I don't know how to help

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Please can someone advise me on how to help my mum?
A few weeks ago, out of nowhere she became paranoid that she was being followed, that all her devices were bugged, she was extremely anxious. This seemed build up over a couple of days. She has always suffered from depression but would not get help for it and seemed to manage OK before this. This was very new and seemed to appear out of nowhere. Eventually after a day ot two of things getting extremely worrying as she was getting very scared and agitated I managed to persuade her to get an emergency appointment at the doctors. Whilst there it emerged that she had been prescribed anti depressants earlier in the year but had not been taking them. The doctor persuaded her to start them which she did the next day but this seemed to make her feel much worse the next day.

I ended up taking her to A&E where we waited to be seen for almost 12 hours, she was assessed and eventually sent home after many health tests and told that the mental health team would come out to see her in a couple if days.

The next day she had deteriorated even further so we were back on A&E where she was sectioned.

Whilst waiting for a bed in the mental health ward, more health tests were carried out and there was some confusion over her sodium levels, a couple of years earlier her sodium levels dropped to a very worrying level and she was admitted to hospital with this. Low sodium levels can cause mental issues and my mum became convinced this was whst the problem was and nota genuine mental condition. (She has become fixated on this)

Anyway eventually a bed was found on the mental health ward where she was prescribed aripiprazole and an antidepressant, she had a horrendous time in the ward and was only seen by the psychiatrist twice while she was there (2 weeks) there was a covid outbreak and she was quarantined in a room for a full week with 4 other people. She was discharged and on the day she was discharged the doctor doubled the dose on the aripiprazole. This made my mum feel terrible, she felt very agitated on it but was told to carry on taking it which she did for a week but eventually decided it was making her feel to ill so just came off them. I was so worried about this but she was still in touch with mental health team so I was concerned but felt better that they were still involved.

At no time did the mental health team come out to her, she had to go to them, even after contracting covid on discharge from the hospital which she had caught in there.

My mum became convinced it was her sodium levels that had caused everything and suddenly decided to just take half the antidepressant as she said that was making her feel strange too. I was very concerned and persuaded her to talk this over with the mental health team who seemed to think this was OK.

I got a call the following week to ask if my mum would be able to make an appointment with them the next day which neither if us had any knowledge of another appointment had been made. I told them I would take her but needed to check my mum could attend as it was short notice. We couldn't get in touch to let them know she could attend and when calling the hospital to confirm were told they had no record of the appointment so assumed there had been a mix up and didn't attend. The next day I got a call asking why we didn't attend and explained what happened, the nurse then called my mum who git very agitated and told them she no longer needed their help ashe has no mental problems and it's her sodium and was discharging herself, which the nurse agreed to!!

This was a couple of weeks ago and at first she seemed ok but over the last couple of weeks my mum has become paranoid again she wont tell me how she feels and is very anxious and I just kniw it has come back but she is adamant she is OK.she suffers from high blood pressure and I am do scared because she is getting worked up about her devices again. I can see she us deteriorating but she won't accept any help,, other than going up to the full Tablet on her antidepressant. She is avoiding going out now and seeing people and because she doesn't want to tell me what's happening with her she is being very distant with me. Although I am still getting calls asking me to sort out her devices as she's convinced she's being hacked all the time. This us now becoming an obsession with her and happening pretty much every day and causing so much stress. I want to help her but she gets really angry with me for even suggesting it's her mental health. I'm struggling and don't know how to help her. I'm sorry for rambling on but I can't sleep for worrying. If anyone can help please?

It sounds like she's been really let down by the mental health team. I'd go back to the GP and explain that she's not taking her medication and discharging herself from services and see what they suggest.
Could you afford a private psychiatrist? The waiting list on the NHS is insane.

I'm so sorry you're going through this x

Sorry to hear you and your Mum are going through this. Unfortunately, as your Mum is an adult it is difficult for you to do much, without her consent. Her condition means she lacks insight and without being sectioned, mental health staff and GP have to respect her wishes if she declines support. You could encourage her to see GP about her sodium which may help her to attend. You can call and speak to her GP so they have your insight, but there is little they can do unless she agrees. If concerned for her safety, call the mental health crisis line near you or you could call their community team in the meantime for advice. It is very frustrating seeing a loved one so ill but they are unable to see they need help. It looks like she was discharged from hospital too soon

Do you have an Early Intervention in Psychosis team in your area? If your mum is suffering a form of psychosis (which sounds possible) then the EIP should be able to offer some support. They work in a different way to the CMHT (from my understanding) because they realise that disengagement and not realising you are unwell are part of the illness. Doctors see patients in their homes, which sounds like it would be helpful.

I would keep encouraging your mum to take the meds. If she remains unwell, her nearest relative can request a Mental Health Act assessment. Mind have the information about who qualifies as somebody's nearest relative.

