need help to help my sister.

[bexbrown0111]

My sister has has depression for the last 3 years but only admitted it about 2 years ago. She has been referred to the mental health team had care-co-ordinators until they made cuts but still sees the psychatrist there and goes to cbt too. However she doesn't talk openly too them about how she feels. They know she gets suicidal thoughts etc. But not to the extent that she gets them. She has been close to stabbing herslef, jumping out the 8th floor windown and taken 3 packs each of paracetamol and nurofen. How can I help her she won't ask for help or tell them exactly how she feels how can I help her, I feel that she could actually do something soon. Would appreciate any advice. Thanks

[MaggieMaggieMaggieMcGill]

Sadly, your sister has to decide that she wants/is worthy of help.
Which of the above has she actually done and has it been brought to the attention of medical peeps?
Is she on medication? If so, what and does she take it?

[bexbrown0111]

So far she has taken the overdose and had the knife to her skin. She is on mitizipane 45 mg and citolapran 40mg and they know about the overdose but that is it. She really needs help but she won't ask for it, she finds it all embarrasing. I don't know how to help her, when she needs it so much.

[bexbrown0111]

So far she has taken the overdose and had the knife to her skin. She is on mitizipane 45 mg and citolapran 40mg and they know about the overdose but that is it. She really needs help but she won't ask for it, she finds it all embarrasing. I don't know how to help her, when she needs it so much.

[MaggieMaggieMaggieMcGill]

Is she taking the medication every day as she is meant to? Does she drink or take drugs?
I guess as her sister letting her know that you love her and you want her to be around and ask her what she needs/what you could do for her.
I don't think her reluctance will be about embarresment, though this might have been what she has told you when you ask (I'm getting a sort of image in my head of a shrug and "Don't know, I feel embarrassed" sort of scanario).
It's much more likely to be that the depression is telling her that she is not worthy of help, that she will never amount to anything and that the world would be a better place without her in it.
At the moment, she doesn't have the tools to fight those messsages she is giving herself, so someone from the outside (like yourself) giving her the message that she is loved, needed and worthy of help might be a good starting point.

[bexbrown0111]

Thanks for the reply, she takes the meds morning and night so she tells me, she has an alarm on her phone as a reminder to take them, but I can't supervise her the whole time. She doesn't take drugs other than the meds and hasn't had a drink since she found out she was pregnant with her oldest son and before that she wasn't a big drinker. I think part of it is embarrasement but another part may be something else, I will be talking to her later so will see if I can find out any more. I don't know if she feels like she is beyond help now as she has tried loads of different meds on all the strenths and then had the talking therapy as well which doesn't seem to have made a difference. Does anyone know what the next step would be if the talking therapy doesn't work? X

[MaggieMaggieMaggieMcGill]

If talking therapy and lots of different meds are not working then the next stage would normally be ECT, which is done under General Anastetic nowadays and is very effective for treatment resistive depression.
Another thing to maybe look at is 'ketamine Infusion therapy, it's fairly new and not very well tested but has been shown to have good results:
'ketamine infusion

[bexbrown0111]

Thanks for the link, I have looked at it, but I think its a bit far for her to travel to. (If she would) ect is probably going to be the most likely, if she opens up to the psychatrist. We had a long talk earlier, and from what I can make of things she doesn't want to open up through fear of having to go into hospital. :( I tried telling her she wouldn't have to or even if she did its not like they were years ago but it just didn't seem to reach her. Was completely blank. As the time goes on I'm just getting more and more worried about her. I don't mean this in a horrible way but I don't know when she last had a bath. Her hair was greasy. I so badly want to reach her, I hug her and tell her I'm here for her, but it doesn't seem enough :( xx

[amillionyears]

Does she have a fear of hospitals because of something that has happened in her past?

[bexbrown0111]

No not as far as I know, she has never been in hospital really, other than when she had her oldest son, but that wasn't that long, I don't know why she doesn't like the idea, I'm guessing its because of the stigma attached to it. X

[amillionyears]

If you told her that it is a strong thing to do to get help, might she take any notice of that do you think?

[MaggieMaggieMaggieMcGill]

Do you know anyone in real life who has suffered depression and recovered? Perhaps getting her to talk to someone who has been through it would help.

[Iatemyskinnyperson]

My BIL has had depression for years, one real suicide attempt, a couple of hospitalisations.

Last time round he had ECT and is doing really well. I would think he'd be similar to your sister in that he didn't really fully engage in the talking therapies. As a pp mentioned, they generally reserve ECT when all the others haven't really worked, but it really helped him. He hasn't mentioned any side effects apart from initial short-term memory loss..ie he lost some time immediately before/after the treatment.