EDITOR’S NOTE: Names have been changed to protect the medical privacy of some sources.

Alfred (not his real name) had noticed erratic changes in his nephew Jay’s behavior. Normally a pleasant and easygoing kid, Jay had reported that people were following him, and he seemed unusually paranoid and distrustful — even of family members.

Though Alfred wanted to believe Jay, he wondered if he might be exhibiting signs of schizophrenia. He had learned about this mental illness in his college psychology classes. He reluctantly decided to talk things over with other family members, hoping to come to a decision with them about what to do next.

Dealing with a loved one’s mental struggles can be a difficult experience. Public stigma and personal shame are common. Stereotypes and lack of knowledge can cause unnecessary fear and confusion. To reduce stress, it’s important to learn about the types, symptoms and treatment of mental illness.

Though most disorders are chemically based, stress and trauma can trigger or worsen a mental disorder. People should know that many seemingly inconsequential stresses can pile up.

People don’t often feel comfortable saying, “I feel like I’m losing my mind” and should be asked probing questions about how they’re doing. Also, a life spinning out of control can be a very real sign that a person is crying out for help.

The media’s recent focus on star Brittany Spears has shed more light on mental illness and its impact on family. Her hectic celebrity lifestyle, recent childbirths and the ongoing harassment by paparazzi may have all influenced ongoing emotional challenges. Fortunately, her mother noticed changes and had been hoping to get help for her daughter for some time. She was finally admitted for treatment.

Actor Heath Ledger did not fare as well. He was reportedly mentally exhausted and suffering from extreme sleeplessness before his tragic death in January of this year.

The National Alliance on Mental Illness (NAMI) offers these tips for family members of the mentally ill:

* No-one is to blame.

* If you feel extreme resentment, you are giving too much.

* The illness of a family member is nothing to be ashamed of, but the reality is that you may encounter stigma from an apprehensive public.

* After denial, sadness, and anger comes acceptance. The addition of understanding yields compassion.

* You should request the diagnosis and its explanation from professionals.

* Don’t be afraid to ask your sibling or parent if he or she is thinking about hurting himself or herself. Suicide is real.

* Don’t shoulder the whole responsibility for your mentally disordered relative.

* Remember, you are not alone. Sharing your thoughts and feelings in a support group has been helpful and enlightening for many.

Though it often takes time to find the most helpful resources, most people who receive treatment see some sort of improvement in their lives. It is also possible to prevent or at least delay major symptoms by keeping stress at bay through self-care and seeking support.

Many people choose to enter counseling for life issues before they become major problems. In so doing they learn skills to deal with problems beforehand, and they often cope better than those without these skills. Insight also helps them to be more aware of their own feelings, needs, and limitations.