Kenia's dad was always the life of the party. But then he became moody and confrontational. Small disagreements would turn into big fights. There were a lot of highs and lows. Kenia worked hard to understand his diagnosis and meet him on his own terms. And a therapist teaches us how to notice if a family member is struggling with their mental health.
Our expert, Blanca E Amaya is a Licensed Clinical Social Worker who provides psychotherapy in English and Spanish. She owns her own practice, Amaya Counseling in Pasadena, California.
Check out Amaya Counseling. And if you loved this episode, be sure to listen to When's the Time to Write a Will? and Papí and I Don't Talk, We Argue.
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Let’s connect on Twitter and Instagram at @TalkToMamiPapi and email us at firstname.lastname@example.org. And subscribe on Apple Podcasts, Spotify and anywhere you listen to your favorite podcasts.
Hi, everybody. Thank you, thank you, thank you so much for coming back to How to Talk to [Mamí and Papí] About Anything, and welcome to those of you joining us for the first time. I’m the host and creator, Juleyka Lantigua-Williams. Every week, I’ve been talking to adult children of immigrant parents, like me, and some experts, who have knowledge and expertise, and experience about taboo topics that sometimes make it hard to communicate with our families. We’ve talked a lot so far about values, and personal beliefs, and how to manage expectations and set up boundaries. But today, we’re gonna get into something a little bit deeper. Something that can at times be way more complicated. Mental health.
What do we do when we think that a member of our family might have a mental issue? What do we do? How do we bring it up? How do we talk about it? What if we’re the ones having a mental issue? How do we bring it up? How do we talk about it? In this episode, we’re very fortunate to have Kenia, who wanted to share her story and her father’s story with us, about how she found an informed and compassionate way to get closer to him and to openly talk about what was going on with him. Let’s get into it.
Kenia: My name is Kenia. I am Dominican, born in the Bronx, and in my family we call my mom and dad Mamí and Papí. So, the way I would describe my dad is that he’s a character. I mean, he’s constantly making people laugh, constantly just making up stories just out of nowhere, poetry too. He will say like, “Avión aves!” And we’re like, “Oh, what’s gonna happen?” Like we don’t know. And then it’s usually just some very silly, ridiculous story. And he’s just, I’ve learned, sometimes very misunderstood, but also just a very loving and well-intended person. He always means to care for us in any way that he can, even though sometimes he can’t. But I think he’s a very important figure in my life, at least. Especially in my adult life. We’ve grown a lot closer.
In our culture, I feel like especially, mental health isn’t really talked about. And especially as a kid, it’s not something that you realize, like sometimes you see extremes, but you just think, “Oh, maybe he just had a bad day.” I think in high school was when it really became apparent to me that something else was amiss. We had a few really hard-hitting moments, where I just remember his reaction, so like we were in a car. I said something. It was probably religion related, because we bumped heads on religious topics quite frequently. And I think I was just questioning something, and I think for him it was so offensive, and it just quickly, like in a matter of seconds, he just became a completely different person, and that was the first time I knew there was something really wrong.
And I didn’t know what it was, I didn’t know how to describe it, but it was definitely something where he pulled over the car. I felt unsafe. And that had never… I mean, to this day, I’ve never felt that way. And so, from there, he just became more introverted. This character that I’ve always known my whole life, he became just somebody else, and I don’t know what it was. He never came to school functions. He just wasn’t present.
The diagnosis was bipolar disorder, but it was something that I… They didn’t explain to us thoroughly enough. I don’t even think he understood what it was. It was something where they instantly just gave him medication and then he became even more of a zombie. Everything just became normalized to me, like I didn’t question it any further. It was just the way things were. And by that time, I was the only kid in our house. My brother was in college and my sisters were still in New York, so I just kept chugging along. And then it wasn’t until college, after my parents got divorced, I was a sophomore, that my dad ended up moving to New York. And I was like, “Oh, this is my chance. I can finally talk to him.”
We had spent at that point like three years without a relationship, and then he was at my aunt’s house and I went up there to visit him, and I brought with me this project that I had been working on. I took it upon myself to kind of research what it meant to be bipolar disorder, like a bipolar person, and I learned a lot about what could be a trigger, how sleep affects them differently. There are just so many concepts that started to make more sense to me as I worked on that project and I shared it with him, and I think that was the first time where he felt seen. No one had ever really tried to understand what he was going through. And not even himself, like he just was told, “Hey, this is the thing I need to do. Everyone keeps telling me I need to take this medication. I don’t feel like myself with that medication. What else can I do to better myself and be there for my family?”
So, we talked about it, and from there on, he’s been a steady figure in my life. Took a little while to build it up again. But it really did help me understand what he was going through. For the rest of my family, it’s interesting, because my siblings, my brother and I were really close in age. My sisters are much older in age and there’s so much history that I’m not aware of in their relationship, or there’s so much… Everyone’s had a completely different experience with my dad and his diagnosis, his bipolar disorder, so I shared with my brother and I think it did help him understand what we were experiencing. It just felt almost surreal at that point when you’re in it, and then when we were retrospectively looking at everything. I think it helped understand our father better.
