How to Deal with a Mentally Ill Person: Setting Boundaries

Cloth embroidered by a schizophrenia patient
Cloth embroidered by a schizophrenia patient | Source

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. This 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 nee to grieve the loss we are experiencing and begin setting new boundaries.

Setup Boundaries

Setting boundaries does not mean outright rejection. It means, I am limiting their influence on my life. This 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 times it is also better and more healthy for the sick person as well.

One question to ask yourself when setting up boundaries is does that person take advantage of you. If they take advantage of you, it's important for you to learn to say, "no." Until you learn to say no, they will continue to take advantage of you. You may feel you have 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 actually 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 better help them, since our emotions are not worn and patience lost.


Are You An Enabler?

Also, you need to be honest with yourself. One of the hardest question, 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 of 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. This needs to be assessed very carefully, since its easy to make excuses for your reasons for intervening or helping the person out. Often we have good intention with disastrous results.

Is This a Toxic Relationship

Another thing you need to ask yourself; is this a toxic relationship? A toxic relationship means any type of relationship where you are being abused mentally, verbally, or physically. This is the hardest kind of boundary, because for your own protection, you need to distance yourself from the abuser. Its hard to distance ourselves from someone we love. We often want to a martyr in order to help the other person. We cannot do that at the expense of ourselves. This 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 own 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.

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 for such diseases. Although it does not take away life, it takes away 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.

© 2010 Angela Michelle

Comments 31 comments

Jojo 4 months ago

I don't disagree with a lot of what is said here. In fact, in many respects, I do agree. And yet I feel as if it's really important to not feed into the stigma of mental illness; the truth is that living with a mental illness or treatment-resistant depression is emotional torture. It is your own brain telling you that you do not matter, you are a horrible person, everybody hates you, life is worthless, everything feels deeply painful all of the time. Nobody with mental illness wants to feel this way - we desperately want to feel better, and we truly want to stop hurting the people around us. We are aware of the pain we cause to the people we love. We already know that not enough is known about the human brain to cure such diseases; that is the torture of being mentally ill. We know that we are no longer the healthy person that we used to be. These are thoughts running through our minds constantly.

So where is the hope, for us, then? We are already grieving ourselves, our former, healthy selves, and what it feels like to be happy. The stigma that society places on the mentally ill is alienating and adds to the distress that we feel, and that is why I find this article very difficult to read.

I feel apprehensive to share my situation, but if I ever get well again I know that I need to make it my objective to spread awareness on mental illness. I cannot give details on my particular situation, but I feel that it's important for me to express that most, if not all, people with mental illness have experienced trauma of some kind. And living with PTSD is incredibly difficult.

It took me a very long time to accept and take steps to treat my mental illness; it's important to remember that depression, bipolar disorder, BPD, PTSD, anxiety, panic disorders, etc. are cyclical illnesses, that can be treated, but the tragedy that this article emphasizes is that every person is different and will thus respond to treatments differently. I for one do not have a definitive diagnosis, despite being in the privileged position of being able to afford programs that provide comprehensive diagnostic evaluation; I definitely have major depression & anxiety, but I exhibit traits of bipolar II and BPD (borderline personality disorder; which for me manifests itself in attachment and abandonment issues) as well but do not fill the criteria for a complete diagnosis for either of these diseases. It is harder to treat people who do not have a definitive diagnosis because it is harder to figure out the right medication. In my situation, I did not seek help for my depression until I was 23, after I graduated from college. I began seeing a therapist which did help, but she retired after I was seeing her for 6 months, and it is very hard to start from scratch with another therapist, especially when you've found someone you trust. I almost immediately began spiraling after my work with this therapist ended, and within a couple months my relationship of almost 5 years ended -- which was devastating, I wanted to end my life, I was hopeless, but I didn't want to do so without at least trying to see if I could get better. So I sought out another therapist, which turned out to be complicated, because I needed to move back in with my parents within a month or two (I am from the east coast but was living out west, where I went to school). I wasn't well enough to go to work or live independently; I'm lucky to have the parents I have, they somewhat forcefully got me to seek help. I began seeing a therapist who referred me to a psychiatrist who immediately put me on medication (lexapro) and the medication helped significantly--my boyfriend and I got back together shortly after, I applied to graduate school, and embarked on a solo backpacking adventure. I was doing very well & was very happy for a year and a half.

