So scared, don't know what to do - update post 17 - Mothering Forums

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#1 of 17 Old 12-13-2009, 03:01 PM - Thread Starter
 
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First of all, if you get to the end of this long post, bless you!

My wonderful, loving, supportive sister has suffered mental illness and addiction issues for most of her life. She has been my best friend and my primary source of emotional support most of my adult life. She attended both my births and has a very special relationship with my kids. Her entire adult life has been bouts of depression with long periods of sobriety interrupted by occasional relapse of alcoholism and addiction. She is in her fifties now and has recently lost both a 15 year relationship and her house (it was sold at the dissolution of the relationship). She has two grown sons who live in another city and are not terribly supportive.

Since her breakup she has become severely depressed, had an alcohol relapse and has decided that she would like to move to my city. This is probably a good thing, as there are many more mental health services here than the small city she came from. At the time her house was sold she was in a very delicate and vulnerable position, grieving so much loss, that I asked her to stay with us while she looked for an apartment. I asked that she stop drinking, start going to AA meetings and give up the pot, as I have two little kids and live in a rented house. She was unable to do so, but I let her come anyway, because I felt she had nowhere else to go. Since she arrived over a month ago, I have realized that her physical and mental health issues are much more severe than I had previously understood, and probably were significant contributers to the end of her relationship.

She has always suffered from depression (severe), has endured many, many traumatic events in her life (including suicide of a child ten years ago), obsessive behaviour and extreme, constant, debilitating anxiety (to the point where she often finds it impossible to make a phone call or leave the house). She went through two rounds of electro-convulsive therapy in the past 9 years. I think much of her behiour of late is a result of severe PTSD. She also has what I would consider extreme memory loss and a myriad of other health concerns. She doesn't take her meds on time and sometimes not at all. Her perceptions of reality are skewed (I can't think of any other way of saying that). She doesn't eat properly (mainly due to dental issues) and often stays up all night. She then sleeps all day. She spends most of her time downstairs and interacts with my family sporadically. She sometimes drives around the city all night "exploring". I fear she is drawn to dangerous situations, and for that reason I am reluctant to ask her to leave before she has services in place and hopefully at least a little sobriety under her belt. She has deteriorated so much in the past two years that I barely recognize her as the person she used to be.

She has had a CAT scan which was clear, but needs further neuro-psychiatric evaluation. She has been into mental health services and has a case worker, a counsellor and a psychiatrist (whom she hasn't met yet). She has found an AA sponsor but has yet to get to a meeting. She had a meeting with addictions services, which she had to cancel due to pneumonia and has yet to book another appointment.

She now feels pressure to leave and has started looking for an apartment. Tension is affecting our relationship and bringing a new dynamic of conflict that never existed before (mainly because her ex-partner always dealt with this stuff and I just got to be her sister). My concern is that she may not even be capable of living independently at this time, but I have no idea how to help her see the need for, and then find a safe alternative. Living with us permanently is not an option, although I feel that all the recent cuts to health services makes this nearly a necessity. She has some money from the sale of her house, and may qualify for a long-term disability benefit (she missed the deadline for benefits application due to depression but her doctor is intervening on her behalf to appeal the deadline), but I don't see how she could possibly work in the condition she's in. And of course, to top it off, she doesn't seem to have any idea how bad these issues really are.

I love her so much and I just want her to have a safe place to call home, care for her physical and mental health issues and family support. But I fear the impact this is having on my own family and understand the need for establishing boundaries and having realistic expectations. I am trying to have compassion at all times, but I find myself becoming irritated with her for things she can't control, like the memory loss and the OCD behaviour, as well as for the things I think she should be able to control, like not eating or sleeping or taking meds. I plan to start going to al-anon meetings for my own sanity and a support group for care-givers offered by mental health services. My life has changed permanently. I am having a hard time adjusting to this new reality and I have no idea what to do. I am scared and resentful and so very, very sad.

Diane, SAHM to DD (June 05) and DS (April 07).
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#2 of 17 Old 12-13-2009, 03:11 PM
 
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I can't help but think that seeing your compassion for your sister will be a positive experience for your children

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#3 of 17 Old 12-13-2009, 03:58 PM
 
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Oh Mama, it is so hard. Do you feel she is a danger to herself? If you do can you take her to the ER. That would get the ball rolling and into in patient care.

