My big brother, Tom, has challenges beyond my understanding. He struggles with schizoaffective disorder. Although I've never looked up his "diagnosis" in the official record of mental illnesses, the DSM, I know he has problems. I know this by his fixations on seemingly benign things that happened 20 years ago. Or the threats he might make from time to time to family members who love him.

Tom goes through cycles, ups and downs, which is typical for people suffering some types of mental dis-ease like schizoaffective or bi polar disorder. Despite his struggles, my parents have always required Tom to work and forge ahead as best he can. I lost track of the jobs he's had, mainly because there have been so many! Over the years my siblings and I have taken on various roles in his life. Most of us have simply drifted away from him ignoring his desire to spend time with each of us. My hunch is that many "affected others" ignore and stay away because they don't understand the illness or they feel compelled to "do" something to make "it" better. It can be very challenging and frustrating for the caregiver/ or affected other to interact with the person without feeling overwhelmed.

There are ways to stay connected to or participate in the life of someone struggling with mental dis-ease. My top 5 list includes:

1. Make a list of things you can offer the person. Maybe you enjoy the movies and will commit to taking him/her every 2 months or so. My commitment to Tom is to have him come stay with me for 4 days every 2 months. The important thing here is consistency and follow through. Try not to take on more than you can reasonably do. Remember, for someone who might have a small social circle, this date with you can be critically important to the person.

2. Try to let go of all wishes and desires for certain behaviors for the person. Simply meet them where they are and "be" with them instead of "doing" anything that you feel might "help" them or "heal" them. Now there are exceptions to this. One might be if you are trying to encourage better dress habits. Tom, for example hates wearing socks and underwear. If he is coming somewhere with me I make it a requriement that he at least put socks on!

3. Always check with the person before giving them something that you think they might want. I have found that many times we "think" the person would like something when in fact they don't. Don't be offended or try to encourage it, simply let it go and honor the answer you are given.

4. Have a solid set of boundaries for dealing with the person. If you are not able to give something, tell them. Don't treat them differently from how you might treat someone else. It takes too much energy and, quite frankly, it's unnecessary. Treating all people with respect and honesty is generally a good policy.

5. Send the person a card or make a quick phone call just to say "HI, I was thinking about you...". Nothing more, nothing less. Just a small but significant thing.

In the end, all relationships with people struggling with mental dis-ease can be a challenge. But caring for yourself and taking appropriate steps to protect your life will, in the end, help you to keep on giving.