But near the end of my first year in grad school, I stopped taking my medication, and within a few months, I was completely immersed in depression again -- I barely left my bed for an entire summer. I started lexapro and was also put on new medication (abilify) that made me extremely lethargic, then tried another (latuda) which made me feel the same, then finally lithium, which at first seemed to help, but not significantly, because within months I harmed myself and had to go to the hospital. It was extremely traumatizing and put an enormous strain on my relationship. He did many of the things suggested above in response. I knew I deserved it, I was and am very unhealthy, but it didn't make it any less hurtful. Within months he left and has been very adamant about setting the boundaries with me described above over the course of the past 3 months since. It's not that I don't understand it; it's just extremely difficult to deal with the shame & regret for what my mental illness has done to me and to him. I feel truly awful for the pain I've caused.

A couple of weeks ago I entered a well-regarded treatment program; a live in facility with a full psychiatric team & group therapy, the diagnostic evaluation that I mentioned earlier, but it's only meant to be a 2 week evaluation. Most of the other patients and staff I met there were absolutely wonderful people, and all of us were trying our absolute hardest to get better. Ultimately, it did not improve my condition; despite being on several medications, I do not feel any better. I have tried 6 medications in the past year and have consistently been in individual and group therapy. I wrote out 6 pages of reasons as to why I felt the program was ineffective, so I won't go into detail here, but I will say that even the best psychiatrists in the country will say that mental health treatment in the US is a mess and extremely underfunded. Yet the statistic is that 1 in 5 adults suffers from some sort of mental illness. Seeking professional help is not as simple as it sounds, and does not work for many people, who are trying to do everything they can to survive. I don't believe that the majority of people want to die from depression, however I must emphasize that suicide is the fatal result from depression. I find it hard to believe that most people who threaten suicide simply do so for attention or to manipulate people. They are crying out for help to the people they love.

Anyway, there is much for more to say, but I will leave it there. I wanted to post a comment partly because it helps to write this out, but I also think it's important for people to think about how difficult it is to live with mental illness and to seek help for it. We all want to live, but sometimes it is extremely difficult to do so. Emotional pain is a very real and seething thing and no one truly wants to suffer or make others suffer for it. Thank you for listening.

narol denison 2 years ago

i will like to share my testimony to you all.i just got married to my husband about a year ago we start having problems at home like we stop sleeping on the same bed,fighting about little things he always comes home late at night,drinking too much and sleeping with other women out side.i have never love any man in my life except him.he is the father of my children and i don't want to loose him because we have worked so hard together to become what we are and have today.few month ago he now decided to live me and the kid,being a single mother can be hard sometimes and so i have nobody to turn to and i was heart broken.i called my mom and explain every thing to her,my mother told me about Dr Jatto how he helped her solve the problem between her and my dad i was surprise about it because they have been without each other for three and a half years and it was like a miracle how they came back to each other.i was directed to Dr Jatto and explain everything to him,so he promise me not to worry that he will cast a spell and make things come back to how we where so much in love again and that it was another female spirit that was controlling my husband.he told me that my problem will be solved within two days if i believe i said OK.So he cast a spell for me and after two days my love came back asking me to forgive him.i Am so happy now. so that why i decided to share my experience with every body that have such problem contact him email.

narol denison











angela_michelle profile image

angela_michelle 3 years ago from United States Author

You need to report him.

Angel 3 years ago

I was molested when i was 5 or 6, there were to men, I carried it with me all my life like it was a bad dream,

but i knew that it is reality just did not want to admit the problem. After 30 some years my uncle reminded me of what i thought was a bad dream he made

it reality. There is no possible way anyone could have known unless that person was involved or someone that he knows was involved that was there at the time.

My life has taken a bad turn ever since. I'm misunderstood for being a nervous reck, plus it makes it worst cause i have a neurological disorder called CMT.

My uncle is a wealthy man with, set me up because what he said to me back fired on him he was expecting me to keep my mouth shut. I've known him all my life. He reminded me after 30 some years later.

