Brother's Mental Illness Concerns

Forums: Relationships, Family, Anxiety, Mental Health, Depression
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I got back in touch with my brother (by phone only so far) after a considerable length of time, and it turns out AFAICT that he has some serious mental problems I was not previously aware of.

He mentioned on the phone he is suffering from "depression and anxiety" plus he is now phoning me upwards of four or five times per day. Also he seems incapable of remembering what he said the last time we talked, let alone what he said five minutes ago.

I am not an expert in mental illness by any means, nor have I yet talked to his wife (soon to be divorced as I understand it) nor is my sister forthcoming as to his condition (for reasons that escape me even though she encouraged me to contact him).

In any case, I am not realty sure how I can help him given that his mental faculties seem to be failing, plus from what I can guess of his speech patterns and monotone voice, he is on some sort of meds.

I get the impression (unconfirmed at this point) that he wants to sell his house and/or find a roommate, that his marriage will end, and that he needs someone with normal cognition to act in a guiding capacity.

From what I can tell he is still employed and finances are not a concern, but I could be wrong on these points.

He is almost 60 years old, and the bottom line is that I could get drawn into a set of responsibilities I have neither the inclination nor skill-set to see through adequately.

I live 1 hour away, and AFAICT there is no one else that would have his best interests in mind living anywhere nearby, thus near enough to be of assistance, but I am not fully sure on this point.

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Type: Question • Score: 7 • Views: 2,611 • Replies: 30

@Chumly,

The most important comment I saw here, Chumly, was:

Quote:

He is almost 60 years old, and the bottom line is that I could get drawn into a set of responsibilities I have neither the inclination nor skill-set to see through adequately.

Do whatever you deem reasonable with that thought as paramount...which, of course, might mean...do nothing except gracefully decline to do anything.

Family is a hard thing to ignore...and if you feel you can get past that stuff...perhaps you can help him to apply for public assistance (to obtain proper mental health care). But any move you make draws you closer to actually getting involved in something you seem to have little stomach for.

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@Frank Apisa,

Yes Frank, well said, I have had to help other imbalanced / suicidal / hospitalized family members and it's the antithesis of a walk in the park.

One consideration I did not mention was that we live in Canada and support services for these types of things is on average considerably better / different / more readily available than in the US (again AFAICT).

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@Chumly,

It may not be mental illness, it could be physical. There is a disorder causing excess fluid to collect around the brain and it mimics dementia/Alzheimer's. People afflicted tend to walk with a shuffling gait and exhibit most of the symptoms of dementia, untreated it can lead to death. It can be treated by inserting a shunt to drain the fluid harmlessly into the body and folks completely recover.
I understand you may not be able to personally care for your brother, but maybe there is an organization near his home who can advocate for him. If he does have dementia or a mental illness, it would frighten me entrusting his care to just anybody who would move in and eventually have complete control over his health care. Does he have any children who might step up? I'm not suggesting that you should do it, but perhaps you can get the proper authorities to supervise his welfare.

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@glitterbag,

I do not know anywhere near enough at this stage to provide an assessment in terms of his condition, however his wife is a nurse and I speculate it's very unlikely that his condition is predicated on hydrocephalus or the like.

However the questions at hand go first to how much involvement I may wish and only then to what the best course of action might be for both myself and my brother (assuming any common course of action at all).

As to your question about children, I already posted: "I live 1 hour away, and AFAICT there is no one else that would have his best interests in mind living anywhere nearby, thus near enough to be of assistance, but I am not fully sure on this point."

As to your views about "the proper authorities to supervise his welfare" I've already discussed my views in terms of my involvement to initeate and/or provide overview in this regard.

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@Chumly,

Oh, he has a wife. She probably needs to either get his power of attorney, or begin the guardian/conservatorship process. I have no idea of the process in Canada or British Columbia, but it sounds like he might be close to the point of not being able to make useful decisions for himself.

Have you talked with her at all?

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@roger,

Ah yes, assuming I decide to follow through with increasing my involvement, the next logical step would be to collect valid information, however I am not at all sure I want to move in that direction, or for that matter any direction that would be common to both my brother and myself.

I am not certain I appreciate his company, to put it in simple terms.

I am not certain it is possible to make rational decisions based on familial obligations / conditioning / expectations / societal pressures. At the least there's not much going on in the free-will department of the Chumly mindset.

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@Chumly,

I really didn't mean to sound critical of your situation, I would not ever want to responsible again for my brother. I dread getting that phone call that he is broke and his kids need medical attention, or something else where I was put in the position of saying no. I also don't know what AFAICT means, so if I made suggestions that seemed half-cocked, perhaps it was my lack of understanding. Morally, I think he is his wife's responsibility. She needs to step up and not try to off load him on you. If he is mentally diminished, he may have forgotten any earlier difficulties between himself and siblings. Families are complicated, and things can get unpleasant...and sometimes unbearable, so I wish you the best.

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@glitterbag,

No worries glitterbag, all's well!

