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How Families Cope with Mental Illness

Family caregivers
Ms. Revital Ordan, Psychiatric nurse, Director of the Ambulatory Array, Mental Health Division, Ministry of Health
6 November 2025

Supporting a person with a mental disorder is a complex task that affects the entire immediate circle. If you have a relative who is dealing with a mental disorder, you will face a variety of challenges that may affect all areas of life. Interpersonal relationships change, roles in the family are redistributed, and it is necessary to deal with the social environment, identify early warning signs, and assist persistently in treatment. Along with this, it is important to remember that support from the immediate circle is an important factor in the recovery process. When it comes to dealing with mental conditions, there are no magic solutions or quick ways to recovery – it is a process that takes time.

It is important to distinguish between helpful empathy and harmful identification – how to support without "drowning" with the person struggling, and when partnership in the rehabilitation process is preferable to a complete reversal of roles.

At the same time, it is important to remember that you are not alone and that there is someone who sees you. Treatment is not an easy task and it has implications that are important to talk about and acknowledge. During the process, it is worth paying attention to these signs of burnout:

  • Constant fatigue
  • Difficulty concentrating and sleeping
  • Self-neglect
  • Feelings of despair

If you recognize these, it is worth implementing some general rules, such as setting healthy boundaries, defining clear roles, maintaining a routine and social connections, and seeking help for yourself early on. The main message is that in order to support another person in the long term, you must first take care of your own mental health.

If you need guidance or additional support, you can consult with the treatment personnel who accompany the person struggling – they can give you practical tools and professional advice. You can also contact a social worker at your HMO clinic, or look for counseling and help centers that specialize in supporting families of people struggling with mental illness.

And of course – it is always worth remembering that with appropriate treatment and support, most people who deal with mental disorders manage to achieve significant improvement and a better quality of life.

According to the World Health Organization, 1 in 4 people will struggle with a mental disorder during their lifetime. This struggle does not only affect the person themselves, but also affects those close to them – family members and close friends, who constitute a significant support system for them. This close circle, which includes partners, parents, children, siblings and close friends, also encounters quite a few emotional, functional, social and financial difficulties.

If you have a loved one who is struggling with a mental difficulty, it is important to remember that you are not alone and that there is someone who sees you. Your coping is complex, treatment is not an easy task and has implications that are important to talk about and recognize. You also deserve support.

The impact of mental coping on family members and friends

Studies show that family members or close friends are a central factor in the recovery process and in improving the quality of life of a person dealing with a mental disorder. Alongside this, it must be understood that the disorder affects not only those who are dealing with it directly, but also the entire immediate family and social system.

Here are some of the common challenges:

Family members and friends of a person dealing with a mental disorder are required, and are even expected, to be attentive, empathetic, and avoid judgment. It is important to be aware that the emotion and distress that the person dealing with the disorder experiences may also cause family members to have similar feelings – sometimes positively as empathy, and in other cases there may be a response of identification. To deal with these types of feelings, it is worth being careful and maintaining awareness and a distinction between empathy and identification – with empathy, one can feel the other and share the emotion with them, while with identification there is a danger of self-cancellation and difficulty setting boundaries between my feelings and those of the person dear to me. In cases where there is difficulty setting the boundary between me and the other and there is insufficient awareness, or there is use of ineffective defense mechanisms, such as denial, repression, or projection, family members or friends may feel negative feelings such as apathy (disconnection), frustration, anger, guilt, and blame.

In all mental disorders, daily functioning is impaired, so the treatment plan will always include components of rehabilitation and return to function. When talking about functioning in mental health, we refer to broad aspects of daily functioning alongside psychological, social and occupational functioning. A decline in functioning inevitably affects family members and close friends in several aspects, including a change in the array of roles.

Each person has a collection of roles that they play in their family, social and occupational lives. In a situation of acute flare-up or prolonged coping with a serious mental disorder (SMI), these roles become unstable. Since these roles are always in a dynamic state, a change in one person's role will lead to a change in the roles of the people around them. For example, in the case of close friends, whose relationship is based on mutual contribution and equality – when one of them is coping with a mental disorder, the relationship may become a relationship of caregiver and patient. This change may also cause a sense of loss of the original relationship, or even of the person one knows and is connected to. In addition to the interpersonal aspects, this also has implications for daily life, such as a burden of roles, multiple tasks, worry, and financial pressure on the family member who are caring for them or close friends. Often, this burden creates emotional and physical detachment, which may lead to burnout and a situation in which things are done in place of the person struggling, instead of being partners in their rehabilitation process. Although partnership in the rehabilitation process, instead of a complete change of roles, requires more availability and mental and physical strength, it is ultimately what leads to real long-term change.