Hi thank you for all your replies. I am classed as my mums nearest relative and I think my mum blames me for her being sectioned so I feel she doesn't trust me enough now to tell me everything. She was diagnosed with psychosis but she won't accept that that is what it was. We have had her sodium tested a couple of times since she was discharged and although it is on the low side the doctor seems to think not low enough to cause her mh problems.

The trouble I have atm is that if I were to contact the mh team (she's has told me specifically that she doesn't want to deal with them ever again as it was the worst thing she's ever gone through) I think her trust in me would totally be gone. I have a brother who says she has him that she's angry with me for not believing her (about her delusions) and he thinks I need to back off. I have never said I don't believe her as I know it can make things worse, I know I probably do mess up sometimes by trying to help by trying to make her realise that nobody would dislike her enough to want to stalk, spy, hack her and upset her so much but I realise she is so ill she will think I'm in on it or something. My brother is next to useless and although knows she is unwell seems to think it will blow over which I know won't happen without help.

She has said she will never take the anti psychotic again(aripiprizole) after how they made her feel but until the doctor upped her dose she was doing great on them. I do think he was wrong to double her dose on discharge as it was just too much for her and this has made things so much more difficult. It doesn't help that my dad died 5 years ago after a terrible time and her trust in doctors is very low anyway.

She lives alone and although I see her every single day, she is very lonely and now because she is avoiding friends she seems to be so down. Whenever I see her now my mood is very down which is impacting on my family and so now I feel like if she won't accept help why should I keep putting myself through it at all, the guilt and worry about her makes me go every day but I'm finding that because it is just me and her we now struggle to speak because we have nothing but her illness to talk about and she doesn't want to talk about that it's like a viscious circle, the worse our relationship is getting the more down she's getting and the more anxious she seems. So sorry for the very long posts.

I'd speak with the GP, you don't need to ask for info, so no confidentiality issues. Explain the situation and concern this will lead to an emergency admission. Hopefully they will re refer to a cmht who may try a gentle approach and focus on helping your mum to feel as in control as possible.
Aripiprazole often makes people feel more anxious when they start taking it. There are lots of other medications she could try.
It maybe helpful for you to focus on the 'truth' in the situation with your mum is that she feels very unsafe and how frightening that is. If she knows you are genuine in that respect she may be able to be open with you.
Look at Mind or local supports for carers for support for you. Good luck OP

08Rustnot I will look onto whether there is an EIP team in my area, I'm just so nervous about alienating her further and her having nobody to help her through this.

37Bebabelouba Thank you, I will try to get an appointment with her doctor. I have been for a couple of appointments with her, just so that I can keep a note in case she forgets anything abd whenever I've tried to ask or say anything about her condition she will glare at me and tbh she can be quite intimidating so I can't get the point across. It might be better when I go alone I just wasn't sure I could do that or if they would discuss her with me?

You need to look after yourself and daily visits may be too much. As pp said find the contact number for the local Early Intervention Service and explain your concerns. They are experienced in having patients not want tl engage, it is part of the illness, they may be able to try to talk to her and gain her trust. Don't try to rationalise that she has no need to be paranoid, people aren't stalking her etc as to her it is very real and scary. Don't go along with her beliefs either, just say although you have not noticed these things, having these thoughts and feelings must feel very scarey and you are wanting to help if you can. Encourage her to divert her thoughts if possible, concentrate on practical support, ensuring she is fed etc, go out for walks or do yoga together, as exercise can help. She may find listening to music or podcasts through headphones helps. Increasing her medication so quickly, appears to have back fired as the side effects from a rapid increase must be difficult for her
Just keep calling the Early Intervention Service until you get support. It may rske her getting worse before she gets the help she needs

44Caughtup Thank for your reply. Music is another thing atm that scares her as she thinks all songs played are a message for her. I really do try not to contradict what she says as I know it can make her withdraw I just find it so difficult. The thing is although everything she believes is happening is so unbelievable, she can sometimes be so convincing that I doubt myself. She is soobesessed with her devices also and every other day I'm being asked to reset things, check settings and wipe stuff, even asking us to buy new things as the ones she has are compromised, it really is getting to be such hard work but my mum is also very strong willed and gets so angry with me for suggesting she gets help, my worry is that if I contact anyone abd she finds out she will go mad abd not speak to me again. I suppose though I'll have to take that risk to help her.

That is really difficult for you, nothing you do in terms of resetting or checking things for her will make a difference. You do need to take a step back and insist the mental health service try again. Nothing will change until she gets the help she needs, unfortunately she may have to get worse before she gets this (another section possibly) As her nearest relative, explain you feel she needs a mental health assessment, she does not need to know it was you. She will not remember you have done this when she is better probably
You should be entitled to a Carer's Assessment and support from the service yourself. They should put you in touch with other relatives in similar situations if that would help. Look at the Rethink and Hearing Voices Network sites for informatiom
In reality, unfortunately there is little you can do until she accepts the help she needs or until she is sectioned