If I could control your thoughts you wouldn’t be this angry at me

July 16, 2012 4:54 PM

My father in law is bipolar and self-medicating with alcohol. He is the sole carer for my house-bound mother in law. They live 5 hours’ drive away and they resist efforts to help them. How do I best cope with him? How do I practically help them both? Long and painful story below the cut.

My husband’s parents live in a city about 5 hours drive away from us (in New South Wales, Australia). For clarity, let’s call them Jane and Mike. They’ve been divorced for over a decade and live separately.

Jane has emphysema and must be on a constant oxygen supply. This means she is generally house bound, and has difficulty moving around – she can still take herself to the toilet and shower, but could not leave the house without help. She mostly just watches TV, as she has no friends or other family. We call her nearly every day to chat and check up on her. She suffers from depression, and has all her life. She is a hoarder, and intensely private – as a result she has no in-home support arrangement apart from family.

Mike is Jane’s carer. He buys takes her out to get groceries, takes her to appointments, picks things up for her, helps around the house, etc. He visits her nigh-daily. He has a couple of friends, but no hobbies. He is retired, and we’re not sure what he does apart from look after Jane. He was diagnosed with bipolar a year ago and sees a therapist about once a month (he says the therapist wants to see him more often but he resists this). He deeply resents having to look after Jane, but also engages with her way too much. We’ve asked him to cut back on the visits or organise other in-home support but he won’t.

We try to visit once a month and stay over at Mike’s apartment on the couch. Jane has a three bedroom house but due to the hoarding there’s no room for us (not even a couch).

Mike has always been difficult, but some visits are worse than others. This weekend was incredibly bad. He was extremely agitated, paranoid, angry and upset. Conversations over the course of the weekend went badly. He says we are terrible people, suspects we are out to get him, thinks we try to control his thoughts and emotions, hates and regrets his life, and wants us to leave him alone (these kind of comments were reactions to pretty innocuous conversions about setting up a budget for Jane, trying to think positively, etc). The things he says are hurtful and I struggle not to get angry and upset at him when he speaks to me and my husband. In the end, he stormed out of his apartment, then texted my husband telling us to get out.

This weekend Mike also admitted he is drinking (about a bottle of wine a day) because he ‘has no other outlet’. Yes, we’ve tried to suggest activities and things for him to do before – these are either shot down, or shown as examples of us trying to control his life/thoughts.

Now that we’re home, I’m starting to fret. I’m fretting that Mike is in serious trouble; he hasn’t threatened self harm but he seems unpredictable and angry – and the new factor of potential alcoholism is terrifying. I’m fretting that if something happens to him, e.g. hospitalisation, Jane will be left without a carer. Needless to say, it would be pretty crap if we had to go up there every week.

We're calling the local mental health unit to ask for advice today (particular for emergency care for Mike, and any carer services for Jane), and I'm trying to find alternative accommodation for when we're in town.

What else can I do? My husband and I are fixers - we want to take action, make life better for them, do whatever we can. Sometimes I wonder if this attitude is making things worse though.

I also need to improve my attitude towards and understanding of mental illness. Can you help me understand what Mike’s going through, how to best interact with him, and stop getting upset when he’s hurtful or angry at us? Sometimes I find myself blaming him, or being angry at him, or resenting him – and I know I shouldn’t.

(The good news: my husband and I are a totally solid unit of support for each other – this whole drama has made me so grateful for him and proud of him. Hooray for having a fantastic partner to lean on!)

posted by little-egglplant to human relations (9 answers total)

Sorry to be blunt, but you want Mike to cut back on the visits and arrange other care for his ex-wife, your mother in law. What else can you do? Visit more often and/or arrange other care for his ex-wife, your mother in law. Sounds like you are being negative about Mike not being well enough to take care of the things you don't want to take care of. Instead of looking for ways to make Mike better why don't you look for ways to make your mother in law's life better, and probably Mike's as a result?
posted by uncaken at 5:07 PM on July 16, 2012 [3 favorites]

You've taken on a lot of responsiblilty. You feel responsible for your MIL's care, social life and finances, your FIL's mental health. These are adults, people older than yourselves than have chosen to live in a way that is most convient for themselves. There is no incentive for them to "fix" their own lives because they have shoved all the consequences (onerous weekend trips, worry, searching for resources, walking on eggshells around your FIL) on yourselves.

