Discussions By Condition: Mental conditions

Heart condition or mental health problem?

Posted In: Mental conditions 30 Replies
  • Posted By: elicurious
  • October 16, 2006
  • 09:14 PM

:confused:

My sister in law seems depressed to me, and she has spent the last 5 years in search of a diagnosis for a problematic heart. She is 21 years old and does not attend school or work. She lives with her mom and doesn't leave the house much. She says it is because of her heart. After a few years of doctor shopping she claims to have finally received a diagnosis. She says he told her she has a sticky valve.

She now waves a big bag of medicines around whenever someone asks her to run an errand. This bag contains:
topiramate (anti-migraine)
corazepam (anti-anxiety)
chlorpheniramine (anti-allergies)
sertraline (anti-depressant).

I don't think I believe her about the heart condition, and I worry that what she really has is depression, possibly caused (or worsened) by interactions of all these different drugs she's taking. All 4 bottles have different doctor's names on them. She says she also takes valium regularly but I didn't see a bottle of that in her bag.

I would like to intervene in what I think is a dangerous situation for a depressed young woman. But I'd like to do some research first and I don't know where / how to begin.

Thoughts? Suggestions?

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30 Replies:

  • In your sisters defense, many anti-depressants and anxiolitics are used in treating conditions unrelated to mental health.
    Anonymous 42789 Replies
    • January 10, 2007
    • 04:29 AM
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  • If she has a racing heart and dislike of social situations, she probably has Anxiety Disorder, not Depression. People with Anxiety problems, obviously, tend to like Valium. As for intervening, why bother? She obviously is no innocent victim here, she is doing what she wants to do.
    Non Servium 85 Replies
    • January 10, 2007
    • 04:40 AM
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  • I guess that's why I'm not 100% convinced of my position, and need to tread lightly or do nothing at all. My main concern is that doing nothing seems to be how her family has decided to handle this, and having had my own history of depression, I know how unkind that can be. She may need the shock of confrontation, she may need professional counseling. And of course there is this really mean part of me that just hates feeling "had" and like she's lying to me and my husband - her parents recently urged her to move to our city, so she is becoming our problem, not theirs.
    elicurious 14 Replies
    • January 10, 2007
    • 00:00 PM
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  • Aren't anxiety disorder and depression very closely linked? Isn't anxiety disorder a finely tuned form of depression, caused by insecurity? Maybe I should move this thread to a new forum! But, I do also appreciate the input about her meds - like I said, that's why I'm not entirely comfortable with my own stance, I could definitely be wrong.
    elicurious 14 Replies
    • January 10, 2007
    • 00:03 PM
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  • Well, sometimes anxiety and depression are comorbid (meaning they are present together at the same time in the same individual), however it is not a sure thing that they are "related" and I guess I would caution you in making that assumption. However, I can explain it by stating that anxiety (especially of the social sort) causes an individual to isolate themselves, and isolation is strongly correlated with cycles of depression. Does she spend time outside of the house with friends?
    Anonymous 42789 Replies
    • January 10, 2007
    • 02:13 PM
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  • Yes - she has a lot of friends and they go out regularly, mostly to bars / drinking. That is probably pretty normal, from what I remember of being 21. Doesn't sound very depressed, does it? ;) But on the other hand, she is completely detached from things - she hasn't unpacked the apartment she's been living in for months. And I don't mean there are boxes in corners, I mean you literally can't walk or sit down. She broke a lamp and left the glass shards on her bedroom floor for weeks, until my husband cleaned it up for her. She cries frequently, over things that shouldn't trigger a crying jag. She flunked out of 3 different schools, and spent 12 months on her mom's couch. She lies a lot, and mostly about things that will get her attention. I was really thinking depression, but am definitely open to hearing other possibilities. Sometimes I really, really dislike her because of the lying and her general selfishness. But then I remember that she has many likeable qualities, and I don't want to be unkind to someone who is struggling.
    elicurious 14 Replies
    • January 10, 2007
    • 10:29 PM
