How did we end up here?

March 9, 2011 7:31 AM

I live with a couple, A and C, to whom I am very close. We all have mental health problems, and try to support each other. Mostly, this works OK. Lately, it doesn't seem to be enough and it's getting a bit overwhelming. Our living environment is horrible and dirty; C can't keep track of all the pills she has to take through the day and keeps skipping them; A consistently forgets his doctor's appointments, forgets what he was going to discuss during his doctor's appointments, forgets to refill his prescriptions, forgets he hasn't told us that his prescription has run out, and also doesn't make appointments he needs because he's worried that his work will respond badly to all the time he has to take off. It seems like everyone's tired all the time. Halp.

We live in the UK. We all work full-time. Everybody has depression! C also has GAD and has had periods of anorexia. Everyone's gettting psychotherapy, A and I on the NHS and C privately. I'm on one antidepressant; C is on one antidepressant, one anti-anxiety thing she has to take several times a day, and the pill; A takes two antidepressants and also Lithium. It's really important that he have regular blood tests of his Lithium levels, but he often forgets to do so or puts it off because he doesn't want to take time off work. He's just spent two weeks without one of the antidepressants because he couldn't manage to get the prescription filled and then forgot he hadn't told either of us that this was happening. He also has terrible headaches and nightmares, but can't face talking to a doctor about them because he 'has enough problems'. C is woken several times a night by him talking anxious nonsense, and she has to calm him down.

It seemed that we were doing OK until we were burgled over Christmas, but that shook people up somewhat and since then things have gone a bit pear-shaped. Nobody had done any washing-up in three weeks until I set to it a bit yesterday. The sofa and chairs in the living room are covered in clean laundry that hasn't been put away.

I am trying to keep on top of this, but I've been struggling myself lately and I don't really know where to begin. I'm really worried that A is going to mess things up with the Lithium and suffer serious harm. I'm also worried that C has been skipping meals lately.

Are there any resources we could access that we're not? Any approaches that might be good? Any angles I'm not seeing? I'd really appreciate some advice; I feel like I'm floundering here.

posted by anonymous to Human Relations (22 answers total)

I am a little concerned by how unconcerned you seem to be about how you are faring in all this...
posted by vivid postcard at 7:39 AM on March 9, 2011 [6 favorites]

A and C are adults and need to take care of their own medical problems. This is not your responsibility. It may be time for you to move out. What do you need from your living situation? If you need something clean and stable, but living with A and C prevents that from happening, move.
posted by crazycanuck at 7:49 AM on March 9, 2011 [14 favorites]

You need to take care of yourself first. It's nice to feel like helping A and C, but they really need a professional (as in a doctor) to provide the help they need.

You, also, need a professional to help you if you are also suffering from mental issues. A cluster of co-dependent roommates isn't doing anyone a favor. Move out, and seek professional help.
posted by Rosie M. Banks at 7:55 AM on March 9, 2011 [2 favorites]

Wow. It sounds like the blind leading the blind, around and around in circles until you're in a deep rut.

I'm with crazycanuck, you need to worry about you. These people are your friends and I totally understand the instinct to want to help them. Honestly though, you can't do anyone any good until you get your own stuff figured out. Somebody has to climb out of the rut before they can give anyone else a hand up.

It's my opinion that you need to get out of this relationship. Having a support group who understand what you're going through can be a great thing. Unfortunately you all are just enabling each other.
posted by TooFewShoes at 8:01 AM on March 9, 2011 [2 favorites]

This is the kind of situation a cpn is ideally placed to help with. They get to see living situations as well as medical problems, and they are versed enough in what's available to you to know who to prod, and they'll advocate for you if you need a referral or are too ill to handle something. Your GP can refer you for one if they feel its appropriate for you. Your GP should probably be told about how you're currently struggling anyway, because that is a medical issue important for your well-being.
posted by talitha_kumi at 8:07 AM on March 9, 2011

Do not, I repeat, do not ever get entangled with someone who cannot or will not comply with his or her medical treatment regimen. It's not your responsibility, and you will only get dragged down with them.

Move out. Refer your roommates to the British equivalent of social services. This will ensure that your life stays stable.
posted by deanc at 8:16 AM on March 9, 2011 [4 favorites]

You are a good friend for being concerned about this. However, I'm with crazycanuck and the others that this is not your problem, nor is it something you can solve yourself. You need to take care of yourself. I know a couple who both have major issues with depression. They have been living together for a few years and they feed off each other. They live in what I can only describe as total squalor and have both burned many bridges because when one decides to stop showing up for work or school for a month, the other follows suit. Their behavior has only worsened over time. I urge you to consider removing yourself from this situation and seek help for your own issues.
posted by futureisunwritten at 8:28 AM on March 9, 2011

OP here. I signed up for a sockpuppet account, because I think most of you are missing the mark quite a lot with your advice.