Make sure you are able to call her Docs and caseworkers about her. My husband didn't put my name on the list when he was first diagnosed. Now that we have moved I do have access to his records. Before his Docs wouldn't even talk to me.

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#4 of 17 Old 12-13-2009, 04:26 PM - Thread Starter
 
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Yeah, I know ER is an option if things get too scary, but to be honest I'd rather avoid the psych ward at the moment. I don't think she's an immediate danger to herself, but I will call 911 should the situation warrant. I would love to find some sort of in-patient alcohol treatment program followed by some supportive transitional housing, but who knows how that's accomplished. I've already pissed off her case worker by suggesting that his MA in psychology may not qualify him to change her diagnosis after one 90 minute session.

Diane, SAHM to DD (June 05) and DS (April 07).
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#5 of 17 Old 12-13-2009, 08:33 PM
 
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Hugs! Your sister is lucky to have you.

I live in Victoria, and I assume things work in the same way, generally. Going through the hospital is a shortcut to accessing services for the most part. If she is of *any* risk to herself or others, it may be the best approach. Emphasize the level of crisis involved if you have the chance to speak with her health care providers, and tell her to do the same if she's on board about getting help. It sounds like she's on a train that may crash anytime.

It also sounds like she may not be capable of seeing anything in her own life clearly right now, including the impact she's having on you and your family. How does she respond when you "take the reigns"? If you explain to her what you think she needs, and a plan for getting it, would she be likely to follow through with it? If so, then great. Do everything you can do advocate for her.

If not, then it may be time for some tough love. Your relationship is deteriorating simply by virtue of your proximity. If you approach her with a plan (for services the two of you can work on getting in place) and a timeline for her to be out, explaining that you want to help her but also want to preserve the parts of your relationship that are most valuable, I don't think anybody would be the worse for it. There's such a fine line between helping and enabling with addicts and the emotionally unstable. Al-anon will help with this, of course.

I hope things take a turn for the better for her. You're right, though, services are vital in this case. Again, the hospital may be the place to go to speed up that process. If you do end up taking this route, ask to speak with the hospital social worker, too. Sometimes they can connect you with resources in the community (e.g. a group home for her to live in rather than her own apartment).

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#6 of 17 Old 12-13-2009, 08:36 PM
 
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Quote:
Originally Posted by Vancouver Mommy View Post
I would love to find some sort of in-patient alcohol treatment program followed by some supportive transitional housing, but who knows how that's accomplished.
We're just across the border from you, in the states. I have no idea how the system works in Canada, but the case manager should know. Is the case manager a mental health CM, or some other kind? If he is the mental health case manager, although you suggested he might be kinda incompetent, he's the one that's going to get her on the lists she needs to be on. It might be worth it to try to develop at least a working relationship with him, or get your sister to request a new case manager.

It sounds to me like she does need an inpatient mental health stay to get her meds straightened out and see what she is like at baseline (e.g. not drinking). Its really hard to evaluate someone's mental health accurately while they are still using. Anyone who drinks alcohol to the point of having an addiction WILL have depression. Alcohol is a depressant.

Discharge from the inpatient mental health unit directly to inpatient chemical dependency treatment, followed by intensive outpatient chemical dependency treatment in clean and sober program housing, along with co-occurring disorders treatment.

In our county, to access inpatient treatment if you are low income, the person must have two failed stays at social detox (e.g. go to detox drunk and spend the night there on two separate occasions). Then they qualify for inpatient chemical dependency treatment.

The case manager is the best person to set this stuff up for her. Keep bugging him.
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#7 of 17 Old 12-13-2009, 09:19 PM - Thread Starter
 
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Oh, keep it coming, ladies. I so appreciate the advice. I'm such a noob at this.

