My father needed therapy, but I couldn’t make him get it. I hated seeing the hurtful effects his mental illness caused, but to keep our relationship healthy, I had to learn to step away.
The first time I heard my father acknowledge his own mental illness was three years ago in Karachi, Pakistan. Just minutes before, his confrontation with our neighbor (about how our water supply had been turned off) escalated into a physical altercation so quickly that the gardener turned the water hose on the two men to literally cool them down. When my father was back upstairs, he looked shaken.
I can still remember our neighbor’s anger: his dilated pupils and the tremor in his hands as he yelled at my father, looming so closely that my father recalled being able to see cracks in the man’s yellow teeth.
“Is he crazy?” my father asked me, struggling for an explanation for our neighbor’s outburst.
“Do you think he’s crazy?” I asked in return.
Heavy questions, weighted honesty
The conversation paused, and we looked at each other.
When my parents moved back to Pakistan from the United States, the small, anxious tics my father had started blooming into concerning habits. How these anxiety “quirks” interfered with his daily life became more evident after I moved back after being away.
He had always been neat, but now he lashed out when he saw a stray strand of hair or a single dish left in the kitchen sink. He’d always valued punctuality, but my father would grow stormy if he was ready before us, even if it wasn’t time to leave yet.
Both he and my mother struggled to navigate around his volatile habits. Even I found myself calculating his reactions and weighing each conversation before speaking to him.
Our family doctor, a round, practical man, who also doubled as our landlord, noticed my father’s anxiety and prescribed escitalopram. The medicine helped. My father stopped slowly plucking the hairs on his forearms during idle moments. He stopped yelling when we failed to read his mind. When I told the doctor about the invasive ways my father’s anxiety affected all of our lives, he encouraged my father to go see a cognitive behavioral therapist. For an hour every Thursday, my father would sit with a quiet woman who asked him to reflect on the conflicts he faced every day.
In Pakistan, people don’t speak about mental health. There are no conversations about self-care or the dark spiral of depression. People use the words bipolar, schizophrenia, and multiple personality disorder interchangeably. When my grandfather passed away, my younger brother sank into a grief that felt all-encompassing and my parents couldn’t understand why he couldn’t snap out of it.
Getting help can ultimately be a matter of family support
When my father actively chose to seek help for his mental illness, I watched my mother struggle. Convincing my mother that my father needed help, and that his treatment would improve all our lives, proved to be impossible.
She oscillated between thinking that there wasn’t a problem at all — sometimes defending my father’s problematic behavior as though we were at fault. Other times though, she agreed that while my father could be difficult, it wasn’t because he had a mental illness. Medicine wouldn’t fix anything.
When the counselor suggested she start coming to therapy too, she flat out refused. Two months into cognitive behavioral therapy, my father stopped going and blamed my mother’s resistance to change. A few months after that, he quietly stopped taking his anti-anxiety medication.
That day in the kitchen, after his fight with the downstairs neighbor, my father did finally acknowledged his anxiety disorder. He realized that he didn’t move through life with the same ease as many of the people around us. But when he discontinued his therapy, my father began to doubt that he had an anxiety disorder at all.
Dr. Mark Komrad, author of “You Need Help!: A Step-by-Step Plan to Convince a Loved One to Get Counseling,” said that the importance of family is instrumental in helping someone with mental illness. When I initially spoke to him, I wanted to learn how to get everyone in a family on the same page, but quickly into our conversation I learned that, often, the person championing therapy and asking their loved one to seek help often needs help as well.
“Often someone comes to me for help with their family member, and I end up taking the person on as a client,” Dr. Komrad said. “You have more power than you think, more influence than you know, and you might be unwittingly part of the problem too.”
It hadn’t occurred to me then, that as the lone member of my family trying to convince everyone and my father that therapy was important and necessary, there was a chance I would need therapy as well.
Where my father and I are now
After four years of living with my father, I started to resent the emotional labor of convincing him that he needed help. At times, it seemed as though I was the only person who believed that his life could and should be better.
Before I moved back to New York City, my father came down with a bad cold. For the first day, all he did was complain about his sinus headache. The next day, wordlessly, my mother put an Advil and an antihistamine in front of him.
“Just take it,” she told him. “It will help.”
Later that day, he mentioned that he could’ve survived fine without the medication, but taking it had definitely helped him get through the day. I used the moment to explain how anti-anxiety medication could do the same.
“We all know you can live without it,” I told him. “But you don’t have to.”
He nodded a little but immediately began texting on his phone — a clear indicator to me that the conversation was over.
I’ve moved away from home since then. Now there’s a distance of over two oceans between us. I no longer interact with my father every day. That space has also dulled the immediacy with which I want him to seek help. It’s not a perfect answer, but I can’t force him to get help.
Sometimes I see how much he struggles, and ache for him and for the impact a world that doesn’t believe in mental illness has. But I’ve chosen to accept that, perhaps for the sake of our relationship, this is a battle I don’t always have to fight.
Mariya Karimjee is a freelance writer based in New York City. She's currently working on a memoir with Spiegel and Grau.