I Think My Sister Is Mentally Ill, and I Don’t Know What to Do (LONG)

[Kathy in Cambridge]

I am the oldest of three girls and we are all in our thirties. My youngest sister (A) and I are concerned about the mental health of our middle sister (B) who is 35. We all live within a few miles of one another, and until a year and a half ago, my two youngest sisters lived together. A and I are considering an intervention, but we don’t know how to really approach it.

Since about 1989, B has been depressed. I rarely remember a time when she was happy. Every job she has been at she has had personality conflicts with people or been victimized by a coworker. Every relationship she’s in is a drama. She also suffers from chronic insomnia. I pushed her to see her Primary Care Physician and she finally did last week. I told her to ask for an anti-depressant temporarily so she can get some sleep and maybe gain some perspective. Her doctor gave her a prescription for exercise and a new job. When I asked B if she told the doctor about her chronic insomnia and depression, B said “No, it’s because of this job”. We were speechless-she is in deep denial.

B is staying at my house-she just found an apartment after leaving a roommate situation that soured. She comes home every night and is grouchy or teary. She never learned coping skills and tends to overreact emotionally to perceived slights-whether she is overemotional because of insomnia or can’t sleep because of emotions I’m not sure.

B also pours out her day at work in excruciating minutiae, but it her stream-of-consciousness rants don’t seem to make her feel any better. She also can display at times a lack of concern for others because she is so wrapped up in her own head/problems. There are so many stories I could relate, but prefer not to because it makes me sad. :-(

I am worried that she will continue on this way unless we do something-I don’t want to let this go and in five years she is still floundering in a shitty job, relationship, and life. I would feel awful and responsible.

[Faygo Kid]

1. She needs help - You need to find how

I would suggest YOU see a competent mental health therapist to determine your next course of action. Sounds like clinical depression to me, and you need to know not only how to help her, but how to cope with it yourself. You are a compassionate person. Be compassionate to her, and also to yourself - but also be effective. You will not find easy answers, and especially not so on a chat site. (Even this one.)

[LisaM]

22. Also, what about a sleep counselor?

I know someone who works in sleep studies, and it is amazing what sleep deprivation can do. I certainly can't diagnose her problems, but starting with sleep counseling might be useful - and less threatening to her as a place to start.

[Don_G]

2. You Need To Talk With A Professional

Who can give you some solid answers and guidance.

All we can do here is to offer you any and all support we can give you as compassionate human beings.

[Girlfriday]

3. She's lucky to have such caring sisters

I really think she needs more than a visit to a primary care physician. Have you suggested a psychologist?

[Kathy in Cambridge]

5. We've tried-she saw a shitty therapist in her early 20s

and has never gone back. We try to get her to go-she has health insurance and everything-but she says she doesn't have time/is too tired, and a variety of excuses.

[Cheswick2.0]

4. I don't know what she has, but she has something

sounds like clinical depression. Or perhaps bi-polar. I could be wrong of course and so could you, but you are doing the right thing getting her to a doctor. Other than that, and if she refuses to go...there isn't much you can do. She has to decide to get help.

On the other hand if she goes completely around the bend you can get her to the emergency room and let them out her on the phsych ward for a day.

[Kathy in Cambridge]

6. We looked up borderline personality

and it sounded like her.

I don't know how to intervene without making her defensive.

[NaMeaHou]

19. Personality disorders

are the most difficult to treat, particularly borderline. Please don't assume that's what it is though - we all can sometimes fit into some of the categories at given times.

I would recommend her physician first order lab work to rule out thyroid problems or other physical ailments. If the blood work comes back good, then seek out a psychiatrist who may be able to prescribe something to lessen her anxiety and depression.

Obviously, this is a long-term problem, and your sister will need to work at changing her life from the inside out. It is not easy, and I wish you and your family the best of luck.

If her insurance won't pay for a private practitioner, there are many psychiatrists attached to community mental health centers that do a wonderful job.

[Kathy in Cambridge]

21. She did have the thyroid test dome-results back next week

It runs in my family-I'm on medicine and so is my mother.

My symptoms were depression and fatigue, but I think this goes deeper than that.

[eileen_d]

7. Like others have said, this requires professional help

Perhaps you could talk to a mental health professional yourself - a doctor or a professional counselor, or anywhere in between.

