Dear Victoria,

I am writing to you on behalf of my family who are very concerned for my brother who is seriously involved with a women who has two boys from a previous marriage and who a little more than a year ago had a little girl together.

Almost immediately after giving birth my brothers girlfriend went into what we thought was post partem depression. But since then her behavior has escalated into rage, not being able to reason, imagining things, extremely paranoid and the list could go on. We have all tried to embrace her kindly and with acceptance, but her behavior is such that we actually fear for the children, which she uses against my brother.

My brother has pleaded to go for counseling as he wants to understand her. They have gone to 3 sessions but cannot talk about things that would resolve some of the issues, as it is too touchy for her. She verbally and physically attacks my brother and then in the next breath is extremely broken. It's during those times my bother goes back because he thinks she is changing.

I work for a health care facility and have encountered sine patients with bipolar disorder and some of my brother's girlfriends systems are so close. I cannot explain the urgency enough, our family want to help, but she cannot see there is a problem. Her own family is scared of her and is at a loss as to what to do.

Is there any help, or support that we as a family could be part of.

Please advise. Sincerely yours - Connie

Dear Connie,

As you know all too well, when someone in the family is ill, with a mental disorder or otherwise, it becomes a family challenge. I applaud your willingness to look for help. Denial only makes things worse, as you also have seen.

First and foremost, it's important to keep yourself well and to avoid falling into the role of ‘fixer'. Pace yourself and have realistic expectations. Over-extending yourself will only cause further problems in the long run. Perhaps what you can offer your brother is a strong shoulder and objectivity.

Family support (within reason), in my opinion, is vital in recovery. It helps minimize damage that would otherwise take place had the support not been there in the first place. Although you may feel your actions have had little impact so far – you are ahead of the game. It is making a difference, trust me.

As I began my journey back to health, my parents' acceptance and healthy boundary setting was and is pivotal in my recovery. Even as I denied the illness, I knew in the back of my mind, my parents were a ‘soft place to fall'. When I eventually recognized I needed help, I knew I could turn to them. And I did. Don't think your kindness falls on deaf ears – our soul or unconscious registers far more than we realize.

Some tips for supporting a loved one and their partner:

• Inform yourself as much as possible about the illness being faced. OBAD, your local CMHA (Canadian Mental Health Association) and MDSC (Mood Disorders Society of Canada) have good resources to help you understand the illness and the route recovery often takes.

  An excellent resource is also “I Am Not Sick. I Don't Need Help!” by Xavier Amador. This easy-read gives practical suggestions about how to help those with a mental illness who don't believe they are sick. The process out of denial, into acceptance and insight is one only that person can take. You cannot unfortunately accept the illness for them. Love and acceptance, an open mind, accurate information will help however.

• Find out why she doesn't believe she has an illness. I resisted diagnosis for two reasons:
  1. Much of my illness involved spiritual components. I feared a 'label' would see any spiritual insights as pathological and part of the disease. I needed to find a healthy balance incorporating both a medical and spiritual approach. This allowed me to explore medical options of which I was wary.
  2. I was very suspect of medication. It was a band-aid solution to a psychological problem I thought and would put me in a 'Stepford-like' stupor, smiling constantly without the use of any my faculties. I needed accurate information and a healthcare professional without his/her own agenda to explore the use of medicine.

  If you determine why she is so strongly resisting, you can investigate those objections together and let her come to her own conclusions. Much better in the long run.
  Instead of trying to guess what would work: ask. Your brother can tell you what would help him most. And asking your brother's partner how you could support her may open some dialogue. See if you can accommodate the requests.

• Encourage you brother to go for counseling on his own. This can be of enormous benefit. Working with a qualified therapist gives a person clarity, objectivity, solutions not previously seen and a place to safely deal with the feelings rising from such a difficult situation.
• Finally, check out support groups for family members and those experiencing mental illness. The Mood Disorder Association/Society, OBAD, Canadian Mental Health Association, hospitals and your family doctor will either offer good programs or know of some. Check your local area for specific groups.

Your love, acceptance and patience for your brother and his partner are more effective than you realize. Although you may feel helpless and see little progress, without those three elements which you are already providing – any other kind of help is empty. And remember, please find adequate support for yourself and treat yourself with kindness. A challenge like this is not easy.

I hope I satisfactorily answered your questions. Many warm wishes for you and your family.

Yours, Victoria Maxwell