Once Upon a Roleplay

A Guide to Living With Someone With a Mental Disorder

There are a lot of guides floating around about characters having a certain mental disorder, but I haven’t seen one on what it’s like to be on the other side of the fence. Most everyone with a mental disorder has someone in their lives, be it family, friends, their doctor or counselor, etc. It’s not always easy to live or interact with someone who has a mental disorder, and it’s not anyone’s fault. It’s the way it is, and people have to try and navigate around that.

Contrary to popular belief, there is a huge amount of people in the world with diagnosed mental disorders that function incredibly well. I guarantee that every person in the world has met someone who has been diagnosed with a mental disorder, and simply not known it. Because of how sensational the media can be, most people think that there’s someone on a psychotic break hiding around every corner. This is not the case. That said, just because they function well, doesn’t mean that these people don’t still struggle with their disorder, and so do the people around them.

Any sort of major change within a household can cause a major strain. If you’ve ever moved, think about how stressed you or your spouse or your parents were leading up to it. While this sort of thing is temporary, a diagnosis of a mental disorder is similar in the way that it causes a shock to the way people have always lived their lives. Most of the time, it requires significant changes in lifestyle for both the person with the disorder and the people around them. For example, someone who is diagnosed with major depressive disorder might have feelings of intense guilt over things they can’t possibly control. They rationally know this (sometimes), people around them rationally know this, but they can’t just brush it off because that’s not the nature of things. A new balance has to be found between coddling the person and treating them as if they don’t have the disorder at all. Like with any shock to a larger system, it takes time to adjust to and there are always going to be bumps. Here are a couple tips to help smooth these bumps over a little.

Do your research

Forget all those late night Criminal Minds marathons or any Law and Order episode you’ve ever seen. Forget all your preconceived notions about whatever diagnosis your friend, significant other, spouse, family member, etc. just received. Sit down, find a couple books written by experts in the field, hell even the DSM is a good start point. Start from scratch and work your way up. Talk to their doctor about it, what they should expect, any tips they might have. Talk to the person with the diagnosis if they are comfortable with it. There are support groups for people going through the same thing, and while experiences aren’t exactly the same, hearing others go through it successfully can be encouraging. It’s not all going to come at once. There are going to be days where things are just hard, for both you and them, and it’ll be something that you need to be ready for. However, having that basic knowledge is going to save you a lot of energy in the long run.

Learn from your mistakes

Honestly, this is something we should all be doing, but it becomes even more important when someone close to us is diagnosed with a mental disorder. As the name suggests, a mental disorder is an affliction of the mind, and it can and will cause those diagnosed with one to perceive things differently from we do. This could be as simple as them thinking that you are angry with them or as extreme as them thinking that you are out to murder them. No one expects you to be perfect, but in a situation that can become volatile, it is imperative that people are aware of themselves and their actions. A negative reaction to an offhand comment by a person without a mental disorder could simply be a twinge of hurt before they move on. A negative reaction to an offhand comment by a person with a mental disorder could be a psychotic break. The more you can do to limit any distress for them, the more you are helping them out.

Don’t coddle

While you may need to adjust and reevaluate certain priorities in response to a diagnosis, this does not mean that you should coddle and fuss over someone with a mental disorder. Unless they are especially low-functioning (can’t dress themselves, can’t feed themselves, etc.), they will appreciate it much more if you let them breathe. While it may be tempting to want to do whatever you can to help them, remember that they are still people. Patients who have gone through years of being independent, don’t take kindly to suddenly being treated like a child. Even children with mental disorders tend to lash out when they’re feeling smothered. Never allowing them to do anything can foster resentment or an insecurity. Again, it’s all about finding balance, allowing them to be independent to the extent they can be.

Expressed Emotion

Expressed emotion is composed of three elements: criticism, hostility, and emotional overinvolvement. Criticism is defined by making a comment or does something that revolves around explicitly disliking or disapproving of the patient’s actions. Hostility is a more extreme form of criticism, where someone criticizes the person themselves rather than something they do or say. Another form of hostility is anything that might indicate rejection of the patient, like sighing in relief whenever they leave the vicinity. Emotional overinvolvement is whenever someone acts dramatic, overprotective, excessively devoted, or self-sacrificing over the patient. This is coddling. These characteristics all come together to create expressed emotion. Expressed emotion is a fairly reliable predictor of relapse for people with mental disorders. Environments that are high-EE tend to be more controlling over the patient, either through criticism or overbearingness. People with high-EE tend to see the person at fault more than the disorder, and have an underlying belief that if the patient only tried harder to control themselves and their behaviors, they would magically become better. They aren’t as good at reciprocating positive emotions and portray negative emotions more. It can develop because patients aren’t making the progress that their family and friends hope to see, and they become frustrated with the patient and the situation as a whole.

Not every person with a mental disorder is the same. In fact, no two people share the exact same experiences when it comes to mental disorders. Just like everything in the world, there are so many different factors that play into how people respond and react, and it’s important to remember that there is no set way. Ultimately, someone who is attempting to be supportive will try and do all these things, but they won’t get it right all the time, and certainly not the first time. There is a learning curve for this sort of thing, habits that need to be relearned and routines that need to be changed. It’s not easy, but it’s trying and learning that will make all the difference. Everyone is human and makes mistakes from time to time, but it’s what happens after those mistakes that is the most important.

Not every character who is faced with this situation is going to know these things. Have your character make mistakes. Maybe they’re having a bad day and aren’t as patient which can lead to some sort of conflict with whoever they’re interacting with. In an ideal world, this is how everyone would handle things, but think on your own character. What are their own views on mental health? How has that changed since someone close to them have been diagnosed? How might their personality naturally predispose them to act a certain way? Take the things you already know about your character (their history, personality, etc.), and apply it to this new challenge in their lives.

These are a couple quick tips on how someone might learn to live with a loved one with a mental disorder. Of course, there are always other things that others can do to help, dependent on who that person is. Any questions, responses, etc., feel free to drop by my askbox and we can chat. Thanks for reading.

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