The most difficult challenge to assessing whether a loved one needs the help of a psychiatrist is to try to see them objectively. To have developed a relationship of love with this person, generally a family member or friend, you will have spent a lot of time around them or possibly live in the same household. It is very difficult to see someone’s behavior in an objective way when you are too close to see the “big picture”. We also want our loved ones to be healthy and happy, so we might filter out some signs or symptoms that are uncomfortable for us to deal with or awkward for us to react to. Also, if you spend a great deal of time with a person, we miss subtle changes. It is similar to children growing up. When you live with them, you sometimes don’t detect the subtle growth changes, but a visitor who hasn’t seen your children in even 6 or 8 months will come in your door and be amazed at the change in your child! When those close to us change slowly over time, it can be accepted or even go undetected because of the subtle change over time.
Try to be objective and look for the same signs that you would notice in a more casual friend or in a co-worker. It is easier to see signs like lack of interest in activities, loss of appetite, extreme changes in weight or crying spells. But are there subtle signs? Are they doing what they did 6 months ago? A year ago? Do they talk about hopes for the future or dwell on the past? Have they changed the way they dress? Eat? Sleep? Did they previously love outside activities and now spend more and more time at home than they used to? If you see changes, are they subtle or debilitating?
Your loved one should see a psychiatrist if they have signs or symptoms of emotional or psychological stress that hinder health or their ability to enjoy their lives. Certainly they need help if relationships are being ruined, careers are in jeopardy due to absences at work or if they are endangering their health by extreme loss or gain of weight or have resorted to drug use or over consumption of alcohol as a means of coping. But it is much better to see and address symptoms before they reach this point. Keep the doors of communication open. Don’t be afraid to say “I’ve noticed that you rarely go out of the house anymore. Is there something wrong?” or “You just don’t seem like yourself.” That presents a general statement of observation that leaves it open to your loved one if they want to respond, and to what degree they want to expound on any issues. Let them know that you honestly care. You are not prying into their business in a nosy way, but in a caring way because you want them to be happy and healthy and you are genuinely concerned.
Communication is the key in any relationship and with loved ones, this can sometimes be lacking between people very familiar with each other, as odd as this may sound. We often assume that, being close, a family member would tell us if they need help or if they have stress. We feel that we would surely notice that something was wrong with someone living in our own house. In many cases, this turns out not to be true. If we always practice good communication; talking openly and often about our feelings and our health and not just the weather and other daily issues, it opens the door to easier communication when a loved one needs the help of a psychiatrist or counselor.
