Ask MetaFilter questions tagged with mentalillness

How do you get a 19 year old who has already been convicted of a felony into rehab for cocaine abuse?

Anonymous — Mon, 07 Dec 2009 10:33:06 -0800

How do you get a 19 year old who has already been convicted of a felony into rehab for cocaine abuse? Family complications outlined inside. I’m just going to lay the whole story out here because I feel like I don’t even know what details are relevant. I will try to respond via a mod if necessary. FWIW, I’ve read the previous threads on rehab and addiction… but you know, special snowflake and all that.

My brother is 19 and lives at home. My sister is 22 and also living at home while finishing college. They live with my mom and stepdad. Mom has always exhibited the classic symptoms of BPD, Stepdad is a good person but sometimes plays into her problems. I am the oldest kid and live very far away.

Last year, Brother was arrested for felony theft. He went to jail for a week. The details on this are still sketchy because Sister and I only found out months after the fact when he was brought to trial. It turned out that Mom had told Sister that Brother “ran away” while he was in jail and the only reason it came out was because Sister started suspecting something was up and snooped through the house to find out what it was (there is a long history of playing “guess the horrible secret” in my family). Brother was sentenced to several years supervised probation and 6 months house arrest. He enrolled full time in community college, sees a court-appointed therapist and psychiatrist (who diagnosed him as bi-polar), and works part time. Once I found out all of this, I called him to voice my support and offer help. He rejected the help and said that he felt like he just had to make better decisions.

A few weeks ago Sister called me to tell me that she suspected Brother was using cocaine. She said she could hear him doing it in his room and that he was uncharacteristically selling his stereo. The next day she snooped again and found a bag of white powder in his desk and confronted him. He flat out denied it and said that she didn’t know what she was talking about. She told him that if he didn’t quit she would have to tell someone for his own good and he accused her of wanting to put him in jail. She told me all of this and I started poking around online to see if there were any more surprises. When I googled his phone number, bunch of Craigslist ads came up- one for his stereo plus 5 other ads for expensive electronics. Sister and I agreed we had to tell someone and decided to go to Stepdad.

To our surprise, Stepdad had noticed the signs way before we did (although he wasn’t computer literate enough to know about the Craigslist ads). He had even brought it up with Mom, but Mom had said that Stepdad was “out to get” Brother (which is ludicrous). Stepdad then told me that right after the sentencing, Mom had switched Brother’s therapist after the first therapist suggested he needed rehab. I pulled together the ads so Stepfather and Sister could confront Mom. After that, Mom and Stepfather finally confronted Brother, who (no surprise) denied everything. Mom said, “see, I told you everything was fine” and things seemed to improve over the next few days. Brother told Sister that he’s looking into the military, so I reached out and tell him to offer encouragement and support again.

Today Sister said she heard him doing coke again. I looked on Craigslist and sure enough, another ad. Stepdad, Sister, and I all strongly suspect these are stolen goods (but don’t know where he’s stealing from) and we all want him to go to an inpatient, preferably 90 day rehab. Stepdad says he’ll talk to Mom again but doesn’t think the outcome will be good. Brother’s house arrest will be up in less than 10 days and Sister, Stepdad, and I are terrified.

So here’s the actual question part of the question: We want him to go to rehab, not jail. How can we do that with or without Mom’s help? How do we convince him to go? Is mandatory rehab an option given his criminal status? Who should we talk to? Can we trust his court appointed therapist/psychiatrist with this information? How can I continue to manage this from far away? My sister is getting ready to graduate and move out, but she feels totally responsible because while Stepdad means well, he’s ineffectual, and Mom is… as ever. How can I do more so she can feel comfortable getting the eff out of there?

Should I mention I'm mentally ill on a graduate school statement of intent

Anonymous — Mon, 16 Nov 2009 05:35:36 -0800

Should I mention my mental illness on my graduate school statement of intent? Brief background - I have social anxiety, depression, and Asperger's syndrome and a year ago, I graduated with a B.S. in Economics from a fairly prestigious technical school. I really want to go on to get a Master's in Economics, followed by a PhD.

However, mostly due to depression and anxiety, my grades were not that fantastic, 2.6 or so overall and my grades in some of my econ courses were not that great (for instance, I got a C in my Math Methods of Econ mostly because I had to miss a week of class since I was in the mental ward at a hospital because I was ready to kill myself). I do have support from one professor who I actually talked to when I was in school who would be glad to write letters of recommendation to some schools I'm looking at he thinks are realistic options given my background, not to mention I did pretty alright on the GREs (though only a 670 on the Math and 580 on the writing).

However, it was suggested to me by someone that I mention the fact I have mental illness, especially Asperger's, on my statement of intent, that is my essay on why I want to attend graduate school. I've been told that schools like to let in disabled applicants because it makes their departments look good, and that having Asperger's would be an asset as people would think I'm some kind of genius (to be honest, I really wish I had that super-Aspie power of concentration on academic subjects, as I tend to obsess over the Internet and more useless topics). Likewise, someone else suggested I use it as saying that I've "overcame adversity."

But I'm concerned about the fact that there's a stigma associated with mental illness and that an economics department might be reluctant to accept me into their program because they think I'm sort of skizo who hears voices or has multiple personalities or more or less just flake out. I'll also be honest - I really don't think I've "overcome" my mental illness. I wish I could give an inspiring personal account how I overcame it but it's something I struggle with everyday but if I mention it, it would explain why my grades were less than stellar. I think that they might view the fact I'm mentally ill as more of a liability than an asset to their department.

As a tangential issue, I'd like to have the aforementioned professor look over my statement of intent since I can't think of anyone else to do it, but I'm afraid if I do mention it, he'll find out I'm mentally ill and that would ruin our relationship and he'd stop wanting to help me.

So should I bother mentioning I'm mentally ill in my statement of intent? If so, how should I go about it?

I'm not so much ashamed that I'm mentally ill, only that I don't want to be rejected on the account of the stigma associated with mental illness.

As a final clarifying note, yes, I do realize that graduate school will be harder than my undergraduate program. However, I do want to get a PhD eventually because I love doing research and that's something I'd like to do for the rest of my life because it actually makes me happy.

Help me deal with my mentally ill father, who I still need to talk to.

Anonymous — Sat, 03 Oct 2009 13:27:56 -0800

How should I go about handling my (very) mentally ill father who goes through (primarily) emotionally/psychologically abusive phases with anyone he holds a relationship with? Completely cutting off contact is probably not a solution for a few reasons. Sorry for a long post, but...

