Keywords: Mental illness, stigmatization, parentification, caregiver’s burn out, quality of life, out of pocket, Nigeria.
Introduction.
Mental Illness Effects on Family – Nigeria. Living with mental illness in the family. What symptoms does the affected family member show? Coping with mental illness in the family.
Mental illness is an illness that affects the way a person thinks, behaves and interacts with other people. It actually affects the person’s function in all aspects of life. Examples of mental illness include depressive disorders, anxiety disorders, bipolar disorders, schizophrenia, post traumatic stress disorders, etc.
Those who are mentally ill may engage in disruptive behaviours and the family members will find ways to control these. The family members must learn coping strategies and be able to understand the ill person’s characteristic behaviours.
The family members act as informants to the doctors and therapists on issues concerning the mentally ill. They also act as co-therapists at home. So it is their job to ensure that the ill person complies with all the required treatments. They also have to go out of their way to show extra love to the ill person. Thus the need for the topic – Mental Illness Effects on Family – Nigeria.
Living with mental illness in the family.
When someone has mental illness he/she is not the only one that suffers. The entire family members, friends and even coworkers suffer as well.
The immediate or nuclear family members suffer the most. The nuclear family members bear the greatest of the burden. This is because the immediate family members are the caregivers to the mental ill person.
So they suffer physically, psychologically, socially and economically. Even parenting issues become faulty.
Physically:
The immediate family members are usually the first target of those who have mental illness. If the person has psychotic issues, the immediate family members usually get beaten up or even killed in the process.
The parents or spouse to the ill person may in the process of caring for the ill, develop physical illness. The physical illness could be hypertension, diabetes, asthma, cancer, etc. Such a person is also at risk of frequent home and road accidents. And death can ensue from any of these.
Psychological:
In the family that has a mentally ill person; members suffer a lot of psychological abuse. It is either the ill person focuses the verbal abuse on the rest of the family members, or vice versa. This leads to a lot of quarrelling.
The family member may have grief issues, especially after hearing the diagnosis. Many parents and spouses start from the doctor’s office to reject the diagnosis.
From having normal grief, the family member may enter into pathological grief.
The family member(s) may breakdown with mental health issues like caregiver’s burn out and mental illness such as depression, anxiety, etc. Substance or drug abuse is also a possibility as well as suicide.
Taking care of a mentally ill person is a huge task that can cause burn out. This is a state of physical, emotional and mental exhaustion. The caregiver feels an overwhelming fatigue, has sleep problems, feels helpless and hopeless, etc.
Socially:
Stigmatization –
The family members are usually stigmatized by the rest of the society for being related to a mentally ill person. They are ostracized or excluded from the extended family and from the society in general. So the members of the family are denied many of their rights and entitlements.
This stigma compels the family members to hide their mentally ill member from the public. Thus the ill member will be deprived of the needed treatment, making the mental illness worse.
The stigma coming from within the family, nuclear and extended, will result in reduction to family bonds. It will also increase family quarrels, fights, and divorce.
Parenting issues –
The parents of the ill person will have difficulty in parenting methods. The parents feel obligated to care for their ill child, whom they cannot leave to suffer alone.
They maybe so engrossed in caring for the ill person that they forget that they have other children to care for. So other children may feel unloved and uncared for. This has its mental health consequences.
Children with parent(s) suffering from mental illness blame themselves for this. When a parent, especially the mother has mental illness, the first child has to take up this motherly role. The child has to grow up too early and is denied of his or her childhood.
In Nigeria, the Ada, or first daughter takes up the responsibility. This is called parentification or parent child reversal role.
Socialization –
Taking care of a mentally ill person deprives the caregiver the opportunity to socialize with others. The family member caregiver has no time to care even for herself/himself. Going to meetings, shopping, parties and other social gatherings become problematic. Even taking care of one’s health becomes impossible.
These caregivers have problems with making intimate relationships. This is because of the stress burden they find it difficult to express love to another person. They don’t even have time to put into an intimate relationship.
Problems with their coworkers and employers may also arise. This could be due social issues or low work output.
Quality of life –
The quality of life the family members should have is much reduced. This means that they do not get full satisfaction out of living.