Coping in more external circles, such as extended family, friends and acquaintances in the wider circle, the workplace, and so on. The people who are close to the person struggling are often required to help and mediate their coping with people in more external circles, explain their situation, and minimize damage. This may cause feelings of unpleasantness, discomfort and embarrassment, and beyond that – there may be wider implications, such as financial challenges as a result of layoffs resulting from conflicts at work, avoiding participation in social events, dealing with rejection by the environment due to the symptoms of the disorder, and more.

Part of recovery is good management of the disease, preventing repeated flare-ups and creating quality of life and the possibility of realizing personal goals. One of the strategies in managing a disease includes early identification of the first signs of a flare-up of the disorder, and a contingency plan with clear steps to take when these appear. For example, immediately contacting the treating physician to consider a medication change, increasing supervision of the person dealing with the mental disorder, and thinking together about steps that can help. Signs of deterioration can vary from person to person, for example, for one person the signs may be a tendency to close-off and going to sleep earlier at night, while for another person it may be actually expressed in an increase in the level of activity and involvement. Outsiders may not notice these changes, but family and close friends, who know the person well, will be able to recognize the change.

Managing an illness in general and a long-term illness in particular requires following medical, therapeutic and rehabilitation instructions. Often these instructions affect other daily tasks, which may cause a feeling of loss of personal independence, difficulty in persisting in treatment and a constant reminder that there is a mental disorder to deal with. Furthermore, managing the illness also requires the ability to organize at the mental and behavioral levels, which is often impaired by the mental disorder. Because of this, family members and close friends are often required to assist with various tasks, such as managing medication (providing reminders and sometimes also making sure that the medications have been taken), creating a healthy routine that allows for regular sleep hours and a balanced diet, assisting with decision-making and balanced schedules, preventing conflicts and tensions, arriving for regular treatment follow-ups, and performing tasks as part of the treatment and rehabilitation plan.

NOTICE

NOTICE

Although support from the close circle is extremely important, the main responsibility for treatment lies with mental health professionals. Family and close friends are an important support system, but they do not replace professional treatment.

It is important to take care of yourself as well

To support a loved one who is dealing with a mental difficulty, it is important to take care of yourself as well. Without internal resources, it is difficult to hold someone who needs you. This can be likened to instructions for an emergency on a plane, when parents are asked to put an oxygen mask on their faces and only then put the mask on their children. In other words, to deal with an acute emergency with someone who is dear to you, it is important first to take care of your safety and well-being.

The goal is to reach a situation where you have the knowledge, tools and skills that can help support a loved one, and at the same time be able to reinforce the strength and resilience of the family, with the understanding that in most cases this is a coping process that takes time. The idea is to define a framework in advance within which the abilities, boundaries and roles are defined, alongside the places where there is space for compassion and breathing, fulfilling needs and realizing dreams.

Signs of burnout that are important to pay attention to:

  • Constant fatigue
  • Difficulty concentrating or sleeping
  • Changes in appetite
  • Self-neglect
  • Physical symptoms, such as frequent headaches or backaches
  • Lack of interest in things that used to be enjoyable
  • Feelings of despair or hopelessness
  • Thoughts of anger or frustration toward the person dealing with the mental disorder

If you notice these signs in yourself, consider taking the following steps:

Try to set healthy boundaries on an interpersonal and physical level, that is – define personal space on an emotional level, as well as attitudes, values, goals and dreams. At the same time, it is important to define physical space, and understand that you cannot be available 24/7.

It is important to define your role and place in relation to the family member who is struggling and in relation to the outside world. For example, in a relationship with a person who is struggling with a mental disorder, is my role to be the partner or the caregiver? Defining the role you choose will help you pinpoint which areas should receive appropriate support and treatment, such as mentoring as part of a rehabilitation basket, help from the extended family, and more. This definition will also help you focus on the areas in which you want to invest, for example, if I chose the role of a partner, it is worth thinking about how to create intimacy again.