History: My father is mentally ill, diagnosed as having a number of issues. He does not properly take his medication, and I'm not even sure that he bothers taking it at all, any more. It shows. I have been out of my (now divorced) parents' household for many years, but he calls me frequently--once a week--and tries desperately to keep tabs on what I'm doing, where I'm going, etc. as he likes to try to gain control over people, so he can manipulate situations. It's a taxing relationship that would normally not be worth having, other than there are some issues at hand with cutting all ties. That's where I'm hoping to get some advice.

I thankfully haven't seen my father in about two years, but he's called me and known where I lived, which wasn't an easy place for him to travel to...intentionally. About a month ago, I began a big move, selling a bunch of my stuff with the idea of starting afresh and getting better stuff. I've graduated college, so it is a bit of a new life.

Before leaving where I was, I told my father that I was in the process of moving, but was going to drive around and find a place before settling down, which I have done; I said I'd have trouble getting in touch with him, as I'd be busy, which was/is true. I've only just gotten into a place over the past week. (Maybe it's worth noting that the place is much closer--several hours' drive--and more accessible to him now, which is a slight concern.) My father's been going crazy, though--no puns intended--as he only had my last landline number, so he hasn't been able to speak to me or keep up with what I'm doing. I emailed him a couple of weeks ago, but that wasn't enough, and now he's sending me emails saying I haven't gotten in touch with him for three months. That may be one of his occasional delusions, and I have no way of calculating whether he's reacting angrily or otherwise to it all. Overall, this isn't my problem.

My problem is that...well, really my problem is just that he's crazy, and I'm not (no more so than most!), and there's not really anything either of us can do about it, particularly if he's not going to take his medication and/or consistently go to therapy. When he calls me, he wants to act like he's never treated me badly. He wants to be all buddy-buddy, as if I've never had to keep him, a very large man, from chasing my mother; as if I've never had to call the cops on him; as if he's never verbally disowned me or threatened me to my face in one of his fits. Despite all this, I would still be more than happy to keep a distant relationship with him, where we send cards at holidays and we speak over the phone a couple of times a year. Being mentally ill, though, and pretty damn unapologetic, he can't seem to understand any of this, and he'd even somehow be offended if I tried (yet again) to get him to understand it.

Core Question: With all of this baggage and the issues that still exist, his latest email accusing me of not talking to him for three months (again, untrue) and the fact that he doesn't know where I am / doesn't have an easy means of contacting me leaves me wondering how I should handle it. I have options, but I'm just not sure which I should choose. Should I just cut ties? Should I tell him where I am? Should I give him my phone number? Should I see him again? Is it safe for me to? And on and on and on. I drive myself batty dealing with this.

"So, why are you still in touch with him at all? Why would you even consider it?" you might ask. There are three primary reasons:

1. This is the biggest reason, and it is a material one, but one I care deeply about, nonetheless. There is a lot of land somewhere that, as his only child, will go to me, unless he outright denies me from having it in his will. Some of that land is already in my name, but only a very small portion of it. I want it all, when he finally keels over from all his bad decisions, as morbid and vulturistic as that sounds. I grew up on that land some, and it means a lot to me. I am concerned that cutting contact with him would mean I would never see all of it again. On a lesser note, where he lives is where my parents lived for a long time; it is also the place my mother fled from, finally, a few years ago. A lot of my childhood keepsakes, that I desperately want, are locked up in that home with him.

2. He gets frantic and does some wild things that might affect my life. My father has been known to wiretap, hide recorders, hire private investigators, etc. He currently doesn't know where I am, but if he ever got into the frame of mind where he wanted to know, he could actually easily find out. He would even know if he looked on my Twitter account, but he's too lazy. He loves spending money, though, so if he decided he wanted to track me down, I'm sure he'd hire someone. Doing things like that seem to give him a feeling of importance. Clearly, for my own sanity, I don't want to be tracked down! It seems that minimal, but existing contact is the only way to eliminate this possibility.

3. One of the few ways my father has always tried to "apologize" to both my mother and myself is by spending money. He paid for my college tuition, and a very small part of me is a little bit afraid that if I piss him off, he'll try to come back some sort of way and get that money from me. He'd not have much on his side, as I've got emails from him which don't state I have to repay anything, but I don't want to go through the hassle or heartache of any of that. My father is "lawyer-and-sue happy," so this is a possible scenario, even if small.

So, yes, hopefully you see why I'm hesitant to completely cut ties. I feel like both material/financial and emotional things are at stake here.

Two final things:

Please note that "talk to a therapist" is not the answer I'm looking for, so I'd appreciate it if no one went that route. I have spoken to therapists and guidance counselors in the past, as recently as this year. They all recommend I distance myself from my father, if not completely cut ties. This is good advice, but it doesn't take into account some of the things I have at stake here, which counselors always seem to overlook for some reason. That being said, therapy to help me process all this crap probably is in order, and I'll see to that at some point, when I've got time and a steadier income.

The law is not on my side, really, other than in emergencies, so you shouldn't assume that it is. Restraining orders do little good, other than to rile up the mentally ill party, and it is incredibly difficult to institutionalize someone, even when they have emotionally and even physically abused people. Most of the time you can only get someone locked up for a few weeks; my father has been locked up for that amount of time in the past, only to be released, because of legal reasons concerning how long mental health patients can be kept under certain circumstances. I'm probably not looking for a way to deal with all this, law wise, but if you know of something I don't, I'd appreciate your sharing it.

I hope someone can help me figure out how to communicate with him, but still stay safe and get what I want in the end. Thanks, everyone.

Mental illness and sin

Anonymous — Mon, 07 Sep 2009 13:11:16 -0800

I am looking for a forum or community (e.g. Facebook group) about mental illness being dismissed by churches as sin or demon possession, or people with obvious mental illnesses not being referred to doctors by their pastors. Here is an article about the issue. I want to find a group of people who are concerned about pastors trying to cure mentally ill people in their congregation instead of referring them to mental health practitioners. Or a group of people with mental illnesses (or their friends and family) who have had their illnesses blamed on their own sins. I am having a hard time with Google because mostly links about "Christianity being a mental illness" come up. Can you help me find a community?

How best to help someone who thinks you're out to get them?

