What To Do When You & Your Family Hit Rock Bottom From a Loved One’s Addiction and Mental Health Disorders

When was the last time you heard someone ask you, a family member, or a loved one with addiction or mental health struggles? How are you? You probably had to think about that for a while. It has been long since anyone asked, or you can’t remember. For some, no one ever has asked. Why is this? The reason behind this is primarily because of the focus on the person who is struggling with addiction and mental health disorders; it is all anyone ever thinks about or talks about. 

No matter where you go or what you say, the focus is on them. Treatment centers are the same way. Very few have a family program and the ones that do cover only the basics. Many family programs at treatment centers are nothing more than enabling 101, visitation, and sporadic updates. No family program at any treatment center gives the family a voice, nor does it empower the family to hold their loved ones accountable. Some go as far as to suggest you accept their disease and consider them a victim of circumstances. Teaching a family there is nothing they can do unless their loved one wants help, asks for help, or hits bottom is not helpful; it is harmful. The greatest challenge we face with treatment centers today is therapists. Most believe the client is the most knowledgeable when it comes to knowing what they need. Some go as far as to convince the families of clients to accept relapse as part of recovery and to take a soft approach rather than stand up for themselves.  

Clients are the least qualified people to know what they need, and never more so while actively using drugs or alcohol, living with untreated mental disorders, in treatment, and in early recovery. It takes years before someone with addiction and mental health is instinctively able to do the next right thing and advocate for their care in a positive direction. As you continue reading, you will see that believing patients or intended patients for addiction and mental health know what’s best is clinically ineffective. Consequences of negative lifestyle choices and behaviors are the only things that cause change in another direction. Encouragement in any way for continued behavior is counterproductive and disables the ability of a person with addiction and mental health disorders to move through the recovery stages of change. 

Before Family First Intervention published this article, we published an article called “What Does Hitting Rock Bottom in Addiction and Mental Health Mean.”. The article primarily helps the reader understand what rock bottom looks like for a person with an addiction and mental disorders. What the article and this article have in common, whether speaking on behalf of the intended patient or their family, is a single common denominator. In this lifetime, and most likely the next, one of the most prevalent common denominators that holds in addiction and mental health is what precipitates change. 

Consequences are the only proven method to recognize, address, and change a problem. Regardless of whether you are a weak counselor or therapist who coddles their clients or an old school Alcoholics Anonymous counselor who believes in the school of hard knocks, or anywhere in between, they all concede, or should anyway, to consequences being necessary to move from the second stage of change to the remaining three stages of change in the recovery process. Therapists and counselors are taught this in school up to the Psy D. level. Where and why anyone shied away from this is beyond comprehension. 

The rest of this article will discuss the importance of the family acting when they are at their bottom and not having to wait for their loved one first. 

What Families of Loved Ones with Addiction & Mental Health Go Through

Anyone living with or connected to a loved one with addiction or mental health disorders understands the challenges and the heartache. Some want to know how to live with a person in this condition. Families rarely see how their actions prevent their loved one from wanting help, asking for help, or hitting bottom. Families are almost always unaware of the importance of their recovery from the addiction and the mental health of their loved ones. If a family believes their loved one must want help, ask for help, or hit bottom before anything can change, why can’t the same principles be applied to family members on the receiving end of the problem? What families are going through is the same as that of their loved one who needs help: fear of change and the unknown outcome. Although there are many reasons why both sides do what they do, fear of the unknown and fear of change are the two most significant factors that keep people from doing what they know they need to do in their hearts.

Along with fear comes psychological justification for maintaining the status quo while families cling to their acquired maladaptive family roles and coping mechanisms. Many families can not or will not accept the addiction and will tell themselves just about anything to believe the problem stems from an underlying mental health disorder. The belief contributes to the victim mentality even when factual. For most families, it can be impossible, at times, for a family to believe what we are saying by the time they get to us. 

