Support for relative (suicide trigger warning)

[ostrom]

I am struggling with the response and how to help my Mum. She has become severely depressed and anxious in response to a life event. In the past two weeks she has threatened multiple times to kill herself (she spoke with NHS 111, then her GP, who then organised anti-depressants and repeat appointments). She is refusing medication. Last week she took an overdose and had to be treated in ICU (with an intention to kill herself). I fully expected her to remain in hospital - in the days leading up to this she hasn't been able to function, needing to be told how to dress, when to eat, wash etc - like a small child). But the medical team declared her fit and well (1 on the rockwood scale and she was sent home). Since then she's told me she lied to the team to get her out the hospital, again she is not functioning for herself, acts like a toddler, then cries and again keeps saying she wants to kill herself - today she asked me to end her life for her. I really don't know what to do - I am going with her to the mental health nurse on Thursday - is there anything I can do before? I have kept a diary of everything she says and when. She doesn't want to take medication. I am at a total loss.

(regular poster but NC as outing)

Do you have private medical cover?

Sadly not…

Unfortunately it's incredibly difficult to get inpatient mental health care. All you can do is keep pushing the mental health team and let them know what she is doing and saying. If you believe she is at immediate risk of harm please take her to A&E or call 999.

One thing that's important, please stop referring to her as a child or toddler. She's very unwell and people can act out of character in those circumstances. Using derogatory language helps no one.

@Orf1abc - I’m sorry I didn’t mean to come across as derogatory about my Mum I was simply explaining how she is acting. I am pushing and pushing with the NHS and getting no-where. I have called the mental health team with her, and my Dad was with her after the overdose. I’m really struggling with what to do next. My father is now in hospital having his own surgery which was planned and I am lacking support in real life.

I'm so sorry you are going through this and I'm sorry I don't have the answers you need, is there a mental health team for her - sounds like she needs help with day to day life and it's taking it's toll on you and your dad.

Are you claiming carers allowance and is ur mum claiming pip?
I'm just thinking that maybe some extra finances for your family may help with those things that mental health patients find challenging and will take pressure off you, such as cleaning help / laundry or a paid carer to come in sort a meal - especially whilst your dad is in hospital too and for his recovery etc

Whilst all this focus is made around mental health - the NhS is so hard to navigate.
My brother came off an ICU ward recently too - so I feel your pain - the ward he was moved to for recovery / monitoring didn't even know his cause of illness was from a suicide attempt and took me couple of days of shouting to get them to refer him to psych liaison team and to get someone to get him back on his medications.
He thankfully has private cover - something my mum has maintained for him from 20 years of ups and downs - so whilst I can't guide you through that I do empathise and send big hugs! Maybe get yourself someone professional to talk to too - it's a lot to take on!

The nhs would too have discharged my brother in to the community like they have your mum - I was shocked...

I honestly don't understand how a person recovering from a serious current suicide attempt - to have warranted ICU treatment - isn't enough to warrant inpatient care - surely the next step is successful suicide and too late. Breaks my heart!

An after thought - can you get her a therapist and afford to pay privately - you should be able to arrange that fairly quickly and if she's anti medication maybe talking to someone about the life event and strategies of how to deal with it might help her with the suicidal thoughts

@ostrom, how old is your Mum? And what else is happening in her life?

I ask because I'm 70 and quite frail (multiple health issues). At the moment I have good and not so good days.

I know the time is coming when the bad days outweigh the good, and I'm not sure I want to be around for that. I've done my job, my DD is well set up and is for and healthy. I don't wasn't her spending her years caring for me, as I get more and more dependat.

I'm so v sorry you are in this situation.

I guess I'm asking you why your mum feels like she wants to die?

Thank you @PlateSpinnerJuggler for your responses. I think I’m struggling to process what has taken place in less than a week can’t understand the lack of follow up care. It does scare me that she was considered medically fit two days after what had happened (and with evidence of prior attempts). I have got a cleaner for us, and my grandparents (who are 90) are actually cooking for us this week whilst my Dad is in hospital so I can have a break but can’t really relate to the situation. I am talking to my own councillor tomorrow and I’ve gently tried to encourage my mum to talk to a councillor privately also. I’m struggling as she’s so reticent to any treatment and keeps saying she wants to be at peace. It’s breaking my heart.

