Help me understand what's happening to my cousin
June 27, 2017 7:27 PM   Subscribe

My cousin has recently made a few semi attempts at suicide (he stopped himself each time and called 911). He's just been committed again. This has all been so sudden and my family is reeling trying understand what is happening. To complicate feelings, we're all still grieving my brother's OD about a year and a half ago.

This is my younger cousin by about 8 years. He's early 20s. I watched him grow up and he's like a little brother to me. He's been an anxious kid since as long as I can remember but it's always been something he's been able to cope with, and he has been on medication and in therapy in the past.

A month ago he finished an incredibly busy school year. He seemed very much to be enjoying himself from my how he spoke of things year (he had a rough first year). He has a girlfriend and they seem to have a wonderful relationship. Everything seemed to be going well for him.

Since he's been home he's been experiencing increasingly severe anxiety and obsessive thoughts about his health. Over the course of just two weeks he has begun to fear for his life. He's been saying he thinks he's too far gone and his personality will never come back. He's told family and friends he loves them and he's sorry he didn't take better care of himself. A few times he's put a belt around his neck and choked himself almost to unconsciousness before coming to his senses and dialing 911.

The first time they put him on medication and he seemed to be improving. He went from practically catatonic (he would stare into the distance and mumble very basic replies with no affect) to back to his old self, cracking jokes and smiling with just a tinge of an anxious edge. They released him.

Within days he was back into this anxious mess, back to thinking he was dying because all he could feel was pain. He couldn't shower or shave, hated being in a car or hearing loud noises or seeing bright lights because he says it all physically pains him. He just wanted to be held at all times. He attempted again and called 911 so he's in a different hospital now.

Shortly before my brother died he confided in me that he heard voices that told him to do things. I never would have guessed. He said he'd heard them for much of his life but never told anyone before me. So now I'm worried that schizophrenia runs in the family and it's just now showing in my cousin (who doesn't drink or do drugs so he wouldn't be able to suppress these thoughts and feelings like my brother attempted to). There's a long line of depression, anxiety and addiction in my family.

I'm so scared of losing another family member. The past several years have just been loss after loss. Two good friends (one car accident, one cancer) and my brother have passed. I am trying to be the calm, reassuring person to everyone, saying that this will all be taken care of. They just need to find the right medication to stabilize him and he'll be better in time. But inside I'm quietly freaking the fuck out because if I lose someone else I'm afraid I'll lose all the progress I've made putting my life back together after my brother's death.

Aside from keep seeing my therapist, what can I do to not fall apart? And is what is happening to my cousin sound like anything that anyone has experienced or known someone who has? Thank you.
posted by blackzinfandel to Health & Fitness (11 answers total) 1 user marked this as a favorite
This reminded me of my schizophrenic family member's descent into the onset of full blown schizophrenia around age 18-19. Sorry I can't help more but it sounds similar.
posted by jitterbug perfume at 7:52 PM on June 27, 2017 [6 favorites]

Ditto. This mirrors a close friend's diagnosis of schizophrenia at 22. Early 20s is the typical age of onset. I would consider a local support group for families of people with mental illnesses. NAMI should be able to refer you.
posted by DarlingBri at 7:56 PM on June 27, 2017 [4 favorites]

I have experience with this not only with family. I have severe depression and probably would have attempted suicide by now if not for the knowledge if would end my parents life. Last week my best friend was commited for suicidal thoughts and plans and I was never so scared that he would do it despite being as close as brothers for 17 years. So I know what you are going through for the most part.

The first thing to do is to make sure your cousin has someone to be around after he is discharged. It is a really, really good sign that he has always stopped and called 911. He likely knows the effect it would have on loved ones. But whether he has a GF, wife, or anyone he lives with, they need to be up to speed with what is going on. I had to call my friend's fiance and let her know the details because I was the only one he sent the suicide note to, so don't assume that even those close to him fully understand.

This may be a lifelong struggle for him (and yourself). There is a lot of hope for improvement, but make sure your expectations are grounded. No amount of hospitalization will cure him. Depression is a lifelong condition as you probably know, especially this level of severity.

What can you do? Know that you could not have done anything to prevent or mitigate this. Know that whatever happens, it is not your fault. This doesn't make it easier. The best thing you can do is to make sure you take care of yourself and keep up with therapy etc. Group therapy targeted toward this is also available. Remember that you can't really help anyone no matter how good your intentions unless you take care of yourself first. Even though it sounds callous, your health is the number 1 priority followed by his.
posted by WhitenoisE at 7:56 PM on June 27, 2017 [4 favorites]

I think you need to immediately tell his parents, your parents and his doctor about your brother. Schizophrenia and anxiety/ depression are quite difference and it'll help them to know what they're up against.
posted by fshgrl at 8:10 PM on June 27, 2017 [13 favorites]

IANAD, but this sounds like a schizophrenia diagnosis waiting to happen. Others have mentioned, but let me briefly add my experience:

If it is, do not be alarmed. With treatment and support, it's reasonably treatable. The Best Man at my wedding, and one of my best friends, was diagnosed at 20 after a suicide attempt. He was a very bright and handsome engineering student, and then.... weirdness prevailed. It was scary for quite some time. He completed college and is married with kids and a steady job. He's doing alright. There is much more, but the details don't matter, here.

He's still a bit loopy, but, he's a good husband and dad. He had a good support network, and lots of help and such. Try to provide that for your kin. There's such a bullshit stigma - and the treatments can be pretty effective, but do come with severe side effects. But, he's not evil or stupid. Just mis-wired.