AFAICT http://en.wiktionary.org/wiki/AFAICT

If I was to aptly sum up my feelings at this moment it would be ambivalence combined with relief (that I'm comparatively of sound mind). I don't think that schadenfreude plays a part in my outlook however, as I empathize with his situation.

Listening to his flat uninflected voice on the telephone is eerie, because it sounds similar to my own in certain ways, and almost sounds like the voice of the brother I once knew (but in some real sense that voice is now empty).

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@Chumly,

Oh crap, I don't recognize most of txt shorthand. As far back as I can remember, military and defense employees used an entirely different shorthand when communicating on the old OPSCOMM, you moved fast because you never knew how long you connection would last. You would sign off CUL for see you later. And it's close to midnight here so I am too tired to remember the others.

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@Chumly,

Hi Chumly, Very Happy

I am a nurse (US).
I feel as though to better answer the question and/or for me to offer meaningful advice would require a better understanding of his(your brother's) actual condition. Your brother seems in no condition to accurately/truthfully inform you of this.

Is it possible for you to contact his wife?
I imagine that if he is in fact on psychiatric medication, then he would have a therapist. That is medical best practice.
I am unfamiliar with Canadian law, in the US your brother could authorize a medical professional or social worker to discuss his situation with you.
Perhaps you could visit your brother to see his condition for yourself (if that is not too painful).

The bottom line is your brother obviously needs help. We need to ensure that he gets it. Verify that he is in therapy. If he is having trouble functioning in life (living situation/continued employment, etc.) then he needs a referral to a social worker. These things could be done without necessarily becoming your brother's keeper.

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@MattDavis,

I like the idea of authorizing a medical professional or social worker to discuss his situation with me!

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@Chumly,

Great. That is what I would push for in this situation. Your brother of course would have to consent to it. Good luck. Feel free to ask regarding anything you find out. You can PM me as well if you wish.

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I have a brother who is alot like that, only he is an alcoholic. He has a guardian who I can contact at any time to see what's going on.

You say that his divorce is imminent? Better talk to the wife ASAP. If she plans on moving out, then she needs to make sure he has the support care needed. I am surprised that she has not contacted you to tell you what's going on.

His lethargy may be a side effect to the meds or some physical ailment. Is this something new? or have you noticed it (depression, affective tone in voice) before. Men do go thru a menopause, too. He may be crashing. But she should know what's happening, as a nurse.

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@PUNKEY,

Remember, we only have the word of Chumley's brother that divorce is imminent. He could believe something completely different in another five minutes. Not to say there is no truth there, but we can't really tell.

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@Chumly,

Doesn't sound like you want to get very involved so don't. Not really sure why you're asking what you should do when it sounds like you don't really want to do anything. You're not close, you're not sure what's wrong with him, and you're not equipped to deal with his problems. Do you feel he's your responsibility?

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I agree. It's one thing to get the correct information, but you don't have to DO anything about it. I'd say the wife is the main person here to figure things out for him.

She may pack up and leaves, however.

But don't think it's your problem to solve. You can be his telephone support (i.e. listener) right now, and that's enough.

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Well let's see, in recent chats (he's taken to phoning a few times a day as I mentioned) he tells me he was seeing a therapist, is likely still on some sort of medication, is not seeing a therapist any longer, and his wife no longer takes an active interest in his wellbeing.

I am considering dropping by for a visit. Man his short-term memory is shattered. I've been asking him to have a notepad etc. at the ready when he calls, to no avail however.

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@Chumly,

Quote:

Man his short-term memory is shattered

While severe depression can certainly affect memory, it sounds like something neurological might be going on. One possibility might be early-onset Alzheimer's which would initially affect short term memory, and proper diagnosis of that condition is often missed in the initial stages. He may be calling you so often because he forgets the previous calls. There is medication that can help to slow the progress of early-onset dementia if that is his problem.

Is he aware of his short term memory problems? How does he explain or account for them? Has he told his doctor about them? Do you know what medication he is taking? Depression and anxiety could be secondary to a neurological problem of some sort, or a reaction to a neurological problem that affects his cognitive functions.

Visiting him might help you to better evaluate his condition. That might help you to decide just how involved you wish to get with his current situation and how much responsibility you want to undertake.

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@Chumly,

From the limited information available it seems obvious that your brother needs a proper medical evaluation. There may be organic reasons for his difficulties (as Firefly mentions) substance abuse, medication side effects, infections (meningitis), vascular disease (stroke, TIAs), there are many many possible causes for the symptoms you mention. Your brother requires diagnostic evaluation beyond that which can be gathered over the phone.
He needs to see a physician.
If he is on medication he should be also seeing a therapist. Pharmacological therapies absent therapy are only minimally effective, and are in fact quite dangerous without medical supervision. Ask your brother for the name of his last physician/therapist. Call that person and express your concerns.
Delaying treatment is not going to help him, and by extension will only make dealing with the situation in future more difficult for anyone else involved.

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Brother's Mental Illness Concerns

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