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What if your loved one lacks insight?

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What if your loved one lacks insight?

Unread postby AndrewBCSS » 15 Nov 2016

What if your loved one lacks insight?
This month's newsletter provides helpful tools for a situation many family members of persons with schizophrenia and bipolar disorderexperience - what do you do if your loved one is very ill but is unable to see that? What do you do if they are clearly very ill but do not think they need medical treatment? How can family members help?

About Anosognosia or Lack of Insight
Anosognosia, also called 'lack of insight', is when a person is unable to detect or recognize that they are ill when it is clear to everyone else. Anasognosia can be a symptom of schizophrenia, bipolar disorder, strokes, brain injury and Alzheimer's dementia. It happens when the person's brain stops being able to take in information that their health has changed. Anosognosia can be a common symptom of schizophrenia and bipolar disorder. Like other symptoms, will often get better when the disorder is being treated. Here is some more background information on anosognosia

How to talk to a loved one who does not understand they are ill
Xavier Amador, a psychologist and family member, is the author of the book "I am not sick! I don't need help!". In his book he makes the following suggestions for family members.[*]Listen to your loved one with the goal of understanding how they see themselves and what their beliefs are about whether they are ill or not. Ask them what they would like to get out of life and try to understand things from their perspective. You don't have to agree with them, but you can avoid jumping in to disagree with them or challenging them on their beliefs. [*]Empathize with your loved ones feelings. Reflect back what they are feeling. For example, if they don't understand why people are encouraging them to take medications when they don't feel that they are ill, you can say "It must be confusing to be encouraged to take medication when you feel fine". [*]Validate your loved ones experience. Let them know that you might feel the same way if you were in their position. [*]Partner or form a team with your loved ones to work on goals you can share. For example, they might not wish to take their medication for their schizophrenia, but if they would like to feel less anxious, concentrate at work or sleep better and the medication helps with that, then they may be willing to take it for that purpose.

How to get help in BC for someone who is critically ill but lacks insight
The BC Mental Health Act is designed to help and protect people who are critically ill. In BC that protection legally includes protection from from likelihood of physical harm to themselves or others and also includes financial harm, vocational harm, family harm and social harm. If you think your loved one might be at risk in one of these ways due to their illness, then you may wish to review the legal information about how to help them in this video with legal expert Gerrit Clements. You can also contact a BC Schizophrenia Society Educator (see contact information below) to help you figure out what to do.

How to find psychiatric intake services in BC

The place to call if your loved one is ill but is not yet receiving psychiatric services in BC is called psychiatric intake. An intake line is where you can call to look into how to connect your loved one with help. Psychiatric services are covered under the Medical Services Plan, so there will not be a cost. Most services are available in mental health clinics in your community.

If your loved one is willing to see their family doctor, they can also go there to be connected with psychiatric help. Your family doctor will need to see your loved one in person in order to help them.

To find the psychiatric intake service nearest your loved one, please call 811 for HealthLinkBC. You may wish to write down the details of what is going on before you call the intake line so you can refer to it.

If you need help connecting with services or support for yourself, the BC Schizophrenia Society (BCSS) has family educators in most areas of BC who can help you, even if your loved one has a mental illness other than schizophrenia or is undiagnosed. You can connect with your local educator by calling the BC Schizophrenia Society office at 604-270-7841 and asking for the educator for your town, or you can visit the BCSS website and email your local educator via the contact form there.
___________________
Andrew Stewart
Operations Manager
British Columbia Schizophrenia Society
A reason to hope. The means to cope.
www.bcss.org

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Lori
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Re: What if your loved one lacks insight?

Unread postby Lori » 24 Dec 2016

We have an adult son who, after 3 psychotic episodes over the last 5 years, finally admits that he is Bipolar. Unfortunately his lack of insight as to how his illness (combined with a learning disability) contributed to him losing his job over a year ago. He was in a job that he was clearly unsuitable for, but he continues to believe he lost his job because of a personality conflict (harassment, etc). We finally convinced him to take part in the EPI program this past year but he has discontinued because he (and his EPI team) think that it is not necessary. Apparently he always appears to be doing fine when he goes to his Mental Health appointments. Meanwhile, we see him continue to have problems, especially when stressed. His EI is running out soon and so far he seems very reluctant to seek employment. He doesn't appear to have a "clue" as to what his future plans are, and doesn't want to discuss it with us.

Any suggestions on how we can help him to move forward by getting a job when he doesn't seem to appreciate that he is not suitable for certain types of work (like trades)? This could be due to a learning disability. In other words, how do we tell our son that he is not as good as he thinks he is at some things, and needs to be more realistic about his job prospects. He is only on Risperidone.

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AndrewBCSS
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Re: What if your loved one lacks insight?

Unread postby AndrewBCSS » 29 Dec 2016

Hi Lori,
I'm not sure that you can. However, there is a program in your area that might be able to help him find suitable employment. Here's a link to it: http://www.opendoorgroup.org/ I knew someone who found it very helpful and is now happily employed, despite some limitations that would have otherwise made it hard to find a job.

Dr. Amador's book that I talk about above is also very helpful when talking to someone who isn't able to understand fully that they have an illness. As well, his mental illness may be making it difficult for him to think well. Even when psychotic symptoms are under control it can take years for the person's brain to recover enough for them to have motivation or do complex tasks (these symptoms are called 'negative symptoms' if you want to look them up).

Sincerely,
Sophia
___________________
Andrew Stewart
Operations Manager
British Columbia Schizophrenia Society
A reason to hope. The means to cope.
www.bcss.org


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