A 12-week course helps families cope with a disabling disease.

When a cholesterol test comes back with LDL levels in the 200s, the American family has a measure for action. Their loved one is at risk for cardiovascular disease, the chief thief of healthy years of life in developed countries.

Doctors and families have a regimen to turn to – stress tests, statins, diet and exercise; it is an illness that medicine and culture have mobilized to combat.

But for the families of those suffering from the second leading cause of disability, the prognosis is far less clear.

“There are no blood tests, no MRIs to identify mental illness,” said Jane Cartmell, a member of the National Alliance for the Mentally Ill (NAMI).

Cartmell and fellow islander Jim Decker lead a 12-week course on severe mental illness that trains family members to understand and cope with their relative’s mysterious and devastating disease.

“It’s not an area most people have much knowledge of; it’s not an area you want to have much knowledge of,” Decker said.

While they refrain from discussing specifics outside the confines of the class – privacy for their relatives and confidentiality for participants are central tenets of the course – both Decker and Cartmell bring to the “family to family” course their experience as longtime caregivers to the mentally ill.

While victims of these severe brain disorders – which include schizophrenia, bipolar disorder (commonly known as manic depression), panic disorder and obsessive-compulsive disorder – exhibit a variety of symptoms, they share what Cartmell, a trained social worker, describes as “delusional thinking” and an unreliable sense of their own condition.

“Working, remembering, the ability to concentrate – a lot of basic things are not available to them,” Cartmell said.

What the families share are feelings of confusion and powerlessness.

“One of the biggest things you realize is you don’t have any support,” Decker said.

When symptoms first appear, families often struggle to get a medical diagnosis – a necessary step toward accessing insurance benefits and public health services.

The subjective nature of brain disease and the overlap in illnesses make them moving targets.

“It’s not a matter of going to get a medication and you’re cured,” Decker said.

Identifying mental illness is further complicated by the stage of life in which brain disorders frequently appear – during the turbulent teenage years, or early adulthood.

“Often, families are in some kind of denial,” Cartmell said. “The symptoms are often attributed to adolescence. People think the (sick person) is being lazy or irresponsible, using drugs or alcohol.”

In the course, Decker and Cartmell help families understand and empathize with their family member’s disease, while teaching them to navigate the maze of medical and social services available to their family.

“There are a lot of resources in the public health arena that most people don’t know about,” said Joan Pearson, a psychologist who helps lead NAMI’s monthly support group on the island.

“The emphasis is on helping families navigate the treatment community for mental illness – exchanging skills and knowledge about what they need to do.”

For islanders, access to that care can be a challenge.

“Bremerton (where Kitsap Mental Health Services is located), is a long way to go,” Cartmell said. “In a crisis, we find it difficult here on Bainbridge.”

Both the course and the support group emphasize the need for caregivers to know their own limits.

“People are always str uggling with ‘am I doing enough, am I doing the right thing, and when do I know that I’ve done as much as I can,’” Pearson said.

“(The class) gives people permission to take care of themselves.”

“A lot of times, you don’t know you can have hope,” said Decker, who, with Cartmell, attended the first Bainbridge class seven years ago.

“You learn to accept that you can’t have that picture-perfect family, looking like a Norman Rockwell painting,” Cartmell added. “It’s hope tempered with reality.”

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Not alone

NAMI-Kitsap sponsors a Family to Family education class on Bainbridge Island, beginning April 19. Jim Decker and Jane Cartmell, trained family members, teach this free 12-session education program for families of individuals with severe brain disorders (mental illnesses). Information and registration: Jane Cartmell, 898-6092. Find out more about NAMI at www.nami.org.