My Father's Mental Health Challenges After Divorce

My father's mental condition?

Hello Doctor,
Family situation: There are four people in my family.
I am the eldest son, and I have a father, a mother, and a younger sister.
Both my sister and I work overseas and cannot return to Taiwan frequently due to the pandemic.

Description of the situation: My father is 66 years old, and my mother is 51 years old.
They are divorced.
The reason for the divorce is that my father becomes very irritable and difficult to control whenever he sees my mother.
Now that my mother has moved out, my father is very sad and wants her to come back.
He keeps saying that he will work on controlling his emotions.
Every time he talks to my sister and me on the phone, he ends up crying.
He feels very sad without my mother.
However, when my mother comes back to the house to pick up some things or help with matters concerning my sister and me, my father's temper starts to flare up again.
This has happened repeatedly, more than ten times, and it’s not an exaggeration.
He has seen a psychiatrist and had brain imaging done.
The doctor said there are four small strokes in his brain, and he is currently on medication for control, including antidepressants like Prozac.

Question: Since I remember my father having a bad temper since I was a child, could this be related to a mental health issue?

Qiang Ge, 20~29 year old female. Ask Date: 2021/06/27

Dr. Wang Yaoting reply Psychiatry

Hello, it sounds like your father is experiencing a situation that is understandably concerning for the family, and it can be distressing not knowing how to help him.
Based on your description, it is difficult to make a complete assessment.
However, if the issue with emotional control became more pronounced after a minor stroke, it could potentially be "vascular depression," which is associated with localized, non-specific vascular changes in the brain leading to poor emotional regulation.
It is advisable to continue follow-up care in a psychiatric outpatient clinic and to consider long-term medication management.
If your father is reluctant to seek medical attention, I suggest that other relatives in Taiwan try to assist him in a collaborative or guiding manner.
Start by listening to his discomfort and responding with empathy, then use his physical discomfort as a way to guide him to the psychiatric outpatient clinic.
If he resides in the Taipei or New Taipei area, you can apply for community service programs through the health department, where a physician can conduct a home assessment.
I hope this addresses your concerns :)

Reply Date: 2021/06/27

More Info

Understanding your father's mental health challenges, especially after a significant life event like divorce, can be complex and emotionally taxing. It’s clear that your father is experiencing a tumultuous time following the separation from your mother, and his emotional responses are likely influenced by both psychological and physiological factors.

Firstly, it’s important to recognize that your father's emotional state may be exacerbated by his medical history. The presence of small strokes (often referred to as "silent strokes") can have a profound impact on cognitive function and emotional regulation. These strokes can lead to changes in mood, personality, and behavior, which may explain some of the volatility you observe in his reactions. The fact that he is on medication like antidepressants (such as sertraline, commonly known as Zoloft) indicates that he is being treated for depression, which is a positive step. However, the effectiveness of such medications can vary, and it may take time to find the right dosage or combination of treatments.

Your father's difficulty in managing his emotions, particularly his anger and sadness, can be linked to several factors. The stress of divorce is significant, and feelings of loss and loneliness can manifest as irritability or anger, especially if he feels abandoned or rejected. His repeated cycles of sadness followed by anger when your mother is present could indicate an emotional struggle to cope with the reality of the separation. It’s common for individuals in such situations to oscillate between wanting to reconnect and feeling overwhelmed by the circumstances that led to the separation.

Moreover, your father's history of having a difficult temperament may suggest a long-standing pattern of emotional dysregulation. This could be rooted in personality traits or even undiagnosed mental health issues that have persisted over the years. It’s crucial to consider that while some behaviors may appear to be a result of his current situation, they could also be indicative of deeper-seated issues that have not been addressed.

To support your father during this challenging time, consider the following approaches:
1. Open Communication: Encourage open and honest conversations with him. Let him express his feelings without judgment. Sometimes, just having someone listen can provide immense relief.

2. Encourage Professional Help: It’s vital that he continues to engage with mental health professionals. If he’s open to it, suggest that he explore therapy options alongside his medication. Cognitive Behavioral Therapy (CBT) can be particularly effective in helping individuals manage their emotions and develop coping strategies.

3. Monitor His Health: Given his medical history, regular check-ups are essential. Encourage him to maintain appointments with his healthcare providers to monitor both his physical and mental health.

4. Promote Healthy Routines: Encourage him to engage in activities that promote physical health, such as regular exercise, a balanced diet, and adequate sleep. These factors can significantly influence mood and overall well-being.

5. Support Networks: Help him connect with support groups or community resources where he can share his experiences with others who may be going through similar situations. This can help reduce feelings of isolation.

6. Set Boundaries: While it’s important to support your father, it’s equally crucial to set boundaries to protect your own mental health. If his behavior becomes overwhelming, it’s okay to take a step back and prioritize your well-being.

7. Family Dynamics: Since you and your sister are overseas, maintaining a consistent line of communication can help him feel connected. Regular video calls or messages can provide him with a sense of stability and support.

In conclusion, your father's emotional challenges are likely multifaceted, influenced by both his mental health and the recent changes in his life. By fostering open communication, encouraging professional help, and promoting healthy habits, you can play a significant role in supporting him through this difficult period. Remember, it’s essential to take care of your own mental health as well, as navigating these family dynamics can be emotionally draining.

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