Help--my loved one needs help! Or how to manage caregiver burden

On a fairly regular basis I get messages from concerned family members or friends of someone who “really needs to see” me. Whether it is due to addiction, severe depression, or difficulty coping with a medical condition, those who reach out to me on behalf of another are always very concerned for their loved one’s wellbeing–so much so that they have taken the steps to find their loved one a therapist, and even make the first contact! 

Unless you’ve experienced a loved one struggling with their mental health it may be hard to imagine why someone might feel so desperate to get their loved one support, or to understand how the loved one is so incapacitated that it takes reaching out to a professional on another’s behalf to get them the support they need. I’d sure like to think that I would do whatever it takes to help my close friends and family when they are unable or unwilling to help themselves. 

At the same time, getting into psychological treatment is not necessarily something that someone else can sign you up for without your express consent. I’ve met enough people in my career to know that not everyone thinks therapy is the right solution for them–and they might be right. That’s why I never take referrals unless the individual seeking therapy reaches out to me directly. Sure, sometimes someone is so incapacitated that it’s nice to get the ball rolling for them until they can take the reins a bit more. But if that transition never seems to come–then what? Where does that leave the concerned friend or family member? If they can’t sign their loved one up for treatment, what can they do? 

Don’t worry, they (and you) can still do plenty! 

There are two common responses to loved ones who are engaging in behaviors that do not seem to be in their own best interest, e.g. using substances, or not reaching out for support when sick or depressed. One response is essentially to blame the person for the situation they are in, confront the individual about their behavior, withdraw support if things don’t change, and hold rigid boundaries until they can ‘make better choices.’ This has been a common response to addiction in our country over the last several decades and has resulted in many people hitting “rock bottom” before they actually get treatment.

If you’re reading this right now, I’m guessing that is not your typical response! You are probably more likely to respond in the other direction, and offer plenty of emotional and practical support, be more understanding of why someone is struggling and try to help where you can, and to have looser boundaries until the person gets to a point where they can take better care of themselves. This is a much more compassionate response, but it comes with its own challenges. For example, once patterns are established they are sometimes hard to break, and can leave you feeling like you are overfunctioning for your loved one--a hallmark of caregiver burden. This can make it hard to keep up the work of caring for yourself and your loved one at the same time–especially if it doesn’t seem like your hard work and support is appreciated or paying off like you had hoped. 

If this sounds like you, the first thing to do is to take care of yourself. You may have been giving so much of yourself to others that you are running on empty–which ironically makes it less likely your loved one will get support from you in effective ways. Decide how much you can give and where you may need to pull back in order to sustain the support you’d like to provide long-term and avoid caregiver burnout. When you take care of yourself, you are able to show up more effectively for your loved one. 

Next, pay attention to the way you communicate with your loved one. If you find yourself attempting to persuade, convince, or even beg them to get into treatment–start by taking a step back. Most people have a self-righting mechanism that cannot function fully while someone else is trying to steer the ship. Give your loved one enough space to decide for themselves what they need–even at the risk of things getting worse in the meantime. After all, treatment can only be effective when the person receiving it is bought in and engaged themselves. 

If your loved one doesn’t end up choosing treatment, there is still plenty you can do. As their trusted support, you have a huge influence on their lives. Learn ways to communicate that withhold judgment and increase the likelihood that they will seek treatment. Learn how to be patient with their struggles despite your imminent worries about them, and how to be in difficult moments with them without attempting to fix the problem. Learn how to respond to their behavior in ways that will help them want to change, i.e. not rewarding unhealthy behaviors. These strategies are described in more detail in Beyond Addiction: How Science and Kindness Help People Change, which I highly recommend! 

If your loved one does decide to pursue treatment, by all means help them navigate finding it! Even intelligent people with relatively minor problems have a hard time figuring out how to find healthcare providers covered by their insurance that meet the specific need they have–we all need all the help we can get! 

If I’m the person that you found that can help your loved one, please have them reach out to me! I’d be happy to talk through what treatment with me might look like. If you’re having a hard time figuring out how to be there for a loved one and would like professional support for yourself in that process–please reach out to me! I’d be honored to help you figure out how to support your loved one effectively and take care of yourself.