Columnist and trained counsellor Fiona Caine offers her perspective to a concerned sister, and a mother who has fallen out with her daughter.

MY 17-year-old nephew has been a difficult lad for as long as I can remember. However, it wasn't until last month that my sister took him to see a specialist and learned that he has schizophrenia.

He's now undertaking some kind of assessment but, in the meantime, he has been prescribed medication to calm him down. My sister isn't handling the situation well, although most of the time she tries to pretend that nothing is wrong.

I know that she's been crying a lot and is very depressed by what has happened - how on earth she is going to cope with this for the rest of his life I do not know. I'm there for her as much as I can be, but I'd like to do more.

Other than her doctor, are there any other sources of help I can investigate for her? - MW

Fiona says: Be supportive and accepting

People who have complex mental health issues are usually entered into a care plan known as a "Care Programme Approach" - the first stage of which is the assessment. It sounds as if your nephew is still in the early stages of this programme, so what might help your sister is to understand exactly what it involves.

I would suggest you steer her to the NHS website ( as there is a huge amount of information on schizophrenia, and also treatment options.

Sadly, and in spite of a number of brilliant campaigns, there is still some stigma attached to any form of mental illness, and I suspect this is what causes your sister to pretend everything is fine. Unfortunately, schizophrenia is particularly poorly misunderstood and there are myths around about "split personalities" and a fear that people with the condition are dangerous.

Whilst your sister may already be receiving some support from mental health professionals, one of the most important things she needs from you is acceptance.

So many people are afraid of being ostracised when a diagnosis like this is given to a family member. Your nephew has a complex medical condition and he will need help and support to deal with it - but it can be dealt with.

Treatment usually involves a mix of medication and therapy and it's tailored to the individual, as each case is different. In most cases, it means a use of anti-psychotic medicines and cognitive behavioural therapy (CBT). Once this is all in place, there is every chance your nephew will be quite well day-to-day.

Having said that, he may have periods when he relapses; his symptoms could return but, the help, support and treatment should help reduce the impact schizophrenia has on his daily life. For your sister, though, there will be a huge adjustment to make.

It's natural for her to be upset, confused and probably angry, because any diagnosis of an ongoing condition changes things. The child she thought she had is, somehow, different, and her expectations for him will have to change too.

This is not the end of the world - even though she may feel it is at the moment - so please continue to offer her and her family all the love and support you can.

Once the result of the assessment is known, everyone will be in a much better position to think about what happens next. For the future, both your sister and her son will need help and encouragement to come to terms with this diagnosis and what it means.

Finding out all you can will help you feel positive and helpful while they go through a period of adjustment. Rethink ( also provides a wealth of information on many different types of mental illness, their treatments and what it means to live with them. It also offers advice on how to access services and an individual's legal rights.

How can i patch things up with my daughter?

MY daughter and I had a terrible row a couple of weeks ago about whether she should be allowing her daughter (my granddaughter) the freedom to go out with boys.

She's only 16, but she's allowed to stay out until midnight. There's even been occasions where she's stayed with her boyfriend's parents.

I've tried to talk to my daughter since, but she is avoiding my calls and isn't returning my messages. Why can't she see that I only have her daughter's best interests at heart? I really don't like the atmosphere between us now. - EH

Fiona says: Understand where your daughter is coming from

You may be concerned about your granddaughter, but I don't think you are showing much support for your daughter. Raising children isn't easy (as I'm sure you know) but there's nothing more annoying than someone telling you how to raise them.

At 16, your granddaughter is more than old enough to have a boyfriend and, providing she is sensible, be allowed to stay out. You think of her as a child but you're forgetting, she's old enough to get married.

Your daughter has had to make difficult decisions about her daughter - if she is too restrictive she risks alienating her. She has obviously decided that her daughter and the boyfriend are sensible, and she may know and trust his parents too.

If you genuinely want to heal this rift, you are going to have to re-establish contact with your daughter, and if she won't answer your calls, I suggest you write or perhaps visit her.

Why is my dad so miserable?

Over the past few months my dad has become very withdrawn and miserable. He's stopped playing bowls, going out with friends and spends a lot of time sitting in front of the television.

When I mentioned this to my mum, she shrugged it off and told me not to worry, as he will eventually snap out of it - but I'm not so sure. This is so out of character and he's only in his early 70s.

Should I talk to him about my worries? - SS

Fiona says: It sounds like he may be suffering from depression

You're in a difficult position here. If you talk to your father, after your mother has said there's nothing wrong, she may resent it.

On the other hand, from what you say, his behaviour does sound out of character. It's possible your parents are keeping something from you, but it's also possible she genuinely thinks there is nothing to worry about.

The behaviour you describe suggests to me that he may be depressed, so could you talk to your mother again? She may be completely unaware that depression is a very real and serious illness but, if she still sticks to her original response, you may have to talk to your father anyway.

If you then think there is a chance he is depressed, he needs to see his doctor and get treatment.

Why is my son overworking himself?

MY son - who lives with my ex-wife - has just finished Year 12 and got his AS exam results with a mixture of As and Cs. He's going on to study four of the subjects at A-level, but he is very disappointed and wants to re-sit the C grades again.

As far as I understand it, better grades won't count towards his final A-level results or his chosen degree course, so I can't see why he wants to put himself through the extra work and stress.

He's being a bit uncommunicative at the moment - more than is usual for a teenager - and I'm struggling to get through to him. - KF

Fiona says: Try to encourage him to relax over the summer

I can't tell you if you're right, I'm afraid, as it depends very much on where your son lives in the country. In England, under the reformed A-level system, the mid-term exams (AS levels) won't count towards the final A-level grade.

In Wales and Northern Ireland, AS levels still count for 40% of the final A-level mark. I think I can assume that he's not in Scotland where the exams are called "Highers" and "Advanced Highers".

Wherever he is, though, he's going to be subject to the same huge emotional pressure and stress that young people go through to do well in their exams. There's a lot of peer pressure too and, if your son feels his results don't stack up with his mates, that might explain his wanting to re-sit them.

There's probably little he can do during the summer holidays, so the best thing, for now, would be to suggest he talks to his teachers when term starts. Meanwhile, you should encourage him to relax and have a break.

The teachers will know whether he needs to re-sit and can steer him away from this if they think it is unnecessary. It's also worth encouraging him to realise that, while exams are important, there's a lot more to life and plenty of people have achieved great things without them.

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