Emperor SnooKloze — Tue, 01 Sep 2009 17:23:04 -0800

Seeking some advice on how to best help my father in law. You are not my lawyer; you are not his doctor. My father in law has just been discharged from a psychiatric facility after he stopped taking his Haldol a couple of months ago and spiraled into paranoid delusions and ended up in the emergency room (he has also suffered from epilepsy his whole life & ended up in the ER after a seizure, but that's not the issue at hand).

Short version: he cannot continue to be held at the psychiatric facility, and a course of Resperdol has gotten him aimed back at lucidity, but he isn't there yet. My wife is the only child in the local area, and her parents are divorced, so the onus falls on her. In speaking with the psychiatrist and doing some research on my own, here's where I am in trying to help address his health and well-being over the medium and long term:

1. A durable medical power of attorney (and possibly a bundled advanced directive) would be a proximal step; because this was not in place, getting cooperation from the hospital staff was right out of One Flew Over the Cuckoo's Nest. There are freebie legal forms for this.

2. Home health care agency services. He needs medical supervision because prescription blood thinners are a medical necessity. Ideally, I'd like to ensure as much as possible that he stays on the Resperdol as well. I realize this may be in vain, but I have to try.

3. Conservatorship, Or

4. Guardianship, with the help of a probate attorney. I'll freely admit that my grasp of these last two are profoundly shaky, but I'm a quick study.

Add the fact that his paranoia is still very manifest makes these options fraught with potential drama (suspecting my wife and I of being complicit in the conspiracy). For that reason, and because I'm concerned about continuity of care should we relocate away from the area, my instinct is to look into naming an agency as guardian/conservator of record.

Obviously, he may not consent to any of this. What I need from the hivemind is advice on the above options, please. Insights, pitfalls, the like. Also: if he does not consent to any or all, how do I seek assistance (not where; I'm okay finding local resources - I need to know what questions to ask).

I have the name of a probate attorney as an initial contact; his psychiatrist has also begun the process of contacting a home health agency to get at least that ball rolling. Thanks in advance.

Trying to adopt with a psychiatric diagnosis

Pater Aletheias — Thu, 27 Aug 2009 18:08:07 -0800

Is it possible to adopt a child when a spouse has bipolar disorder? We have two biological children, a three year old girl and a five month old boy, and would like to adopt a third child--not because we couldn't get pregnant again, but because we feel that we could provide a good home to a child who needs one. In fact, that's been our plan since we were engaged--two biokids, anyone after that is adopted.

But in recent communications with international adoption agencies that our friends have used, we've been told that applying would be a waste of our time and money--there's no chance of being approved for adoption because my wife is diagnosed with bipolar disorder.

Is that the final word? We can accept it if it is--many couple who want to adopt would be delighted just to have one of the two wonderful kids we are already parenting. But if there's some avenue for adoption, I'd like to pursue it.

Is it legal to solicit paid friendship?

Anonymous — Wed, 19 Aug 2009 08:11:18 -0800

Is it legal (or even safe) to buy friendship? This is a followup of sorts -- I'm the same guy who posted this here back in January, the shut-in asking help to fight isolation/depression. The story's pretty much the same, though, so I'll try not to repeat what I said there -- I have gone back out a few times since then (with my family/caretaker, not on my own), but at best I'm still only at the point where even if there aren't many other people around, I can only stay out for half an hour at most before I start blacking out & need to be taken back home.

I think that given some more years I could become passably functional in the outside world again, but I'm not certain I have the time... I think my mental illness is getting worse & that at some point sooner or later, I might deteriorate past the point where i can go out again, with or without help. (Not suicidal, just trying to get my act together -- like I said before, I want to fight it if I can.)

So at the risk of asking what may be the stupidest question ever asked here... *is* it legal to "buy a friend," to offer payment to someone in return for non-sexual companionship? (I can't imagine why it wouldn't be, but America isn't exactly running short of laws that make no sense to me, so I figure/hope there's no harm in asking.) And even if it's not illegal, would it be safe? Or would a post on craigslist basically saying "mentally ill shut-in will pay $xx/hour to someone willing to take him around town, talk to him & teach him how to act in society", in so many words, just be advertising for trouble? (And yes, of course I know that friendship can't be bought, any more than you can pay a prostitute to genuinely love you -- but I figure that at this point, the substitute can't do me any harm, or at least keep me going until I *could* find the real thing.)

Oh, and to answer from before: therapy isn't really an option for me (I'm uninsured, and in any event have had horrible experiences down that particular path to keep me from ever wanting to pursue it again). I like the thought of volunteering w/ the elderly or needy, at least in theory, but would have a very long way to go first in just getting to the point where I can hold it together around strangers at all (much less the point where I could actually be useful to anyone there). As for pets, I've had them & loved them dearly, but, well, it's just not the same.

Anyhow, thanks for reading. (Even if this *does* turn out to be the stupidest question in ask mefi's history!) I've posted very little on mefi but I've been reading/following it nearly every day since the beginning (literally the 2nd or 3rd week of its existence), more than enough for it & for many of the people here to have claimed a huge part of my admiration and quiet gratitude over the years. Had to say that, by way of saying that I deeply appreciated all the kind feedback to my last post, more than I can express -- and thanks for reading this one.

Mental health from states away

lizjohn — Thu, 16 Jul 2009 16:19:31 -0800

What can an adult son do to help his homeless, possibly mentally ill mother states away? My husband just got a call from his aunt that they have found his mother living homeless by the river in Madison, IN. My husband (27) has not spoken to his mother (55) in two years and the relationship has always been strained. He has long suspected that she is mentally ill and moved out as soon as he could. I have had little experience with her, but here is one example. She came to visit us and her other son 3 years ago. One night of the visit, my husband and I were going to take her out to our favorite restaurant. While we were at work that day, my husband gets a call from her saying that he is "sneaky and deceitful" and that she wasn't going to allow us to take her out to dinner. She then rented a hotel and stayed there the rest of the visit (she had previously been staying with us). Both my husband and his brother asked her what she meant, but she wouldn't tell either of them. I have no idea what it could have been. She didn't call him for a year. Next time they talk, she accuses him of being on drugs and hangs up on him. He has never done drugs in his life. My husband tells these horror stores from his childhood. I don't know what type of illness she may have, but according to family, it's been getting worse.

