Q&A: How Do I Maintain Boundaries with Someone Who Has Mental Illness?

I receive a lot of inquiries from people asking for advice about living with mental illness, loving someone with a mental disorder, and doing ministry among people with mental illness and their families. I can’t offer the kind of advice and help a mental health professional can give, but I can point people in the direction of resources that might help them. And I can share some of the wisdom I have learned in my own family’s experience as well as countless conversations with people who have experience in similar situations. Sometimes it’s a matter of just introducing people to resources that are available. Sometimes it’s a matter of sharing my own personal experience and my own perspective.

Occasionally I share some of these interactions* here, for the benefit of others who may have similar questions.

Here’s one:

Question: My sister has a serious mental illness, and it’s really hard for me to be in a relationship with her. I love her a lot, and when she’s doing well, we have a lot of fun together. But I never know which version of her I’m going to get. She counts on me a lot, and I try to help her as much as I can, but I have my own family and job to worry about. Plus, sometimes I’m just tired of trying to help. How can I help her and love her but still have some boundaries around my own life?

Answer: I’m so glad you’re asking this question. It’s important! Your life matters as much as your sister’s does, and the other people who are counting on you–your family, your co-workers, and others–need you to be available to them too. And ultimately, you won’t be a great help to anyone, including your sister, if you are not healthy and well yourself.

I recommend you consider attending a group that can help you understand how boundaries work and support you as you establish and enforce them. You might be able to find a boundaries support group in your area. Or you might consider attending a recovery group, such as Al-Anon Family Groups or Celebrate Recovery. This might sound funny if no one in your family has a substance-abuse problem, but these groups are very effective at teaching boundaries and helping people enforce them. A family affected by serious mental illness can have a lot in common with a family affected by addiction (which is a kind of mental health problem): family secrets, poor boundaries, and unhealthy patterns that can even keep a person who’s ill from getting better.

You might also consider reading a book about boundaries, such as the classic book Boundaries by Henry Cloud and John Townsend. This book also has several spin-offs that apply to specific relationships.

Aside from those suggestions, here are some tips you can use right now:

* Address your needs for healing.
If necessary, engage in therapy. If you’re going to establish healthy boundaries and respect your own needs, it’s important to understand how your wounds have shaped you and to seek healing.

* Understand who you are and what you are called to.
Find your own sense of purpose outside caregiving. What are you here for? Then you can figure out how helping yoru sister fits into that overall purpose. You must understand and respect not only your limits but your limitations—you cannot do it all. You have to respect not only yourself but others as well (like your sister), trusting that they have access to resources beyond you. You’ll have to trust God, that he is capable of doing his work without you. This requires some humility–acknowledging that you are not the true, complete answer to anyone else’s problems.

* Be proactive–establish your boundaries before you need them.
Think about boundaries that will establish patterns that reflect the way you want your life to be in 10 years. Then tell people what your boundaries are. Carefully consider the best way to communicate your boundaries. Someone with mental illness may need you to explain them very gently, yet clearly; in a way they can hear, understand, and respect. Then, if they violate those boundaries, you can remind them of what you already told them. Holding to your boundaries in this situation is far easier–and way more effective–than making them up on the spot.

* Be consistent.
If you want people to take your limits seriously, you need to take them seriously. You can’t just react in the moment when you’re tired; you can’t draw a boundary one week and cave in on it the next week. That doesn’t mean you can’t make exceptions; of course you can. But consistency is key.

* Get ready to disappoint people.
This comes with the territory. Not everyone will be happy with your boundaries. And this is something you can survive. Keep in mind, if you don’t disappoint someone, you’re going to disappoint someone else. Maybe someone very close to you. No one can keep everyone happy all the time.

I hope this helps. If you’d like some help in finding healthy boundaries, establishing them, and sticking to them, consider working with me as your coach. I can help support you and provide accountability as you make this important change in your life.

*Question has been modified for the sake of brevity and to protect privacy.

  1. Pat Franklin says:

    Thank you for this timely blog. I deal with mental illness in a relationship that definitely has boundary issues. A couple of your comments hit the bulls-eye in a helpful way. I’m learning that disappointment can be endured although uncomfortable.

  2. LISA RICHMAN says:

    This really touched me. Tears. In the only child of a mom with mental illness. Her therapist wants me to call her. I’m so anxious about that. I feel so embarrassed and humiliated that my mom is like this and I’m the child. It reminds me of her not being a mom as a mom should be my early life.

