Coping with a Family Member's Relapse in Long-Term Depression

Regarding a family member who is a long-term patient of depression, there has been a recent recurrence of symptoms?

Hello, Doctor: My mother has been a long-term depression patient and is on regular medication.
During my high school and college years, her condition improved significantly, possibly due to her faith.
However, recently, my father has stated that he will no longer provide her with living expenses (he has long neglected her and cannot understand her illness), which has caused her to worry about financial issues.
Even though I want to help her financially, she refuses, believing that my current job is not stable enough (I have only been working for two months), so she has started to consider finding a job.
A former classmate of hers has been very enthusiastic and actively helping her look for work, but she inadvertently mentioned that my mother must persist in any job she finds, which has led my mother to worry about whether she can perform well and for a long time.
Additionally, she is alone at home (I work in Yunlin, my sister studies in Taipei, and my father is busy with aquaculture at our hometown), creating a vicious cycle that has worsened her symptoms.
For the past six months, she has been experiencing shallow sleep, and in the last two weeks, due to diarrhea, she has been constantly thinking about when she will feel better, which keeps her awake at night.
Negative emotions keep surfacing, and her movements have become sluggish.
A couple of days ago, her doctor urgently adjusted her medication, and she feels she has slept a little better, but she says she doesn't feel rested, and she doesn't know if she is hot or cold or hungry or full.
When asked questions, she often replies that she doesn't know; she keeps saying she doesn't know what to do, cannot concentrate, and questions the meaning of life (but due to her faith, she currently does not exhibit self-harming behaviors).
She has even lost interest in basic activities like reading the Bible or praying.
I took an emergency leave to care for her, but my own health has deteriorated, which has made her feel even more guilty and worried.
She insists that I should stop caring for her and let her fend for herself.
Given this situation, does she need to be hospitalized for treatment? As a family member, how should I adjust to this situation?

A-Gui, 20~29 year old female. Ask Date: 2016/01/03

Dr. Ding Shuyan reply Psychiatry

Hello, I am very touched by your filial piety, especially for us men, which is truly commendable.
First of all, for inpatient treatment of depression, you need to check if the hospital where your mother is seeking treatment has available beds for admission.
Additionally, consider whether your mother can accept the inpatient environment; some hospitals have patients with various mental illnesses together, which can feel too complex for some individuals and may not be preferred.
As for whether she needs to be hospitalized, if she were my patient, I would recommend hospitalization in this situation.

Regarding adjustment issues, it is essential for you to remain optimistic, as this will help your mother feel more at ease and reduce the likelihood of her falling into a negative thought cycle.
Depression is treatable, and improvement is definitely possible.
The current situation will not persist indefinitely; suffering will come to an end, it’s just a matter of time.
You might also want to learn more about depression, as it will increase your confidence.

Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2016/01/03

More Info

Coping with a family member's relapse in long-term depression can be incredibly challenging, especially when the individual has a history of mental health issues and is currently facing additional stressors. In your case, your mother's long-standing depression has been exacerbated by financial concerns and feelings of inadequacy, which can create a vicious cycle of worsening symptoms.
Firstly, it is essential to understand that depression is a complex mental health disorder that can be influenced by various factors, including biological, psychological, and social elements. Your mother's situation illustrates how external stressors, such as financial instability and lack of support, can trigger or worsen depressive episodes. The fact that she has been on medication and has shown improvement in the past is a positive sign, but it also indicates that her condition requires ongoing management and support.

Given the symptoms you described—such as insomnia, lack of appetite, feelings of worthlessness, and inability to concentrate—it is crucial to consider the possibility of hospitalization. If your mother is experiencing severe depressive symptoms that interfere with her daily functioning, or if there is any risk of self-harm, hospitalization may be necessary to ensure her safety and provide intensive treatment. A mental health professional can assess her condition and determine the best course of action, which may include adjusting her medication, providing therapy, or considering inpatient treatment.

As a family member, it is vital to take care of your own mental and physical health while supporting your mother. Here are some strategies to help you cope:
1. Educate Yourself: Understanding depression can help you empathize with your mother's struggles. Learn about the symptoms, treatment options, and the impact of stress on mental health. This knowledge can empower you to provide better support.

2. Encourage Professional Help: While you can offer emotional support, it is essential for your mother to receive professional help. Encourage her to communicate openly with her healthcare provider about her symptoms and any changes in her condition. If she is resistant, you might consider attending appointments with her to provide support.

3. Set Boundaries: It’s important to set boundaries to protect your own mental health. While it’s natural to want to help your mother, you cannot be her sole source of support. Encourage her to engage with other family members, friends, or support groups.

4. Practice Self-Care: Caring for someone with depression can be emotionally draining. Make sure to prioritize your own well-being by engaging in activities that bring you joy, practicing mindfulness or relaxation techniques, and seeking support from friends or a therapist.

5. Open Communication: Maintain open lines of communication with your mother. Let her know that you are there for her and that it’s okay to express her feelings. Sometimes, just knowing that someone is there to listen can provide comfort.

6. Encourage Small Steps: If your mother is open to it, encourage her to take small steps towards re-engaging with activities she once enjoyed, such as reading the Bible or spending time outdoors. These small victories can help improve her mood over time.

7. Monitor Symptoms: Keep track of any changes in your mother’s symptoms and communicate these to her healthcare provider. This information can be crucial for adjusting her treatment plan.

In conclusion, coping with a family member's relapse in depression is a multifaceted challenge that requires compassion, understanding, and self-care. While you can provide support, it is essential for your mother to receive professional help to manage her condition effectively. By taking care of yourself and encouraging her to seek the necessary treatment, you can create a supportive environment that fosters healing and recovery.

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