How do we help MIL with MH

[Caper86]

My MIL has severe MH issues that are getting worse (became very apparent on Xmas day). She needs help above what she is already getting but I'm not sure where to start. Can anyone with experience of this make any suggestions?

I know she has severe anxiety, depression and suffers from alcoholism. I'm sure there are other issues though I don't know what her diagnosis is. She sees a psychiatrist and is on a lot of meds, but as far as I can see these aren't doing much for her - she can't function at all until afternoon, she can't leave the house, she still has a lot of panic attacks, she's paranoid and extremely bitter and nasty to everyone around her (for want of a better way of describing her behavior), her appearance has deteriorated massively over the past 6 months to the point where she's lost teeth and is extremely thin. No friends or socail life or DP. She's only 50.

In all honesty unless she gets help soon I'm genuinely worried something awful could happen. It's breaking my DH heart to see her like this and is having a bad effect on the rest of her family who aren't so patient with her.

Are there any other therapies she can try? Is it possible for my DH to speak with her Dr to try and understand what's really going on with her (she doesn't openly speak about her illnesses)? And how is best to get the family around her to help her rather than getting embarrassed by her and not speaking to her?

Ok, this is complex so lets take it bit by bit.

Firstly none of your MILs health care proffessionals will talk to you or DH about her without her consent, all her healthcare is confidential. This doesn't mean that you can't talk to them about your concerns, but it will be a one way conversation. It sounds like she has always liked to keep her mental health private so you need to ballance your concerns with respect for that too. She has the right to make decisions that we may consider unwise too.

Next you say that shes on a lot of meds, but they arn't doing anything for her and she can't function in the morning. The meds may be the reason that she can't function in the morning. When DH is on a high dose of meds he doesn't function well in the morning either as they make him very drowsy. Psychiatric meds can have some unpleasant side effects and its a case of ballancing the side effects with the symptoms of the illness. And if haven't seen her without the meds you can't possibly know what things would be like without them. Psychiatric meds don't necessarily 'fix' the illness, they just help to manage it.

As for the alcoholism, that in itself can cause brain dammage (Wernicke's encephalopathy) which can lead to memory loss, and challenging behaviour. It can also cause malnutition as the alcohol causes problem with vitamin and mineral absorbtion.

If you and DH think that she is an immediate risk to herself or others then call 999. If you think there is a risk but less immediate then could DH pursuade her to visit her GP or ask the GP for a home visit. Or if she has a CPN involved DH could speak to them and let them know his concerns. Other than that there really isn't much you can do. If she doesn't want DH involved in managing her mental health, thats her choice.

to me it also sounds like lots of help she needs she wont get because of the loved ones attitude to her.being embaressed of someone so horrendously struggling.not speaking to her. she will be already paranoid and this reaction to her she will feel and it will only cause those feeling and mh probems to worsen then it causes that circle of not getting any help.
does she want more help.does she accept she needs more help.
it wont get further if she cant reach out for it.and unfortunetly with mh and alchohol or addictions no matter what action you take it can only ever come from her.
even forced she will only then come from that with the same mindset of not being able to get help in her mind and instead will have been forced into something shes not ready for.
the best thing and sorry hardest thing I can say is what she needs is reasons. she needs love and so much patience and care it will make your jaw ache. with addiction they almost need treating and cacooning like a child.its stemming from how they feel about themselves. if they though they were worth more theyd want more from life and would feel more able to change.
so it needs people to support her and if there isn't that I'm afraid ive never anything changing. the sufferer needs reason to change to make a reach for life. she wont if there aren't those with such strong patience to sit with her through some horrific times as she does so.
not saying you aren't or don't care.the fact your on here asking for help says you want to help.#it is going to take someone talkig to her.and it will be hard. just let her know your there,let her know shes needed and that you can sort something and will help her get through but she needs to reach out to you and sit and go through what can be done.

Thanks both. She absolutely does want help and doesn't want to be the way she is - although she doesn't really talk openly about her illnesses she does express she's frustrated and upset with the way her life is, and quite openly feels sorry for herself. But it's the taking action bit that is a sticking point especially as she's basically agoraphobic- I think the thought of trying or seeing anyone new stops her from getting the help she needs.

It's definitely the drugs that stop her functioning in the morning. I guess I find it quite hard to accept that that is a way to live. I haven't seen her off meds and can't compare, but even if it is worse, does that mean that she should just accept her current life? The not functioning in the morning is just a small part of it, she is depressed and not really 'with it' the rest of the time. She's had MH issues for over a decade and I guess we're finding it very hard to accept she could be like this for the rest of her life.

If she is willing to accept help I wonder if her GP or psychiatrist could do a home visit, maybe with DH present if she is happy for this. The psychiatrist could maybe review her meds, however sadly a lot, particularly the older psychiatric meds which have a lot of negative side effects particularly with long term use. For DH the side effects are definately worth the improved quality of life with Meds, but obviously your MIL is struggling so a review might be helpful.

It is great that you care enough to seek help. I agree with pp that lots of love and reassurance if the best course. Its not always easy, infact it can be very hard emotionally supporting someone with their MH. DH and I are lucky that we have a very supportive MH team. A good CPN makes a huge difference, I don't know if MIL has one, might be worth her asking about if not.

DH and I really do want to help her - we'll pay if it means going private. But I totally get that it needs to start with her. Maybe we have to have a proper chat with her (at the moment it's just him trying to get her to talk about it but I think he's scared of what she'll say so doesn't push too much).

What's a CPN?

CPN is community psychiatric nurse. I've got no idea what the private options are to be honest.

HI

I would address the alcoholism first, see what programmes there are available.

While it might not be the case, depending on meds, it might have a bad effect on the drugs, not going out the house till afternoon, could be due to a hangover. Alcohol and depression are never a good combination, also her appearance could be due to the alcohol.

You have the vicious circle, that a person could be depressed because they are anxious, then the anxiety gets worse so they get depressed and then self medicate with alcohol, which worsens the depression and anxiety.

I am not saying this is the case, but its something to look into.