Someone very close to me has had a nervous breakdown?

Question

She's on anti-depressants and anti-paranoia tablets but they dont seem to be working. She been on them since last November. If anything shes getting worse. She's ok with some people but not others. How can she be ok one minute with one person and totally out of control with someone else. I'm afraid she's going to seriously injure someone. Please help.

She cant do exercise/yoga as she has a broken hip

Perhaps I should give a bit more info. she is paranoid about hospitals and doctors, she lives in very remote area on a farm and cannot consider a holiday. she has had her medication upgraded twice is under a clinical psychologist and psychiatrist and a community nurse visits her once a week but she's just not getting any better.

This person is not a friend she is my mother. She has already thrown a glass at my father and cut his head badly, she hit him a couple of times this week-end again. Should she be sectioned for her own good we didnt want this initially but am beginning to think it may not be such a bad idea.

Answer 1

I understand what you are going through. My mother suffered a break down over 20 years ago. Mostly the condition is managed with drugs now but we have had difficult periods.

One of the hardest parts is the sufferer doesn't necessarily accept the fact that they have a problem. To them, their anxiety and paranoia is perfectly reasonable. The medical intervention becomes part of the conspirisy.

First, realise this is a medical condition. Like any other condition such as diabetes or epilepsy, it needs to be managed. The distinction between a condition and an illness may seem minor but when you are dealing with a long term situation it is easier to understand and cope with the methods of controling it.

Unlike diabetes you can't tell if the medication is working simply by taking a blood test. The only way to do it is trial and error. They try a particular combination of drugs and see how it affects the patient. This can take time. As you mother has been on the same medication since November and showing no sign of improvement it's probably time to got back to the doctor and tell him to try something else.

I know how frustrating and frightening this must be for you and your family. My mother was never violent (except once when they got her drugs completely wrong, luckily she was in hospital at the time!) She has been suicidal though.

It's hard but you need to see these actions as being a result of the chemical imbalance in her brain, this isn't your mother, it's her condition. Perhaps sectioning or if you can persuade her voluntary hospitalisation, may be the solution in the short term. The advantage of her being in hospital is the doctors are on hand to observe the effects of the drugs themselves. This may make it easier for them to find a combination that works. It's a very difficult choice to make. You need to consider what is in the best interests of everybody including your mother. Discuss it with your doctors, this may help you to make a more informed decision.

I won't lie to you. Getting this type of condition under control is a long, difficult, and traumatic process. Also it will require constant monitoring, possibly for the rest of your mother's life. Her pyhsiology will change and she may need to change her drugs from time to time. But it's worth it, it is managable. Have patience, and know you are not alone.

The best of luck to you and your family.

Answer 2

She "cannot consider a holiday". But can't you just get her away from the home environment for a week? It might be a problem with the environment that is doing it.
For example is she eating a balanced diet? On a farm?
I think a time-limited stay, say two weeks, in hospital might be a good idea here, if nothing else to ensure she is getting a good diet, and is free from stress.
If that doesn't result in any improvement, perhaps she should try other medication. Such as Lithium for bipolar, or Risperdal for psychotic conditions even.

Answer 3

If you really are concerned that she may be a danger to others or even to herself then you need to speak to a member of her care team. I understand thar this isn't always easy (in my case I forbade my care team from talking to my family) however they should at least be willing to listen to your concerns.
If she's been on the same medication since November (and taking it properly) and neither you or her are seeing any improvment thenshe needs to speak to her psychiatrist about it. Anti depressants should start to have an effect within 4-6 weeks although it can take a little longer.
It is "normal" to be ok with some people and not with others. Unfortunately it's the nature of the beast and it doesn't always make sense - to anyone. I know that I found it intensely frustrating because I was hurting people and I couldn't understand why.
All I can suggest is to get in touch with her care team and tell them why you are so worried. It may be that when she sees them she's putting on a front (I certainly did) so they may ot be aware of just how bad things are.
Don't feel ad for considering sectioning as an option, sometimes it's the best choice. I would have hated it at first but at times I wanted it to happen as I felt so out of control and just wanted someone to make the choice for me. Somewhere safe where she can talk, rest and get meds sorted may be the best thing for all involved.

Good luck and don't forget to take care of yourself too.

Answer 4

I understand your concern. There are two considerations: one, the drugs may need to be changed, or the dosage. Different people react in different ways to drugs, and while one may help person A, it may make person B worse. This is particularly the case with some of the new psychoactive drugs that haven't been around as long as some older ones.
Another consideration is that she may have been misdiagnosed and given the wrong medication entirely. Get a second opinion if you can. I understand your dislike of having her sectioned but a temporary arrangement for closer observation by trained professionals may be your best way forward.
I'm so sorry you have to watch your mother go through this, of course you suffer from her behaviour but also you know how distressed she is to react like this. Remember to find support from friends and family for yourself and your father at this difficult time.

Answer 5

I've had personal exprience with this kind of breakdown & the fallout from it.
The tablets should have worked by now,but since they haven't and she's tried others then obviously drug treatment isn't working for her. Call out the doctor next time she freaks out & insist on immediate psychiatric help,temporary sectioning might work-at least she'll be carefully assessed.
When I had this I was exactly the same and was only comfortable with certain people,it's not unusual for this to happen.
If she goes into hospital they have to sort things out properly with meds & counselling etc before sending her home. If she is becoming a danger not only to herslf but is getting violent to other people then she needs to be in a psychiatric unit for the time being.

Answer 6

If she has been on the medicine since November, things should have turned around. As you know, medicine for depression and paranoia takes several weeks to take effect.
Talk to the psychiatrist about what you see and express your concerns.
There are provisions for the involuntary committal of your mother if things get out of control. This is a drastic measure, but it may have gotten to that already if she is harming others in the house.

Answer 7

If it gets too overwhelming she may need to be booked in. Poor lady, this kind of stuff happens to people with anxiety disorders all the time. She should try her best to see a shrink and have them readjust her meds, or she can just book herself in for a few days and get the help she needs..By the way some anti depressants, ( when you first start them), can increase anxiety temporarily..She needs personal support when she first starts them, ( reassurance). I know because when I first started antidepressants, I was a little anxious. My hubby took a few days off to be there for me.

Answer 8

All you can do is be there for her like you are doing,don't ask to many questions or judge her on her actions at least not to her face .I have experience in this problem don't leave her on her own to long as this can aggravate the condition,find things she enjoys doing and make sure she does them in a subtle way.There is no quick fix to these problems, but love and time is a very good medicine.......... I just read your add on. I agree if she is doing this then time in hospital would be good idea for her and your family ,people call it tough love :)

Answer 9

Talk to her and ask her to talk to her CPN and psych about the fact that the medication isn't working.

Why do you think she'll injure someone? Most people with mental illness are only a danger to themselves not others..

Although if her behaviour is pointing towards hurting someone- maybe you should mention it if you cross paths with her CPN.

She is ill, try to be a good friend, supportive and caring.. but don't put yourself in danger.

Answer 10

I'm always hovering in the 50% range. As long as someone doesn't screw me over around the time that I'm having that wonderful monthly female issue, I won't climb to the top of a bell tower with a riffle.