His aunt (who also has a strained relationship with her sister) wants my husband and his brother to come out and have some sort of intervention. What are their legal options? We live in AZ and don't have much money. We can afford a couple of flights, but not much else. I know it's very difficult (if not impossible) to get someone committed involuntarily. She is apparently very deeply in debt and hasn't been employed in over a year. She has her MA and she used to have a successful career. Would the state of Indiana pay for any sort of help? She's lived there almost her whole life. I saw the other question earlier this week, but I was hoping someone would know something pertinent to Indiana, or about children helping parents. She divorced my husband's father years ago, and he has since passed. She doesn't really have anyone close to her. What about social security? Or state health care?

Any suggestions would be helpful. Thanks for letting me ramble on a bit

Help me to help my ill brother

Avenger — Sun, 12 Jul 2009 00:35:26 -0800

My introverted 19 year old little brother just confessed to me that he "hears voices" (telling him to hurt and kill people) and that he "sees things that aren't there". Help me find some resources to help him. You can read more about my brother here. This all started with an argument we were having about alcohol. He's been drinking heavily lately and we got in a fight over it. He ended up telling me that he "feels good when he drinks" because it helps to silence the voices and keeps him from feeling uncontrollable rage at the rest of humanity. This is totally new to me. I've never even heard a hint of this from him before. He says it's new to him too, only showing up in the past year or so.

So, he needs help. The problem is that he's 19 years old, works odd jobs for 10 hours a week (making around $8 an hour), has no health insurance and otherwise has no resources. I'm looking around for local psychiatrists but it's obvious that without health insurance our family will be unable to afford more than a single doctor visit or two.

I live in Harris county, Texas. There is a Harris County Mental Health office but they seem to only serve people who have already been diagnosed with schizophrenia or major depression. Barring them, it seems that (ironically) his only other option to get affordable care is to commit a crime and get to see the jail psychiatrist.

Does anyone have an inkling of where I can even start with this? Help!

PS- we can't buy private health insurance for him because he has a major pre-existing condition (harrington-rod spinal fusion). Thx insurance co's!

I'm not an attention seeker, I'm depressed

Anonymous — Tue, 07 Jul 2009 18:48:20 -0800

Should I reveal my depression to my co-workers? I've struggled with depression and anxiety for most of my life, and began taking meds and getting therapy a couple of years ago.

Throughout my life, I've always put on a happy face to hide my true self. This was partly due to a bad family situation and the shame I felt because of it. As a result, I'm outwardly gregarious, while I feel low down inside. There are times when I fall into a deep funk and withdraw into myself.

I see my psychiatrist twice a month, and haven't told my co-workers why I take an afternoon off every couple of weeks. I keep getting asked why I take time off, but always deflect these questions by saying its a private matter.

Last week, I was in one of my funks and was keeping to myself, which runs counter to my usual habit of going around and talking to everyone. Today, my boss was joking around and said that she and my other co-workers found my moping last week to be very unpleasant and that they thought I was faking to get attention.

I feel bad now because people don't know my internal struggle. I laughed off what my boss said, but it hurt. For so long, I thought my condition was something for weak or damaged people. My boss bringing up the possibility of my faking mopiness brought up some bad feelings.

So, I'm wondering whether I should reveal that I'm seeing a psychiatrist and my struggles with depression. I don't want people to think I'm just trying to get attention when I'm really in a funk. I'm really confused as to what to do.

Any help is much appreciated.

What will happen in counseling?

dilettante — Sun, 05 Jul 2009 16:09:52 -0800

What can my friend/former SO expect from community mental health counseling? Long background explanation: I have lived with someone for 9 years. He has mental health problems, with an ever-shifting diagnosis. This shrink it's Bipolar I with features of personality disorder, last was Bipolar II, before that...well, assorted nuts. All his previous treatment has been pharmaceutical, barring some short-lived and disastrous attempts at counseling when he was a teenager.

Most of the time I don't mind having him around and may actually like him to be present, but sometimes he gets angry, and turns it on me. For example, his computer desk breaks, and this turns into screaming, getting in my face, and calling me names, with screaming soliloquies about my assorted personality traits as viewed by him. This has happened occasionally as long as I've lived with him. I find it unacceptable, possibly abusive, and after several years of broken promises and apologies, he is to move out very, very soon.

I have suggested he go to counseling for (what I see as) an anger problem, and he says he will ask his shrink next week. He is on SSI, so his options for counseling will likely be limited to a community mental health system we have here. What can he expect from this, assuming he makes it through the waiting list? They say they use CBT - does anyone have any personal experience of whether this is effective with anger problems? Are there any other useful alternatives for someone with questionable motivation and no money?

Note that SSI leaves people desperately poor, and we are leaving open the possibility that he can move back in when his new lease is up if this helps (although he says he's not convinced this is his problem). He has not been an SO for several years now, but he is still my good friend and I do not want him at any risk of surviving in shelters or starving naked in the street.

What is the proper way to react to another person's delusions?

vorpal bunny — Sat, 13 Jun 2009 08:41:03 -0800

What is the proper way to react to another person's delusions? Recently I have struck up a friendship with a person who likely has some form of mental illness - possibly schizophrenia. This person makes intricate drawings of various machines. They are always interesting to look at and talk about, though some are clearly the product of mental illness. Could I be doing harm by taking interest in them and pretending to understand how the machines 'work'? Could the positive feedback be somehow deepening the person's mental illness? If so, what would an appropriate response be?

Under what circumstances can a Uk hospital give ECT without the patient's consent?

tulipwool — Wed, 06 May 2009 11:13:41 -0800

Depression that doesn't respond to drugs - what are the guidelines on ECT for unwilling hospital patients? My mother was hospitalised a week ago for depression. It's not the first time - in fact she's been in 4 times before over the last 30 years. Every time before she continued to go downhill for weeks or months after admission while the doctors messed around with courses of antidepressants, none of which have worked. Then as a last resort each time they administered ECT, which did work. My sister and I were expecting the same to happen this time so we were surprised, but pleased, to turn up at the hospital 2 days after she went in and find out that she was not there because she had agreed to ECT, but she was back half an hour later - she refused at the last minute. A couple of days later, exactly the same thing happened. My mother is not very lucid these days and says she wants to be sectioned so they will force her to take the treatment (that happened before after one of her suicide attempts). Well, she says that some of the time. At other times she is sure the treatment will kill her. Will they be able to section her while she is still talking in sentences that mostly make sense? Or must they wait until she becomes totally unresponsive (which has been the case another time)? We were supposed to be able to see her consultant yesterday but he cancelled the meeting, and I am very worried (though I should be used to all this since it's been going on since I was a small child). She won't be able to kill herself inside the hospital, surely? Her plans at the moment include starving herself to death and smashing her head against a wall - I think the nurses would notice in either case.
Any responses from people familiar with the UK mental health system gratefully received.