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  • The last statement you wrote was very important: "Sometimes I really, really dislike her because of the lying and her general selfishness. But then I remember that she has many likeable qualities, and I don't want to be unkind to someone who is struggling." I am glad you are aware of these feelings, not because I think you have a problem (nope, not at all), but because most people struggling to understand why others act the way they act don't ever come to this realization. Moreover, you already know that your sister-in-law is her own person and no matter how off-the-wall some of her behaviors may seem she makes her own decisions and is responsible for her own happiness. Drinking is talked about in my profession as "self-medicating" and although she is a 21 year old (pretty normal behavior) she needs to be aware that drinking when on anxiolytics and anti-depressants can be very dangerous. Alcohol is a depressant - - continues the depression cycle as well as increases risks for problems associated with the heart. Have you considered talking to her about your concerns? Is there a way you could bring up your thoughts without offending her? Why not be a positive role model?
    equestrian 14 Replies
    • January 10, 2007
    • 10:42 PM
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  • Thank you very much for reading my posts and replying, really. I think it does make sense to discuss my concerns with her, so long as I can approach her from a caring place and not an angry one. Lately, that's not so easy! lol! But reading your responses has made me remember why I started thinking about her behavior so much - that I like her, and that I want to help her. But I need a mantra to help me stay on her side - bc lately I have really had difficulty controlling my frustration. Any suggestions?
    elicurious 14 Replies
    • January 10, 2007
    • 10:50 PM
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  • Well, that's a hard one. I think that is where the professionals have their hands tied in dealing with mental health. The problem is that we can provide all of the hype and encouragement to get the ball rolling, but it is up to those actually involved in the situation to finish the job. Here are some pointers: 1. Like you said, find a neutral environment. Confrontation brings stress on both the confrontee and the individual sharing their concerns. I would not suggest a public place, nor her home. Why don't you invite her over for dinner? Talk after dinner - keep dinner positive. 2. Keep it private, directly tell her that what she confides to you won't be shared with anyone else (even her family!). Follow through on your promises - if exceptions need to be made (i.e., she admits she is at-risk for hurting herself etc.) you need to discuss these with her. This is important because if she hasn't told how she has been feeling, she might feel judged already - stop that cycle. 3. I would suggest you prompt her with questions about how life has been for her? Does she have any goals? How are her friends?....any questions you may think are relevant and may promote discussion on her mental health. Remember, you can't just present your observations and expect her to have a total change in lifestyle. You need to change the way she thinks about what is going on. 4. Don't let things get negative. Don't focus on the problems in her life too long...or without bringing up the positives about her first. 5. Stress that you care. 6. Make sure you think ten steps ahead. Plan for how she will react. 7. Avoid yes and no questions - ask her to elaborate, check with her to make sure you are understanding correctly and not making assumptions. 8. Be compassionate and don't make judgements! Wow, I could go on and go, and probably never hit the information that will be the most beneficial for you. Mostly, I would remember to be positive, compassionate, plan ahead, don't judge or accuse and set goals for the accomplishments you want to make. This conversation will probably not be an "end-all", but rather, a start! Maybe it would be most appropriate to spend time with her and build trust first (if you don't already have a considerate amount of trust). I know with many relationships within the family you may feel like you can trust someone, but in reality you feel that you couldn't confide your emotions in that person because they will judge etc.. So, the take home message.... You'll do great, the bottom line is you care - - and that is the most important motivator in "helping" - - which is what you are doing.
    equestrian 14 Replies
    • January 11, 2007
    • 00:18 AM
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  • Yah, I'm not sure about the trust thing. I know she used to have respect for me and used to listen to me, but lately she seems more interested in competing with me. Your suggestions all sound very good and sound, and there are words I can pluck from it for my mantra to keep me positive in her presence. Eventually, hopefully, I can build or rebuild a trust relationship and then slowly move forward from there. Again, thanks!
    elicurious 14 Replies
    • January 11, 2007
    • 01:07 AM
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  • Anxiety and Depression are way different. Obviously, anyone with a mental disorder tends to be "depressed" about the disorder, but that is not the same as clinical Depression. Anxiety is a fear of fear, ad infinitum. Its not depression caused by insecurity. You have all kinds of screwed up issues of your own, regarding her. Who cares if she doesn't trust you? I mean seriously, what does that matter? You should just never associate with this person or think about her again. If you keep doing it I'll gaurentee your wife will find a reason to get *****d at how you handle it, and then you'll really get *****d and do something rash and make it even worse.
    Non Servium 85 Replies