Also see if there is a chapter of NAMI (National Alliance for the Mentally Ill) or another mental health advocacy group in your area. Check your phone book and give them a call - if they can't help you directly, they can probably give a referral.

I wish you good luck, and also remember to take care of yourself, as having a relative with a mental illness is its own kind of stress. (I am saying this as someone with a mental illness who stresses out my own family.)

Edit: this is the NAMI web site http://www.nami.org/

[Kathy in Cambridge]

8. Thanks, Eileen

I'll contact NAMI.

I have suffered from situational depression and anxiety myself, and I can't imagine being in that state constantly-it must be so stressful.

[eileen_d]

12. Also, about NAMI

I think they offer support groups and information for friends and family of people with mental illness. So even if your sister does not seek help right away, you and your sister can get some support.

[papau]

9. Depressed - but is it "depression" -

In any case the effect of Prozac can be obtained for about half (or more?) of the population by Omega - 3 in the diet (a lot of fish - or a pill).

Exercise actually will help (and is a great thing to do together!).

Now I am so far over my head I probably should not post anything.

I can only send you my best wishes and a hug for you both.

Good luck

:-)

[dofus]

10. The chronic insomnia

makes me suspect bi-polar disorder. And some people can be mono polar, and just be alwasy manic or always depressed.

I thought people who were clinically depressed tended to sleep a lot. She definitely needs help, and it's so good of you to be hanging in there and doing what you can for her.

As someone with an alcoholic sibling who cannot live on his own (he lives with us) I know how difficult it can be. All the best to you.

[NaMeaHou]

20. Depression will affect people in different ways.

Some people indeed do sleep 14 or more hours per day, but many others with diagnosed major depression will typically go to sleep at night for a few hours, wake up, and be unable to return to sleep.

I will reiterate what I mentioned in another post. Various physical problems may create depressive symptoms. Have blood work done, particularly the thyroid.

[blueraven95]

11. I'm not a doctor, so I can't actually offer medical advice, but

my whole family suffers from depression, so here goes...

The only way B will ever be able to feel better is if she realizes that she does have a problem...I know this sounds cliched but I also know from personal experience that a doctor cannot help some one who is unwilling. So you have to convince her that there is a problem.

I know what worked in my family was just having someone sit down and tell me that I had a problem (and being adament about it). A depressed person is generally not aware of how "normal" people feel and react to problems, so she or he does not believe that anything is really wrong or that there is anything you can do about it. Having someone you love tell you can make a really big difference. There are help lines for families of people suffering from clinical depression, and you should find one for ideas of how to address your situation.

I don't generally endorse ultimatums, but you might want to consider telling your sister that if she doesn't attempt to get help, that you will have to insist she finds another place to stay. I know this is extreme, but make sure that you are not enabling her to not get help.

The other thing to keep in mind is that depression is a real disease. There is a general stigma in this society that depression is a fake illness that people should be able to work through. Because of this, many people suffer because they do not want to admit to seeming weak. (This attitude is perpetrated by the health insurance companies who will often not cover all of the mental health care costs.) Treat this illness as any other serious disease (like cancer). Also, remember that as a person without depression, you will probably not understand everything your sister does, but be understanding and caring. Dealing with depression, even after getting help, is very difficult and can take a long time, and generally has some setbacks.

Another thing to remember is that many times depression is caused by a physical condition. After your sister gets immediate help, insist that she look into what is actually causing her problems.

I know this is long, but I hope it helps. Good Luck!

[1monster]

13. Sounds like chronic clinical depression...

and it can be hard to make those who suffer from it get treatment.

The problem with her not being honest with her doctor is that some antidepressants can be very wrong for different types of depression and will aggravate the condition rather than help relieve it.

My advice to you would be to call her primary care doctor and talk to him/her about your serious concerns and her denial of the seriousness of her condition.

Good luck. I've been there (and still am there) with a husband that has periodic bouts of serious chronic depression, and he won't get help either. It is very wearing on family mamebers.

[juajen]

14. Sounds to me as if she has adult ADD

Or, in the alternative, Asperger's Disease. It is very hard to get diagnosed, because doctors often rebel against giving an adult the meds (some of them are amphetamines) they need. Also, adults lie to doctors and to themselves, and because of confidentiality laws cannot discuss their diagnosis with family members.