ELIZA and the efficacy of "professional" therapists versus the rest of us

XMLicious — Mon, 20 Apr 2009 14:48:35 -0800

Meta-Meta-RelationshipFilter: Have there been any scientific trials to study the efficacy of talk therapy that involved a placebo as control? I'm thinking, is there any definitive proof that a professional talk therapist is substantially more effective than just talking about shit with a friend who doesn't charge a fee (which, granted, RelationshipFilter isn't necessarily like), or even substantially more effective than simply sitting someone down, telling them "we're going to have conversations that will explore and fix your psychological problems" but then having a discussion about any old thing that will run the clock out?

My own experience with years of visiting a variety of talk therapists would appear to indicate that at least with the average therapist I've seen the answer would be "No, there is no substantial difference" but I'm curious to see what if anything science has said. I'm definitely not saying that RelationshipFilter is any replacement for hours of ongoing, focused personal discussion, I'm just curious as to whether "professionalism" in this area, even of practitioners who are licensed or certified, has any demonstrated and quantifiable value.

Also, my hairy legs mean that I have "failed at being a woman."

liketitanic — Sat, 11 Apr 2009 21:19:48 -0800

How do you deal with a crazy person's total hostility? My brother is in the psych ward again, which is good, and he's getting good care, which is good.

But he's acting like a caged animal and says a lot of nasty abusive shit to me. I KNOW that he doesn't really know what he's saying and that it's not his fault. But I'm having trouble not taking his bait and not being hurt by it. Like when he says that I must really love this (being here with him) because it's easier than holding down a job. Or that I lie to him. Or that I don't keep promises to him.

How do I react to him, and how do I react in my mind? It hurts.

Should I try to convince my mother to move across the country so I can take care of her and improve our relationship?

Anonymous — Fri, 03 Apr 2009 08:51:08 -0800

Due to years of my mother’s mental illness, dependency on prescription medication, and wildly varying levels lying leading to all sort of trust issues, I am a 30-year old woman with a very complicated relationship with my aging mom. I feel more than a little guilt and sadness about this, and authentically would like to improve our relationship. There are, of course complications. I moved to the east coast about 6 years ago and am now happily engaged to a wonderful man who is from here and we have no plans to move to the west coast at any point in the near or foreseeable future. All of my family is in California, and we travel to visit them a few times a year. I do miss my family, but for the most part I feel good about my level of involvement with them as much as I can from a distance. My parents are divorced and my father has been remarried for over 10 years; my brother is a couple years older than I am. Basically, I feel like I have solid relationships with the two of them and though I’d like to see them more, I’m not worried about them in the same way that I am about my mother, because I know she is totally lacking a support system.

My mother has struggled with physical problems, mental illness, and various addictions (primarily to pain medication) for years. Our relationship is not what I would describe as close, but I do love her and care for her and it’s becoming very worrisome for me to think about what will happen to her during the course of the next few years. She does not work (she lives off of alimony and has tried over and over to be accepted for some sort of disability as well) and is constantly in and out of the hospital for her various medical ailments. She lives with her sister currently, but they have a very volatile relationship and I don’t think it’s healthy for her to remain there indefinitely. She recently inherited some money when her own parents passed away, and she has been talking about using the money to buy a mobile home to live in by herself. I do not think this is safe, and I am considering trying to talk her into moving near me.

If I lived in California, I have no doubt that I would be working harder on my relationship with her. Due to the geographic distance between us now, I speak with her occasionally, but my level of involvement in her life is limited. This is both because it is difficult for me to talk to her and hear about her problems over and over, and also because she purposely distances herself from me at times. She knows it upsets me to hear about her medical problems over and over, so when she is going through difficult times she just won’t be in touch. Several times over the past six years when I have been in California visiting family, something has come up with her health where she has said, “I don’t want you to see me like this, don’t come see me.” So, I won’t see her, and then I won’t have opportunity again for several months, and then I feel guilty, etc. etc. I do think that if we lived geographically closer, it would be a little easier to work through these issues.

I know that a lot of the issues between us are very long-standing and would not be solved simply by being closer geographically; however, on a very practical level I also just want to know that someone will be taking care of my mother as she gets older, and I don’t think anyone else is going to tackle this. She has burned a lot of bridges over the years, but now it seems that she is in a place where the addictions are gone and she truly is suffering from physical ailments and mental illness. I know I can’t fix her, but I would like to be able to spend time with her and try to improve our relationship while she’s still here.

Since I know that I will not be moving anytime soon, is it completely crazy to broach the idea of her moving here? Throwaway email is whatamamess@gmail.com

I suspect he is not actually the child of novelist Robert Parker.

liketitanic — Sun, 22 Mar 2009 06:49:29 -0800

Has my brother completely lost his mind? And if so, what do I do now? Before 9 PM today I was prepared to ask about biodiesel cars. My brother, in his mid-twenties, appears to be having a psychotic break in a distant city, and I'm not sure how to proceed. He called me yesterday and rambled for 3 hours about all manner of things in a completely crazy way--including the fact that he had located our long-missing older brother, but that Brother #2 was using a fake name, perhaps because the Feds are watching and there was a private investigator outside his house yesterday and he might actually be the son of novelist Robert Parker and perhaps he and I don't have the same father and is Brother #2 the same child our mother miscarried 27 years ago and when he tried to buy a computer at Best Buy the other day they switched them on him and and and. It went on like this for three hours. When I spoke he did not actually respond to the things I said, but continued in this vein.

My suspicion is that it is schizophrenia. He's the right age for it. It might also be a very long bender, because he also says that he has been using heroin until recently. Next week is also the anniversary of our mother's death. He says he is mad at his friends because they are telling him he's "crazy." The friends I managed to track down tell me this started about a week and a half ago--but that at the time he was mostly ranting about money and the stock market, not this insane baroque family shit. He also says he is getting on a plane to go to New York on Monday to see a girlfriend who told him it was probably not a good idea. I could not convince him otherwise.

