Helping a Family Member

Stories, signs to notice and what to do

The Door That Stayed Closed

Fatima, 15, in Lucknow, has started spending evenings in her room with the door shut. She skips meals, her marks have fallen and she snaps at her younger brother. Her mother, Zainab, is hurt and angry, and says, "Come out and stop being dramatic."

Zainab's sister suggests another way. That night Zainab knocks and says softly, "I miss you. I'm not here to scold. If you want to talk, I will listen." She leaves tea outside and walks away. Two evenings later, Fatima opens the door and says she feels empty and tired and doesn't know why.

Zainab does not interrupt or fix. She says, "That sounds heavy. Thank you for telling me." She asks how long it has been, and gently asks whether Fatima has had thoughts of harming herself. Fatima says no, but that she cries a lot.

They agree to meet the school counsellor together. Zainab keeps routines steady, with meals together and a short walk. Over weeks Fatima opens up more, and the family stops treating her mood as laziness. Zainab admits that the hardest part was staying quiet and curious when she wanted to correct her daughter. She tells her sister that waiting was harder than shouting, but worked far better. Fatima begins to speak a little more each day.

How to recognise it

• Withdrawal, spending long hours alone.
• Changes in appetite, mood, school performance.
• Irritability or tearfulness for more than two weeks.
• Comments like 'I'm tired' or 'nothing matters'.
• Pulling away from friends and favourite activities.

What this story explains

Family support begins with understanding a teenager's experience and talking in a calm way, using listening, gentle questions and encouragement to seek professional help.

Probable root causes

• Possible depression or anxiety.
• Academic and social pressure.
• Hormonal and developmental changes.
• Feeling misunderstood at home.

What to do

1. Choose a quiet time and place for a talk.
2. Start with care, not criticism.
3. Listen without interrupting or fixing.
4. Ask directly and calmly about thoughts of self-harm.
5. Suggest seeing a school counsellor or doctor together.
6. Keep daily routines and stay available.

Whom to consult

• School counsellor as a first step for a teenager.
• Paediatrician or family doctor for a health check.
• Child and adolescent psychiatrist or psychologist if low mood continues; emergency service if there is talk of ending life.

Do and don’t

How to behave and communicate

• Say: "I am here and I am not angry."
• Keep a soft, steady tone.
• Reflect back: "You feel tired and empty."
• Avoid lectures; use short sentences.

Appa in the Village

Mr Gowda, 76, lives in a village near Mysuru with his son's family. For months he has been quiet, forgets where he put things, and says, "I am a burden." He sleeps little and eats less. The family thinks it is old age and tells him to rest.

His daughter Kavita visits for a festival and notices he no longer joins in the singing he loved. She sits beside him at dusk and asks, "Appa, what has been the heaviest thing lately?" He says he feels useless since his wife died, and sometimes wishes he would not wake up.

Kavita does not panic. She thanks him for telling her and asks if he has thought of ending his life. He says he has not made plans, but the thoughts frighten him. She says, "We will get help for this."

The next day she takes him to the doctor, who checks his health, sleep and memory, and explains that sadness in older people can be treated. The family arranges company, daily walks, and visits from neighbours. They also make sure someone is with him, and keep medicines safely stored. Neighbours begin to drop by in the evenings, and his grandchildren sit with him to share their school news. Some evenings he even hums an old song, and the family quietly takes this as a good sign.

How to recognise it

• Withdrawal, poor sleep, appetite loss, feeling like a burden.
• Memory complaints that may be linked to low mood or health issues.
• Loss of enjoyment after bereavement.
• Comments about wishing not to wake up.
• Family dismissing it as normal ageing.

What this story explains

Older adults can have depression that is mistaken for ageing. The chapter's special considerations remind families to listen, ask directly and involve a doctor.

Probable root causes

• Grief and loneliness.
• Physical illness and pain.
• Loss of role and independence.
• Possible memory or other medical conditions.

What to do

1. Sit with him quietly and ask open questions.
2. Ask directly whether he has thoughts of ending life.
3. Never leave him alone if he talks of suicide; contact emergency help.
4. Arrange a full health check with a doctor.
5. Increase company, routine and gentle activity.
6. Store medicines and tools safely.

Whom to consult

• Family doctor for health and mood check.
• Psychiatrist or geriatric specialist if low mood or memory trouble continues.
• Emergency service or hospital if he speaks of a plan or cannot be kept safe.

Do and don’t

How to behave and communicate

• Speak slowly and warmly: "You matter to us, Appa."
• Ask directly: "Have you had thoughts of ending your life?"
• Listen without judging.
• Use his language and respect his dignity.

Brother, Bottle and Blame

Imran, 35, in Kolkata, drinks every evening and more on weekends. He has missed work, lost his temper with his wife and borrowed money. His younger brother Salim is exhausted by lies and promises. He has poured out bottles, shouted and given ultimatums, but the pattern repeats.

Salim speaks to a counsellor who explains that substance use is a health problem, not just poor character, and that shouting often pushes people to hide. She suggests choosing a calm moment, when Imran is sober, and describing specific worries without blame.

Salim says, "Bhai, I love you. I am scared when you miss work and when you shake in the mornings. Will you see a doctor with me?" Imran bristles at first, then says nothing. Salim leaves it there and tells him the offer stands.

A week later Imran quietly agrees. The doctor explains that stopping heavy drinking suddenly can be dangerous and should be done with medical help. Salim also looks after himself, joining a family support group, because he realises he too needs care. Imran's wife says the house feels calmer simply because people have stopped shouting. Salim learns that his patience and boundaries matter, and that he does not have to rescue his brother alone.

