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Hitting Bottom with a Mental Illness
"Hitting bottom" is different for everyone, but sometimes it's a necessary step to getting better. Learn more about how to help someone with a mental illness when they find where the bottom is.
It is said that addicts have to “hit bottom” before they are ready to get treatment for their addiction. Things have to be as bad as they can possibly be before a person is willing to do the work to turn their life around. “Bottom” might be when a person loses their family, job, or home to an addiction. Or it might be waking up in the intensive care unit after almost having died the night before.
“Bottom” is different for everyone.
What I think is clear though is that those with a mental illness like bipolar disorder also often have to hit bottom before they agree to get help. Nothing else, it seems, motivates people to do the seemingly impossible work of getting treatment.
What Makes People Get Help for a Mental Illness?
Recently I threw this question out to my audience and the answers were somewhat surprising. The primary response was that something had happened to the person with the mental illness to cause them to seek treatment. There was nothing that people said, or people did, but it was actually an event that forced the person with the mental illness to see the need for treatment. People talked about having breakdowns, losing jobs, having to drop out of school, unreasonable spending sprees, and more. It was these dramatic moments that lead to the “ah-ha” in the person’s mind that they had to get help for their mental illness.
Can Others Help Turn the Light On?
But, in some cases, others were instrumental in suggesting help for the person with the mental illness. Most often the advice was not taken, but sometimes—sometimes—the advice to get help was exactly what the person needed to hear exactly when they needed to hear it.
Can Others Help Turn the Light Off?
Of course, on the other hand, people could also make a person less likely to seek treatment. People, unfortunately, could stigmatize the person with the mental illness, treat them poorly, or approach them in ways that just didn’t work. People around the person with the mental illness could cause more harm than good.
Here are some real things that people with a mental illness were told that did not help:
- It’s not in my job description to help you with those kinds of problems.
- Look, I can see you’re not yourself. Why don’t you get some help?
- That’s a dramatic story.
- You’re just not the same person. I try but it’s all too hard for me. Please get some help.
- Oh, hallucinations, cool.
Helping Others Get Mental Illness Treatment before Hitting Bottom
The goal for any loved one of a mentally ill person is to help them receive treatment before that inevitable “bottom.” No one wants to watch while their loved one loses his or her job, family, home, or even worse. So if you want to help a person with a mental illness, here are some of the things that others reported helped for them:
- Discretely offering a note that outlined personal experience with psychiatry and ways to get help
- An employer insisting their employee use the employee assistance plan at work
- Suggesting a person seek counselling for a physical symptom
- A wife insisted on her husband getting help or she would leave him
- A friend ensured the person with a mental illness got in to see a psychiatrist she trusted
Stopping Your Loved One from Hitting Bottom
The important thing to remember is that different things work, or don’t work, for different people and the fact is you might not be able to convince your loved one to get help. Sometimes it does take hitting bottom for a person to be able to accept that they need the help of a medical professional.
But when you do talk to a person that needs help, remember:
- Do not stigmatize the illness—recognize it is a health problem like any other.
- Tell the person that you care for them and always will. Do not treat them like they are “sick” or “different.”
- Offer useful, concrete suggestions of how to get help.
- Take the first step with the person by offering to make the appointment or, better yet, join the person at the appointment.
And if this doesn’t work, it isn’t your fault. Just be there and be ready to help if the person does hit bottom and decide it’s time to climb up.
For more on telling someone they have a mental illness, see here.