Emotional Disorders: Symptoms, Treatment, and Family Impact

Emotional disorders

Hello, doctor.
I would like to ask what symptoms you think are described in the following situation, and what methods can be used for treatment or improvement? Originally, I lived at home with my parents and my sister, but after a falling out with her, I moved out for college.
My sister started exhibiting these behaviors in high school.
At home, if things don’t go her way, she begins to yell and scream, even over trivial matters that most people wouldn’t react to.
She is very disrespectful to my parents, especially my mother, who tends to accommodate her.
Whenever something doesn’t go her way, even in the middle of the night, she will bang on doors or create a scene, yelling at my mother and crying uncontrollably, unable to manage her emotions or communicate rationally.
She also engages in destructive behaviors, such as throwing things or damaging household items.
Now, three years after graduating from college, she still hasn’t found a job and spends all day at home.
Sometimes when I come home, she might be happy to talk to me, but usually, she just sits quietly on her phone and doesn’t respond when I try to engage her, possibly because we’ve had our own arguments in the past.

She has severe obsessive-compulsive tendencies, leaving things in disarray and refusing help to organize them.
She heavily relies on my mother but often lashes out at her when upset, even resorting to retaliatory actions like cutting my mother’s clothes or hiding her belongings.
My mother has started to ignore her, but she continues to make noise.
She rarely goes out and seems to have no friends.
I initially thought her outbursts were limited to home, but she has also lost control around relatives, although it primarily occurs at home with my mother.
Over time, my parents and I have found it difficult to maintain a calm demeanor around her; I feel a strong aversion whenever I see her.
She has previously seen a doctor and undergone counseling but refuses to take medication, believing it would harm her health.
Currently, it seems no one can persuade her to see a doctor.

Xiao Jin, 20~29 year old female. Ask Date: 2020/03/11

Dr. Peng Liyun reply Psychiatry

Hello, based on your description (the information is insufficient), it is not possible to determine a specific emotional disorder.
It may be related to personality traits or simply issues in interpersonal relationships.
If this situation is causing you distress, it is recommended that you bring a family member to a nearby mental health or psychiatric clinic or hospital for further evaluation and confirmation.
Our clinic has consultations available from Monday to Friday, both in the morning and afternoon.
We suggest you consider visiting the clinic for a personal assessment of your symptoms by a physician, so that we can discuss the best decision for you together.
Wishing you mental and emotional well-being.

Reply Date: 2020/03/11

More Info

It sounds like you are dealing with a very challenging situation regarding your sister's emotional and behavioral issues. Based on your description, it appears that your sister may be exhibiting symptoms consistent with a range of emotional disorders, potentially including mood disorders, anxiety disorders, or even personality disorders. Her extreme emotional reactions, inability to communicate effectively, and reliance on your mother, combined with her aggressive behaviors, suggest that she may be struggling with significant psychological distress.

Symptoms and Possible Disorders
1. Emotional Dysregulation: Your sister's intense emotional outbursts, especially when things do not go her way, indicate difficulties in regulating her emotions. This can be a hallmark of various mood disorders, including Borderline Personality Disorder (BPD) or other mood disorders.

2. Interpersonal Issues: The way she interacts with family members, particularly her disrespect towards your mother and her tendency to lash out, can be indicative of underlying issues with attachment or unresolved conflicts. This behavior can also be seen in individuals with anxiety disorders, where they may project their frustrations onto those closest to them.

3. Social Withdrawal: Her tendency to isolate herself and lack of social interactions outside the home can point to social anxiety or depression. The fact that she has few friends and prefers to stay at home further emphasizes this.

4. Obsessive-Compulsive Traits: The severe cleanliness and refusal to allow others to organize her space may suggest obsessive-compulsive tendencies, which can coexist with other emotional disorders.

Treatment Options
1. Psychotherapy: Engaging in therapy, particularly cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT), can be beneficial. These therapies focus on helping individuals understand their emotions, develop coping strategies, and improve interpersonal effectiveness.

2. Medication: While your sister is hesitant to take medication, it is important to understand that many emotional disorders can be effectively managed with the right pharmacological treatment. Antidepressants or mood stabilizers may help alleviate some of her symptoms. It would be beneficial for her to have an open discussion with a psychiatrist about her concerns regarding medication.

3. Family Therapy: Given the dynamics within your family, family therapy could provide a platform for all members to express their feelings and work towards healthier communication patterns. This can help in addressing the underlying issues that contribute to the family conflict.

4. Support Groups: Encouraging your sister to join support groups for individuals with similar experiences can help her feel less isolated and provide her with coping strategies from peers who understand her struggles.

Family Impact and Self-Care
The emotional toll on you and your parents is significant. It’s crucial for family members to take care of their own mental health while supporting a loved one with emotional disorders. Here are some strategies:
1. Set Boundaries: It’s important to establish healthy boundaries with your sister. This can help prevent emotional burnout and resentment.

2. Seek Support: Consider seeking support for yourself and your parents, whether through counseling or support groups for families of individuals with emotional disorders.

3. Open Communication: Encourage open and honest communication within the family. This can help in expressing feelings and frustrations without escalating conflicts.

4. Educate Yourself: Understanding more about emotional disorders can help you and your family approach the situation with empathy and knowledge, reducing frustration and improving interactions.

Conclusion
Your sister's situation is complex and requires a multifaceted approach to treatment and support. Encouraging her to seek professional help while also taking care of your family's emotional well-being is essential. Remember, recovery from emotional disorders is often a long process, and patience, understanding, and professional guidance are key components in navigating this journey.

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