What the fuck do I do, Metafilter? He keeps saying, unprovoked, that he's not going to hurt himself, so I think that EVEN IF the New Orleans police took me seriously they would ultimately not intervene. Who can I call? Will they even let him on a plane? Should I try to go to New Orleans? To New York? How can I help him? I'm worried sick.

Hi, I'm your big brother. Remember me?

snapped — Wed, 18 Feb 2009 18:00:32 -0800

How do I connect with a half-sister who is only six years old? Details of our estrangement and additional background inside. I am a 26-year-old married male living in Louisiana, while my grandmother, mother, and half-sister reside in Georgia. I have long struggled to remain connected to my mother since my parents split over a decade ago. My mom is mentally ill and has struggled since I was about one year old. She is, in a word, difficult. My sister is phenomenal considering the adversity she's had to deal with at such a young age.

Since Hurricane Katrina, the three of them have lived out of state, and so I've had limited contact with them except for phone calls and occasional mail. My mom tries her best to keep me updated on the three of them, but I frequently disappoint her. I promise to return calls, send photos, etc., but I am unreliable. Dealing with my mother is emotionally draining for me, mostly because I feel guilt and sympathy but know there is literally nothing I can do. She is not employed, but rather collects disability and other state and federal assistance. My grandmother is in the same situation, and so the two of them survive mostly due to government aid and the kindness of strangers such as churches and volunteer organizations.

Ella, my sister, is being raised by these two women. Her father is not known to her, and we would all like to keep it that way. She recently was blessed with a Big Sister from the Big Brothers/Big Sisters program, and has many people in her life who care for her and protect her. However, I don't consider myself one of those people. While my mother tells me she asks about me frequently, and can recognize my voice and face, she doesn't KNOW me. We haven't even seen each other since before Katrina, almost four years ago.

I desperately want to be a part of her life, even if it is a small part. My biggest barrier at this point, besides the distance, is not knowing how to connect with her. I don't know what six-year-old girls like, and I'm not keen on googling that for fear of the FBI arriving at my door. Are there books on this topic? Have any of you in the hive mind dealt with a similar situation? Are there support groups for this?

I want to connect with her on her level and let her know that I will always be available to her, despite the distance and our age difference. I don't even know if this is a concept six-year-old children understand. My wife's advice is to give it time, but I fear that not connecting and reaching out will just make the gap between us wider as she grows older. In other words, if I wait until she is fourteen, it might be too late.

I say he's crazy; therefore, he must go through an evaluation.

metalheart — Sun, 01 Feb 2009 09:37:51 -0800

Australian (and U.S.) Mental Health/Legal Filter. Can you just go and talk your GP into having someone put through a psychiatric evaluation? One of my close friends is studying medicine here in Melbourne, Australia, and in one of his various internships, a psychiatrist told him that anyone can recommend someone get a psychiatric evaluation, through their GP. In other words, if you wanted to, you could go through the process against another person, like so:

Go to your local GP. Talk to him about the person you consider to be mentally ill, and, if the GP agrees with you that this sounds like a mental illness that could cause harm to that person or those around him, that person must, by law, go through a psychiatric evaluation.

Psychiatrist telling him this or not, I call bullshit on it--at least some of it. It seems like, surely, there must be some evidence (other than words/hearsay) that a random individual has to provide for a GP to sign this off. Moreover, it would seem the GP would actually have to see said mentally ill individual, not just hear what some other person has to say about him.

If not, I can very easily imagine people doing this just to disturb someone they don't like/broke up with/fired, etc. It seems too easy: pick a mental illness, go speak with a GP, get him to agree with you, and in no time at all, the person you're saying is mentally ill has to go in for an evaluation. Talk about stressing someone out, if you're lying!

Is this true? If so, under what law? I've not been able to find it through searching. I'm looking for laws and policies, if possible, though anecdotal evidence is okay, too.

Extra Question: I know a bit about involuntary commitment and the like under U.S. law, and I know that a doctor himself can recommend involuntary commitment for one of his own patients that he deems a danger to himself or others, but is there anything similar to the above?

If these laws do exist in either or both countries, what provisions are there to protect individuals from being evaluated wrongfully? I.e., suing doctors and the like.

Can you break a lease in Massachusetts without pentaly because of a bad neighbor and unresponsive landlord?

csimpkins — Wed, 14 Jan 2009 20:20:07 -0800

My friend and his fiance have a mentally ill woman living below them who is making their lives absolute hell. They live in Massachusetts. Would there be consequences if they break their apartment's lease to leave because of her? The lady who lives in the apartment below them is schizophrenic. She routinely throws furniture around, pounds on walls, screams during the night, posts awful derogatory (and often scary) notes in common areas (pics of some are posted on my flickr, if you're interested), and stomps up and down the building's stairs while singing in the middle of the night.

It's getting worse. Neither of them are sleeping well and they don't feel safe there anymore.

They've already called the landlord regarding her behavior many times. Over the last couple months, they've called at least once a week to complain. The landlord keeps saying he wants to take steps to evict her, but other residents at the building claim he's been saying the same thing for longer than they've been living there. (Can you even evict someone because of a mental illness?)

They're six months or so into a one year lease. Can they legally break the lease and move without penalty because of the situation? If so, are there any formal steps that need to be taken to either get deposits back or protect themselves from this guy taking action on them?

We all go a little mad sometimes.

greekphilosophy — Mon, 12 Jan 2009 15:05:02 -0800

Were the mother and daughter subjects of the documentary "Grey Gardens" mentally ill? I know they're something of cult heroes to some people for being outlandish and quirky, but I was aghast at the mental condition these women were in at the filming of the documentary. And these very different reactions people have to these (staunch) characters sort of confuses me.

My therapist boyfriend suggested that Little Edie Beale had a lot of Axis II stuff going on with her lack of boundaries with her mother and her constant attention seeking behavior. It also seems that his musing on the possibility of a "folie a deux" between them is shared by others who have seen the documentary.

But I noticed some more stark qualities that were more than just personality based quirks. (And, surprisingly, I'm not talking about the raccoons living in the attic.) It appeared to me in one scene that Little Edie had a hard time with time/date orientation - and she even at one point talks about how hard it is to tell the past from the present. Her extreme anger at the discussion of the previous caretaker, Tom Logan, seemed curious and not wholly rational.

