Daily Steps… Steps… Developing a holistic mental health care plan for your loved one.

www.hopeandhealingcenter.org

contact@hopeandhealingcenter.org

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The Hope and Healing Center & Institute developed this material in partnership with The Grace Alliance.

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Mental Health Grace Alliance is a 501(c) 3 non-profit organization that provides recovery programs, support groups, training, and collaborative partnerships to impact mental health care.

Joe Padilla, CEO

201 Old Hewitt Drive, Suite. D

Waco, Texas 76712 (254) 235-0616

info@mhgracealliance.org

www.mentalhealthgracealliance.org

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The Hope and Healing Center & Institute is a comprehensive mental health resource dedicated to transforming and restoring lives through education, training and supportive services.

Matthew S. Stanford, PhD, CEO

717 Sage Road

Houston, Texas 77056 (713) 871-1004

contact@hopeandhealingcenter.org

www.hopeandhealingcenter.org

contact@hopeandhealingcenter.org www.hopeandhealingcenter.org

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Introduction

A holistic approach to mental health care relieves physical and psychological suffering with medication and psychotherapy, while revealing the unconditional love and limitless grace that is only available through a personal relationship with Jesus. The following resource was developed as a simple guide to help you design a mental health care plan for your loved one that takes into account all three aspects of their being: physical, mental, spiritual, and relational.

A Holistic Approach to Mental Health Care

The Scriptures teach us that we are complex creatures, having both physical (material) and nonphysical (immaterial) aspects to our being. Jesus himself describes the complexity of the self in Mark 12:30-31. Asked the greatest of all the commandments, Jesus responds by saying, “Love the Lord your God with all your heart and with all your soul and with all your mind and with all your strength. … and Love your neighbor as yourself.” In other words, love God with all aspects of your being, your whole self and through your relationships. So you and I are a unity of physical, mental, spiritual, and relational facets with each facet affecting and being affected by all the others. Physical We exist in a physical body so that we can interact with the material world around us. Our bodies have been specifically designed to take in information from the environment and relay it to our brains. We see, hear, taste, smell, and touch the world around us. The processing of sensory information by our brains produces thoughts, feelings, and emotions, which then result in some outward behavioral display. Mental Are our thoughts, feelings, and emotions merely the product of neurochemical changes and electrical discharges in our brain? Or is our mind something more—something immaterial, more than the sum of our parts? The truth is probably somewhere in the middle. While the functioning of our brain is integral to the existence of our mind, that alone is not sufficient to explain it. Similarly, to imagine our mind as completely separate and unrelated to the brain doesn’t seem correct either. Spiritual In our inmost being we are spirit, the very breath of God placed into a shell of dust (Genesis 2:7; Ecclesiastes 12:6–7). As a spirit being, it is possible for us to be in an intimate spiritual union (Proverbs 20:27; Romans 8:15–16) with our Creator, who is also spirit (John 4:24). No other living creature, not even the angels, has been given such an opportunity. Relational We were created to be in relationship. God Himself said that it is not good for us to be alone (Genesis 2:18). While our first and greatest relational need is to know God, we should never underestimate the importance of being in fellowship with other believers. Relationship is one of the reasons why Jesus gave us the Church; so that we might be together and never be alone.

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Figure 1: The Holistic Self

The person struggling with a mental illness needs a holistic approach to care that takes into account all

aspects of his or her being. Treatments that focus solely on a single aspect of one’s being can bring

only limited, short-term relief at best.

Figure 1 below shows the spiritual, mental, physical, and relational facets of our being, each

separate but interacting with the others. Our body senses and reacts to the external environment, and our mind uses that information to perceive, understand, and interpret our

surroundings. The mind forms our thoughts and plans out our actions. Our spirit, when

connected to God, works to transform the mind into the very image of Christ (2 Corinthians 3:18). This interaction within our being allows us to be involved in healthy, meaningful

relationships with others.

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Structure and Routine

A daily structure and routine will help your loved one thrive. It is suggested that you take the physical, mental, spiritual, and relational needs described on the following pages and explore ways you can build them into a daily or weekly routine/schedule for your loved one. Don’t worry about the minute to minute but view the “needs” as broad general principles to be implemented. Involve your loved one in developing the routine. Adjust the schedule to what they prefer or what builds their confidence and helps them succeed. Keep it simple. If it isn’t simple for you, it won’t be simple for them. Take your time and don’t feel like you have to rush and get everything in place all at once. Because of cognitive confusion and memory problems (due to their disorder and/or medication), some individuals living with mental illness may need to physically see a schedule of things they are going to do that day to be successful. Everyone is different, so be patient and keep learning what works and doesn’t work for your loved one. This should be viewed as a process, not a quick fix. In relation to recovery, you should think in terms of months and years rather than days and weeks. As your loved one heals and gains more stability, they will be able to do more and will move beyond a highly structured daily routine or schedule. Adjust accordingly as they become more independent and successful at navigating daily life.