Diane, SAHM to DD (June 05) and DS (April 07).
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#8 of 17 Old 12-26-2009, 03:22 AM
 
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How's she doing? Any luck in getting some more supports in place? We're thinking of you!
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#9 of 17 Old 12-26-2009, 03:36 AM - Thread Starter
 
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Hey, thanks! Actually she went into emerg. last week. They kept her over night and sent her home, but told us that they would call as soon as the next bed comes up. That finally happened last night (Christmas Eve). I got her in at about 6, came home, had dinner with the kids, wrapped presents and watched a movie. Felt a bit sad today but I know that it's for the best. The psychiatrist was lovely. He will be her physician while she's in and is working together with the concurrent disorders counsellor to find a longer term treatment program for her. They doc also recognized my 'caregiver burnout' and will do everything in his power to keep her in hospital till a bed comes up somewhere else. She is currently detoxing, so is pretty groggy from the adavan and a bit weepy, but I know she's safe. We had a lovely, relaxing Christmas without having to worry about any weird behaviour or potential psychotic breaks.

Diane, SAHM to DD (June 05) and DS (April 07).
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#10 of 17 Old 12-26-2009, 03:38 AM
 
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I couldn't read without posting. Your a wonderful sister and your sister is lucky to have you. I hope that she is doing better and that you are getting some support and peace.

Scarlett bfinfant.gif , DH Boris geek.gif , DS 1/29/08 Julian kid.gif DD2 6/7/12 babygirl.gif missing our DD 1/06/06 Sonja angel3.gif and MC @ 9 wks 11/18/06 Satchel  angel.gif

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#11 of 17 Old 12-26-2009, 10:38 AM
 
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I am so happy/relieved to hear your news. its for the best.

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

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#12 of 17 Old 12-26-2009, 01:05 PM
 
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So glad to read that she is getting help now, hopefully she'll pull out of it & get stronger. You're a great sister.

"When the external begins to define the internal, instead of the internal defining the external, one begins living as a mortal rather than as a universal being." ~ unknown
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#13 of 17 Old 12-26-2009, 03:24 PM - Thread Starter
 
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Thanks everyone. Your words of support have meant so much to me over the past few weeks. I think at most she will be able to get about 6-10 weeks of inpatient treatment, and then I don't know. I guess we wait and see how much is salvagable out of this mess. When you combine addiction with mental illness, it really seems like a degenerative disease. When my sister arrived at our home we'd only lived here for 5 weeks, so now it feels like we're settling in for the first time. Luckily the hospital is close and visiting hours are conveniet.

Diane, SAHM to DD (June 05) and DS (April 07).
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#14 of 17 Old 12-26-2009, 03:40 PM
 
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My husband did an outpatient intensive therapy program for a couple of weeks. Most of the people there were alcholics or drug abusers. So it seems mental illness and addiction go hand and hand. My husband felt the odd one out because he is Bipolar II but not a drug or alcohol abuser.

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

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#15 of 17 Old 12-27-2009, 04:02 AM
 
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Oh, I'm so glad to hear she's getting some help. You're right, though: mental illnesses can be degenerative, especially if the person isn't properly treated or drugs/alcohol are interfering with brain function. Hugs. I hope things just get better from here, for her sake and for yours.
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#16 of 17 Old 12-27-2009, 04:14 AM
 
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I think it's very common for people with Mental Illness to self medicate with drugs/alcohol. It's much more socially acceptable to be an addict than to have a mental illness.

I'm so glad that your sister could het the help and detox she needs and you can get some relief from care giver duties. Allowing you to be her sister again.
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#17 of 17 Old 12-28-2009, 03:15 AM - Thread Starter
 
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Apparently there are three separate personalities that she has been doing her best to suppress. I am a bit overwhelmed by the additional information. I always knew it would be scary, but I was not prepared for this. I have decided to stay off internet medical websites and wait to speak to the psychiatrist before jumping to any conclusions. She is so scared of being committed, but I'm not really sure whether this is sufficient reason. She is non-violent (although one of the personalities is a mouthy bitch) and does not appear to be an immediate threat to herself or anybody else, but to be honest I don't really know what else she is keeping from me. She is there voluntarily and has no plans to bolt (I have her money and car keys anyway). On a positive note, the health authority provides a nine week training program for caregivers to mentally ill family members, and the inpatient unit holds a weekly support group for relatives. Between those and Al-Anon meetings, I'll practically have a social life.

Diane, SAHM to DD (June 05) and DS (April 07).
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