Does the more recently released follow-up documentary shed any more light on this? Were there other indications of mental instability that professionals might investigate further or use as guides for developing a diagnosis (aside from, you know, living in squalor)? IANAD, but maybe you are. And maybe this will help me form a more coherent reaction to this documentary.

Non-Spontaneous Human Combustion: How Do We Stop It From Happening to Mom?

julthumbscrew — Thu, 08 Jan 2009 14:21:15 -0800

The short version: mom's morphed into a reclusive, depressive, heavily-medicated, quasi-narcoleptic shell of a woman. She's given up on life and herself. More disturbingly, she's burned holes in hundreds of household items (carpets, floors, computer keyboards) after falling asleep while smoking. It's a recipe for tragedy(s) - fires, skull fractures, etc. We want a better life for her (or hell, any life at all, given the fire hazards). What can we do? The longer, far-more-depressing version (you might want to grab a coffee and a bottle of Paxil prior to reading):

My mom's falling apart... physically, mentally, emotionally, existentially. Her disintegration's been progressing for years. We've never attempted an intervention because we didn't know where to start. There were complications on complications (Ball of Yarn, meet Can of Worms).

We can't ignore it any more. Her life's in danger. We have to do something. But what? In order to help describe the extent of the issues, I'm going to kick it case history style. I'll describe a typical Day in the Life of Mom. Then, I'll provide some back story to help elaborate the factors which contribute(d) to the current miserable state of affairs.

The Problem(s):

She wakes up at noon, groggy and in pain. Bad pain. Where? Everywhere. Between the fuzziness and physical aches, tiny tasks take ages. By 1:00, she's managed to put on a robe, make a pot of coffee, take a pain pill and smoke the first half-dozen victims of a four pack-a-day habit. She spends some time shuffling between her heating pad and the coffee pot... flipping channels on the TV... nodding off and augmenting the carpet's array of cigarette burns. On a good day, this lasts an hour. On a bad day, it never really ends. Even on the best days, she's near-catatonic until the trifecta of coffee, cigarettes and morphine has worked its magic.

If it's a bad day, she'll go back to bed. If it's a good day, she'll putter from task to task, only sporadically finishing any of 'em. She puts on a load of laundry... then the phone rings!... she finishes her phone call, goes back to the laundry room, realizes she needs fabric softener. But the dog needs to be let out!... she lets the dog out, decides to sit down and watch some TV... but she still needs fabric softener!... but her car keys are next to the sink, and it's full of dirty dishes!... but she can't wash them, of course, until the silverware drawer is organized... oh, shoot, the dog's barking... forgot to let her in!... she lets the dog in, stops by the refrigerator to get a snack... and that nice roast is going to expire! Need to cook it! But the stove's covered in dirty dishes, too! Better organize the cupboards.

It's an unrelenting ADDeath shuffle, fueled by copious quantities of coffee, cigarettes and morphine. Not to feel good, mind you... to suppress the myriad of inexplicable aches and pains which would otherwise debilitate her.

At 5 PM, my father gets home from work. She says she's exhausted, that she's "been running all day!". She didn't even have time to shower! My father - an engineer of the "gentle robot" type - doesn't particularly care that the house is a crap hole, that dinner hasn't been made, that the carpet's a mass of charred polyester. He does the chores she requests. He fetches take-out. He calls in sick when she's too pained to get out of bed. He's supportive in all the ways she requires... and none of the ways she really needs.

Robo-Dad goes to bed at nine on the dot. Mom's day has barely begun. She can't go to bed! The house is a wreck! No one else is going to clean it! So begins the nightly suburban stations of the cross. She shuffles from room to room, chipping away at chores, trying (and failing) to fight fatigue. Falling asleep sitting in chairs (with her head pitched forward at a sickening, painful angle). Falling asleep at the kitchen table. Falling asleep on the toilet, falling off, hurting herself. Falling asleep standing up. Dropping cigarettes and burning holes in every surface imaginable. Eating sweets. Watching five-minute segments of movies ten times in a row because she keeps nodding off. Growing increasingly foggy, confused and incoherent.

Sometime before dawn, the inevitable wins and she passes out for an hour or two... sometimes in bed, sometimes on the couch, often while slumped over in a chair. She rarely sleeps for more than two or three hours before waking. When she wakes, she cannot/will not go back to sleep without taking another whack at the whole "shuffle around house, burn holes in shit" routine (she claims that sleeping for more than four hours at a time "messes up" her back). After two or three shuffle-interrupted blocks of sleep... surprise! It's noon again... rinse, repeat.

It's no way to live. Yet she has been, for years. And now her daily hours of lucidity have begun to wane. We're sad and scared.

What We Want, Ideal-World Version:

- We want her to stop endangering her life and those of her family.
- We want to help her address the sleep issues which are so detrimental to her life.
- Ditto the depression issues.
- We want a better life for her than the one she's living. She deserves it.

The Background Info:

- Let's set a few things straight. She's a wonderful woman. She's damned intelligent, hilariously funny, incredibly supportive, one of the few genuinely moral people I've ever met. My entire concept of ethics and decency comes from her. Hell, the bulk of that which is good in me comes from her. Hence my desire to sift through this clusterfuck and help her.

- She's in her early 60s. She's suffered from clinical depression for over fifty years. It's ebbed and flowed. SSRIs currently keep it from spiraling out of control (though they don't make it much better). She's also had intractable feelings of worthlessness and failure - they've always been there, and always been incredibly painful and shameful. She was bright enough to have gone to medical school... instead, she became a secretary, then a homemaker. Wasn't encouraged by her parents.. wasn't encouraged by Robo-Dad... wasn't confident in herself. As such, she never achieved... well, much of anything, by outside standards. She's lived a good and decent life... but it's done nothing for her ego.

- My siblings and I are grown. Two of us have moved out. The youngest, Former Junkie Sister (now Suboxone Sistah), lives at home, works part-time, has little direction, spends a lot of time fighting with mom. Due to Former Junkie Sister's issues (as well as those of her other children), mom believes herself to have been a huge failure as a parent.

- Per my father, mom's always had issues with insomnia/resultant narcolepsy.