@user1471453601 thank you also. I am sorry about your multiple health issues. My mum is the same, she’s 57 but has suffered with severe migraine for many years. Since covid she’s had very high anxiety. This has been triggered since she found my dad was due to have his hip replaced (the op was today). She’s worried about him not being able to help her in the house. But we’ve got a cleaner (and I’m helping too) and can stay as long as she needs. They were staying with me (I live four hours from them) when she first voiced she wanted to die. She said she’d had a fairytale in her head she could come and live with me forever and runaway from my dads operation. I can’t look after her forever but I said I would support them as a couple through the operation and afterwards. Once she came back to her home It got worse until the attempt on her life. Throughout this my Dad and mum and I talk with the GP and mental health team. But as soon as we’re there she reverts back to her old self almost - and everything is masked. She says she does this as she doesn’t want to be taken away (I don’t want her taken away!) I just really want her to try Councilling or medication but she’s refusing any intervention. I’m an only child so it’s all falling to me. Sorry it’s such a long post. Long day.

Also @PlateSpinnerJuggler I’m really sorry to read about your brother. Thank you for taking the time to write back. I will look into the Pip and caters allowance. This is really helpful.

57 is young, what is being done to sort out the migraines ? How often is she having them ?
Migraine in women can be hormonal and will then stop after menopause, is your Mum menopausal now, eg over two years since her last period ?
Or Migraines can have other triggers, neck problems, food reactions.

Could also be linked to the depression....
When my bro was first ill some 20 years ago the gp didn't believe the pain meds he prescribed weren't helping his head aches... he insinuated that he was drug pushing.

How was the nurse app today?

Your mums reaction to your dad having a hip operation sounds very extreme (although obviously mental illness isn’t rational, I know!) but I wonder why she’s feeling so stressed by this? What is their relationship normally like? I am wondering if she’s feeling worried by having him at home more or if there is conflict you’re unaware of?

57 is very young.. like a previous poster I am wondering if this is actually a menopause/ hormone thing especially with the migraines. I wonder if she would consider HRT? Have a look at the Newson Health website for menopause advice - severe depression and anxiety is a classic symptom.

@PlateSpinnerJuggler - the appointment went better than expected today. Mum was very open about how she was feeling (it was very sad to hear). The nurse read through the diary I had been keeping. She is also agreed that Mum should not have been discharged at the weekend and recognised the follow-up care was inadequate from the hospital. She has referred Mum for an urgent mental health referral and the team will be coming to the house to assess her in the next three days, and then we will have another appointment with the nurse on Tuesday. I stressed that I was unable to ensure she is safe (which is true) - that I could manage today, and tomorrow but beyond the weekend I needed a care plan/plan in place for how to manage this - hence the referral to the team coming at the weekend. The nurse believed prescribing more anti-depressants wasn't the right course of action until she had been assessed in the home but this is something to talk about on Tuesday. My Mum was very open in that she doesn't feel she can think or function for herself without being told what to do.

@SirVixofVixHalland @Bagelsandbrie. My Mum has suffered severe migraines for 20 years - she's not been able to work because of them, managed through triptans (nasal sprays), she's also drastically changed her diet to see if that would help, doesn't drink alcohol, rarely has caffeine etc. She's taken part in drugs trials (and funds the work of migraine trust when she can). Previously she also managed it through beta-blockers and antidepressents. Frustratingly (this was her terminology) the frequency and severity of them have reduced over the last year (she hasn't suffered from one for over two months) but instead has shooting pains in her leg (this has been diagnosed at the doctors and she has been given naproxen to treat this, I can't remember the name of the diagnosis). Mum still has a light period, although infrequently. I have discussed HRT with her but is adamant when she brought it up with the doctor a couple of years ago this wasn't right for her - I do not know if this is the case.