I feel like he’s found his own sort of therapy. I mean, he’s stubborn as hell. He has land in the Dominican Republic. He has passion fruits and goats and he lives like in his bubble of goats, and passion fruits, and just no internet. He’s loving life. And it’s almost like if he didn’t have that, if he didn’t have that fresh air, if he didn’t have that kind of manual labor, I don’t think he would… I think he would be in a very dark place. So, that’s where he is now, and I think our family has just tried to understand him the best we can.
So, I really applaud Kenia for taking the initiative, for seeking knowledge, for really being active in learning about her dad’s condition. But for many of us, mental health is really hard to talk about. Especially hard when we need to talk about it with our families, so I called in an expert. Someone who can help us approach the conversation, can teach us how to help ourselves, and our relatives, so that no one has to suffer in silence.
Blanca Amaya: My name is Blanca Amaya, and I have a private practice in Pasadena, California.
Now, you heard Kenia’s story. What did you hear as you listened?
Amaya: I heard Kenia really support her father through this mental illness journey that he’s having. What I also heard is that what is very common in our community and in other communities is that mental illness is not talked about, that there’s so much shame regarding mental illness, and also the lack of information in our community regarding what mental illness looks like, what trauma is in our community, there is also a lack knowledge regarding receiving treatment and alternative treatment for mental illness.
So, I’m really happy that you brought that up, because besides the very moving personal story, I did hear that, because I heard that a lot with my friends. And so, let’s talk a little bit about what it is about our Latino culture, I’m also Latina, and definitely we don’t talk about this enough. What is that about?
Amaya: I think it’s a lot to do with just the shame. A lot of people don’t want to talk about it. They don’t see mental illness as something that is also related to medical. For example, we don’t shame individuals having diabetes and going for treatment and receiving medication to treat diabetes. So, a lot of the times there isn’t the understanding that our mental illness is as important as our medical health.
So, what do you think was different in Kenia’s case, where you found that she was supportive and understanding of her father’s condition?
Amaya: I think what was different in Kenia’s case is that Kenia met her father where he was. She really wanted to understand her father and what was going on with him, like she held compassion for her father and what was going on with him.
Do you see this dynamic in your practice often?
Amaya: Oh yes. I see it a lot. Unfortunately, sometimes families don’t understand what’s going on with their family member. They don’t understand why all of a sudden their family members are not getting out of bed, or are not being themselves anymore, and a lot of the times, family members do come in to be that support for their family, to say that I’m here and walking with you through your journey, and I think that is so important to walk with them and meet them where they are, because that’s so important in order for them to receive services. To feel like they’re not alone in this journey.
So, let’s talk a little bit about some of the signs. Because you just mentioned one, which is the not getting out of bed, but what are some of the other signs to look out for when a loved one might be going through something that has to do with their mental well being.
Amaya: Yeah. Some of the signs that somebody is needing some assistance with their mental well being, like I had mentioned, not getting out of bed, changes in appetite, not being the usual social person that they are. There’s also times when individuals tries to isolate from their family members. There’s days where they don’t go to sleep. So, just depends on each individual.
In Kenia’s father’s case, he had a medical diagnosis of bipolar disorder. So, this is now a clinical level, right? This is not like, “Oh, I have the blues. Oh, I’m just really sad about something that happened.” This is actually a condition that has to do with the chemicals in our bodies. So, how can especially a daughter, or a son, or someone younger, talk to an older person, a tía, a tío, a parent, a grandparent, about getting help? Especially just to get a preliminary diagnosis to begin with.
Amaya: It’s very important to talk to them about what they’re noticing in a compassionate way. So, coming in more of a concerning way, like, “Oh, I’ve noticed that,” for example, in regards to bipolar disorder. “I’ve noticed that you have been sleeping for a couple of days. I’m noticing that you have elevated mood and then you’re depressed, and I’m just really concerned about you, and I was wondering if you wanted to go with me to go talk to somebody? Maybe we could go talk to the doctor.” You know, you can always start with your medical doctor, and then they can let you know if you need to see someone else.
Or, “Hey, do you want to go with me to go see a mental health specialist? Just to talk to them, to see what’s going on.” If we come in like that, as I’ll go with you, also come in like, “You know, I’m just concerned, and I just want..” If we can go with someone, to talk to them together, I think that really helps.
That sounds great. I’m just gonna throw a little landmine in the way, which is that the person basically doesn’t… is someone who maybe doesn’t know how to accept help. How can the person make the case that their mental health also impacts the person who’s trying to help, right? Because this is definitely the truth, that if someone is not well in your family, whether they’re physically sick, or whether they need some mental support, it impacts the household. So, how can someone make a convincing case when the person says, “I’m fine. I don’t need help.” Or, “I’m not crazy,” which is what a lot of people tend to say when someone talks about mental health. No, no one’s saying you’re crazy.