How to recognise it

• Drinking daily, with shaking or sweating if he misses it.
• Missed work, money problems, broken promises.
• Anger, secrecy and denial.
• Family exhausted and arguing.
• Repeated failed attempts to stop alone.

What this story explains

Substance use affects the whole family. Supportive, calm conversation and medical help work better than blame, and caregivers need support too.

Probable root causes

• Habit and physical dependence.
• Stress, grief or underlying mental health problems.
• Social and family patterns.
• Easy availability.

What to do

1. Pick a calm, sober moment.
2. Describe specific behaviours and worries without blame.
3. Offer to go with him to a doctor.
4. Remember that stopping heavy drinking suddenly can be risky, so it needs medical supervision.
5. Avoid covering up or giving money for drink.
6. Look after your own wellbeing too.

Whom to consult

• Family doctor or addiction specialist for a safe plan.
• Psychiatrist or counsellor if there is depression or anxiety.
• Emergency service or nearest hospital for seizures, severe confusion or a very sick person.

Do and don’t

How to behave and communicate

• Use I-statements: "I am worried about you."
• Stay calm even if he is defensive.
• Offer help, not ultimatums.
• Listen to his side first.

The Daughter Who Held Everything Together

Lakshmi, 40, in Hyderabad, looks after her mother who has schizophrenia, her two children, and works part-time. She gives medicines on time, goes to every appointment, and sleeps little. Relatives praise her, but she snaps at her children and cries in the bathroom.

One day she forgets her own medical check-up, then admits to a friend, "I am tired of being strong." The friend says caring for someone is hard and that she is allowed to need help.

Lakshmi talks to her mother's doctor, who connects her to a family support group. She shares the tasks with her brother, who agrees to take the Sunday clinic visit. She asks a cousin to sit with her mother two evenings a week and starts a short walk each morning.

The illness has not changed, but she feels less alone. When she next feels close to breaking down, she talks to the doctor about her own stress. She says, "I learned that looking after myself is not selfish. It is how I keep going." Her children notice that she laughs more, and her mother's doctor reminds the family that a rested carer is the best support a patient can have. Lakshmi keeps one evening a week just for herself, and nobody complains.

How to recognise it

• Caregiver tiredness, irritability and tearfulness.
• Neglect of own health and sleep.
• Feeling alone and carrying everything.
• Guilt about taking time off.
• Comments from others praising strength but offering no help.

What this story explains

Caring for the caregiver is part of family support. Sharing tasks and seeking help keeps the caregiver well enough to continue.

Probable root causes

• Long-term caring duties.
• Lack of shared responsibility.
• Sleep loss and no breaks.
• Stigma that stops asking for help.

What to do

1. Share tasks with other family members.
2. Schedule regular rest and one enjoyable activity.
3. Join a family support group.
4. Keep your own health check-ups.
5. Talk to the doctor about your own stress.
6. Ask for specific help, such as sitting with her for two evenings.

Whom to consult

• Family doctor for your own health and stress.
• Counsellor for caregiver strain.
• Psychiatrist if your own sadness or anxiety becomes severe; emergency service if you ever feel unable to stay safe.

Do and don’t

How to behave and communicate

• Ask clearly: "Can you come on Tuesdays and Fridays?"
• Accept help with thanks.
• Share how you feel without blame.
• Listen to others' offers.

Using ALGEE for Anil

Anil, 29, in Delhi, has been unusually quiet, has missed work and says little at family dinners. His older sister Rekha feels something is wrong. Remembering a first-aid approach, she decides to follow five steps: Approach, Listen, Give support, Encourage professional help, and Encourage self-help.

She approaches him privately on a walk and says, "I've noticed you seem low. Can we talk?" She asks him open questions and listens without interrupting. He says he has been unable to sleep and feels hopeless. She asks calmly whether he has thought of ending his life. He says sometimes, but he has no plan, and she thanks him for his honesty.

She says, "You are not alone, and this is not your fault. This is treatable." She offers to go with him to a doctor and helps him make the call. She also suggests small steps like regular meals, walks and sleep.

Rekha tells him she will stay close, and if he feels in danger at any time they will call the emergency service. Anil begins to attend appointments, and the family learns to speak gently and not to dismiss his pain. Rekha keeps checking in by phone each evening, and she learns she does not have to solve everything; she only has to stay close and help him reach care. She also takes care to rest, knowing she cannot support him well when exhausted.

How to recognise it

• Withdrawal and quietness over weeks.
• Missing work or responsibilities.
• Poor sleep and feelings of hopelessness.
• Hints about not wanting to go on.
• Needing a calm, trusted person to talk to.

What this story explains

The ALGEE plan gives a clear order for helping: approach and assess, listen, give support, encourage professional help and encourage self-help.

Probable root causes

• Possible depression.
• Work and life stress.
• Isolation.
• Reluctance to ask for help.

What to do

1. Approach privately and say what you have noticed.
2. Ask directly about suicidal thoughts.
3. Listen without judging and give reassurance.
4. Help him contact a doctor or counsellor.
5. Encourage self-help like rest, meals and activity.
6. If he is in immediate danger, stay with him and contact emergency services.

Whom to consult

• Family doctor as first contact.
• Psychiatrist or clinical psychologist for ongoing care.
• Emergency service or nearest hospital if he has a plan or intent to end his life.

Do and don’t

How to behave and communicate

• Say: "I am worried about you, and I am here."
• Use a slow, steady voice.
• Reflect his words without judging.
• Ask: "Have you thought about ending your life?"

This book is for education and general awareness. It does not replace diagnosis or treatment by a qualified professional. If anyone is in danger, contact your local emergency services.