AIBU about my sister's depression/aanxiety?

[working9while5]

I'm finding it really hard she won't get any treatment. She is on an ultra low dose of Citalopram (10mg) and won't increase. Won't go for therapy. Signed up for a Mindfulness course when well but never went. Won't do anything anyone ever suggests. .. and is actively trying for a baby right now...

I had moderate-severe PND and severe OCD last year so I understand the feelings she's having.. but I'm really annoyed and worried she is looking at ttc in this state. She is morbidly obese and significantly depressed, I know she thinks a baby now will make it all better and this is probably as much a symptom as anything... but she is the baby of our family and reacts to every setback by wanting everything and everyone to stop and take care of her and now is not the time to be bringing a baby into the mix.

I feel really helpless. I'm not even in the same country as her. I am keeping quiet about my thoughts and feelings but I feel so frustrated that she won't go for help and at my mother for propping it up, giving her wads of cash to spend on clothes to 'perk her up' when clothes shopping seems to trigger worse moods as she is so obese, giving her unlimited amount of time off work (she is her boss) that just leads to her sit at home and ruminate and go downward into the spiral.

I guess I'm just struggling with not being able to help and watching it get worse and worse with each bout. I worry where it's going..m

Any advice?

I don't think there is anything you can do to help. But you can mentally cut of responsibility for her and realise there is nothing you can do.

Theoretically I know that. It's soooo hard to do though.

As hard as it sounds she has to take responsibility for herself and it looks like if things get worse she has support around her - money, family, ability to access treatment if she wishes.

We cannot live people's lives for them and whilst we may not thing things are wise etc people have to make their own decisions, take treatment or not. Worrying about them does not help anyone sadly.

That sounds so difficult. I'm sorry, OP.

I just noticed you had said that you've kept quiet about your feelings. I think it's important to talk to her about them in a delicate way of course. Sometimes when I'm unwell it takes people telling me things I don't want to hear for me to consider it. It is a difficult situation when people, especially those close to us, won't accept help, but we do have to come to terms with not being able to change that.

Is she under a Mental Health Service? One option may be to see if she could get an appointment with Perinatal to discuss having a baby. They'll discuss things like meds when pregnant/ttc, how it could affect your symptoms and in a way advise you whether it's a good idea to try right now as well as helping you plan what would happen if you were particularly unwell in pregnancy/after birth. My DH and I had one organised through my Psychiatrist and it was very helpful. It might just help her think more carefully about it.

Also, if she is actively ttc, does she have a Partner? Would it be possible to talk to them and get them on board with Perinatal and possible advice?

Smoke she's in Ireland so no mh service really for perinatal stuff.

It is hard. I know part of it is we are different sort of 'depressives' and I find it hard she wears her depression so openly so to speak. I am a sort of 'not waving but drowning' person. Even when really seriously unwell part of my ego-preservation trip is to hide it and withdraw etc/talk to no one. Even at home, I just became withdrawn and silent.. so hardest thing for dh was watching me present an image to the world and collapsing wrecked after it/sleeping etc. She is more rageful and can be very badly behaved at times, very vocally hopeless and despairing eg responds to pther people being happy by tearing it down and then if you challenge it she flies off the handle and it's very hard to be around her.

I'm just dreading Christmas with her. I have two boys and am pregnant with the third and am traditionally more vulnerable myself in pregnancy. I'm seven years plder than her and would usually be her shoulder to cry on but I'm considering cancelling our trip home because I just can't do it right now. Which makes me feel shit.

That's tough. There should be a psychiatrist and counselling available in the maternity hospital she's attending, do you know which one it is?

She is having treatment as she is on citalopram which should be monitored by her and the GP. Not even her GP can force her to have treatment against her will.

Whilst you have has your own issues and have some empathy to her situation, you are not walking in her shoes. What worked for you, is not necessarily what will work for her.

You are obviously very caring, but all you can do is voice your concerns and leave it at that as it is up to her and her GP as to how her condition is managed unless you think she is a risk to herself and others.

