Mentally ill SIL and emotional and verbal abuse

[Bets64]

Posting here for traffic. I would appreciate some advice on my SIL. She lives abroad (my DH from another country)and has had mental health issue her entire adult life - bulimia, depressive episodes, and within the last 10 years or so, psychotic and manic episodes. She has apparently been diagnosed as bipolar, although nobody seems quite certain. She certainly has complex issues. She refuses to take medication for long, and therefore is never stable. She self-medicates with obscene amounts of Xanax. Nobody in the family can make her listen to reason. I actually think that they have all been conditioned over the years to accept her behaviour, and always make excuses for her.

Recently, her husband and son have said that they cannot live with her any more, and she has been staying with her mother, who she hates. She has been verbally, emotionally and sometimes physically abusive to her mother over the years, and this has now spiralled. She has also become extremely abusive towards my dh, who has been doing his best to protect his mother. He is suffering from insomnia and is extremely stressed about the situation. I had enough, and asked her to stop, and now I have become the recipient of her abusive texts and emails. My father died by suicide a few years ago, and she has sent unforgiveable messages about how this is my fault, how I need to be sectioned as my children are unsafe, and on and on. My husband has told her to stop, but it is constant, and is starting to really take a toll on me. I've asked him to stop replying to her messages (I have) but he seems unable to.

AIBU to insist that we cut her off completely, at least for a while? I feel like the whole family is being destroyed.

You can block her, but you have no right to insist that your husband does the same.

I would absolutely block her!

I don't think you can tell him to have no contact with her. You block her and tell him you want no updates whatsoever from him regarding his DSis. He then becomes totally responsible for the stress he's feeling.

Block and delete her.

Yes block her not sure dh will do though. His poor mam ☹

Could you set up a redirect somehow on her messages so that she thinks she's sending them, but you're not having to view them?

What mental health services are available in sil's country? Ignoring her need for help hasn't solved the problem so dh needs to support their parents in seeking help for her. Sil's husband also needs to step up. Between them they can surely get her help.

Thanks for your replies. She sees a psychiatrist regularly, and was sectioned a few years ago. She last spent time in a mental health ward in the summer, which was voluntary. Unfortunately, despite this, she is never 'well', as she never complies with the medication for long. She always knows best. My MIL is a blind widow with Parkinsons. She has a lovely carer who lives with her, but she has resigned today, because she cannot tolerate my SIL anymore. It really is a nightmare situation...

Cut her off. Your husband has to make his own decision of course, which is much more difficult because she is his sister and he is also rightly concerned for his mother.

Ok, 2 comments about her not taking medication.

1. Depending on what she is prescribed most medication for serious mental health conditions come with pretty awful side effects. These vary dependant on what you take, but they all have a high level of adverse reactions …it’s a question of finding the least awful medication that still works a bit. Know one fully understands the mechanism of these sorts of mental health conditions, so most medication is a large hammer to crack a nut and results is these side effects. A good psychiatrist will work with patients through various options..but this is a hugely time consuming process because the patient needs to be on the mediation for some time to be able to balance risk/benefits - eg 2 years.
2. A lot of patients with psychotic type illnesses have a symptom of their illness called ANOSOGNOSIA . This means they are completely unaware they are unwell . The disordered thinking they have means they are more likely to understand the world in terms of people who challenge them being ill. It’s really not that they are refusing to believe they are I’ll, they simply cannot comprehend it- it simply doesn’t make sense that they are in terms of what they’re experiencing.

Both these means compliance to mediation is extordinary difficult. Even people who have been taking medications for years, can suddenly decide to stop with catastrophic results. But no one can force anyone to take medication unless they are not mentally competent (and have been formally sectioned). And that is unlikely these days unless they are a risk to themselves or a significant risk to others.

You have a difficult decision to make. Do you walk away or try to continue contact and potentially bang your head against a brick wall. That’s up to you. You can’t dictate to your husband either. But you can get him to look up statistics that say there is a 1 in 3 probability that those caring for individual with serious and enduring mental health conditions will at some point become mentally I’ll themselves (normally depression, anxiety etc). Warn him to look after himself. To put firm boundaries in place for him and his mother. To protect themselves from being dragged into a weight of responsibility placed on him from mental health care professionals if they perceive he is now the “carer”…support packages are so none existent that the mental health teams are relieved to dump responsibility for day to day on family in name of “care in the community” until major crisis happen
I know this. Had to walk away from my marriage. Hardest thing I ever had to do. We were married for 30 years.

What country are they in?

Oh, and nobody knowing for sure she has bipolar. Completely normal. No test for any of these psychotic type illnesses, it’s all based on a complex set of observations. There are dozens of differential diagnosis that all differ by small differences in these observations. It is far form uncommon for individuals to be re diagnosed frequently as their condition. Evolves or even as new physchiatrist review their case again.
In this country, these observations are mostly done in 30-40 mins out patient appointments - it is completely ludicrous.

Thanks, especially MayMorris for such a detailed response. I recognise so much of what you say; my father had a psychotic depression in his last years, and it was impossible to help him understand that he was ill. I think the doctors just try different cominations of meds in the hope that something will work, but so often it doesn't. I'm so sorry about what you must have gone through in your marriage.

I guess I just wonder whether this abusive side of my SIL is her personality, or her illness, and how much choice she has over it. I suspect more than she will admit to.

Definitely block her on your phone, your DH can decide whether he wants to.

Tbh, your DH's main priority should be his vulnerable mother, as she can't be left without a carer and she could be in danger living alone with his sister. Personally, I think he should get on a plane ASAP to sort this out in person - i know it's a huge pain with work, etc., but he really needs to (unless another close family member is there who can sort this out) His sister can't live with his mother if it means that carers won't stay. She needs to be rehoused somewhere else.

Sorry you're going through this. I also have a relative who suffers from mental illness and they've really put the family through the wringer at times.

If she's had mental health issues all her adult life its impossible to unpick what's her personality from what's her illness. It becomes similar to trying to work out what aspects of your personality are "because" you're female or because of your mother tongue or birth order or the culture you grew up in...

Yes, he is obviously sorting out a new carer now, we have until the summer. There's a chance that the existing person, who is amazing, will decide to stay, as SIL has now moved out, for the most part, into a temporary flat (paid for by her husband). I agree that it's impossible to unpick her personality, but it it frustrating that everything she does is put down to her illness. I think it enables her behaviour, but not much can be done. Thank you to all who shared their experiences of trying to cope with family members in similar situations; it really makes me realise how many of us have to struggle with these issues.

Thank goodness she's out of your MIL's house now, you must be so relieved.