Physical Needs

The physical needs associated with mental disorders go far beyond medication and include rest, nutrition and exercise. Keeping the body (and brain) healthy will help take the edge off of symptoms related to the disorder and can enhance the action of psychiatric medication. Sleep – Insomnia is a symptom of several mental disorders as well as a side effect of some psychiatric medications. Being appropriately rested is vital to maintaining daily stability. Sleep deprivation leads to irritability, agitation, and stress, which can trigger more serious symptoms of the disorder. Activities that can increase restfulness include having a set bedtime and routine, avoiding caffeine and nicotine, taking a nap in the afternoon, and talking with the doctor to discuss the positive and negative effects of medications on sleep. Medication – Educate yourself about the psychiatric medications that have been prescribed to your loved one. Know what they do, their potential side effects, interactions with food and other medications and how sensitive the effects of the drug are to missed doses or non-compliance. Organize their medications in such a way that they can be taken regularly and with ease (e.g., weekly pill dispensing boxes). Relaxation – The physical symptoms of stress and anxiety (heart racing, sweating, shortness of breath, nausea) can be overwhelming. Relaxation techniques such as paced breathing can be helpful during these episodes of panic but can also help when done on a daily basis to bring down your loved one’s general level of stress.

6 Nutrition – Evaluate your loved one’s diet and eating habits. A healthy diet replenishes electrolytes and amino acids. This in turns affects neurotransmitters in the brain and can enhance the effects of medication. In some cases, nutritional supplements such as essential fatty acids may be helpful. These supplements should be used in addition to, but not in place of medication. Always check with your doctor before taking a nutritional supplement. Exercise – Some sort of daily physical exercise is recommended for those living with a mental illness. This does not need to be an intense workout at the gym, but something that gets them moving and is easy to maintain (e.g., a 15-minute walk or 30-minutes working in the garden). The goal is to be regularly active in order to strengthen the body against stress and the benefits can help relieve anxiety and depressive symptoms.

Mental Needs

Mental disorders are often a battle between reality and wrong or negative thoughts that overwhelm a person’s mind. A structured approach to psychological needs is just as important as physical needs and includes regular psychotherapy, healthy thinking, positive coping strategies, and enjoyable mental activities. Psychotherapy – Talking therapy in conjunction with medication has been shown to be the most effective approach to treating mental illness. Psychotherapy is done by a licensed clinical psychologist and focuses on managing symptoms related to the disorder and improving an individual’s general quality of life. Healthy Thinking – Simple tools to address the ongoing negative thinking are essential for the recovery process. Developing a process of healthy thinking helps the individual identify how negative thoughts and stressors are affecting their moods and behaviors. Coping with Problems/Stress – When individuals struggling with mental health difficulties take direct positive action to cope with their disorder, they put themselves in a position of power. Active positive coping is empowering and takes away feelings of helplessness. Mindfulness – Mindfulness is a mental technique that focuses one’s full attention on an activity, subject, or image in order to calm the mind. Mindfulness meditation means simply becoming more aware of things and accepting what is happening, moment by moment. Through meditating mindfully, we learn how to be more present in our lives. Cycles and Triggers – Understand the patterns of your loved one’s illness, how they tend to cycle through their specific symptoms (e.g., depression every winter) and recognize specific triggers (e.g., crowds, holidays) that cause distress. Knowing your loved ones cycles and triggers is a key factor in maintaining stability. Mental Activities – Find mentally refreshing and stimulating activities that are enjoyed by your loved one. These could include painting, drawing, reading, photography, music, gardening, appropriate comedy outlets, word games or puzzles, or other hobbies. This type of activity is highly therapeutic and will help them feel good about themselves. Try different things. They may not last, but for the moment it helps them experience normality and gain stability.

