Living with someone who has a psychopathology can be difficult and challenging for the family members and the partner, especially in cases in which the individual refuses therapy. There are the daily difficulties such as the financial responsibility or taking care of the children without help, but there are also psychological and emotional implications of being a caregiver. Caregiver burden is not thoroughly researched, especially when it comes to psychological problems.  The implications are not always talked about nor acknowledged. I want to talk a little about the experiences of the caregivers.  Each family member reacts differently and/ or experiences to the same situation in a different way. There is no one fit all situation representation that one can use. The intention is just to give a sample of possible reactions that some people have in common.  

The psychological symptoms of the family member, for example sake, a severely depressed mother, put limitations on the other family members and shape their lives. For example, if the depressed does not work and is socially isolated herself, then the budget of the family becomes limited and socially everyone becomes more withdrawal. Family members often have to give up allot in their lives. The dynamics of the relationships change.  It goes without saying that needs of the children and the partner are not being met. They may even feel forgotten, unimportant and neglected. The drastic life changes will reduce the level of satisfaction, which they experience in their lives. The loss of interest in social or sexual activities may lead to the partner to feel angry, hurt, alienated and undesirable.  In can also lower one’s self-esteem. To continue our example, if the depressed does not share her emotions and thoughts with her partner, not only the level of intimacy of the relationship will be reduced, but the partner may feel rejected, insulted and lonely. Some may even blame themselves for their loved one’s emotional distance. Beside the overwhelming stress and worries about the continuance functioning of the family, the partner and kids often also worry about each other. I.e. what not to do to make her even more angry… will she come to my birthday party? Will she get upset if the kids ask X of her?. This increases stress and distress levels felt by all family members.

One of the first reactions many family members have is sympathy for their loved one. People feel very sorry that someone they care about is going through difficult times. Sympathy is beneficial as it provides support but it can also have negative implications. When sympathy leads to taking over all the responsibilities, over-protectiveness and babying the individual then they start developing dependency and have no incentive to change. As a result, in the long run stress and frustration levels of the partner will duly increase. 

Sometimes family members develop negative feelings. The psychological symptoms have changed the person’s character and behaviour. They may experience that it is not the same person they fell in love with or it is not their mother anymore but a stranger. They may feel disgusted by the new behavioural patterns and their implications i.e over-drinking. Family members may feel hurt, alienated, angry, disappointed or discouraged because they don’t see any change in the situation, or because of refusal to go to therapy and achieve that change. The experiencing of negative feelings may at times also lead to the feeling of shame and guilt for feeling that way in the first place. There may also be self-disappointment for the lack of ability to help or filling up the necessary gaps.     

When family members constantly feel anxious, worried, angry, or depressed, they are more likely to develop health problems such as sleeping disturbances, stomach aches, headaches and muscle pain.  Bad habits, such as drinking, smoking and binging may also cause health problems in family members. Some partners may start drinking/smoking to help them get through the day or escape their feelings.  Kids may also start misbehaving, neglecting school work, drinking and/or using drugs with their friends just to avoid going home to their problems. A turbulent home life and unstable relationships are also two of the causes of eating disorders among teens as it is their way of achieving control over the uncontrollable.

People do not live in a bubble or a vacuum. We all interact and influence each other behaviour, thoughts, emotions and attitudes. It is sometimes easy to forget it, especially when all the attention is focused on the client, the one who has the psychological symptoms. Treating the individual and also combining the context which surrounds the client often leads to the best results. This is why many psychologists often involve the family members in the treatment of the individual. One should not forget, however, that the family members are also influenced by the situation and attention should also be paid to their needs.