These people are my family. There's a lot more to our relationship than just this. They're the ones who make sure I'm OK when I can't, and not in an 'enabling' way, but in a genuinely helpful one. They're good for me, and I want to be good for them too. I don't think we're dragging each other down at the moment - we're helping each other (yesterday C and I sat down and put everyone's appointments into a shared calendar so that they don't get forgotten, together with reminders to refill her daily pillbox and make more appointments), it's just that we can't seem to help each other quite enough at the moment. People in this thread have done a lot of handwaving about 'professional help' and 'social services', but we're all getting a lot of professional help already, and as far as I'm aware you can't just call social services and say that your friends haven't put their laundry away.

The CPN suggestion is one I'll be researching, especially for A as I'm not sure he is getting the co-ordinated care he needs at the moment. I've got the impression, though, that it's quite difficult to get access to that kind of help when you're employed, even though it's sometimes just a case of not having enough energy after working a full day to do any of the other things that need doing.
posted by La chaussette, c'est moi at 8:54 AM on March 9, 2011

If you're all working full time, do you have the cash to hire a housekeeper or cleaner to come in once or twice a week and do your washing up and laundry and things? Taking that pressure off might help you all devote some more energy to getting your health issues under control.

Also, do you have other friends? Maybe spending some time with people who aren't on the verge of a mental health tailspin would be a good break for you. Honestly, this situation sounds sort of unhealthy to me, but if you're unwilling to "break up" with them, maybe you could take a break and disengage a little?
posted by MadamM at 9:00 AM on March 9, 2011 [2 favorites]

I'm sorry things are so crazy and that you are having such a rough time. I agree with the above posters that you need to take care of yourself, but I thought of a couple organizational things you could try.

1. Consider getting everyone one of those plastic days-of-the-week pill containers and have a little ceremony on Sundays to fill them. You could even keep them out somewhere where everyone can see them and help remind each other to take their daily doses. (This will only work if folks are truly forgetful and not avoiding the pills on purpose).

2. A poster board or wipe board or large calender for tracking regular monthly appointments/tests, etc. You might choose two days during the month to "check refill needs".

As for the cleaning issues, a clean(er) kitchen is important because of germs/bugs, but maybe worry less about clean clothes on the furniture. I'm sure it's frustrating, but at least they're clean. Don't try to do everything at once. Good luck and I hope things get better.
posted by Glinn at 9:12 AM on March 9, 2011 [1 favorite]

Regular "house meetings" might be helpful - say, a weekly sitdown to go over everyone's schedule and needs, assign chores, maybe plan meals together.
posted by shiny blue object at 9:16 AM on March 9, 2011

Mod note: comment removed - OP you're welcome to update the thread, but please do not turn this thread into an argument, feel free to ingore advice that is not helpful.
posted by jessamyn (staff) at 9:24 AM on March 9, 2011

You cannot make somebody do something they don't want to do. This applies to many situations in life, regardless of personal relationships and mental health issues. Sounds like you and C are doing okay, but A really needs more help. I have no solution for how to make someone realize they need more help. I wish I did.

Anyway, moving on. The shared calendar is a great idea. I'm also big fan of making lists of small tasks. That way, instead of being faced with "Cleaning the entire house," I can settle for "Cleaning the broom closet" and still have some feeling that I'm getting things done. I also found that it helped a lot to pare down my clothes and dishes, to pack away or get rid of excess stuff. In my house, less stuff to clean = less crazy.
posted by futureisunwritten at 9:29 AM on March 9, 2011

Since you all three seem to be working, is it financially possible to hire an aide? Someone who comes in for a couple hours once or twice a week and does meds, housekeeping, etc.? If you had someone to manage the cleaning and putting away, and to lay out the meds for everyone that needs it, maybe it would allow those of you who are better functioning to focus on making sure the medications get taken on the appropriate schedule, people get to the doctors as needed, etc.
posted by crankylex at 9:32 AM on March 9, 2011

A cleaner seems like a near-unambiguous good-way-to-go here - if you're three employed adults living in a shared place, this ought to be within the realm of financial possibility, and it'd be a huge weight off all your minds. With cleaning and etc out of the way, you can devote your "right lets get this sorted" ideas purely to administrative stuff, rather than doing the dishes or laundry or whatnot.
posted by piato at 9:34 AM on March 9, 2011

These people are my family. There's a lot more to our relationship than just this.

Nevertheless, my advice still applies regarding people, except minor children under your care, who cannot or will not follow their treatment regimen.

Housecleaners and aides are all good advice. But you need to start with the assumption that A is going to mess things up with the lithium and that C is going to relapse back into anorexia and figure out how, given those situations, you are going to keep yourself afloat.
posted by deanc at 9:42 AM on March 9, 2011 [4 favorites]

The CPN suggestion is one I'll be researching, especially for A as I'm not sure he is getting the co-ordinated care he needs at the moment. I've got the impression, though, that it's quite difficult to get access to that kind of help when you're employed, even though it's sometimes just a case of not having enough energy after working a full day to do any of the other things that need doing.