He said "what you haven't sucked ____ " refering to the male private part, and other things. I was in a dark place after i heard that. I'm at a point where this man to protect his reputation is turning everyone against me. Because he is afraid if that ever comes out or spreads it will be his life down the drain. This is the man that believes from a book he read, that you need to destroy your enemies in every way financially and other. I am the person of respect, my uncle turns people against me with money. He formed a cult with people that are on his side. I am afraid for my life and my family's.

angela_michelle profile image

angela_michelle 3 years ago from United States Author

agreed. :)

PNforHP 3 years ago

The need to set boundaries is not just for some people, but all. Having survived an extremely toxic and abusive relationship with a family member, who got away with it because he is not mentally ill, it must be said, that sometimes it is NOT the person with the mental disease but the person without one that is a boundary violater. They get away with it because they laugh off the abuse they give to the person who is mentally ill, as 'crazy', 'dont know what your talking about', 'never happened', etc., only to start the process all over again, in effect lying to their face, and people who are mentally ill, just like everyone else, soon realize this, hope to keep the relationship, but heartbreakingly realize that this person is not safe to be around for any length of time, that the person they knew is not the same, but not mentally ill either. Sometimes it is not the person who is mentally ill, but the person who is not, that is the one who needs help.

angela_michelle profile image

angela_michelle 4 years ago from United States Author

I'm sorry you had to grow up like that. I'm glad you are learning to change from the learned habits.

Tara7 4 years ago

It's very difficult to deal with somebody who has a mental illnes.. I grew up with a mother who is bipolar. We were always fighting and I got always the blaim for it, cause my father always took her side.. We, my father and me couldn't show emotions, she was the only who could do that.. She always need all the attention,...So when you grow up like that, you don't know better.. You get two types of people like the really quit scared one, and the rebel fighting against it.. At a young age the fear changed into anger, and I was always fighting outside..You have no idea what an impact it got on somebody who grew up like that..Now that I am older and I have a beautiful son, I slowly start to change, babysteps.. I learned that you don't always have to fight back if somebody is upsetting you, cause that was the first thing I always did, you making trouble with me, I make sure you really get scared of me, so that you never ever bother me again..I do meditation and slowly I get to know the real me :-) Cause the way I grew up, was different, and thank God my father was in that point a very good example, and he still is..Slowly things getting better for me.. But I always used to attracte situation simalor like the way I grew up, were I got humalited al the time by my mum, crazy enough cause it made feel safe...

angela_michelle profile image

angela_michelle 4 years ago from United States Author

I wish I could, hopefully someone else will have better advice. I can and will pray.

mistyfier 4 years ago

My mother-in-law is very obviously mentally ill. I have no doubt that she is in need of professional help. She is verbally abusive, demanding, degrading, and unappreciative to everyone that is close to her. She seems to be an expert at fooling the rest whether they be doctors or strangers. My husband said it all started when her father died. she went into what they call a "coma" because, for an entire year she didn't speak or show emotion at all. Being a child of an achoholic and an ex-wife of a full blown addict of opiates and narchotics I have done alot of research on the subjects. So from personal experience and research I van say that without a doubt she is an alchoholic as well as addicted to pain medicine and OTC allergy medicine. she snaps. She lives. She pays you off to not say anything. My poor husband and his father have been accepting (enabeling) this behavior for years. I have brought attention to the fact that this is not OK. something has to be done. I have set my boundaries but this situation needs an intervention. Any one out there know where i should start

angela_michelle profile image

angela_michelle 4 years ago from United States Author

I do have family members who have a mental illness. There are actually multiple people in my life who have mental illness.

Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina

Angela-this is one of the most 'right on' articles I have read concerning knowing and caring for the mentally ill. Your advice is sound and accurate, and I must add, makes me curious if you have a family member who is M.I. Your advice comes from a place of experience.

I applaud your acknowledgement of the grief that comes up. When people do not recognize grief it shows up in other ways: frustration, anger, resentment and physical illness. How honorable that you give voice to the loss of the potential of another human being.

What one must also remember is that we are all teachers for each other; even those who have mental illness. Setting and keeping boundaries is not an easy task, but a necessary one. Not only is it healthy, but it is the compassionate thing to do.

Rated up/I/U and A

angela_michelle profile image

angela_michelle 4 years ago from United States Author

Sue, the truth of the matter is, you cannot do it alone. You need to try to get him help. You also need to place some boundaries up for your brother. It's very hard, but you need to protect yourself. People who have mental illness who refuse to get help, end up hurting those they love. One of the hardest things to do is to show tough love, but you may come to a point where you have to say, "I love you, but you need to get help. If you won't help yourself, then I can no longer help you." At this point, I don't know where his illness is, but at some point it will get to that point, unless he's willing to get the help he needs. It will be the hardest thing you ever have to do, but tough love is sometimes needed.

sue 4 years ago

Angela, thank you for your writings on mental illness. I am doing my best to care for my ederly parents and takes every bit of my energy to do so. Now, my brother has developed sometime type of mental illness. He believes people are following him etc. So, I have him living with me, I try to help him, I feel it is out of my control. I know my parents see it to, everyone is kind of unsure how to handle what is before us. I am so scared my husband is going to eventually stop supporting me who tried to help everyone. Shame on his if he does. But, I need to know the best way to get my brother help?

angela_michelle profile image

angela_michelle 5 years ago from United States Author

I really wish I did. Boundaries is one, it teaches you about putting up boundaries, but as for just comfort, I don't know of one.