I'm gonna go call my friend. It's been a few weeks, somehow
posted by Pogo_Fuzzybutt at 9:23 PM on June 27, 2017 [13 favorites]

Suicide ideation is a strange beast in a lot of ways, and frankly a very simple one in others. For one thing, things can be going well, a person can be happy, they can have every external thing in the world to live for from an outside POV, but horrible tormenting pain - whether physical, neurological, or as a result of crushing anxiety - can't always be wiped away by a nice girlfriend and a promising future. If you fell down an elevator shaft and broke a lot of bones and had little reason to believe that anyone was going to come along and find you before you bled to death in unresolvable pain, wouldn't you consider your options?

If you've never had a thought or a pain torment you constantly so that you can't sleep or eat or have the air conditioner blow on you, you may not understand desperation. You never hear anyone say, "falling down that elevator shaft was so sudden, I don't understand, he got such good grades!"

And then, on the other side of the coin, that ideation can happen in a second. "Time to go move the laundry to the dryer...or don't and just end it now." It can appear as an intrusive thought, like the urge to run down a long hallway, like suddenly worrying you left the iron on at home. All it takes is one bad moment. It takes a lot of strength and clarity to stop yourself once it starts.

Respect his burden even if you don't understand what to him has been, at moments, a logical-seeming course of action.

And for your own sanity, you have to question your narratives. This is likely far from sudden, this is not surprising when the medication works for a minute and then doesn't, this isn't a rude choice someone makes and it can't be warded off by a nice life, and it appears that something very similar killed your brother - even if your cousin doesn't drink and do drugs at the moment or to your knowledge - so if you have not disclosed everything you know about that, you do have a responsibility to now.

Convincing yourself of all the things that people convince themselves of in the face of a loved one's mental illness will hurt you worse in the end than embracing the unpleasant reality of actually living with one. You do need to put your own mask on first, and you do need assistance to make sure this doesn't get too entangled with your grief over your brother. You doing that or not doing that will made no difference to your cousin's outcome, but you will be more available for support to everyone involved if you are being supported yourself.
posted by Lyn Never at 9:24 PM on June 27, 2017 [10 favorites]

Where does he live? By himself? I'd spend time with him. It does sound like he has schizophrenia. My cousin was diagnosed with it at 18, following a similar onset of symptoms and a scary confrontation with her college's campus security. She's fine now. It's sort of funny but she became extremely religious with the onset of symptoms - she's completed an advanced degree in religion and now has a totally stable professional job. More content than most people I know. The turning point for her was finding a psychiatrist she really bonded with and looked up to. Buck up, history doesn't always repeat itself. You're intelligent to have figured this out, none of us had any idea what was happening. This is an acute crisis but your cousin will likely be fine. I would not leave him alone though. It might be better not to do that, and even to bring him along to things to do that are light hearted if anyone in your family can take on that responsibility. Children (supervised) and animals can be very comforting to people in this type of distress.
posted by benadryl at 10:36 PM on June 27, 2017 [1 favorite]

Plenty of great advice here. You may want to find a local training on Mental Health First Aid so you can approach his situation with a little more awareness.

The Center Cannot Hold is a memoir of a successful person with schizophrenia - there are others, too, if bibliotherapy helps with stabilizing your own center - check that approach with your therapist though as any memoir in this category is full of struggle.

Best wishes on your journey, I had a Year of Death with lots of grieving and got picky about reading. I read Year of Wonders about the plague and felt less alone, and found the Death Sex and Money podcast to be a comfort given its grounding in intellectual curiosity. YMMV, best wishes .
posted by childofTethys at 4:17 AM on June 28, 2017 [2 favorites]

It's common for schizophrenia have onset in early 20's. Agree with the posters above.
posted by Riverine at 7:45 AM on June 28, 2017

Good advice from all. But I would not be so quick to jump to a schizophrenia diagnosis. Symptoms like these can be signs of schizophrenia, bipolar disorder, atypical psychosis, major depression with psychotic features, and I'm sure other illnesses. Please encourage your cousin's treatment, compliance, and working with doctors to get the correct diagnosis and the meds that work best for him. It is quite possible for people with any of the diagnoses above to live happy and productive lives with the correct treatment and support. I have major depressive and generalized anxiety disorders along with ADHD and PTSD and I have had psychotic episodes (though relatively brief, mild, and not dangerous). I'm doing pretty well considering. And you are on the right track with wanting to be supportive. I wish my own family had not been in denial about my illnesses for so long.
posted by Beethoven's Sith at 8:37 AM on June 28, 2017 [3 favorites]

I did tell my aunt about my brother's hearing voices. The doctors don't think it's schizophrenia at this point. It's good to hear that it can be very manageable, though, so thanks to those who shared stories.

Of course I would never make my cousin feel like he didn't have a "reason" to be experiencing anxiety and depression. That was actually something he felt guilty about, that he should be grateful for everything he has, and I reassured him that mental illness is often out of our control and that everyone's problems are relative. I've dealt with depression, suicidal ideation and anxiety off and on for most of my life. This question was written sort of like a stream of consciousness at a vulnerable moment. These concerns are my own fears and anxieties and not ones I would burden with my cousin or my family in the midst of all this.

Thank you again.
posted by blackzinfandel at 3:51 PM on June 28, 2017

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