- For the past 15 years, she's experienced a series of inexplicable, increasingly-severe physical complaints. She's been pegged with fibromyalgia, osteoarthritis, you name it. Nothing's quite fit. Factitious? No. Psychosomatic? Quite possibly, at least in part. Her "treatment" has been limited to morphine sulfate, dispensed by a kindly but clueless local physician. The morphine suppresses enough pain for her to be mobile. Due to increasing tolerance, she's worked her way up to 8 to 12 60mg tablets per day (enough to euthanize a lesser mortal). Due to bad experiences with several specialists ("chronic nonspecific pain" = problematic patient), she's reluctant/unwilling to pursue other treatment options.

The physical ailments and their ensuing limitations were a nuisance... then a problem... then, once her kids were grown, the defining feature of her life. She has no real hobbies, few friends, no goals or ambitions. She doesn't feel she's worthy of these things. After all (in her mind), she's stupid, worthless and, above all, sick.

- Any suggestions regarding her problems are met with denial, incredulity and/or anger. Usually anger. "You kids have no idea what it's like"... "I have a pretty good life, most of the time"... "It seems like you're all turning on me"... etc.

- Aging has made her increasingly depressed/despondent about the course her life has taken. Hopelessness and helplessness are the themes of the day, "it's too late for me" a common refrain.

The Request: what do we do? We have no idea where to start. Psychiatrist? Life coach? Sleep clinic? Family doc? Any course of action has to be pursued very, very carefully; if she thinks we're betraying her, she'll be devastated. We want to help... not destroy.

Any suggestions, stories opinions and errata would be greatly appreciated. We're feeling clueless and desperate over here.

I used to be crazy, now career me up!

xchmp — Thu, 18 Sep 2008 16:34:11 -0800

My many bad decisions about education and work that have left me in dead-end jobs. What's the career of my dreams? And how do I get it? But first, some quick background on how I got here. I have bipolar disorder which is now treated to the point where I have essentially no symptoms. My years of mental illness led to lots of bad decisions with education and careers (and lots of other things, too). I went to a third-rate university, got a degree in international relations and have worked in call-centres since. About two years ago, my years of non-treatment caught up with me and have been off-work since. Since I'm now well, I'll be going back to work in the near future (my last call-centre job's still open for me), but I'm finally in a position to start making long-term plans.

I also have a severe circadian rhythm sleep disorder. I'm seeing a neurologist about this. My sleep patterns are very disorganised and I suspect that even after treatment I'll find it difficult to keep to a fixed schedule.

I asked a more general question about this a couple of months ago and got some good advice. This question's rather more specific: What career options should I be looking at and how do I get there? All the career advice I've seen has been aimed at people who are making these decisions for the first time, or people who are switching from an established career. I'm switching from no career, which makes things a little more complicated.

My current situation:

Awful employment history. No experience in anything other than answering phones. 2:1 degree in international relations from a poorly rated university. I enjoy programming, but have no qualifications; I'm reasonably competent, but probably not at a professional level. I like solving problems, working under pressure and rather enjoy dealing with crises. I'd prefer to deal with people rather than technology. I'm think I'm academically able enough that I should be able to complete any course of study fairly easily, however if I do a second degree I'll have to fund it myself. I'm 26 and live in England.

What I want:

I have nothing specific in mind at the moment. But I've lived on very little money for years and I want to end up financially comfortable. I want to be able to catch up with people who've a few years' head-start; it would need to allow a reasonably flexible schedule from the beginning; and obviously it needs to be something where my history of mental illness won't necessarily hold me back. I'm willing to put in plenty of time and effort, though.

So, AskMe, what career or professions should I be considering and what will I need to do to qualify myself for them?

I'm cured! Now what?

xchmp — Tue, 29 Jul 2008 16:36:28 -0800

I've spent the last fifteen years suffering from bipolar disorder (bipolar II with the emphasis on depression) and a sleep disorder. Four months ago I switched to a medication that turns out to be perfect for me. I feel normal. Assuming this continues, my mood disorder is essentially cured. Fifteen years of mental illness have really screwed up my life. How do I get it back? I'm a 26 year old guy living in the UK. As a child I was academically gifted, but depression got in the way of qualifications. I eventually went to university - though not a good one - and graduated with a 2:1 in politics. Although I have no formal qualifications I'm reasonably good at computer-related stuff.

Since then I've worked in call-centres. Depending on the amount of effort I put into waking up, I either lose jobs from being hours late or feel terrible through lack of sleep. I went kind of crazy after a year of averaging 3 hours of sleep a night. For the last year and a half I've been off work. The sleep problem is not insomnia. I can get enough sleep if I can sleep whenever I need to. I can't maintain a fixed sleep schedule. This may mean that I'll be unable to work full time.

Although there have been a couple of casual things, my last relationship was the only serious one I've had and she was rather unstable herself. We broke up two years ago. My social circle is generally very narrow, although I have at least one good friend locally and a number of people from university who I see now and again.

I have very obvious self-harm scars, which I'm fairly comfortable with. I suspect other people may not be. This could contemplate employment (I'm not planning to go to interviews wearing short sleeves, but neither am I prepared never to wear short sleeves around colleagues). Also, I suspect they're something that will make people rule me out as someone they'd consider dating.

Other stuff, I'm in therapy (although this will end soon as it's provided by the NHS). I'm volunteering at a charity and currently working on an IT-related project for them.

So what do I want? I want a life. In fact, I want the life I thought I was going to get back before I became ill. Qualifications, a job that isn't in a call-centre, friends, relationships. But I don't know how to get there from here. How do I decide what to do with my life? How do I make up for all the social skills I've missed out on? In short, how do I make up for fifteen wasted years?

Can you hear voices without being ill?

Anonymous — Mon, 28 Jul 2008 07:39:39 -0800

I'm looking for scientific information on whether a person who is not suffering from mental illness can experience ongoing, coherent auditory hallucinations, specifically voices. I'm trying to help a friend who is suffering from mental illness but refuses to get medical help. She claims that she hears voices but says that she is not ill. According to her, the voices are coherent and she can have conversations with them. She understands that hearing voices can be a symptom of mental illness but claims that if she was mentally ill enough to be hearing voices, she would be acting crazy in other aspects of her life, and she isn't. Therefore the voices are not an illness but are spirits.

Is she right about this? If you are talking to voices in your head because of mental illness, can you keep everything else together? How unwell must you be before you can have a conversation with the voices?

Peer-reviewed publications in scientific journals would be ideal. I'm not sure if a logical, reasoned discussion about this will work, but I'd like to try it. Even if my friend rejects good evidence that hearing voices is a sign of illness, that will tell me a lot about her attitude to getting help. Thanks.