First, multiple years of letdowns make it challenging to comprehend that change is possible. Remember who has taught you what you know and believe: your loved one and yourselves through the lenses of distorted perception. Families are often afraid to get into the solution with us; first, we have to undo the solutions taught by their loved one who needs help, the family, society from the position of an armchair quarterback, short-term treatment centers, inappropriate levels of care such as outpatient, and ineffective professionals who treat addiction and mental health with kid gloves. Because fear of change is the unknown, we would like to explain what every family will go through. Somehow, families know this will happen subconsciously, so rather than confront the situation, your minds and bodies shut down. The information you will read next is inevitable at some point. Taking part in ineffective solutions and psychologically justifying not engaging in effective solutions kicks the can and allows the problems to increase.

Elisabeth Kübler-Ross identifies five stages of grief, and they apply to both the family and the intended patient. We will explain the five stages from the perspective of both family and their loved ones with addiction and mental health disorders.

Denial

Denial is very rare. In clinical terms, it is called the pre-contemplation stage, the first stage of the recovery process. Very few people deny a problem; however, most deny the need for professional help to address the issue. The most effective way to see if someone is in denial is to gauge their response to the situation when asked. When honesty is present, the person asked about their problem will be non-confrontational and sincerely taken aback by such a question. Their reaction will be a position of cluelessness and, often, inquiry and asking what you mean. One of the issues confronting denial without a professional would be dishonesty and omission on the part of the family or the intended patient. Some will intentionally act aloof as a form of manipulation. 

We have never had an intended patient in the pre-contemplation stage, and most clinicians who treat addiction and mental health rarely do so. We have had family members appear to be in denial on occasion. After enough digging, we found out they are not in denial and are maladaptively acting out. As we said earlier, we often face families and intended patients in denial about needing help for the problem. The only family members we have ever seen in actual denial are those utterly detached from the intended patient and are not involved with the day-to-day drama of the intended patient and affected family members on the front line. 

When you have a family member who is in denial, you have to consider their role and impact on the outcome of the intervention. If the family member in denial is a key player, such as a primary enabler, the interventionist and their team will have to execute specific strategies to overcome this obstacle. We have found that when the person in denial is the primary enabler, there is no denial but a psychological justification to fulfill the needs of an enabler. If a family member is in actual denial, perhaps because they have not been around the person needing help enough to see the problem, their involvement in the intervention process will be on a case-by-case basis. 

The intended patient almost always acts out in denial or significantly downplays the problem. Denial can come in many forms, most commonly with false hope. Denial by the intended patient can range from believing there is no problem, the problem is not that bad, or they will do something about it someday. Some go as far as to admit to the problem and blame everyone entirely and everything else, for they are merely victims. The most common occurrence at this point is families clinging to false hope and waiting for their loved ones to act. 

Anger

Anger is often feared and avoided by family members. In other words, families worry that an intervention will make their loved one mad. When families are angry at their loved ones for what they are doing and what they have done, this can be a great asset and liability, depending on their family role. For example, an older brother acting out the hero role and who is angry will sabotage the intervention. A primary enabler who is furious at how they have been duped by their loved one and is done with providing them resources can be a tremendous asset at the intervention. 

The anger stage of grief always rears its ugly head after intervention when the family system of dysfunction starts to repair itself. The family often lashes out at the intervention company or the treatment center. To put it into perspective, families of loved ones who accept help at the intervention become angry and stay angry longer, far more often than families of loved ones who declined help at the intervention. The reason for this is primarily due to the family intervention when the loved one accepts help, and the family is thrust into looking into the mirror of the dysfunction that carried on during the addiction and mental health problems. 

Although families of loved ones who decline help at the intervention will experience similar challenges, the impact is not as significant all at once, and that is why the anger is less. In other words, they are eased in as opposed to thrown in. Before you panic about being thrown in, it is the best way to come out quicker and on top. Besides, resetting the family system is inevitable if you want your loved one and family to improve.

