Having a loved one with a mental illness is difficult, to say the least. It can feel like a constant cycle of new medications, hospitalizations, middle of the night phone calls, requests for money, and more. This constant cycle of instability to stability can be frustrating, emotionally draining, and wear heavily on the relationship. However, it can be the most frustrating when you are doing everything to help your loved one and absolutely nothing is working. This is when it is important to take a step back and identify whether your help is enabling negative behaviors, or supporting your loved one to establish positive behaviors.

Enabling is defined as the act of helping someone in a way that does not solve the problem at hand, and instead perpetuates it. 

Supporting, in this context, is defined as actions that empower someone to make choices so that they are able to solve their problem themselves.

The word enabling can sound quite harsh and judgmental. It is important to identify that most people do not enable on purpose and are rarely aware that their attempts at helping a loved one are actually harming them. Signs that you may be enabling your loved one include the following: 

Feeling overwhelming anxiety about what your loved one is or is not doing.

1. Always putting your loved one’s needs before your own. 
2. Feeling staggering guilt or anxiety if you do not help them when they ask. 
3. Taking responsibility for your loved one’s actions, feelings, or problems. 
4. Constantly shielding your loved one from the natural consequences of their actions. 
5. Fixing problems in order to protect your loved one from failing. 
6. You are consistently blaming others for the actions of your loved one rather than holding them accountable. 

The word support can sound overly vague and is thrown around very loosely. Support is a very fluid term that changes depending on the circumstances and it can be very difficult to see what support actually looks like in practice. Ways to identify whether your help is supportive include: 

1. Providing assistance ONLY when they are unable to do it themselves.
   1. For instance, you pay for your loved one’s insurance premium because they are on a limited income and their psychiatrist does not recommend to work more at this time. This type of assistance ensures they continue to have access to the resources that aid in their recovery and respects the opinion of the licensed professional treating them. 
2. You provide help or assistance with very firm boundaries in place.
   1. For example, if your loved one begins to be abusive on the phone, you can stop them and say “Joe, I love you and support you but I will not continue to speak to you if you are going to be abusive towards me. We can try again tomorrow if you are feeling better”. The most important step is to always follow through on the consequences that are laid out. A lack of follow through will only reinforce the negative behavior. 
3. You involve your loved one in important decisions.
   1. A lot of times we discredit someone’s current progress due to their past behaviors. So, we often shield them from bad news or tough decisions to make things “easier”. However, when we do this, we take away crucial practice at independence and decision making. Support in this area can look like setting up a group discussion with your loved one, their treatment team, and yourself to have these difficult conversations in a controlled environment where their resources are easily accessible. 
4. Saying no, even when saying yes is easier.
   1. A lot of times family and friends of those with mental illnesses get the constant stream of phone calls asking for an unending list of wants. This can very easily wear someone down enough to start saying yes rather than taking the additional time to say no over and over again. However, if you consistently say no, the individual will learn that their tactics are not successful. This will push them to develop new skills that allow them to get what they want independently. 
5. Allowing them to fail and reap the natural consequences.
   1. Letting someone fail is extremely difficult. It is hard to see someone we love in pain. It is also very easy to feel like their failures are all our fault. However, failing is one of the best ways to learn in life. It is important that we let someone with a mental illness figure out that their choices have consequences, whether good or bad. This can look like not waking them up for work every day because they constantly wake up late. Over time, their tardies and missed days will result in consequences like a write up, docked pay, or termination. If instead we wake them up on time for work every day, they learn to rely on us rather than themselves, which is not sustainable long-term. 
6. Communicating with empathy, mutual respect, and encouragement.
   1. Learning how to be independent again after a mental illness is a very long, isolating, and arduous process. A lot of people are ashamed of their current state and struggle to talk to those closest to them. By communicating this way, you can create an environment where they do not feel judged, less than, or scared. This is the ideal way to rebuild rapport and regain stability. 

Enabling versus support is a very fine line. Identifying whether you are helping or hurting someone with a mental illness can be very difficult. If you are struggling with this, it may be time to engage in individual therapy, family therapy, or speak to your loved one’s treatment team. Mental health professionals have the benefit of seeing these situations from an unbiased perspective, that is what we are trained to do. We understand that being a caregiver for someone with a mental illness is complex and intricate work. As mental health professionals our job is to make sure the person struggling recovers alongside their support system. 

The key takeaway is to realize that enabling only prolongs the process towards healing and recovery. Support empowers the individual to make choices that aid in their treatment. At the end of the day, most individuals will not recover unless they are intrinsically motivated to do so. If we continue to solve their problems for them, they will never find that motivation.