Yes I agree it is an extreme reaction - I have spoken with her about her fears. She is frightened of the "equipment" needed for him in the house - the toilet seats, the walking sticks etc. My Mum has always been very houseproud (I do not want to say OCD as I have already been accused of using the wrong terminology) and new things in her environment cause anxiety. As an example, I have never had my partner to stay at the home, or friends round as a child. She likes routine and this disrupts it for her. I have helped her make lists, put practical help in place (a cleaner, a gardener) but this isn't helping. I would not describe marriage as easy, as much as I love my parents -my Dad is very quiet and at times can be quite emotionless - he hasn't picked up on her low moods. She's also very reliant on her parents at times in life. At my own counselling, we have spent a lot of time working through my childhood and essentially I have spent my life parenting my Mum without realising (on an emotional level). Because of covid I hadn't seen this change in her (I only got to see her for the first time in 9 months when she came to mine two weeks ago, hence not recognising this before).

Apologies for the long post, thank you if you got to the end x

In addition, her own parents (as much as I adore them as grandparents) have a very "put up and get on with it attitude" - which I know she struggled with growing up (as did her brother) and she has not had a lot of "agency" in her own life. For example, she wanted to go to college at 16 but her Dad told her she had to move with him across the Pennines to his new job and he had got her a job in the typing pool. This was the only period of work in her life. She's also openly talk how she didn't want children (ouch to me) but felt it was the right thing to do as she didn't work. It's very heartbreaking - I have spent my whole life trying not to be my Mum essentially (again un-picked through my own councilling).

Is your Mum on the autism spectrum op ?

@ostrom it's great that she opened up and I so hope this allows and gets her the help she clearly needs.
You are clearly a fabulous daughter.

You know you're mentioning OCD with an uncertainty to label that on her house proudness, but really that could be something if she hasn't had a mental health diagnosis - it fits in with how she's behaved all these years from what you say and the break in routine and changes with your dad could be enough to kick it very high to this level that manifests as anxiety / depression and leads to suicidal thoughts / ideation / attempt.
Stay strong - you're doing great!

It does sound as though the migraines will peter out once she is through the menopause.
Migraine does not rule out HRT (unless her BP is very high ? ) but she would be best with a type that carries the lowest risk of stroke.
Migraines and now shooting leg pain suggest a neck/spine issue, can she see an osteopath or chiropractor?

@SirVixofVixHall

Is your Mum on the autism spectrum op ?

I am wondering exactly the same thing. Her reaction to the hip stuff sounds like a meltdown in terms of not being able to cope with change / her environment being changed. My son has severe autism and I recognise a lot of things here.

Wow, thanks again all for your quick responses. This support is helping me (currently got a little bit of space to myself whilst Mum is sleeping).

I hadn’t even considered autism, but the more of write about this it could be an option. Essentially in periods of high stress in her life (or someone close to her) - when the routine is changed there is what I would describe as a sudden change of mood (usually to anger) - flash points in my own life such as exams at school and university (I stayed at home for uni as the thought of me going away was too much for my parents and they refused any financial support), break up with my first boyfriend extra all caused resulted in her getting very angry (despite me keeping myself to myself as i have always tried to avoid triggering swings). Endless holidays were cancelled, booked concert tickets etc throughout childhood. Since I moved home her getting to visit is hard (she falls out with my dad, is usually a day late) but when she arrives and settles in she really enjoys herself (and then doesn’t want to leave). We’ve always been a family of routine, lots of lists, highly organised. I know I keep bringing in my own experiences into this, but again as a teenager I never went out to parties etc, essentially as it was easier not as there would be an emotional outfall from mum the next day. But when the routine is steady she is is truly wonderful, bubbly, fun, loving and I have lots of happy memories.

She has low blood pressure. At the right time I will ask her what the diagnosis is for her leg. She also describes a burning feeling in her arms. Also sweats (which she attributes to the menopause)

Thank you again for your support.

Sorry that should read “moved out from home”. Should I be bringing this up with the mental health team at the weekend?