Caregivers: When to Push and When to Show Extra Compassion

By Stephanie and Andrew Downing | Nov. 13, 2017


Marriage is difficult for anyone, but it’s even more challenging when you add in the complications of mental illness. My husband, Andrew, has schizophrenia. We’ve lived together for nearly 15 years and we’ve found success as a married couple, but our journey has been filled with many obstacles.

Beyond my relationship with Andrew, I am also a mental health practitioner. Whether I’m caring for someone with schizophrenia or depression, I often walk the narrow, unforgiving line of when to push and when to administer a large helping of mercy. Though challenging people to improve their quality of life is risky, if we don't, those who are struggling may continue to struggle.

People have asked me so many times when and how to encourage, or push, someone struggling with a mental illness. Here is what has worked for me:

Practice Compassion and Mercy First

An act of mercy starts with an open mind and a sensitive, understanding voice while communicating. I constantly challenge myself to see the bigger picture and put aside my own frustrations, so I don’t come across as judgmental or abrasive. As this type of personality can prevent an empathetic viewpoint. If I am open about my own problems around my husband, he might be more willing to talk about his own struggles.

Assess Symptoms

To push someone successfully, knowing when symptoms are flaring is helpful. Phone calls, text messaging or other forms of digital communication can make it difficult to assess symptoms. Body language and word choice, comparatively, offer a wealth of information. For example, anxiety can cause a person’s body to twitch and tighten.

Show Love During Confrontation

Unfortunately, caregivers often have to challenge struggling individuals during difficult times. Waiting for peaceful moments or willing ears is not always an option. That's where the art of confrontation and mercy merge into one cohesive act of love. However, yelling or speaking from a platform of self-assumed intelligence, pride, anger or bitterness typically results in a negative outcome. People tend to respond well to a loving presentation of information that reinforces equality.

Build Relationships That Foster Equality

Healthy relationships start with the understanding that mental health conditions have labels, but those labels don’t represent the person. Treat your loved one as a person who is equal to you, not as a lesser person because they have mental illness. If their relationship with you isn’t built on mutual respect and admiration, it will be very difficult for them to grow or be challenged by you.

With all this said, keep in mind that no one has absolute control over another human beings’ actions. Caregivers must let go at times to remain healthy themselves. Holding on to bitterness or regret can cause a caregiver emotional turmoil.

Expect to make mistakes as you grow into your role as caretaker. Though I have often felt guilty for making his life harder with my pushing, Andrew often tells me he may have been lost to a permanent state of delusion without our relationship. I know that my presence in his life has challenged him to be the best he knows how to be. Never give up on the person you love, and try to remember the immense challenges that a person with a mental health condition faces each day.


Stephanie and Andrew Downing are the authors of “Marriage and Schizophrenia: Eyes on the Prize.” You can learn how Stephanie failed and succeeded at pushing Andrew to be his best through the immense challenges presented by schizophrenia. 

Ann Fedele
I like to find out how other "caregivers" be it your spouse, child, parent and so on. I have a 32 yr old son with Schizophrenia, when he was about 22 yr old, he has just started and Stopped taking medication since Jan 2017. He is now on another medication and is so much more like himself, I'm hoping to keep on him this time and instead of stopping meds I told him that the Dr can add another med or increase or decrease his !! I would love some advice on how to encourage him or be more demanding of the taking of meds ?? IDK ?? I feel like I walk on egg shells when dealing with this darn illness.. I've been reading and doing most of what I learned about talking to him and being positive around him, but not overbearing. Sorry I'm rambling . I would appreciate any advise or experience you all may have for me... Good Luck All,
11/20/2017 3:31:54 PM

SteveAnn Bourgeois
I am currently working to get my son approved for SSDI, he is dual diagnosed and in residential treatment. I learned so much when my husband and I attended the 12 week Family to Family class. We have been suffering silently for about 10 years and suddenly realized we were not alone any longer.
11/17/2017 6:31:29 PM

Arelative of mine is needing care since Feb 2017.hes diagnosed Acqire Brain Injury .JUSTyesterday I felt like I needed a short break a day ortwo for me .IT Really takes a whole village of support to care for someone so I have to give thanks to HOME Instead my family support the big and little that you do.BEEN WORKING ON finding him housing I do pay attention to his denial of going to any facility.
11/17/2017 2:42:30 PM

Bill Coussons
Great educational tool...
11/14/2017 9:10:05 AM

Elsie Virginia Ruiz
Informative and inspiring.
11/13/2017 11:21:01 PM

Lizanne Corbit
This is a wrestle that so many people struggle with. I love that you say "expect to make mistakes" -- it's OK! Taking on the role of caretaker is never easy and it comes with a lot of weight. Just as you're being easy and supportive of those you're caring for you have to show yourself the same understanding.
11/13/2017 6:47:16 PM

Kerry Gimbel
Thank you. I am currently trying to help my son who is struggling with mental illness and addiction. I think the time has come to let go for a bit but it is heartbreaking.
11/13/2017 5:29:22 PM

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