    • January 11, 2007
    • 08:58 AM
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  • Non servium, you are hilarious. If you take the time to read the posts / string you're replying to, your advice will end up being much more on target. For the record:My "wife" is a husband. The person in question doesn't seem to have an anxiety disorder - that was a guess someome else made here on this site. I'm pretty sure she is depressed, and has been for years. This person is also a relative of mine, and someone I'd like to help, so disassociating from her isn't an option I'm exploring. The level of trust came into question while discussing whether or not she'd be open to talking with me about how she's feeling / handling life. Maybe you should focus some of your negativity elsewhere, on someone who will be upset by it, cuz it doesn't work on me. :)
    elicurious 14 Replies
    • January 11, 2007
    • 00:12 PM
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  • I don't think I was being negative at all. I didn't notice if you said you were female though. I thought you were male and I know that obsessing over a wife's sister will always screw up a marriage even if the hubby has the best intentions. Therefore, I was trying to save you some grief. I'll add more wishy washy qualifiers and nice nice euphemisms if you prefer (but then you'd have to pay me, like all the experts get paid, for tip toe-ing lightly on delicate sensibilities). Psyches make about $90 per hour ... hey, I'd tell you what you like to hear too for that price, but my previous advice was free. I still think she sounds like she has Anxiety. Racing heartbeat, dislike of social situations, and attraction to valium matches up more with anxiety. Is she suicidal? That would fit clinical depression more. If not, I think any depression she has is a symptom of the anxiety. I still don't think you should try to be her counselor though - for one, she seems to be choosing to do what she is doing. There's no victim here. If she has no will to change course then there is no basis to begin with either. Unless you're the type to try to have people forced into mental hospitals against their will.
    Non Servium 85 Replies
    • January 11, 2007
    • 00:43 PM
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  • Not anxiety Non Servium - And, frankly, elicurious is making very good decisions. As for your opinions on psycs, wrong as well.
    equestrian 14 Replies
    • January 11, 2007
    • 03:12 PM
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  • If she has a racing heart and dislike of social situations, she probably has Anxiety Disorder, not Depression. People with Anxiety problems, obviously, tend to like Valium. As for intervening, why bother? She obviously is no innocent victim here, she is doing what she wants to do.I disagree- she might be allergic to the toxins in the environment- that's why she feels like that in social situations. There was a guy here last week, he explained how he was diagnosed with agoraphobia- but it was really an internal toxic overload.The toxins go to your brain and make you feel really messed up in your mind.Multiple Chemical Sensibility.
    Anonymous 42789 Replies
    • January 11, 2007
    • 05:50 PM
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  • If she has a racing heart and dislike of social situations, she probably has Anxiety Disorder, not Depression. People with Anxiety problems, obviously, tend to like Valium. As for intervening, why bother? She obviously is no innocent victim here, she is doing what she wants to do.Dude- dudeLook in the Diagnostic Manual, there is no definition for Anxiety and no explanation.
    Anonymous 42789 Replies
    • January 11, 2007
    • 05:54 PM
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  • Not anxiety Non Servium - Is there some reason you say this, or are you just handing it down straight from God? And, frankly, elicurious is making very good decisions. When did I ever say she wasn't? As for your opinions on psycs, wrong as well. Thanks for clearing that, up. Handed down from God again? Your post has no content, it might as well have read "Nuh uh." Well, that's a hard one. I think that is where the professionals have their hands tied in dealing with mental health. The problem is that we can provide all of the hype and encouragement to get the ball rolling, but it is up to those actually involved in the situation to finish the job. Ah, no wonder you're this way. You're one of the exalted professionals without whose mistakes this WRONGdiagnosis form would not be necessary. Thank you, really, for confirming with your officious and pretentious posts every stereotype of mental health professionals, glad to know they still hold true. Dude- dudeLook in the Diagnostic Manual, there is no definition for Anxiety and no explanation. I was not aware that the DSMV was the sole source of valid knowledge concerning the minds of human beings. Did Freud and Jung get their copies with time machines? Didn't mean to offend the official Bible of psychology. Tell me, were the older editions where they classify homosexuality as a mental illness as perfect and unquestionable as the current one? I withdraw my advice. Despite your hatred (what it really is) of my communication style (my "sin" apparently) I was just trying to help. You act like I lit a kitten on fire or something. Follow the babble equestrian suggested, I think I heard it on Oprah and Dr Phil last week, or maybe a self help book from the dollar bin. Come back in 6 months and tell us how it went ... when it flops maybe you'll be more open minded.