One of the things that helps reduce stress is creating a regular routine and daily schedule, which reduces the need to calculate the next steps and actions, allowing you to prepare for them in advance and identify the places where you can use other sources of support.

A balanced diet, regular sleep and physical activity contribute to physical and mental health and to better coping with stressful situations.

It is important to identify which activities gave you pleasure in the past and even helped reduce stress, and try to gradually return to them, for example reading a book, going out with a friend to a café, practicing yoga, etc. It is worth dedicating a specific time to these activities in your daily routine, and not giving them up because of stress and lack of time.

Friends and family are key sources of support, so it is worth making sure to maintain these connections. Close interpersonal relationships can provide emotional support and practical help, and can also be a distraction and an opportunity to focus on yourself and what makes you feel good.

Don't hesitate to ask for help from friends, relatives, or professionals. Often, family and friends tend to take on too much, to the point of burnout, and only seek help when they feel they are on the verge of collapsing. It is important to say that help and advice at an early stage help prevent crises and in this sense are more effective. If necessary, it is worth trying to participate in formal support groups in treatment and counseling centers, and informal ones such as support groups on social networks. Often, sharing experiences and advice with people in a similar situation can be helpful and make things easier. In addition, there are cases in which emotional therapy, individual or with the family, can help with complex coping.

Remember

Remember

Our ability to help others begins with taking care of ourselves. Self-care is not selfish, but quite the opposite, it is the essential basis for true help.

Effective communication

When someone close to you is dealing with a mental health condition, one of the most important tasks for both of you is to learn how to build and strengthen your communication. Effective communication can help strengthen your bond and become a key tool in the recovery process.

It’s important to remember that communication is a skill you can develop and improve. It takes practice, patience, and compassion – including compassion for yourself.

Tips that can help improve communication and strengthen your relationship:

  • Listen without judgment: This is the starting point. When a loved one shares their feelings or experiences, try to listen with genuine curiosity, not with the urge to fix or advise. Avoid saying things like “Think positive” or “It’s all in your head.” Instead, validate what they’re saying – repeat their words in your own way and add an empathetic statement. For example, if they say, “I’m tired of taking medication every day,” you can respond, “I hear that taking medication every day feels hard for you. Can you tell me more?” This shows you are listening and empathetic.
  • Notice interpretations and distortions: Fear and anxiety can lead to misinterpretations. For instance, if your partner shuts themselves in a room, you might think “They don’t love me anymore,” instead of realizing they may just need space to cope. Instead of guessing, ask directly: “How are you feeling right now?” or “What do you need from me?”
  • See the person beyond the condition: Avoid generalizations like “People with mental illness always…” or defining someone only by their condition. The person you love is still here – with their dreams, feelings, and unique qualities. Focus on strengthening their healthy, resilient parts, even during challenging times.
  • Keep healthy boundaries: Boundaries make relationships healthier. Recovery is the person’s own process, with professional support. Your role is to love and support them, not to “rescue” them. Trying to “fix” things can lead to frustration and burnout for both of you.
  • Understand limits and complexities: With mental health, it’s not always clear what’s under someone’s control. Work together to identify what they can handle right now, and use that as the basis for gradual, realistic expectations.
  • Set realistic goals and expectations: Recovery is not a straight path – there will be ups and downs. Instead of waiting for a “perfect” outcome, celebrate small steps forward and acknowledge progress together.
  • Cope with your own emotions: Living alongside mental illness can bring sadness, worry, anger, frustration, or even hopelessness. These feelings are valid. Share them with supportive friends, in peer groups, or through counseling. Couples or family therapy can also help improve communication and strengthen your bond, even under difficult circumstances.

Supporting a loved one with a mental health condition is a major challenge for both the person and their family. Family support is a key factor in recovery. There are no quick fixes – recovery takes time. It’s important to care for your own well-being, strengthen your resilience, and develop your skills so you can support your loved one more effectively. If you need extra guidance, don’t hesitate to reach out for help. You can talk with the care team treating your loved one, connect with a social worker at your HMO, or seek out counseling centers that support families of people with mental health conditions. And remember – with the right treatment and support, many people can recover and return to fulfilling lives in many areas.

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