Anger is reasonable and necessary through the eyes of the intended patient. A form of fear always drives anger. When the intended patient gets angry at the intervention, they realize the people helping them stay sick will not do that anymore, and it scares them. The anger comes from the fear of change. You can probably understand why the next phase is bargaining. The bargaining comes from your loved one trying to manipulate you so that you do not do anything different. 

Bargaining

Bargaining is an unhealthy justification of acceptance, whether by the intended patient or the family; bargaining is when we psychologically justify our current state. In the bargaining stage, it is common for someone to repeatedly replay specific events until they make sense, even though they do not. Bargaining also occurs when the intended patient makes false promises, and the family convinces themselves if they do this one thing one more time, the loved one will change their behavior and enter treatment. 

Families also bargain with one another. How often have you found yourself speaking to a friend or family member downplaying or convincing yourself that if this happens, then this will happen? Bargaining can also be a form of denial along with unhealthy acceptance. 

When you look at it, people bargain with themselves to fit the narrative. One of the definitions in the Oxford Language Dictionary is “to part with something after negotiation but receive little or nothing in return.” 

The definition sounds a lot like what happens every day with families and their loved ones who need help for their addiction or mental health concerns. 

Hope is that feeling you have; that feeling you have is not permanent. So the question is, why do families continue to bargain with their loved ones when they know nothing will come of it? Most do because it psychologically justifies that you are doing something when all you are doing is kicking the can down the street a little farther. Families bargain out of selfishness. The family is receiving something from bargaining, so the question is, what? The family behavior all goes back to the acquired maladaptive behavior and coping skills and, more so, the adopted family role of dysfunction. 

From the lenses of the substance user or loved one with mental illness, they do essentially the same thing as a family and for very similar reasons. The intended patient not only bargains with themselves but also with their family to receive continued comfort. Bargaining from the intended patient is full of manipulation and psychological justification. The intended patient often appears overly convincing because they believe their distorted perception is accurate. We have all heard over and over that, anytime a person with an addiction or mental health problems opens their mouth, they are most likely dishonest. 

Although there is truth to this, it is arguable that you can call it a lie when the intended patient believes their false sense of reality. Distorted perception is why we can not stress enough in our S.A.F.E.^Ⓡ Family Recovery Coaching curriculum the importance of boundaries and little to no communication with your loved one after the intervention and in the early stages of treatment. Families often can not help themselves from wanting to engage with and entertain the false hopes and promises of their loved ones. Bargaining is a way for the family to convince themselves to continue the status quo and prolong the inevitable. The inevitable is change and fear of an unknown outcome. Please remember, there is happiness on the other side of change and fear. For some, happiness scares them, too, because they forget what that is.

Depression

Depression comes before the final stage of acceptance. The depression stage is setting the mind and body up for the unavoidable acceptance that your family will have to do something different because what you are doing is not working and will not work. You will become sad and defeated as you realize that everything you have done has not improved the situation. The enabler will recognize that their role of being needed in the relationship and serving the purpose of being their loved ones’ caretaker led them nowhere, and the enabler was taken advantage of by the loved one. 

Eventually, the family will realize how selfishness, dysfunctional family roles, and enabling hurt the whole family. Guilt and shame will set in, and you will believe you have failed. Your family will fear the intervention because you do not want to consider that you have spent all this time trying to help your loved one and how someone else can fix it in just a few days. In the depression stage, you may even start to accept there is nothing that can be done to help and that your loved one is just this way. Some will get stuck in depression, believing that nothing can be done unless their loved one asks for help, wants help, or hits bottom. 

“Either way, your family will move forward with acceptance of either your inability to do anything about the problem or your ability to.”

Families often fear the possibility of depression because of the intervention. Your loved one will go through a depression stage for the same reasons as your family. Depression is necessary to move to acceptance. Your loved one in the depression stage is one step closer to accepting help. We see the intended patient cycle through the stages of grief in every intervention, even when they immediately accept help; it just comes later. 

