A Very Small Boat: On Loving Someone With Severe Mental Illness

I used to wake up every morning in a panic. It would wax and wane throughout the day, sometimes manageable and sometimes paralyzing. By bedtime, I normally felt okay. But morning would come and the cycle would begin again. This was the nature of my mental illness, which was at it’s most severe during my three years of graduate school. At the time, it felt like it would never subside, that I would wake up every morning for the rest of my life with a gasp and a pounding heart. But it did subside, over time. I got better by going on antidepressants, then going off them, by connecting to my faith, by reaching out to my friends and family, and by lots and lots of therapy. More than anything, though, I got better because I knew I was sick. The nature of my mental illness was such that I wanted nothing more than to get better. Not so with my brother.

My Brother’s Reality

My younger brother Charlie (not his real name) suffers from schizophrenia. At least, that’s what we believe based on the observations of expert psychiatrists who know him. Unfortunately Charlie has never agreed to see a doctor on his own long enough to receive an official diagnosis. In his reality, the doctors are conspiring with my family – and his neighbors and the local government and whoever might cross his path – in order to harm him. This harm may come in the form of imprisoning him, harassing him with mysterious lights or sounds, or even murdering him. Whatever our malignant intent, we’re all in it together. Our efforts to convince him otherwise only make him more certain.

Charlie’s paranoia not only warps his perception of reality, it prevents him from seeking or receiving help. It locks him in a cycle where the best thing for him is what he least wants, and what we want for him is what most terrifies him. The only thing more frightening than praying for the thing your loved one fears is knowing that, aside from prayer, you have no control whatsoever. There is nothing I can do for Charlie, because he is an adult and, despite not being competent, he has the right to make decisions about his own treatment.

Our Family’s Reality

Severe mental illness knocks out the center of reality. On more than one occasion, I have asked myself if perhaps I am wrong and he is right. Are my parents evil? Have I been duped by a vast conspiracy? Am I perhaps an unwitting participant in a crime syndicate? No. Of course not. But when someone says something so earnestly for so long, you start to wonder. I find myself running over facts with my husband and my other, youngest, brother. (We’ll call him Josh.)

“Josh,” I’ll ask, “Did Charlie really say that his neighbors are trying to kill him?” “Yes, Emily. He really said that.” “Josh, is his house really covered in insects and garbage?” “Yes, Emily. Here are the photos.” I know it’s true, but I can’t believe it. I begin to doubt my own memories. I remember the long, strange, rants he would go on as a teenager, which I would dismiss as weird brother stuff. Now the rants are longer, meaner, and less coherent. And they don’t go to me. They go to my parents.

I ask myself if I could have seen the signs earlier, if it would have made a difference. I wonder, as everyone in my family does at some point, if something I said or did triggered this. If perhaps that one fight we had when I was sixteen or twenty or twenty-two was the final straw. At the same time, I know that nothing I could ever say or do could cause this. That’s the nature of loving someone with severe mental illness. You can’t believe it, but you have to.

Mental Illness and The Person

Schizophrenia isn’t like what you see in the movies. Charlie doesn’t have a coherent narrative about investigating a crime on a secret island. He isn’t a brilliant mathematician who only needs to let go of his imaginary friend. Charlie is an affable guy who enjoys outdoor activities like hiking, camping, and kayaking. Unfortunately, he can’t get mentally organized enough to do most of these activities safely. He’ll hike into the woods without water or food. He’ll lose his bike and have to wander home.

If I’m honest with myself, I really don’t know Charlie that well. We’ve been mostly estranged for years. He was not invited to my wedding. The interactions we do have are either strained or terrifying. If set off, he will yell at me for hours. When we were teenagers, I thought he was an emotionally abusive jerk. Now I know how sick he was, and I deeply regret how harshly I judged him. But the hurt doesn’t go away just because there’s an explanation. Separating who he is from what he does is not an easy task.

Who Are You? Who Am I?

I have no idea who Charlie is without his mental illness. I don’t know what he would be like if he accepted treatment. Would he still like the same things he likes now? Probably. But what kind of job would he have? Would he be a husband and father by now? Would he be interested in religion and philosophy like me? Or would he be more interested in politics? What kind of causes would he commit himself to? Most importantly, could he forgive me for my lack of patience? Would he still be angry about my wedding, or would he understand? Would he be sorry for the things he has done to me, or would he feel – perhaps correctly – that those were the actions of someone else entirely? I just don’t know. Perhaps I also don’t know who I am without my brother’s mental illness. That is a terrifying thought.

A Very Small Boat

As I write this, Charlie is being held in a psychiatric unit. He doesn’t want to be there, but circumstances which I will not describe have led his doctors to insist. My family has just completed a novena to St. Dymphna, a nine-day prayer regimen where we asked for exactly this outcome. I’m guilty, relieved, sad, and hopeful at the same time. Perhaps when medication kicks in, Charlie will realize that he is sick and will opt for more treatment. Then, perhaps, I will be able to meet my brother. Until that time, loving someone with severe mental illness is like being on a very small boat in the middle of a hurricane. There is someone out there calling you. Demanding that you get out and walk. Walk to them on the water. It’s not rational, but so much of life isn’t. But this person isn’t Jesus and they can’t help you. In fact, they’re going the other direction. Still, you have no choice. You have to try.

And if you sink, well, that’s just what happens sometimes when you try to walk on water.