I have seen a lot of adults sacrafice their own lives, independence and happiness for their parents, and it never turns out very good - for the child or the parent (or the grandchildren, sadly). Was your husband raised in a dysfunctional environment where he was "trained" to always put his parent's (emotional, physical) needs first? That is not healthy and I worry that you are re-inforcing the message he was possibly raised with; that he is not worthy of his own healthy needs lest they interfere with what his parents want. As his partner, you should be putting him first, especially in this situation, and helping him make healthy choices.
posted by saucysault at 5:21 PM on July 16, 2012 [3 favorites]

As the mother of a schizophrenic who has a lot of paranoic thoughts and who drinks almost half a liter of scotch every night I can tell you what he tells me: the drinking quiets the voices and the turmoil in his head. His dad and I have been unable to get him to stop drinking, but we were able to negotiate few terms, such as no drinking and driving, spacing drinks over several hours so that he does not poison himself, drink in a safe place. My son deals with his paranoia better when he takes his meds: he sees a psychiatrist once every two months and has convinced himself that the meds are helping him sleep.

Don't stay with him when you visit, give him his space. This is especially important if he has any paranoic thoughts, which seems like he has from your description. You cannot fix mental illness, just deal with it as best as you can, with love, acceptance and respect for your father in law. At the same time put limits and boundaries between you and him, making clear that you will not accept abuse of any kind, not even yelling. Walk if he starts the verbal abuse.

I hope you can find another carer for your mother in law. Best wishes to you and your husband.
posted by francesca too at 5:39 PM on July 16, 2012 [2 favorites]

You can't help someone who doesn't want your help.

Give Mike his space. Don't stay at his home when you go visit. You can't do anything to control his drinking; it'll just trigger his paranoia. Take a step back and realize that this is not a situation you can control.

Ask Jane if she wants/would be open to alternative care before you actually start to meddle. Don't go behind her back and set up alternate care without her explicit OK - you mentioned she doesn't like having strangers in her house.
posted by buteo at 7:35 PM on July 16, 2012 [4 favorites]

No one ever "self-medicates" with alcohol. That is one of the most pernicious phrases that has crept into the language. He's drinking.
posted by yclipse at 3:54 AM on July 17, 2012 [3 favorites]

You and your husband need to sit down with Jane and discuss a care plan with her. This is a VERY difficult discussion to have with someone, but being forthright and honest is the best approach.

"Mom, we love you and want what's best for you. It seems that the situation here is not helping you, nor is it helping Mike. I know you're scared and depressed and we think these emotions are clouding your judgment. Mike is very sick and I'm afraid that we just can't depend on him any more. We'll try to help him in whatever way we can, but those are his issues to work out. Since we can't be here to help you on a daily basis, we think the best thing is to find a care-giver who can help you out. I know that you have some shame about the condition of the house, and we'd like to help you with that. Please let us help you with counseling for the depression and the hoarding, and with arranging care for you. Tell us, what are your thoughts about this?"

Your MIL will be resistant, but eventually, she'll need to understand that her health and her situation are at that place where she's probably going to be better off in Assisted Living (if she can afford it), or with a part-time care-giver.

Part of the problem with hoarding (and I can't even WATCH those shows it freaks me out so badly) is that not only is the house a mess, but it may be falling down around your MIL's ears. The house may be in such a state of disrepair that it may have no value, even if it is cleaned up.

Hoarding is its own disease and it's not easy for the hoarder to deal with at all. Her worst fears are being realized. She's dependent on other people and she doesn't get much of a say in what's going to happen to her.

One thing that you should get her to articulate is what she thinks is the absolute BEST solution to her problem. Even if it's wacky, or untenable, or scary, you need to understand where she is mentally.

I feel for you, this is a very rough situation and it won't get easier.
posted by Ruthless Bunny at 6:27 AM on July 17, 2012 [1 favorite]

Does Australia have Al-Anon and/or something like NAMI (National Association of the Mentally Ill)? The classes I took at NAMI were invaluable for understanding my bipolar mother. Completely changed my relationship with her.
posted by desjardins at 12:56 PM on July 17, 2012

Thanks Ruthless Bunny, that script is great.

We will definitely not be staying at Mike's again, and we'll focus on getting better care arranged for Jane. Thanks for all your comments - it has really helped.
posted by little-egglplant at 5:45 PM on July 18, 2012

I'm rooting for you!
posted by Ruthless Bunny at 6:25 PM on July 18, 2012