This is a real problem. I know because I have been trying for three years to get my adult daughter diagnosed. She can pull the wool over any doctor's eye and I can't do a thing except attempt to deal with my daughter the best I can. She started seeing a physchologist, but after one so-called test, he said she didn't have ADD. I was furious, but, of course, couldn't even talk to her doctor. I honestly don't know if he said that or she just told me that. She never went back.

There are some very good websites dealing with adult ADD, some with tests that you could take for your sister to determine if this is her problem. Also plenty of books on Asperger's Disease, which closely mimics ADD.

GOOD LUCK!

[amazona]

15. if you can't sleep for years, sure, you're depressed

I'm going to play devil's advocate for a moment and assume that if her PCP didn't give her an anti-depressant, he had a damn good reason.

If your sister is bi-polar, some anti-depressants can actually worsen the condition. Prozac caused a friend of mine to take up gunplay. This is an extreme reaction but apparently not too uncommon with bi-polars. Her PCP is smart to give exercise/diet a chance; most are only too happy to write quickie prescriptions for anti-depressants.

I have personally known of family and friends who were suffering from serious diseases, who were "treated" by being diagnosed with depression and given anti-depressants. One of them, my mother, nearly died, because she was actually tired and cranky from heart disease. She had to receive an emergency quadruple bypass, or she would have died. Another friend's father did die because while he was being treated for "depression," his colon cancer went untreated until too late.

I believe your sister needs a complete physical to learn the cause of her insomnia. If her PCP cannot learn the answer, she needs to visit a sleep lab. It is impossible to be a cheerful, happy person who is free of pain when you haven't slept well for many years. In my case, the pain/lack of deep sleep was caused by something very simple -- caffeine. Yet I did not know the cause of my inability to get a deep night's sleep for many, many years.

As far as the borderline personality issues, alas, I don't think you or anyone else can do anything about a person being a self-centered drama queen who somehow always manages to get involved in quarrels with others. She's in her 30s, her personality is set, and it sounds like you have the patience of a saint to be putting up with it. The depression and insomnia can likely be treated; I doubt the personality is going to change, so I'm afraid what I do in this situation is tune the drama queen out or actually practice avoidance -- impossible in your own home with your own sister, I know. Perhaps once the insomnia/depression is addressed, she won't be so tired and grouchy, who knows.




anti-depressants shouldn't be the first thing to be handed out, they should be way down on the list

[Kathy in Cambridge]

16. Thanks everyone! I appreciate the advice!

My sister and I are going to contact a professional to intervene.

Thanks so much!

[magnolia]

17. You say....

...her doctor prescribed exercise and a change of job as if you thought that was lame. But B needs to at least take his advice and give it a try. Changing jobs is not so easy, but has B gotten into an exercise program? Exercise, especially aerobics does effect your brain with endorphins that are a natural drug. It could help her sleep and also focus on something else. Sometimes the mind is like a computer running the same old programs. If she doesn't even want to try that or see a psychologist...then I would say she needs hospitalization. (Unqualified opinion.)

[Rowdyboy]

18. It took me a year to get my partner to see a doctor for depression...

He was back to normal within a few weeks. Keep trying...you're in my thoughts.

[bleedingheart]

23. I would call her doc and ask for help

my brother suffered with depression for a long time. Two suicide attempts later he finally got the help he needed but it took a lot of work.
Today he is happy, healthy, in a great relationship and has a good career.

[peacebuzzard]

24. I can relate: WATCH OUT!

I too have a very needy and mentally ill sister that took me to hell and back this summer. It was not her fault, she is mentally ill and a few years ago was put on a heavy duty controlled antipsychotic called Risperdal. To make a long story short, the medication went out of control, she doubled her dose by mistake for a few weeks, ran out and then went through severe withdrawals. I had to run to her rescue overseas, pick her up off the streets (she was begging for cigarettes, beer, money) and hospitalize her. I am still not over it. She had not slept in weeks and before I could get help to hospitalize her she kept me awake for a week. It was pure hell. It is really sad to suffer like that, but worse, it is a family illness and affects all. I have a small family: just her and another sister who is basically no help. (I have dogs, and they preserve my sanity). Find help for her and especially for yourself. I am still exhausted and trying to sort out a multitude of personal problems which sprouted from the episode: financial, legal and physical. I am still so drained and the height of the drama occurred in late August/Sept. It will be a long time before I feel normal. You have my sympathy and well wishes.

[Kathy in Cambridge]

25. That's so tough, peacebuzzard, you have my sympathy

Take care of yourself, too!

:hug: