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How to Deal With a Mentally Ill Person: Setting Boundaries

Having loved many people who have mental illnesses, Angela has researched as much as she can about the brain and mental illness.

Cloth embroidered by a schizophrenia patient

Cloth embroidered by a schizophrenia patient

When someone you love becomes sick with a mental illness and refuses to get help, there are a lot of emotions that you will experience. Some of them will come right away; some of them will come slowly. One of the most surprising is grief.

To someone who has not faced this, it may be hard to understand how you can grieve a living person.

The terrible thing about mental illness is that the person themselves change. It's often a gradual change, from healthy to ill, but they do change. As the mental illness holds onto them, like in cases of schizophrenia, dementia, and many other mental illnesses that are gripping those we love, the person gets sicker and sicker.

Unlike other illnesses, their personality changes, they may become paranoid or even volatile. One moment you are talking to the person you used to know, the next you find them screaming at you, and you don't recognize the person before you, which can happen from day to day, or even moment to moment.

Unfortunately, as a loved one, we need to learn to cope with this new change. We need to grieve the loss we are experiencing and begin setting new boundaries.

Setup Boundaries

Setting boundaries does not mean outright rejection. It means that I am limiting their influence on my life, which is probably the hardest part of this kind of grief because where the boundaries should be is different for every person. The ill person may deal with certain people better than others. And different people deal with someone with mental illness more easily than others.

One book I strongly recommend is called Boundaries. It teaches how to set up healthy boundaries. It is not mean or heartless. It is self-preservation, love for yourself, respect for yourself. And often it is better and more healthy for the sick person as well.

One question to ask yourself when setting up boundaries does that person take advantage of you. If they take advantage of you, you must learn to say, "no." Until you learn to say no, they will continue to take advantage of you.

You may feel you have a responsibility to that person; the truth is that if they are an adult, even if they are your child, you do not have a responsibility to be at their beck and call. In some cases saying, "no" is being more loving to that person, especially in cases of enabling.

Also, when we set up boundaries towards our loved ones, it allows us to help them better, since our emotions are not high and patience is not lost.

"When we set up boundaries towards our loved ones, it allows us to help them better, since our emotions are not high and patience is not lost."

Are You an Enabler?

Also, you need to be honest with yourself. One of the hardest questions, especially as a parent, needs to ask themselves is am I enabling this person. Many parents of mentally ill adult children feel that they need to care for that person, even though that person is capable of caring for themselves. By setting up boundaries, you are making them take responsibility for themselves and their actions. It also teaches them to become more independent.

Friends, siblings, etc. can also do this. Are you allowing them to worsen than illness and preventing them from getting the help they need, which needs to be assessed very carefully since it's easy to make excuses for your reasons for intervening or helping the person out. Often we have good intentions with disastrous results.

Is This a Toxic Relationship?

Another thing you need to ask yourself: is this a toxic relationship?

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A toxic relationship means any relationship where you are abused mentally, verbally, or physically, which is the hardest kind of boundary because, for your protection, you need to distance yourself from the abuser.

It's hard to distance ourselves from someone we love. We often want to be a martyr in order to help the other person, but we cannot do that at the expense of ourselves. Not risking our emotional well being is not a selfish tactic.

When we allow others to abuse us, we are incapable of helping those around us who do need help. You may be allowing yourself to be abused by this person, at the expense of helping other people, such as your children, or if the person is your child, your other children. You may find yourself focused on your ill child; you neglect the others. You may also neglect your marriage.

When a person is toxic in your life, you may need to decide when they are no longer allowed in your life. Your heart will break, that's normal, but you are not only protecting yourself but those around you. By cutting off toxic relationships, it allows your other relationships to blossom.

"When we set up boundaries towards our loved ones, it allows us to help them better, since our emotions are not high and patience is not lost."

Allow Yourself to Grieve

Once you have set up boundaries, allow yourself time to cry. The one thing you need to remember is that you are losing someone. Maybe they are physically present in your life, but mentally the person you once loved is gone. Let yourself mourn. Remember the good times, but know that the good times you had were not with this person. It was a healthy version of this person. You can hope you will have them back but be realistic. In most cases, unless that person seeks medical help, they will never be back. They may have moments where they are doing better than other times, but expect that things can change right back quickly.

Mental illness is a terrible set of diseases. There is not enough known about the human brain to cure such conditions. Although it does not take away life, it takes away the quality of life. It can affect those around the ill person more drastically than any other type of illness. Be honest with yourself, be realistic, set up boundaries, and let yourself grieve.

This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.

Questions & Answers

Question: Why do you mean when you write that mentally ill people are mean to the ones closest to them and nice to the outsiders?

Answer: I believe that as the nature of all people, we tend to be the meanest to those we love because we have the protection that they will still love us. We tend to treat those we do not know with respect or at least kind. Somebody who is mentally ill is the same. When they are having a hard day, they are going to allow that frustration to come out more around those they feel safe with. Unfortunately, a mentally ill person tends to have a harder time not sharing these emotions outwardly, and may be more aggressive, meaner than if they were able to control their emotions better. It is for this reason why they sometimes have difficulty even with those they do not know.

Question: Our daughter who is 33 years-old has a personality disorder and needs our support in order to get help, but she is very disrespectful. I finally said you are on your own. Is it alright to distance ourselves from our adult, mentally ill daughter?

Answer: I cannot give my own opinion without more details. There are way too many factors to consider when asking if not helping someone is right. In the case of abuse, I believe you need to protect yourself from that person.