I actually meant that comment for you, OP. But one for A as well sounds a good idea. :)

Whether access to them is rationed or not depends on the resources available in your local area. Mental health is chronically underfunded in the NHS, and often services get rationed that really, really shouldn't be, because there isn't enough to go around so they get reserved only for severe cases. But there is nothing in the rules that restricts cpns to only non-working patients. Six years ago I was in a nasty mental health tailspin, and I spent some time as an inpatient whilst holding down a full-time job. (I worked until the day before I went onto the ward, and after three months enforced sick leave I went back to work) About half the professionals I encountered from there on were amazed that I didn't already have a cpn.

I know that can often be difficult to ask for things that you want, because the possibility of rejection is frightening. (Or at least, it is for me. Maybe you're braver than I am) But as my mother used to say, "those who don't ask, don't get." The worst possible thing the GP could do is say that he/she doesn't think it's a good idea. But you'll never know if you don't ask.
posted by talitha_kumi at 10:13 AM on March 9, 2011

Can you get the pills blister packaged from the pharmacy? Here in Canada you can get "compliance packs" which have each dose in a separate compartment marked by time/day and its awsome to be able to see whats been taken/forgetten and it provides a visual reminder when they're going to run out.

As to the lithium there is a therapudic range that it needs to be in your blood, too little and there is no effect but too much and it can become a big problem, perhaps you can all learn the side effects of lithium toxicity. I know once you get to a stable dose the blood tests are less frequent.

Take care of yourself!
posted by SpaceWarp13 at 11:35 AM on March 9, 2011

OK, this is reminding me that we had a conversation about getting at least a cleaner in about a month ago, and that at the time we all thought it might be a good idea. I'll think, too, about whether there is other outside help we could get in in some capacity or other, and I'll discuss it with my friends. We're definitely going to initiate a Sunday fill-the-pill-box + check-who-needs-their-prescription-renewed thing, and also possibly look into whether we can get the Boots repeat prescription service through our surgery.

I just want to thank everyone who answered here, even those whose advice I didn't agree with. I know I got a bit stressed upthread, but I really do appreciate the concern and well-wishing sent my way. It's also, in a funny way, given me the chance to reflect on what a positive thing it is for me to have people that I love in my life, whatever sorrows that might bring along with it. I have actually been trying quite hard to take care of myself lately, by exercising and meditating and trying to get early nights. With that last objective in mind, I'm going to sign off here. But really, thank you all.
posted by La chaussette, c'est moi at 2:36 PM on March 9, 2011

stoneweaver: It's pretty obvious that the three of you need an outside person to provide at least temporary help in your home to get everything back on the rails. I briefly lived with a couple that had hired someone to come in once a week for two hours and do things like open and sort mail, make routine phone calls, make sure that appointments for the upcoming week were discussed and scheduled, etc. She was not a mental health professional, more like a secretarial service. It relieved a lot of anxiety and panic in the house for her to be helping out this way.

This. This this this. The two people who have been most helpful to me at different times are an assistant like this who performed all these functions, and the world's nicest, bossiest housekeeper. It is tremendously useful to have someone not only to organise you, but to organise yourself around on a weekly basis. Knowing that the person is coming each Sunday means you put away the laundry on Friday, check pills on Saturday, and at least find the mail on Sunday morning even if you don't want to open it.

Not only do things improve, but it also helps to minimise slippage.
posted by DarlingBri at 2:57 PM on March 9, 2011

two suggestions that overlap a little with some of the other suggestions.

1. Your local pharmacist (in my case, Boots) most likely provides a free prescription collection service, whereby your prescription comes to them from your GP and they handle the paperwork and legwork.

They can also put your medication into blister packs (aka a 'dossette box'). They might also provide a home delivery service (mine does).

Also (forgive me if this isn't relevant), if you pay for your prescriptions, the best way to minimise your overall cost is to use a prepayment certificate, a bit like paying your TV licence in installments.

Obviously, this cannot ensure that you take your daily medication, but it will make it easier to stay on track.

2. Use something like Google calendar to send yourself an SMS reminder to take your medication, or programme your mobile phone with suitable alarms. (I have one that goes off mid-morning which basically says 'If you haven't taken your morning meds yet, please do so now' -- if I've already taken them, then I feel a sense of accomplishment that I'm 'ahead' of myself; if I haven't taken them, I try do so as soon as I switch off the alarm.)
posted by davemack at 4:56 PM on March 9, 2011

Any angles I'm not seeing?

You are close to A and C but you have to kinda detach yourself at the same time. They are adults and need to help improve the current situation. Unless all three of you are at the same page how to change things, assuming all three of you agree things need to be changed, it going to be a massive task for you alone.
posted by xm at 4:50 PM on March 10, 2011