It is kind of weird, because it is like they can flip a switch from mentally ill to normal depending who they are around, so it feels like they are purposely targeting you. It's frustrating. I wish I was more help, but all I know is what I have shared.

angela_michelle profile image

angela_michelle 5 years ago from United States Author

I really wish I did. Boundaries is one, it teaches you about putting up boundaries, but as for just comfort, I don't know of one.

It is kind of weird, because it is like they can flip a switch from mentally ill to normal depending who they are around, so it feels like they are purposely targeting you. It's frustrating. I wish I was more help, but all I know is what I have shared.

SLM 5 years ago

My Mother has been mentally ill most or all of her life. She was abused by a family friend when she was 4. She has been diagnosed with many different disorders and frankly I am not sure which if any are the correct one. She is approaching 80 and physically in better health than I. She has a very limited income and relies on me for her transportation etc. She is very demanding and manipulative. She is like a 2 year old that wants ice cream she won’t give up. She does not act this way with other people. I often wonder how it she is cognizant enough to pick and choose. Any suggestions on reading material?

angela_michelle profile image

angela_michelle 5 years ago from United States Author

I think it is so hard, especially as parents, not to enable, because you feel you are meant to care for them through good and bad. So you feel like you are doing good by "helping" them, but then you realize you are not helping them being better versions of themselves, but helping them maintaining their bad choices.

grieving mom 5 years ago

my husband and I have a son with mental illness. he is also a drug addict. IT is a very toxic and mentally and emotional abusive to us. We try to try to help him but he does not follow through. Putting him on the street has been tough. He constantly harrasses us. We need to grieve but .... we have also been enablers.... thinking we can save him.

angela_michelle profile image

angela_michelle 5 years ago from United States Author

Anon, that's a very good question. And I don't have an answer for you.

anon 5 years ago

What about when you are married to the person? This article doesn't help with that...

angela_michelle profile image

angela_michelle 6 years ago from United States Author

I'm so sorry for your loss Asp52. It truly is mourning. I "lost" someone to mental illness many years ago. I think the hardest part of it is there is this constant hope that someday they are going to be normal again. That someday you will have them back. Whereas death, you can move on eventually, I think with mental illness you don't fully allow yourself to completely move on.

Asp52 profile image

Asp52 6 years ago from England

Great hub Angela- my wife has recently been diagnosed type 2 bi-polar and she has called time on our marriage. Of course i will always be there for her but i agree it is like mourning the loss of a living person. I think mourning sums it up completely. Thanks for your article

angela_michelle profile image

angela_michelle 6 years ago from United States Author

I've never heard of that, I'll have to netflix it. I'll let you know what I think. :)

Rich 6 years ago

Check out the film, "Strive For Happiness."

angela_michelle profile image

angela_michelle 6 years ago from United States Author

Your welcome! And I hope you do. I'm so random, I write about everything! I'm obsessed with learning!

mygreatestlove profile image

mygreatestlove 6 years ago from Georgia

Thank you for coming by! I appreciate your comment. Nice reads!!! I look forward to reading more of you!

God Bless!!!

angela_michelle profile image

angela_michelle 6 years ago from United States Author

Lovelypaper, I know how you feel. I love the mentally ill people in my life deeply as well.

lovelypaper profile image

lovelypaper 6 years ago from Virginia

My best friend from High School is mentally ill and a completely different person than she was in school. I miss who she was but love her no less. It's difficult. Thanks for writing about such an important topic.

angela_michelle profile image

angela_michelle 6 years ago from United States Author

Unfortunately, these are things you need to constantly remind yourself of. It's hard to set up healthy boundaries, but we need to... it's hard.

Smokes Angel profile image

Smokes Angel 6 years ago from Broke Alabama

Angela this is awesome. You are an incredible writer and I am glad I read this

    Sign in or sign up and post using a HubPages Network account.

    0 of 8192 characters used
    Post Comment

    No HTML is allowed in comments, but URLs will be hyperlinked. Comments are not for promoting your articles or other sites.

    Click to Rate This Article