    • Amy says:

      Lisa, I can relate so much to what you say. My mom has mental illness too, and I used to feel a lot of shame around that. I worked with therapists to experience my own healing (and I’m still in process with this), but I made a big leap forward when I realized my mom’s illness has an impact on me, but it says nothing about me. I’m not her, her illness is not mine, her behaviors are not mine, and the fact that she has a severe illness is not a reason for anyone to feel ashamed. I think we naturally identify so strongly with our parents, it’s hard to make that separation in identity. But I hope you’ll be able to come to the same place. You have wounds that need healing, just like everyone. And you’re in good company.

  3. Christy McKelvey says:

    Thank you Amy. You’re comments to Lisa really helps me too. My mom and so many of my family members on her side of the family have MI and I have struggled with identity and shame because of it for years. In my immediate family as well, my hubby and one daughter have been diagnosised as well…we didn’t realise until resent years hos family also has MI…you really helped me when I heard you speak in Charleston at the Summit: The Struggle Is Real…I was drawn to the titles of your talks and signed up for every one of them I could prior to the conference…little did I know God would use your testimony and words to teach me its okay tp be who I am and come from the family line I come from.
    I do feel alot of pressure as one of the only people in the family without some form of mental illness to be the ome that calls around checks on everyone…are they going to therapy..seeing the psychiatrist..taking their meds…making healthy decisions…moving as close to wholenss as they can…etc..etc
    It’s huge in my life and so overwhelming. I needed to see this today to remind myself – its God not me- who will love them most..and God not me- who is the lover of their souls and healer of their paincand tormenting thoughts and behaviors.
    Thank you again…you always reset me when I feel too responsible for others. And thank you for praying.

    • Amy says:

      Christy, this is awesome to hear. I’m so glad my words have been helpful to you. I know you really love your family, and your journey is a painful way to travel through life. The people in your life need you–but you have needs too. I wonder what kind of support you have in place for yourself. Please consider who can come alongside you and be with you when you feel overwhelmed (and when you don’t!)

  4. Joseph Fisher says:

    Thank you mrs. Amy for this post. I have a young son that’s only 15 who has a mental illness. He will turn 16 in a few weeks. This is one of the hardest storms I had to go through. It has been going on for about 2 years. My son was a bright kid who was in the band for years. My son had many dreams and hopes for his future. My son mental illness hurt me to my core. I prayed for my son every day. He did not want to be labelled with a mental illness. I asked God to give him peace that surpass all understanding. My son is more open to talk about his illness today. That is a blessing from God. It has been many ups and downs. They have all so been many tears and stressful nights. But our God has giving us peace to accept what we can not change. Our God is good in bad and good times. Life is so short. We are united as a family to take it one day at a time. We enjoy the good days and thank God we made it through those bad days. Our God grace and mercy is more than enough. I thank God for your post on mental illness because it has truly blessed my life. Colossians 3:15 and let the peace of Christ rule your hearts, to which indeed you were called in one body. And be thankful. God bless you and your family mrs. Amy in Jesus mighty name amen.???

    • Amy says:

      Thank you for your encouragement, Joseph. God bless you and your family, and I thank God for the help and grace he has given you. I know it’s not easy!

  5. hayley says:

    I have been separated from from my husband for 5 years, my children were only 2 and 5 weeks old at the time.
    Still to this day he makes me an emotional mess trying to deal with his ups and down and trying to be completely controlling.
    I constantly get crazy emails where everything is put back onto me and everything is my fault. If i choose not to reply to these emails it revs him up more so and things get out of control.
    Over the last 2 nights I have received really hurtful messages and when I reply saying grow up and be an adult, and to stop messaging me there is no reason for you to be messaging me as we are not and have not been together for a long time.
    So now he is due to collect kids from school for weekend, he cant and blames me for his downward spiral. This happens all the time and I am left to manage everything.
    I get no financial support from him and i work full time he knows that i need my break every second weekend and am sure he does this to hurt me.
    What should I do?

    • Amy says:

      Hayley, I’m sorry, this sounds like a frustrating and difficult situation. I’m not in a position to tell you what to do, but I suggest you seek a counselor who can help you grow stronger and relate to him from a place of strength. It can be really helpful to have someone in our lives who will help us make healthy decisions for ourselves and even discover resources we may not have known we had. You can’t control his behavior, but you can control how you respond to it. And it’s possible that changing your response will result in a change in the way he relates to you. I hope that’s helpful!

© 2017 Amy Simpson.