Supporting someone living with a mental illness can be a stressful experience. And it certainly doesn't come with an instruction manual.
For some carers, supporting someone means endless internal dialogue about the health and wellbeing of their loved one. Did they take their medication? Are they out of bed? Have they eaten? Showered? Where are they right now?
These questions can lead to excessive worry, catastrophising and anxiety. We asked three carers – Jo, Terese and Julia – what worries them most, how they control these concerns and what advice they'd give other carers.
Do you feel anxious when you leave your loved one at home?
'At the forefront of my mind every day is my loved one,' explains Terese who cares for her 20-year-old son who lives with bipolar II disorder.
'How are they? Will they be OK today? Have they taken their medication? Did they get to that doctor's appointment? How is their life progressing?'
Julia cares for her son who lives with major depressive disorder and anxiety, and she shares Terese's concerns.
'I worry about all sorts of things, but clearly this varies according to where he is at,' Julia explains.
'When he's unstable I'm anxious about his safety. Other times I worry about simple things: has he woken up, or has he eaten anything?
'He's slightly better after a recent hospital stay and new medication. [But] I still worry he may relapse if I'm not there.'
Seeing their loved one recover is the primary goal for all carers. Recovery means increased ability and potentially new activities, yet this wider scope can cause new concerns.
Jo cares for her son who lives with bipolar disorder. She feels anxious when she leaves the house, but these feelings are magnified if it's her son who goes out.
'I suffer intense anxiety until he returns,' Jo says.
'I often drive in the direction of his route. I fear, from past experiences, that he'll catch a train interstate, beg for money on the street and spend it on alcohol, or simply get lost.'
Has this worry stopped you doing things?
'Sometimes I literally leave work and jump in the car and go straight to my son,' Terese says.
'This could be to help him buy medication, organise his paperwork, check he's at that next medical appointment, or simply to know that he's okay.
'I don't have the time to do this every day, so other times I text him or I delegate to his father.'
For Julia the unrelenting nature of her son's mental illness impacts her life greatly.
'It's stopped me from doing many things: going to work, leaving the house for errands, or taking a short break,' Julia explains.
'I did not, and still don't, feel comfortable leaving him alone beyond a few hours. There have been days where I haven't gone to work because I'm too concerned to leave him.
'These situations have made me feel everything from depressed and upset, to angry and frustrated. Simple things such as shopping or socialising are always coordinated around him and compromised by time constraints.'
How do you manage your worries or anxiety?
'My work affords me great flexibility which has allowed me to care for him and work irregular and short hours,' Julia says. 'This alleviates a lot of my anxiety.'
'I've been able to enlist two outreach support officers (through the NDIS) who take my son out. Unfortunately, they are only with him for an hour so that hardly gives me much respite, but I feel comforted in knowing that he is out doing something.'
Yet, the NDIS doesn't cover everyone. Jo says she receives little support from family or service providers, however she has found other avenues of support.
'During the stable times I write my fears and feelings down in a journal, practise meditation and partake in special meetings that include my son, his psychiatrist, social worker, counsellors and psychologist,' Jo explains.
'These monthly occasions are helpful and I recommend other carers try to organise the same thing.'
Like Jo, Terese says she receives little support from family, she's developed her resilience in other ways, including talking to others in the same situation.
'I have attended some self-help groups for carers, which were useful to readjust my ways of thinking into a framework of more empowerment for me.'
What advice would you give to a carer for minimising anxiety?
'To maximise 'me time' I would suggest smaller activities that can be slotted into the day at any time and don't require too much effort,' Julia recommends.
'Trying to plan bigger activities can be difficult simply because we never know what tomorrow will bring.'
Jo agrees and suggests getting out for a walk whenever your loved one is preoccupied with other activities.
'Go for a walk, be mindful of your surroundings and force yourself to focus on everything around you: houses, gardens, birds, people. If possible, smile or say hello to those you pass,' Jo says.
'Opening your mind to the environment is a great way to gain relief from the anxiety that imprisons you at home. And interacting with others reminds you there is a world out there.'
Julia also recommends remaining focused on the here and now rather than worrying what the future may bring.
'A lot of anxiety arises out of the perpetual worry over something that hasn't happened yet', Julia adds.
'I know this is easier said than done, but it requires consciously taking a few deep breaths, grounding yourself in the present and finding comfort in knowing that right at that moment everything is okay.'