Signs She Needs Psychiatric Help: How to Encourage a Visit to the Doctor - Psychiatry

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Does she need to see a doctor? How should I take her there?


From April 28 to June 7, I worked at a relative's house.
I described these past two months as the most painful days of my life.
On June 7, I had no issues during the day, but at night, I started sitting alone and crying continuously.

On June 8:
1.
I stopped going to work, avoiding contact with the source of my stress by not turning on my phone or answering calls.
2.
At night, I would hit my forehead and the top of my head, claiming it made me feel more grounded because my heart felt empty.
Sometimes I would use an alarm clock to hit my forehead, wondering if it would feel better.
3.
I mentioned wanting to travel alone the next day.
4.
I would suddenly cry intensely, but only for a short duration, less than 20 seconds.
On June 9:
1.
I experienced intermittent episodes of zoning out.
2.
Since I was not allowed to hit myself, I would secretly hide and bang my head against the door, saying it was less tiring and more effective.
3.
When taken out to Tamsui for a change of scenery, I remarked how the waves coming towards me felt gentle, as if they were calling me like a good friend.
(Later, I acknowledged that I still had some rationality and did not go into the waves.)
4.
I believed that only I had the insight to hear the ocean speaking.
5.
While talking at night, I suddenly experienced a mix of crying and laughing, which also did not last long.
6.
While sleeping, I unconsciously kept hiccuping.
The next day, I said someone had been choking me, and I struggled until I fell asleep from exhaustion.
On June 10:
1.
During the day, when my family asked me to take my brother for a follow-up appointment, I loudly refused, not wanting others to think I was idle and could be ordered around.
However, I felt I should take him, so I went anyway.
2.
From this day on, I noticed a significant decline in my memory; I would repeatedly think I had completed tasks that I had not yet done.
I would ask the same question moments apart, and after realizing something felt off, I would eventually recognize I had asked it before.
3.
My language expression felt strange.
For example, I intended to say "flexible" but ended up saying "falling." I could sense something was off but couldn't pinpoint it.
I would confuse words like "watch" with "computer" or "phone."
4.
When I thought about not having money, I would cry intensely, but only for a short time.
5.
The same happened when I thought about not having a job, and I would cry about how others viewed me without work and worry about being a burden to others.
These episodes were sudden and brief.
6.
When I accidentally repeated something said by the source of my stress, I would remark how frightening that statement was and how it made me shiver.
7.
While showering, I, who usually used hot water, suddenly doused myself with cold water, claiming I was smart for testing it first.
I realized how cold it was and felt relieved I hadn't gone into the waves with my "friend." I said I would drown before I would freeze.
8.
Later, I mentioned someone told me to hold my face underwater for a minute to learn how to swim, or that it was simple to ride a bike by just taking it out early in the morning.
(I cannot swim and have poor directional sense, and I don't know how to ride a bike.)
9.
One moment I would say I was floating in the ocean and about to drown, and the next, I would say I was lying comfortably on the beach.
10.
I constantly felt soreness in my calves and thighs, needing to stretch them out.
11.
I expressed feeling like I was living in a third space between reality and the underworld.
On June 11:
1.
I appeared relatively normal today.
On June 12:
1.
I thought I should start taking medication, but I still did not believe I was ill and did not want to see a psychiatrist, thinking it wasn't that serious.
After taking 50 mg of MESYREL and 6 mg of BROMAZIN (Lexotan) before bed at 2 AM, I fell asleep around 3 AM.
However, I felt very dizzy when I woke up to use the bathroom in the middle of the night.
When I got up at 9 AM, I continued to feel dizzy and had heartburn.
2.
That night, I wrote a consent letter to hell, agreeing to end my life.
On June 13:
1.
After taking one Opipramol tablet at 12:30 AM, I didn't fall asleep until 3 AM.
During this time, I cried continuously.
Normally, I could converse without issues, but sometimes I would suddenly zone out.
Only when I returned to my room or was alone did many situations occur.
I could explain everything happening to me.
I did not want to be this way but felt powerless to change my external environment.
I worried that becoming like this would make it harder for my environment to accept me.
I did not want to see a doctor, believing I was fine, thinking that as long as I felt a bit better, everything would be okay.
However, my choice of words and memory seemed somewhat altered.
My overall demeanor appeared drained, with a vacant expression in my eyes.
I had experienced shallow sleep for many years, and under stress, I would suffer from insomnia.
I often felt very thirsty at night.
My legs would feel sore, and sometimes when I felt particularly stressed, I would take my family’s Opipramol, sometimes one tablet, sometimes more.
After June 11, I stopped hitting my head, and the frequency of hallucinations and delusions decreased significantly.
My verbal expression improved, and during the day, I had no issues conversing and could even laugh.
However, every evening before bed, I would feel low, troubled, and cry.
My calves would feel sore, and I experienced shallow sleep.
The next day, I would feel exhausted, lacking appetite, and mostly lying in bed except for a little food.
I felt no confidence in myself, believing I had been discarded by society.
1.
I am unsure if the above symptoms indicate anxiety, depression, or schizophrenia.
2.
How can I encourage her to see a doctor?
3.
Would it be okay if she does not see a doctor?