Your loved one in the depression stage is their body’s response to realizing they have no other options other than to accept help. If your loved one were not in the depression stage, then they would be in denial, yelling at you in anger, or still trying to plead their case about not going to treatment with bargaining tactics. Try not to think of your loved one in this stage as a bad thing, like a clinically diagnosed depression. Try to realize that in this stage, your loved one has passed denial, anger, and bargaining and is moving closer to accepting help. 

If your loved one has received help and they are in depression while in treatment, that is even better. Your loved one could not be in a better place or position than moving through the stages of grief while in treatment. Please remember, the stages will happen. The stages can occur with a refusal of treatment and the days following the intervention or after they arrive. Either way, our aftercare team will walk you through it. 

Acceptance

Acceptance is supposed to be about accepting the problem and addressing it. Some families accept things the way they are and wait for their loved ones to want help and hit bottom. When acceptance of doing something about the problem occurs, positive outcomes occur. Acceptance should also be about families accepting that they can only fix the problem with a professional. Families often try to correct the problem by themselves and without professional help. Once a family accepts the realization that they are just as much in need of recovery as their loved one, effective solutions can and will happen. It is all too common for families to believe an intervention is about someone coming into the home to inspire their loved one to accept help. 

The part of the intervention that involves that discussion is the smallest piece of the puzzle when done correctly anyway. Too many interventionists who call themselves professionals prey on family emotions and make it about just getting your loved one to treatment and never provide any insight into family dysfunction. An intervention that only focuses on the intended patient is not an intervention; it is a free service offered by members of twelve-step groups. 

One of many goals of a professional intervention services company is for families to understand that acceptance comes from accepting the family has control over themselves. Much of what a family does differently significantly impacts what their loved one does differently. Families must move from accepting they have to wait for their loved one to ask for help, want help, or hit bottom to accepting that the family doesn’t have to wait. So many of the family’s behaviors, roles, and dysfunctions remove their loved one’s ability to accept help. Accepting this truth makes the difference between a successful and unsuccessful outcome. 

Once a family accepts the reality that their loved one has an addiction, mental health disorder, or both, they then must admit that they can only change themselves first. Once this occurs, their loved one is held accountable, which creates consequences and leads the intended patient toward moving through the stages of change in recovery. Your loved one will not accept help or accept the need for help until the family stops doing what they are doing, which prevents the intended patient from seeing the need to change. Although easier said than done, it is that simple. 

The most formidable challenge we face with the intended patient accepting help is the family following directions. The number one reason why someone declines help at an intervention or tries to leave treatment after the intervention is because they do not believe their family will follow through with boundaries and consequences. Actions speak louder than words; words are all you had up until the intervention, words you went back on repeatedly. Your loved one will need to see you are serious and that you are never returning to the way it was. The person with addiction and mental health must see that whether they feel they are at the bottom, your family is, and your family being there is all that is required to start the healing process with an intervention. 

Why Families Wait To Do an Intervention

The reasons why families wait to do an intervention are endless. Many of the reasons are like the reasons a loved one with a substance use or mental disorder uses to avoid seeking help. The most significant reason intervention and treatment are avoided is not seeing and feeling the need for change. As long as either side believes the current situation is more comfortable than the alternative, then that is where the person will choose to stay. 

Families are disabled with fear of change and the unknown of what the change will look like. People with addiction and mental health fear the same thing for the same reasons. Both sides acquire maladaptive coping skills and psychological justifications along with unhealthy family roles. Behind these clinical reasons are excuses both sides tell themselves. 

The topic is so prevalent that we did an hour-long webinar on the subject called “Excuses and Objections Families Make for Not Doing or Waiting to Do an Intervention.” 

We also have a page on our website as a resource on the topic, including a video. 

In addition to the family excuses resources page, we have also included the excuses and manipulations that people with addiction and mental health use to avoid going to treatment. Regardless of what people say to avoid intervention and treatment, their excuses run much more profound.

Holding onto dysfunctional family roles is mainly responsible for family denial and not seeing the problem they are causing or contributing to. We are not here to insinuate the family is the cause of the addiction or mental health. We are saying that the family is mainly responsible for not taking a practical first step to improve themselves and the overall situation. 