Oh I'm sorry, I see she's just ttcing at the moment.

It's a difficult situation if she's not willing to take any help. Would your not going home at Xmas have any impact on that? Would she feel she needs to do something?

I know all that... but she's my sister not some random on the street and saying I can't make her have treatment isn't really going to change the feelings of frustration. Of course I can't. Her GP wants her on a higher dose but yes that's her call. I personally don't give a monkeys how she manages to get out of the hole but I don't think just raging on at everyone and expecting all bad behaviour to be accepted and understood because she's 'ill' is fair. Maybe therapy isn't for her. Maybe Mindfulness isn't for her. Maybe more meds aren't for her. Fine. Deciding nothing will work and expecting that there will be endless understanding of constant negativity , rage etc isn't fine and it's not something I'm going to feel neutral about.

Sorry xpost violator.

Make a difference to her? Probably not. To me? Maybe but not sure if it will be helpful yet. Culturally it's hard for me to have that distance as it's family and family are supposed to come first. Trying to make that shift to having my boys and my own family come first but it's hard. She's my only sib and I have virtually no contact with my dad and though I see my mother we are not emotionally close. Essentially she's my family more or less. Having had no choice but to limit contact with dad it's hard to even contemplate wanting to limit contact with my sister. I know the facts in terms of it being up to her but they don't help.

I can see how, logically, she is her own person and responsible for hersrlf qnd her actions etc. But the concept that she is harming no one but herself is erroneous considering she is talking about bringing a child into the mix.

Plus, of course, you would want to feel you'd tried everything you could to help before resigning yourself to effectively leaving her to it.

I don't think you mentioned her partner; how does he deal with situation/feel about ttc?

Can't claim to know how I'd cope in that situation, or make useful suggestions - just wanted to say your response is entirely justified.

Does she have a Psychiatrist that she's under or is it only her GP? Is her GP aware that she is ttc? He/She could probably provide some support around ttc and her situation/diagnosis.

Does she have a Partner and are they supportive of her ttc?

I think you should do what's right for you with going back for Christmas. You have your own struggles and need supporting too, especially as you're pregnant and feeling more vulnerable. It's so hard, OP, lots of love to you.

No, no psych.

Just been chatting to her and she quit her meds without telling GP recently. Now her recent behaviour change makes sense...

Her partner is half the prob. She lives with him in his mother's house and they are very controlling of her to point that even dinner is dictated eg you must eat chicken on a Wednesday etc.. she is married to him and long term plan is to stay in that house until his mam dies but she is not allowed make any decor changes, cook her own food, have friends over. She desperately needs not to be ttcing while depressed in this environment but in recent months is leaving house less and less and not really able to talk to her.

They're not EA they're just v v rigid.. suffered some tragic losses (bil's brother/father) and the house is a shrine and everything has to be done exactly as it was before losses though it's been seven years. She tried to move the sofa in the room that's supposed to be hers to decorate and there was family war etc.

It's very troubled. You can't say anything to her about this being unhealthy, she sees their family as a Brady Bunch dream and ours as dysfunctional because there were issues with our mam and dad.

Gosh, that really is difficult.

If she cannot be encouraged to take her medication/engage in therapy then there isn't much you can do as far as I can see. I'm sorry, working, I wish I could be of some help. Did you mention that coming off meds suddenly could be partly a reason for her feeling worse? What was her reaction if you did? Hopefully GP will notice when she doesn't come back for a prescription. Did you talk to her about your feelings surrounding her ttc? Did she listen at all?

This isn't what you want to hear, and you are probably all too aware anyway, but sometimes people need to hit rock bottom before they take responsibility and start working towards being as well as possible. Maybe she will need to get worse before she gets better? I put that so simply when it's much more complicated, but hopefully you see what I mean. It becomes much more difficult if a baby enters the situation, but there is nothing you can do to prevent that happening.

What does DP think about ttc? Especially if they are living with his mother who may not want a baby crying at all and any hour.

I really feel for you, working.