Mr. Chen, 30~39 year old female. Ask Date: 2010/06/14

Dr. Li Zhengfeng reply Psychiatry


Hello: First of all, thank you for your letter.
Based on what you described, the patient may be suffering from severe depression.
However, a face-to-face consultation with a specialist is necessary for an accurate diagnosis.
If the patient exhibits hallucinations or self-harming behaviors, you can notify the local health department for assistance in facilitating involuntary hospitalization.
Mental illness is not directly fatal, but failing to seek treatment can lead to self-harm or harm to others, which is very dangerous.
Wishing her a speedy recovery, thank you.

Reply Date: 2010/06/14

More Info


It sounds like you are deeply concerned about a loved one who is exhibiting a range of troubling behaviors and emotional distress. The signs you describe suggest that she may be experiencing significant mental health issues, which could include anxiety, depression, or even more severe conditions such as psychosis. Here’s how you can encourage her to seek psychiatric help and some insights into the situation.


Signs She Needs Psychiatric Help
1. Emotional Distress: The frequent crying spells, feelings of emptiness, and self-harm behaviors (like hitting her head) are serious indicators of emotional distress. These behaviors can be a cry for help and suggest that she is struggling to cope with her feelings.

2. Disconnection from Reality: Statements about hearing the sea speak to her and feeling like she exists in a "third space" indicate possible dissociation or psychotic symptoms. This can be alarming and is a strong sign that she needs professional help.

3. Cognitive Changes: The memory lapses and difficulties with language expression are concerning. These cognitive symptoms can be associated with various mental health disorders and warrant a thorough evaluation by a psychiatrist.

4. Physical Symptoms: Complaints of physical discomfort, such as leg pain and dizziness, can often accompany mental health issues. Stress and anxiety can manifest physically, and it’s important to address both the mental and physical aspects of her health.


Encouraging a Visit to the Doctor
1. Open Communication: Start by having an open and non-judgmental conversation with her. Express your concerns without labeling her or making her feel defensive. Use "I" statements, such as "I feel worried when I see you upset," to convey your feelings without placing blame.

2. Normalize Seeking Help: Emphasize that seeking help from a mental health professional is a sign of strength, not weakness. Share examples of how therapy has helped others, including yourself if applicable, to reduce stigma.

3. Offer Support: Offer to accompany her to the appointment. Sometimes, the thought of going alone can be overwhelming. Having a supportive person can make the process less intimidating.

4. Educate on Mental Health: Provide her with information about mental health conditions and treatment options. Understanding that mental health issues are common and treatable can help reduce her resistance to seeking help.

5. Address Fears: If she expresses fears about being labeled or judged, reassure her that mental health professionals are trained to help without stigma. Discuss confidentiality and the supportive role of therapists.

6. Set a Plan: If she is open to it, help her set a specific date and time for the appointment. Having a plan can make the idea of going to the doctor feel more manageable.


What If She Refuses Help?
If she continues to refuse help, it’s crucial to monitor her behavior closely. If her actions become increasingly dangerous (e.g., self-harm or suicidal ideation), you may need to consider more urgent interventions, such as contacting a mental health crisis line or seeking emergency assistance.


Conclusion
Mental health issues can be complex and challenging to navigate, both for the individual experiencing them and for their loved ones. It’s essential to approach the situation with empathy and understanding. Encourage her to seek help, but also be prepared to take action if her safety is at risk. Remember, you are not alone in this; there are professionals and resources available to support both you and her through this difficult time.

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