Addiction and mental health affect the entire family system, and when family members fall into specific dysfunctional roles, they compromise the outcomes for both them and their loved ones. When family members speak with our staff, they hear things they most likely have never heard. Two of these things are that the family is part of the problem and needs their recovery, and families do not have to wait for their loved ones to want help, ask for help, or hit bottom. 

In addition to these ideas, family change causes a change in their loved ones, something they do not realize is possible. Family dysfunctions prevent their loved ones from seeking help. After a while, the dysfunction becomes the daily routine, and the fear of change and letting go of a coping mechanism that is believed to be working is one of the many reasons families wait to intervene or do not intervene at all. 

What Happens to Our Family While We Wait for Our Loved One to Ask for Help Want Help or Hit Bottom

The short answer is simple: the family goes to the bottom with them. The real question is why families choose this route. Waiting for their loved one to ask for help, want help, or hit bottom is much deeper than simply exercising this option. Sadly, families will look for any reason not to confront the situation and cling to their maladaptive family role. As time passes, families learn how to live with the waiting game. 

There is a reason families do this, mainly because of fear. The fear comes from letting go of the only thing you know, which is acting out your family’s dysfunctional thinking. The enabler wants to be the caretaker and have a purpose. The martyr intends to remain a victim of circumstance. The Hero wants to maintain their position of power as a perfectionist. All family members want to keep their family secrets buried. When you think about it, families wait or choose not to intervene out of selfishness. 

As much as we teach you to put yourselves first, you are unable to do that until you detach from the addiction, mental health disorder, and behavior of your loved one. It is okay to be selfish regarding putting yourself first in a healthy way, which helps your loved one. Putting yourself first by clinging to your maladaptive thinking is unacceptable and indeed not helpful. The route harms both you and your loved one. 

Over time, both the intended patient and the family psychologically justify the downward spiral. The slower it goes, the easier the justification. Families often call our office when things get out of the routine. In other words:

“The bottom is when the situation worsens faster than you can lower your standards.”

There will come a time when the family bottom is unbearable, and it will overcome the fear of addressing the problem. The same thing happens to a person with a substance use or mental disorder. When the consequences become more significant than the benefits, change occurs. The next time someone states you can only wait for your loved one to want help, ask for help, or hit bottom, ask them if your loved one can live with them or put up with them until that occurs, and then see what they say. 

How and Why Your Family is Breaking Apart because of your Loved One’s Addiction and Mental Health Disorders

If you have read this entire article up until this section, you know the answer to why your family is breaking apart. Your family is breaking apart because of your family roles and not being on the same page. The most challenging part of treating mental health disorders and alcohol or drug addiction is the family. Hiring a professional interventionist who understands this is paramount. It is challenging for a person with substance use or mental health disorder to recover when their family does not. Here is an explanation of what happens and why it leads to the family breaking apart due to your loved one’s addiction and mental health disorder:

If we asked your family or any other family what the problem was, you and all the others would state that the loved one with drug addiction, alcoholism, and mental health disorders was the cause of the turmoil. The thought would not be entirely wrong; however, it would not be accurate. The job of the intended patient is to create chaos and drama. The job of the primary enabler is to react to the chaos and drama; this is the start of your family breaking apart. 

What happens next happens to all family systems. When the primary enabler, often if not always a family member that everyone needs, diverts all their attention to the intended patient, dysfunctional family roles start to form. Dysfunctional family roles begin to be created because people need love, attention, validation, and affirmation. When the family member who should be offering it is diverted to one other person, it can no longer be provided to everyone equally. All other family members try to attract the attention of the enabler by acting out of their acquired role. 

To review the family roles, click here for more information. 

The unavoidable does not make anyone a wrong person; it just makes them unhealthy.