    Non Servium 85 Replies
    • January 12, 2007
    • 00:29 AM
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  • all right, all right, this has gotten kinda crazy, but thanks for all the chuckles. seriously - i appreciate EVERYONE's responses. the fact that you took time to answer my questions and offer advice is really great, and i have tried to internalize ALL information provided by your suggestions. sure, i think there was some confusion and i know some people think i'm off track, but i never like to dive into a situation without first questioning my motives / information. so thank you too for helping me do so. i haven't made any decisions, i don't believe i know for sure what's going on, and i can't say that i'm definitely going to do anything at all. but what i do have is a refreshed sense of patience with my sister in law - which will obviously help me whether or not i end up trying to talk with her about her feelings / situation. if you feel like i've been too quick to reject anxiety - i just want to say that she really doesn't exhibit any fear of social situations, and she doesn't behave similarly to the other couple of people i've known who have been diagnosed with anxiety disorders. she really does seem depressed to me, and i guess my gut tells me that it's kind of mean to let that go unnoticed. i really believe she needs help, and isn't able to say so. i think she uses medical diagnoses so that people will be nice to her, when really she's struggling with something much more pernicious than a physical health problem. again, thanks to everyone; even if i seemed dismissive of your input, i really did consider and balance it against my own opinions / understanding of the situation.
    elicurious 14 Replies
    • January 12, 2007
    • 00:16 PM
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  • Also - non servium - I wanted to take the time to specifically reply to your recent post about anxiety. she doesn't have a fear of social situations, and the racing heart (if it is happening to her at all, she does have a tendency to lie about physical ailments, it's a long history) could be a side effect of her meds. I've looked them up and at least 2 of them list that as a possible side effect. As to whether or not she's suicidal, well, in my experience that isn't always something you can know about another person, and obviously I'm hoping she's not quite at that point. But doesn't that possibility mean someone really ought to intervene? I haven't ever entertained the possibility of being her counselor - I was thinking more along the lines of opening up a dialogue where I could encourage her to seek professional help. I know, I know, professionals aren't gods, but talk therapy can be VERY, very helpful. I also absolutely agree with you that this is a very sticky family situation, and I definitely do not want to risk alienating anyone or creating more problems for myself. But the reality is that this person was encouraged by her parents to move to our town - and so now suddenly she is our problem. She calls us all the time, she's definitely in our lives whether we want it or not. And given how resentful I've grown in just a few months, well, I don't really see how ignoring her will help me. It seems I'm damned if I do, and damned if I don't. If I offended you by calling you negative, I'm sorry, but your written communication style really does come across that way, and there isn't really a need for that - there is a lot of middle ground between what you write and "nice nice" or whatever you called it.
    elicurious 14 Replies
    • January 12, 2007
    • 00:27 PM
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  • Also - non servium - I wanted to take the time to specifically reply to your recent post about anxiety. she doesn't have a fear of social situations I was thinking of your first post when you said she lives with her mom and doesn't go out much. As to whether or not she's suicidal, well, in my experience that isn't always something you can know about another person, and obviously I'm hoping she's not quite at that point. But doesn't that possibility mean someone really ought to intervene? I suppose I differ with the profit-making "experts" in that I consider almost all non-suicidal depression to simply be realism or a personal choice, not a mental condition. I haven't ever entertained the possibility of being her counselor - I was thinking more along the lines of opening up a dialogue where I could encourage her to seek professional help. I know, I know, professionals aren't gods, but talk therapy can be VERY, very helpful. Well one of my friends on this board went to "just talk things out" and her therapist ended up forcibly committing her to a mental hospital. Once you put someone into the system, even just to talk, you no longer have control over where they end up, what drugs they are given, or what lifelong stigmas are inscribed into their records and can only be removed by very expensive lawyers. There are a million places a person can find someone else to talk to, for free, and without the artificial dynamic of confessor and confessee.
    Non Servium 85 Replies
    • January 12, 2007
    • 01:32 PM
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