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Published June 02, 2012, 11:30 PM

InDepth | 'A lot of ups and downs': Mental health disorders also a challenge for friends and family

FARGO – Karen Friese is a single mother who has been trying to help her daughters, Tracy and LeAnna Jo, with their mental health issues since before they even started kindergarten.

By: Tracy Frank, INFORUM

FARGO – Karen Friese is a single mother who has been trying to help her daughters, Tracy and LeAnna Jo, with their mental health issues since before they even started kindergarten.

She’s had to become an expert in reading their moods, learning when their medications need tweaking, and being a calming presence in their lives, she said.

“Schedules, routine, familiarity, those are all very important,” Friese said.

The girls have strict bedtime and waking schedules, and Friese keeps their meals routine, too.

“These children thrive when they’ve got a routine,” she said.

But it hasn’t been easy.

Friese has been reported for abuse when one daughter wouldn’t stop crying. And she was scraped up when she dove to save her other daughter, who would run whenever she was frustrated or upset, from being hit by a car.

Both girls have been diagnosed with a variety of mental health disorders, but they just want to be treated like everyone else.

Sixteen-year-old Tracy is bipolar and has Oppositional Defiant Disorder (ODD), Obsessive Compulsive Disorder (OCD), Attention Deficit Hyperactivity Disorder (ADHD), anxiety, and a learning disability. But she also likes to dance, draw and paint.

LeAnna Jo, 14, is bipolar and has ODD, OCD, and ADHD. She also suffers from Tourette Syndrome. But she still enjoys playing volleyball, basketball and clarinet.

The girls hate it when something goes wrong and their mental health diagnoses are blamed or someone asks if they forgot to take their medication, they wrote in an email.

“We have bad days or days where we want to just be left alone just like everyone,” they wrote. “So, that does not mean we forgot our medicine, or that we are losing our minds or going crazy.”

Tracy and LeAnna Jo have also had people say they are afraid to be around the girls because they don’t know what to expect.

“It hurts our feelings when they do this,” the sisters wrote. “People need to be less judgmental and critical of others.”

The girls are on multiple medications, which they take throughout the day. The sisters also go to counseling sessions, and Friese uses a lot of positive reinforcement, she said.

When to get help

Local experts say there are a lot things family members need to learn in living with someone with a mental health issue.

The first is how to tell when someone needs help.

The U.S. Surgeon General reports that 10 percent of children and adolescents in the U.S. suffer from serious emotional and mental disorders, the National Alliance on Mental Illness (NAMI) states on its website.

Half of all mental illness begins by age 14, but on average eight to 10 years will pass from the onset of symptoms to the time of intervention for those living with a mental health disorder, according to the NAMI Child and Adolescent Action Center.

But it can be challenging deciphering the difference between normal childhood angst and a mental health disorder, counselors said.

Experts typically look for behavioral cues like how someone is sleeping, eating and interacting with others, said James Pfiefer, a licensed professional clinical counselor with Prairie St. John’s in Fargo.

“Kids don’t have the ability to verbally state, ‘I feel sad. I feel depressed. I feel angry. I feel anxious,’ so you see it typically in their behavior,” he said.

Whether it’s in children or adults, it’s the impact on someone’s daily functioning that indicates whether they need help, said Rachel Blumhardt, an outpatient mental health counselor in The Village Family Service Center’s Fargo office.

“Kids are pretty smart, too. I’m amazed at how many teenagers will tell their parents they’re feeling depressed or having a hard time,” she said.

But sometimes people with a mental disorder just don’t see it.

When help isn’t wanted

It’s a huge challenge to help people who may not want to acknowledge a mental disorder within themselves, said Chuck Summers, clinical manager and in-office counselor in The Village Family Service Center’s Fargo office.

“They’re looking at the world through their own eyes and as far as they know, their eyes aren’t being filtered by a mental disorder of some kind,” he said.

What may be recognizable from the outside, may not be recognizable to the person living with the disorder, he said.

“Oftentimes it’s not until a crisis occurs that makes someone willing to take a more serious look at themselves and decide whether there may be something going on,” Summers said.

And even when people know they have a mental health disorder, they may not want to seek treatment, counselors said.

Sometimes they don’t see the impact medication might be making, Summers said.

It can be hard for family members or others who don’t have mental health issues to understand or empathize with those who do, Blumhardt said.

“If you haven’t ever felt that way, it’s hard to understand why someone can’t just get over it,” she said.

People without a mental disorder can become impatient, angry or blameful toward those with one, Summers said.

“It’s really easy for us to sometimes lapse into our own world and not fully recognize the level to which people can struggle just on a daily basis,” Summers said. “That’s part of where the stigma comes from.”

To support someone with a mental health issue, let that person know you see her having a hard time and ask what you can do, Blumhardt suggested.

Avoiding the issue encourages feelings of shame, she said.

“When we’re feeling lousy or stressed, we tend to push people away from us and we tend to isolate, so we lose that support,” she said. “We may not be open to going out and spending time with people when maybe that’s what we really need.”

People dealing with a mental disorder may also feel guilt or shame for burdening their friends and family so they don’t reach out to others, Blumhardt said.

Counseling can provide that safe, private outlet without the guilt or shame, she said.

Pfiefer said friends and family members also need to listen in a nonjudgmental way. Giving advice or trying to solve the problem invalidates the person, he said.

“If I give advice, I’ve just made myself the expert on their situation and I’m not,” Pfiefer said. “I’m not here to tell somebody how to live their life. I’m here to help somebody develop self awareness of how things got to be the way they are.”

Help for families

It’s also important for families of people with mental health disorders to get some help, too, counselors said.

Friese is involved in support groups for families of people with mental health issues, such as Federations of Families and Family Voices of North Dakota.

Counseling also helps family members learn the best ways of communicating with their loved ones and helps them learn to let go when their children are old enough to take care of themselves, Helgeland said.

“You can’t outlive children,” she said. “You’re likely going to die before they do and they have to learn how to manage their own illness as if it were any other kind of illness.”

Letting go can be one of the hardest things families have to do, Helgeland said.

As difficult as it can be, Friese’s hard work isn’t going unnoticed. Her daughters said they know they can achieve anything they set their minds to because of her.

“Our mom always tells us we are her gifts from God, that she loves us no matter of our disability or special need,” they said. “Our mom has done all she can to show us we are like all people in our community.”