Amaya: Yeah, so what I hear you say, which like you said is very common, that sometimes the individual who is experiencing mental illness isn’t ready to accept the help. And unfortunately, we need to meet them where they are. If they don’t want to receive the services, we can’t force them to receive the services. And we need to do our own self-care. Practice our own self-care. Because that can become very overwhelming and stressful when you want to help your family member, but they’re not willing to receive that help.
Okay, so if the person is just not open to that, then focus on our self-help. So, what does that look like when you’re living with someone who may have a serious mental health condition?
Amaya: So, for your own self-care, what that would look like is you joining NAMI, which is National Alliance on Mental Health Illness. They’re a support group that works with family members who are trying to help other family members with mental illness. So, that way you kind of don’t feel like you’re alone through this journey, and you can also feel connected to someone else who might be experiencing the same thing as you.
In a home, where we have multigenerational folks, where we have immigrant folks, and where we have first-generation folks, where we might even have second-generation folks, what kind of modeling can we do so that we change the culture of the home and we sort of help everyone else become more comfortable talking about what they’re feeling and what they’re going through?
Amaya: Just normalizing and validating feelings. And also, if they’re having a hard time expressing their feelings, start giving them maybe some words, because maybe they’re not used to expressing their feelings. For example, if you notice grandma’s a little sad today, going up to her and saying, “Hey, grandma. I noticed you’re a little sad today. Do you want to talk about it?” I think that is so important, because that way they feel seen, they feel validated, and they feel like they can continue to go to you to express their feelings.
At what point does diagnosis and potentially medication become necessary? And how can a family member realize that that point has arrived?
Amaya: Usually, what we would look for is how are the symptoms that they’re experiencing right now, how is that affecting their daily life? For example, is it affecting their relationships with family members, is it affecting relationships in job, are they losing their job? So, just impairments in their life function is when we start seeing that it’s important to receive services.
In regards to medication and getting an assessment for medication, it depends on where you go to receive those services. And it’s something that I always tell each individual that I see, is that it’s up to you if you want to take the medication. Even though the psychiatrist or doctor is recommending that you take medication because of a chemical imbalance that you’re experiencing, or because they believe that this will help reduce your current symptoms, it’s always up to you and your choice only to receive and take that medication.
Great, so always letting the person understand that these are the choices, that it’s entirely up to them, and that people will be supportive regardless. Right? Because that’s another key. You can’t give someone an ultimatum.
Amaya: Exactly. That will not help the situation when you give ultimatums. And also know that there’s alternatives. You know, there’s always alternatives to receiving mental health services. It doesn’t have to be just one set box of you’re just going to go talk to somebody once a week. There’s other things that you can do to help with your own mental health.
Amaya: Like for example, a lot of individuals, their mood increases when they are more active, when they’re physically more active, when they’re enjoying more of their hobbies. I know Kenia mentioned that her dad had land in the Dominican Republic, and how he was enjoying life there because he had the land, he had his fruits. That was his own personal sanctuary, and that also needs to be talked about and also accepted.
All right, let’s recap what we learned from Blanca. Pay attention to the signs. Not getting out of bed, not sleeping well, changes in appetite, isolating themselves. Approach the person with empathy. Show your concern with compassion and offer to help. Also, offer words that might help them to express their feelings. Focus on your own self-care, especially when someone does not want to accept or seek help. You can go to nami.org, N-A-M-I.org, to seek help and support, and you can also talk to someone close about what’s going on. Avoid threats and ultimatums. They’re not gonna get you anywhere and they’re certainly not going to convince someone to go get help. Seek alternatives to clinical treatments, such as more physical activity and hobbies the person can enjoy. And remember, meet people where they are. If they’re not ready to talk or go see someone, then back away from the issue. Even with medication, it’s always up to the individual to take action.
Thank you so much for listening. We still have stickers. Want some? DM us on social media or send your address to email@example.com and I’ll send you a set for free. How to Talk to [Mamí and Papí] About Anything is an original production of Lantigua Williams & Co. Micaela Rodríguez produced this episode. Kojin Tashiro mixed it. Cedric Wilson is our lead producer. We’d love to hear your stories of triumph and frustration, so email us at firstname.lastname@example.org. Even if you don’t want to be on the show, email us or hit us up on Twitter or Instagram, so I can send you those sweet show stickers. On Twitter, we’re @talktomamipapi, and on Instagram we’re @talktomamipapi. Remember to please subscribe on Apple Podcasts, Spotify, or anywhere you listen, and leave a review. We read those! Bye, everybody! Same place next week.
Lantigua-Williams, Juleyka, host. “Dad’s Mental Illness, on His Terms.” How to Talk to [Mamí & Papí] About Anything, Lantigua Williams & Co., May 29, 2020. TalkToMamiPapi.com.