Family roles are also the main reason why family members do not do an intervention and psychologically justify waiting for their loved one to want help, ask for help, and hit bottom. The family is not waiting for this; it is just an excuse to stay in the dysfunction that has become normal. Families are no longer on the same page, and having a family come around in unison to intervene is tough. It takes significantly more time, energy, and resources to bring a family to an intervention than to escort your loved one to treatment. The intended patient sees their problem and does not need as much convincing as you think for them to surrender to a treatment facility. Interventionists and clinicians’ most significant task is to get numerous family members who cannot and will not see their problem. 

Will an Intervention to Address their Addiction and Mental Health Disorder Push them over the Edge and Make them Worse

Push them over the edge, yes and no. Make them worse, yes and no; allow us to explain. Everyone with a problem will have an intervention at some point. An intervention is a specific action to improve a situation with a specific goal. In other words, to correct a problem, you must address it. So, your loved one will have an intervention; it is inevitable. You must ask yourself whether you want the intervention to happen on your or society’s terms. 

Remember what we said earlier about the five stages of change. For someone to move out of the second stage, called contemplation, the intended patient must see that the benefits of change are more significant than the current consequences of staying the same. With this knowledge, is it possible to avoid pushing or worsening them over the edge? The answer is no. What most families are referring to is whether the intervention will cause them to take their own lives. We have to preface the comment by saying anything is possible, and it has never happened with our services. One could argue they are harming themselves to the point where they could die because of addiction or untreated mental health. We are saying that there is no easy way out of this, and there is a solution that works to get there; it is painful, and we understand that. 

Even when the intended patient refuses help during the intervention, you will have resistance at some point. Families always ask us what happens if our loved one refuses treatment at the intervention. The answer is that it is not if they say no; it is when they say no. No client or patient treatment goes smoothly from start to finish, never. There will always be trials and tribulations, and they will fight to stay sick at some point. Interventions for the intended patient and their family must occur at some point if the situation is to improve. 

Your loved one will worsen before they get better; the same applies to your family. If your loved one refuses help or tries to leave treatment after arrival, you may have to exercise boundaries for them to feel worse before returning to treatment or re-engaging with their treatment. All your fears are unavoidable; this is your life and where you have allowed it to go. What we mean by you have allowed it to go is the longer you wait, the harder it gets for you, your family, and your loved one who needs help to treat their addiction and mental health. 

Always remember, nobody accepts help or changes while on a winning streak. Pain and consequences must be present before someone realizes the need for change. Fearing them getting worse or being put over the edge is an unfortunate yet necessary requirement for someone to get better. 

How Our S.A.F.E.^Ⓡ Addiction and Mental Health Intervention Services Can Help Your Family

Family First Intervention has the largest and most comprehensive intervention services protocol in the nation. We do not say that with ego but with humility and empathy for your family. Your loved one and your family will cycle through the stages of grief often throughout the process. When we first started our curriculum, you could not find the word “Family” on the website of any other intervention company. All interventions consisted of a paid twelve-step call that “talked” your loved one into seeking help. 

Today, many interventionists have added it to their website and still only offer superficial services. After the intervention, Family First Intervention gets involved like no other intervention services company. Whether your loved one accepts help, we guide and assist your family through the turbulence. As we said earlier, it is not if your loved one says no; it is when. The smoothest and quickest interventions can be the hardest for us and your family three weeks later. The most challenging intervention can be the smoothest treatment for your loved one. The common denominator is that the family must execute boundaries at some point, and your loved one must feel the consequences.

Our S.A.F.E.^Ⓡ Intervention Services was built for families and their loved ones and has evolved over the years. We continue to add and build out our curriculum to meet our clients’ and their families’ demanding and challenging needs. We offer several support groups and provide individual family sessions. We collaborate with your loved one’s treatment team and bridge everything together. The goal is to increase the likelihood of a successful outcome for family and loved ones. We know that when only one side addresses their problem, only one gets well. We also know that when one side gets well, the opportunity for the other side to get well increases. In our experience, we have seen many families get well even when their loved ones have not. When family dysfunction, enabling, and codependency are present, we rarely see a substance user or person with mental disorders get well and stay well when their families have not. It is possible, and we rarely see it.