Tom Smith and his wife, Fran, were the idyllic, middle-class American family. Two years into their happy marriage, they had twins, Kevin and Karla. Their world shifted suddenly in 1996, when Karla, at 19, fell into her first major depression. Medication and counseling helped, but in 1998, she experienced her first major manic episode and was diagnosed with bipolar disorder. Karla stabilized, went back to college and earned a 4.0 GPA, and was about to graduate in 2002, when she slipped into another severe manic stage that cycled into depression. She was admitted to a behavioral health care center but released after 10 days, against her parent's wishes. Three days later, Karla found a rifle and killed herself.

"She was 26, beautiful, intelligent and charming, with a promising future. And she was dead," writes Tom Smith in his new book, A Balanced Life: Nine Strategies for Coping with the Mental Health Problems of a Loved One.

Every year, millions of adults and children are disabled by serious and chronic mental illness, and millions of families like the Smiths are deeply impacted by their loved one's condition. Their lives spin out of balance as they struggle-often with little or no support-to cope with behaviors they may not understand. In the wake of Karla's suicide, the Smiths grew determined to give others affected by mental illnesses the guidance and support they wished they had received. They founded the Karla Smith Foundation (www.karlasmithfoundation.org), and Tom has written extensively about severe mental illness.

A Balanced Life is a straightforward blend of information and reflection that incorporates nine clear-cut strategies for coping with a loved one's severe mental illness. Medication, counseling, self-esteem, self-care and warning signs are among the topics discussed. "It gives them a structured planning process for building a support system for themselves so they don't burn out," said Sid Farrar, director of Content Development at Hazelden. Since people with mental illnesses often abuse drugs and alcohol, Farrar said the book addresses substance use and co-occurring mental disorders and is consistent with Twelve Step principles and practices.

Smith brings each chapter to life by weaving in stories from those who have actually adapted the strategies. He also includes discussion questions with each strategy to help readers directly apply the information to their own situations.

It is easy to feel overwhelmed and alone when mental illness strikes a loved one. A Balanced Life provides families and friends with the answers and support they need to make order of chaos and find hope when they thought all hope was gone.

--by Cynthia Orange

Published Summer 2008, The Voice