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Spiritual Needs

The church has a significant role to play in the lives of those struggling with mental illness. Studies have shown that religious support offers resources to the psychologically distressed individual that is unavailable from general social support. Religious support is vital to recovery and wholeness. More importantly we serve a God who loves us deeply, who hears our desperate cries, and responds with sustaining mercy and grace. Hope – Hope energizes people and gives them strength to endure in a way that nothing else does. People without hope become defeated, broken, and unable to cope with adversity. Hopeless people give up. Our hope is not a feeling or a mental exercise but a person, Jesus Christ. Knowing Your Identity – The scriptures teach us that we have been fearfully and wonderfully made in the very image and likeness of God. Circumstances and struggles do not define who we are, God does. Your loved one must be continually reminded of this truth so that they will have a strong foundation on which to rebuild their life. Finding Purpose – Your loved one’s mental disorder does not hinder God’s purposes nor does it in anyway affect God’s plan for their life. We can learn and recognize that a mental health difficulty may be an opportunity for the works of God to be manifested in our life. Spiritual Growth – God desires you to know your loved one in such a way that blesses them and brings rest in their faith. Ways to know God more deeply include meditating on His Word and bringing more meaning to your personal worship/praise and prayer life. Trials and difficulties do not intimidate God; they can be opportunities to gain wisdom. Living in Community – Actively seek out a faith community that can encourage and support you and your loved one. An active and supportive faith community cultivates life while isolation brings frustration and fatigue.

Relational Needs

Mental illness affects more than just the person afflicted by the disorder; it impacts all of their relationships. Difficulties, stigma, and shame often isolate whole families trying to care for a mentally ill loved one from the world around them. In addition, high levels of stress and difficult symptoms can result in relational conflict requiring forgiveness and reconciliation. Family and Friends – It is imperative that the family and friends of an individual living with mental illness gain understanding about the disorder and receive support from others. Without information to help families learn to cope with mental health difficulties, they can lose hope and withdraw. Resolving Conflict – Every relationship will have some conflict, it’s important to learn and grow from them. Resolving conflicts is more about compromising for a healthy conclusion, not proving a point. If you push for your point of view it creates more tension and can come across as manipulative. Overcoming Stigma – Stigma is always born out of fear and misinformation and can only be overcome by truth and education. The purpose of stigma is to minimize, disgrace, or dehumanize someone so that inaction and a lack of compassion can be justified. Other’s wrongly held views and beliefs (stigma) are hurtful and not your fault; don’t own them.

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Opportunities to Serve – As stability is regained, look for simple ways for your loved one to serve and bless others. Whether it is at home, for a neighbor, or at church, serving provides a healthy way to look beyond personal difficulties and engage with compassion for others. Serving others builds value and worth. Forgiveness – Forgiveness is not choosing to inflict the price for an offense. The wrongful act that hurt or offended you might always remain a part of your life, but forgiveness will lessen its grip on you and help you focus on other, positive parts of your life. Forgiveness is a choice we make through a decision of our will (not a feeling), motivated by obedience to God and His command to forgive.

What Does Recovery Look Like?

Recovery is process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Time frames for mental health recovery should be defined in months to years rather than days to weeks. During recovery an individual living with mental illness moves from distress à stability à function à purpose through the following series of steps:

1. The development of hope that mental health challenges and obstacles can be overcome. 2. Acquiring skills in self-care and self-management. 3. Having a good support network and possibly using peer support groups. 4. Taking an active role in planning and managing your own recovery. 5. Movement away from focusing solely on pathology, illness, and symptoms to health strengths and

wellness. 6. The re-discovery of a sense of personal identity separate from problems. 7. Working towards participation in the local community on a basis of equality. 8. Building a meaningful and satisfying life.

Challenges People living with mental illness can behave in strange and bizarre ways. Their perception of the world and those around them is very different than yours. They may even perceive your attempts to help them as a threat. They may deny that they have a problem. They may refuse to be involved in treatment. These are difficult issues — long-term, messy and requiring a steadfast commitment on your part. Don’t expect appreciation; in fact, you might receive just the opposite. Remember that God has called us to “rejoice with those who rejoice, and weep with those who weep.” (Romans 12:15). This is as much your trial as it is that of the person with the disorder. God wants to use it to draw you and your loved one closer to Him. There are no easy answers, and there is no quick fix. This is real life, and sometimes it will seem like you are feeling your way in the dark, but you are not alone. God is present in the midst of this storm and He will provide sustaining grace as you and your loved one walk toward recovery and healing.

717 Sage Road Houston, Texas 77056

(713) 871-1004

www.hopeandhealingcenter.org

Online Resources

Hope and Healing Center (www.hopeandhealingcenter.org)

The Grace Alliance

(www.mentalhealthgracealliance.org)

National Alliance on Mental Illness (www.nami.org)

National Institute of Mental Health

(www.nimh.nih.gov)

WebMD (www.webmd.com)

201 Old Hewitt Drive, Suite. D Waco, Texas 76712

(254) 235-0616

www.mentalhealthgracealliance.org