I remind her that she needed to be treated in a hospital as her in the midst of an episode it is impossible to reason with her. If she keeps up with her counseling, doctors appointments and medication, hopefully it won’t reach a point requiring such extreme measures again.
I also requested that now when is able to reason well, is the best time to set up a plan of action to be taken if those around her see that she is slipping into mania again. She had no suggestions as to what we could do at such a time. I asked her to talk to her counselor to help put a plan in place. This gives her a reason to keep going to counseling.
This article means much to me. I have bipolar disorder II, and.. it takes much.. to step forward. to be better in relationship, finance, job, and future. I didn’t know what happened in me 3 years ago, when I had bad depression if i didn’t find your blog. thank you so much
It is always hard to acknowledge: “Because no matter how you pushed, pulled or dragged us, we still ultimately made the choice to do it and that is a big deal indeed.” It is a big deal and to celebrate that instead of minimizing it is the key for me.
Hi EDDE and everyone, EDDE you are so right on. In a sense, nobody but myself pushed me to take meds. But I’d been trying, trying, trying for 40 years to get some sort of competent help with my terrible depressions and death wishes. Rages, too. Anyway, one of my husbands, who was raised in a Christian Science home, his mother never taking medications or seeing a doctor, my ex was reluctant to do those things, either, even though he was no longer in the church. But one time, he said to me, “Synergy, you think of yourself as a kind, loving person, who cares about other people, don’t you.” I said Yes. Then he said, “Well, if you realized how you affect other people, you might consider taking medication.” That was one of the handful of times he said something real, something honest and truthful to me. Well, his comment went in to the “hopper” in my consciousness, but I didn’t do anything about it for about 4 years. All my life I have had extremely sensitive hearing. It’s called hyperacusis. I’d tried to get some help with this, but no doctors knew what to do, and the tests for my hearing came out n ormal. So finally I was able to talk on the phone to a hearing specialist MD at a local university hospital. His said that it was “anecdotal,” but that some of his patients had said Paxil helped with the hearing problem. So somehow I got a rx for Paxil. When it “kicked in” which it did quite suddenly after a couple or three weeks — it was a “shock” — It was a wonderment. I thought “So this is how EVERYBODY ELSE feels ALL THE TIME.” What a revelation. Wow. So after that I finally found a really good psychiatrist and mental health clinic. One really good benefit is that I have stopped wanting to be dead, every day, all day with these death thoughts and wishing to commit suicide. I’d mostly decided not to commit suicide though, for several reasons. One, because I believe that “something” or some unknown spirit or afterlife is out there. And that suicide would possibly be something I would not want to deal with in this afterlife. Secondly, I had become aware that when a member of a family takes their own life, this can affect the family for generations to come, making it likely that someone else in the family or down the line, to take their own life, too. The third reason continue to take meds is that when I’ve tapered of them — tried to — twice, with pdoc supervision, the depression came back within a few weeks. The final reason (no particular order of these reasons) is that I think about my effect on other people that I love. And other people I don’t even know, because I don’t want to snap at them or be “the customer from hell.”
I have been in the paid full-time and volunteer workforce all my life, in return for insults, abuse and even violence. If you want to know the truth, prayer has gotten me through to where I am today, which is healthy and busy trying to promote and fight for our rights, as well as other work (all of it volunteer – they tend to discriminate against you a bit less in volunteer jobs [maybe]). I need to get a social life ‘though!
Good article, Natasha. I’ll keep all this in mind and save the article for if / when I know someone who won’t work on getting help if they need it. Me, I’m turning into a super grouch because of computer issues. I spent over an hour today — AGAIN — trying to get something to work. It’s something different almost every day. It eats up my day — at least half a day. I need support. Every time this happens I need support. My therapist and I have been working on this extreme frustration I get with these stupid computers. +So far, nothing helps. I don’t want to burden my two best friends with this every time it happens. Certainly this is not for them to try to solve, or aid me on this so often! They know how I react, and don’t need to hear it over and over and over from me.
Is anybody else having these extreme days about computers or other electronic devices? I almost smashed my phone the other day — slammed it down on the desk. I have already broken two phones. One a long time ago, though — I threw it across the street — about 25 years ago. For a funny, that I have printed out in color, and have a small one taped to my computer, go to google.com/images and search for woman shooting computer cartoon