Economic issues –
Caring for a mentally ill person also deprives the caregiver of work opportunities. Because they spend most of their time with the ill and taking them to hospitals, their job is negatively affected.
There is reduction in work hours meaning less pay. They could also lose their jobs and may not be able to get another employment. This translates to no more income from the caregiver and less money for the family.
Even if the ill person had a job, he could face work problems and lay off. This reduces the family income the more.
Also money is spent on multiple hospital visits, in the form of transportation, hospital bills, etc. The family finances get depleted the more, sending them down the socioeconomic ladder.
In Nigeria, most psychiatric hospitals are situated very far away from where the people live. So these hospitals are not available in their localities. At the primary healthcare centres, situated close to the people, the staff are not adequately trained to treat such. Besides, there may not be enough medicines for the patients.
Treatments are also not affordable, because most expenses are done out of pocket. That is the patients or their relatives pay for the treatments. In Nigeria, medicines are very expensive.
What symptoms does the affected family member show?
The symptoms that the family member caregiver presents when negatively affected by care giving is the symptoms of burn out. This is called caregiver’s burn out or caregiver’s stress.
The person feels fatigued, exhausted, has problems with sleep, etc. He or she may become easily angered, has depressive symptoms and irritability.
There will be problems with concentration and remembering. And socially, the person will feel isolated and withdraws to self.
And because the caregiver has no time to care for self, he or she can develop physical illness. So the blood pressure can rise, there could be stroke and even sudden death.
Coping with mental illness in the family.
To prevent adverse effects from caring for the mentally ill, it is important that the family members get well empowered. These are actually ways to reduce caregiver’s burden and cope. These will go a long way in reducing the mental Illness effects on the family in Nigeria.
Education:
It is important the family members get educated on the type of mental illness the ill member is suffering from. So it is very important that the psychiatrist or therapist treating the person tells the family member the diagnosis.
The caregiver should feel free to ask the doctor as many question as needed in order to get clarifications on the illness. Information concerning the types of medications, their side effects and duration of the treatment is important. The frequency of checkups should be known and complied with.
It is also important to get from the therapist the list of dos and don’ts concerning family relationships. More information can also be searched from the internet.
Good family relationship:
There should exist good family relationship between the family members and the ill person. It is necessary that one learns to accept the deviant behavior in order to avoid disappointments that may result from the bizarre behaviour. Also it is important to always keep in mind that the mentally ill member of the family is not pretending. He/she is not in control of the illness.
Every member of the family should learn to show love and understanding towards the ill person. These may seem difficult, but they are possible.
All family members must learn how to have good communication with the ill person in a non threatening manner. So when talking don’t shout and keep a calm body language.
Social support:
Having a strong social support towards the mentally will go a long way to reduce the abnormal behaviours. Family members should have listening ears so that the ill person can speak out his/her fears and complaints.
Let the ill person know that the family members are always there to help in any way necessary. This will include financial, help in shopping, cooking, going for treatments, etc.
Treatment compliance:
To ensure that the ill member gets relief from the symptoms and signs of the mental illness, treatment is imperative.
Treatment should come in the form of orthodox medical treatment. This implies that the patient consults a psychiatrist and other appropriate therapists, like a clinical psychiatrist. Where possible, a social worker and an occupational therapist can come into play.
Ensuring that the ill person is introduced to religion and spirituality will also be necessary. This will also aid in symptom reduction and reduce caregiver’s burden.
Maintaining good wellbeing:
The family members, especially those involved in care giving should maintain a good self wellbeing. This will involve abstaining from drug abuse.
One should ensure that one sets aside between 15 to 20 minutes or even more, everyday for oneself. This set out time is used to do things that one enjoys doing, like dancing, exercise, socializing, etc. It is important and necessary to spend quality time on oneself.
Getting adequate nutrition and sleep are absolute necessities. Having a planned vacation is absolutely important.
To achieve these, the caregiver will require help from other family members or from friends. Ensure other family members are there to care for the ill person when one is away. Family members can take turns in the care giving.
Having someone to talk to and confide in is necessary. This should be a trusted confidant with whom one can talk to and get advice if necessary.
It is also important to consult a professional healthcare provider to care for one’s physical and mental health issues.
Mental Illness Effects on Family – Nigeria.