Personally, if she is sincere about getting help, and needs you to assist her, then I would encourage you to help her if you are able to do so without harm to yourself. Part of her disrespect could be her inability to manage her own feelings due to her personality disorder. I wish I could give a cut and dry answer, but often situations like this are so complex, you would need to talk with a counselor in order to know what the best course of action you should take.

Question: What if you are afraid of a mentally ill person, and you cannot get professionals to help?

Answer: Unfortunately, you need to think of your safety. If you can get the police involved, that is the first step. Be prepared that false accusations could be brought against yourself. If you successfully get the police involved, you can seek a restraining order.

If you live with the person, you may need to consider moving or evicting the person. If you are married, you may want to seek a women's shelter. These are only small pieces of advice from a non-professional. The best bet is to seek a therapist for yourself who can help advise you and help you heal, and possibly lawyers if you are living with them or married to them. If they are your children, you need to show tough love, possibly change locks, etc.

Question: I am the direct support staff for a 19-year-old male. How can I set boundaries with him?

Answer: There are many factors to consider. Without knowing the boundary issues and the nature of your relationship, it is hard to say precisely. I do know that you need to be clear and direct. Avoid noncommittal language such as, "I wish you would...," or "I don't like when you...." This does not give any direction.

Instead, you need to say very firm, direct statements such as, "Do not do...," and "Please do...."

If you are soft natured like me, you may find that you naturally are soft in not only how you say things, but the words you use. You need to make sure your words are very clear. If there is any ambiguity, then someone who has boundary issues will take advantage of that.

Question: How do I cope when both of my parents are mentally ill? I also have the bad luck of being from a country where most people are frustrated with life and abuse others that are better than them.

Answer: I wish I could give you an answer that would cure you of your frustrations. Unfortunately, there is not a cure-all answer for this.

Coming from a biblical perspective, I believe that each person goes through trials to help them grow. It is our choice. We can either allow these problems to make us bitter and afraid, or we can use these problems to educate others and help ourselves grow.

Can you fix what is going on with your parents? No.

Can you make others in your country treat people with respect? Not all of them.

What you can do is be the voice of reason, educating people on the goodness of being kind. You can choose to find joy even when it's not obviously present. Look for the good in life and choose joy. Try to be a light for others, who feel they are trapped in darkness, even when you feel you too are in that darkness.

We cannot change others, but we can change ourselves.

Question: What is the name of the book about setting boundaries?

Answer: Boundaries by Henry Cloud. It is an excellent book. There is a workbook and video series as well.

Question: What kinds of medications are used to treat mental illness?

Answer: There are so many different kinds of mental illnesses with just as many different treatments. It's important for a doctor to be very involved in prescribing these drugs and following up, because the wrong medication can throw off the chemistry of a person's brain, causing them to get worse, not better. Unfortunately, although you could find answers to this question online, each person, even with the same diagnosis, needs to have a unique treatment.

Question: Please tell me where I may buy a copy of "Boundaries" and the workbook at a discounted price?

Answer: Unfortunately, even if I found where they have a discount on it, that may change by the time you look there, as prices online are always changing. That being said, two of my favorite places to barter books is paperbackswap.com and bookmooch.com. Otherwise I look on amazon.com.

Question: My daughter-in-law, who has borderline bipolar, asked my son for a divorce. What can I do?

Answer: The only thing you really can do is be there for your son. Show him that you love him and you support him during his hard time. Encourage him to prevent himself (and yourself) from becoming bitter. Help him reach acceptance.

Be civil and cordial to your daughter-in-law, and do not get in the middle. It will not help anyone.

Question: About toxic relationship, my mom was my abuser while she had a mental illness. After three years, I'm finally seeing her and helping her. She told me she has forgotten about those times. Since I am helping her with rides, food, and clothes, is this still a toxic relationship?

Answer: I wish I could give a definitive answer; unfortunately, it is a complicated question. I have found when dealing with people with mental illness, that they often do claim that they have forgotten their bad behavior. I do not know if I believe them, but I do know it is common. As far as is it still a toxic relationship, that depends on a lot of factors. How does seeing her make you feel? How does she treat you? How do you feel after you spend time with her? Is she limiting your relationships with anyone else? The questions could go on and on. These are just a few to consider. I believe as long as you can maintain a healthy outlook on yourself, and she is not currently negatively impacting you, then she may be no longer toxic for you to be around.

Question: I am a parent of a 40-year-old young man who refuses to accept his mental illness. It has been nine months since his relapse, and I am ready to detach. It's exhausting to encourage him to seek help, work, and for me to focus on my work and needs. Am I approaching this right?

Answer: Honestly, every case is so complicated there really is no right answer. You may have to continually reevaluate the circumstance and adjust. It is not like there is one right way to do it. I strongly recommend you find a counselor for yourself that can help you talk through this. Many churches have counselors for free. Look for a church that is really big, and they are more likely to have one on staff. Many have worked at other facilities, but for whatever reason have chosen to switch to churches. I think you need to make sure you are caring for yourself before you attempt to care for him, otherwise, you are both going to drown. If he is refusing help, you need to be able to remove yourself from him, until he is willing to seek the help he needs. A counselor for you will know what you can and cannot do, and also help you see what is the right way to deal with it for you. A big part of it is putting up boundaries, but boundaries are going to look different for everyone based on temperament, personality, etc.

Question: Do you know of any support groups for family members dealing with this?

Answer: If you want one that is in your area, you may wish to contact the nearest mental health hospital. Otherwise, Facebook has a few. One called "Family and Friend of Adult Loved Ones with Mental Illness" as well as "VOICES (Loved Ones of addiction and Mental Illness)"

© 2010 Angela Michelle Schultz

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