Emotional Instability and Cognitive Issues in Aging Parents

Q: Emotional Instability and Cognitive Issues in Aging Parents

Hello： Based on your description, it seems that your mother may have issues with emotional instability. <br>However, there are many potential causes for emotional instability, including personality traits, life stressors, and mental health disorders. <br>If it is a mental health

Emotional instability, cognitive impairment, mood disorders?

Hello, my mother used to frequently complain to me about my father, his mother, and his siblings, saying they treated her poorly.
She often recounted past grievances, such as, "My father's brother asked my brother to carry his shoes downstairs when my brother was 10 years old," and so on.
I've heard these stories many times over the years.
In 2015, when my father's brother's daughter got married, my mother remarked that she thought her husband was impressive just because he was a civil servant.
In 2016, my cousin had a son, and after he turned one, my mother often brought fruits for him, especially since I am still unmarried at 40 and have no boyfriend.
She had frequently urged me to get married, but she stopped mentioning it after I turned 36.
My brother is married and has two children.
However, since Tuesday, after my father's brother's son got married, my mother's emotions have been very unstable.
My mother is 73 years old, and since last Wednesday, she has been easily angered.
For example, on Wednesday night, when I mentioned that she played mahjong for too long the day before, she got angry.
On Thursday, I ran into her after she had just finished playing mahjong with friends, and when I asked if she took the bus, she became upset.
On Friday night, because it was raining, she opened an umbrella and left it on the kitchen floor.
My father, needing to wash his hands, moved the umbrella to the washing machine, which made her angry.
My father explained it was because he needed to wash his hands, and I suggested he might have forgotten to put it back, but she accused us of "bullying her." On Saturday morning, after waking up, my mother confronted my father, asking, "Are you telling others that my son is not your son?" She also mentioned a dispute with my father's sister and mother, saying they threatened her with a knife, and claimed my father has hepatitis and that now my brother has been infected.
On Saturday afternoon, she told me, "I should have immigrated to the United States with you and your brother to avoid being bullied by your father and his family." (She started crying, and I comforted her until she stopped.) She also said, "My father's mother and his sister threatened her with a knife, and she immediately went out into the street," and "My father has hepatitis, and now my brother has it too." I told her that my brother does not have hepatitis; he has fatty liver disease (discovered in 2015) due to high cholesterol and triglycerides.
Fatty liver is not contagious.
She continued to express disdain for my father's brother's son getting married, questioning if it was something to be proud of.
Most of her comments revolve around negative experiences with my father and his family.
After I asked her about her son, her grandson, and her friends, she stopped mentioning my father.

Could my mother be suffering from a mood disorder? Does she need medication? If she does have a mood disorder, how should I approach the topic with her? She is easily angered and has diabetes and high blood pressure.
She is very fond of my brother; should he be the one to discuss her potential mood disorder with her? Could this be a sign of cognitive impairment?

ivy, 40~49 year old female. Ask Date: 2017/07/11

Dr. Dai Wanxiang reply Psychiatry

Hello: Based on your description, it seems that your mother may have issues with emotional instability.
However, there are many potential causes for emotional instability, including personality traits, life stressors, and mental health disorders.
If it is a mental health disorder, there are various possibilities, and it is currently difficult to determine which specific issue it may be based on the available information.
Since the emotional disturbances are affecting family life, it is advisable to seek further evaluation and treatment at a hospital's psychiatry department, which should be helpful.
Wishing you well.

Reply Date: 2017/07/11

More Info

Based on your description, it appears that your mother is experiencing significant emotional instability, which may be exacerbated by her age and health conditions, including diabetes and hypertension. The symptoms you describe—frequent anger, emotional outbursts, and irrational thoughts—could indicate a range of issues, including depression, anxiety, or even early signs of cognitive decline such as dementia.

Emotional Instability
Emotional instability in older adults can manifest in various ways. In your mother's case, her tendency to dwell on past grievances and her heightened sensitivity to perceived slights suggest that she may be struggling with unresolved grief following your father's death. Grief can lead to emotional volatility, where individuals oscillate between anger and sadness. This is particularly common in older adults who may feel isolated or unsupported after the loss of a spouse.

Moreover, her reactions to seemingly minor triggers—like comments about her playing mahjong or the placement of an umbrella—indicate that she may be experiencing heightened emotional responses. This could be a sign of underlying anxiety or depression, which can often present as irritability in older adults.

Cognitive Concerns
Your mention of her expressing bizarre thoughts, such as accusations of infidelity or irrational fears about health issues, raises the possibility of cognitive impairment. While it is not uncommon for older adults to experience some cognitive decline, significant changes in thought patterns and behavior can be indicative of conditions like dementia or other neurocognitive disorders.

Recommendations
1. Seek Professional Evaluation: It is crucial to have your mother evaluated by a healthcare professional, preferably a geriatrician or a psychiatrist specializing in elderly care. They can conduct a thorough assessment to determine if her symptoms are due to a mental health condition, cognitive decline, or a combination of both.

2. Open Communication: If you suspect that your mother may have a mental health issue, it is essential to approach the topic with sensitivity. You might consider discussing your observations with her in a non-confrontational manner. For example, you could say, "I've noticed you've been feeling upset more often lately. I care about you and want to help. Would you be open to talking to someone who can help?"
3. Involve Family Members: Since your mother has a close relationship with your brother, it might be beneficial for him to be involved in these discussions. Sometimes, hearing concerns from multiple family members can help the individual feel less isolated and more willing to seek help.

4. Supportive Environment: Ensure that your mother feels supported and understood. Encourage her to engage in social activities, hobbies, or support groups that can help alleviate feelings of loneliness and isolation.

5. Monitor Health Conditions: Given her diabetes and hypertension, it is essential to ensure that these conditions are well-managed. Poor physical health can exacerbate mental health issues, so regular check-ups and adherence to medication are vital.

Conclusion
Your mother's emotional instability and potential cognitive issues warrant careful attention and intervention. By seeking professional help and fostering open communication within the family, you can help her navigate this challenging time. Remember, addressing mental health concerns in older adults is crucial for their overall well-being and quality of life.

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