Expert: Jennifer - 11/11/2009

Question
My mom is 59 years old.  Her mother suffered from Bi Polar disorder for most, if not all, of her adult life.  My grandmother's mental illness was obvious.  Her cycles were extreme.  During her up times she would stop taking her medication, and then would spiral downward to the point of hospitalization.  She usually became "sick" (as we referred to it in the family) around stressful times, like holidays, or weddings, generally emotional times exasperated her illness.  Seven years ago my grandmother died from an accidental/or intentional overdose of medication.  It is believed it was intentional, but I believe she only wanted attention from her kids and did not intend to kill herself. (Not to imply that they did not pay attention to her, but when she was in a cycle her need for feeling loved and important could not be satiated)

My mother has always lacked what many would consider emotional strength.  She is reactionary and very defensive (insecure).  We are very careful about what we can and can not discuss with her.  My father has not been in the picture for about 10 years now.  My sister built an in-law apartment in her house for our mom.  We see her getting worse with time.  She's reclusive.  She spends hours a day in the bathroom, doing what, we do not know.  What is evident is that she cuts her hair, a lot.  It is maybe 1/8 of an inch long and she does not have clippers.  She fills in her hair with a mysterious brown powder.  People who do not know her well believe she has cancer.  She makes up events and stories that make her life sound wonderful, or terrible, depending on the way she is feeling.  I believe she truly believes these distortions as she tells them.  She gets verbally aggressive and accusatory with my sister regarding events around the house.  She rarely leaves her apartment, limiting even the amount of time she spends at her part time job in a day care.

We have discussed counseling with her in the past.  The problem is, we don't feel she tells us the truth, or that she was honest with the therapist.  She came away from her one visit stating that the therapist told her she was fine and doing wonderful under the circumstances, and that he understood why she might be upset.

Her episodes are escalating.  We love our mom and want for her to participate in her life.  We have given up on her being a more significant part of our lives.  At this point we just want her to find some happiness besides hiding in her apartment playing computer games.

Other than what we perceive to be mental illness, our mom is very healthy and physically young, although she behaves as though she is 20-25 years older than what she is.

When we have tried talking with her about a specific behavior she first becomes angry and very defensive.  Then she becomes self-deprecating; crying and calling herself a "jerk" or "stupid" or a curse word that I won't use here.  

My siblings and I are feeling it is time to approach her about the need for help and possibly medication.  Because of her mother's history we know she is very defensive about this topic.  How can we approach her and have the interaction be productive?  

Answer
I can't promise that this will work, but it's worth considering at the very least, and may be the only way to reach her.  Tell her how you feel, not that you want her to go to a counselor, or that you believe she needs medication.  Share with her what you want for her - to be happy, to not think that she has to hide away from the world so much, and express how it makes you feel when you see her so obviously unhappy.  In time, you can address the subject of medication and regular counseling appointments, but they should probably be individual sessions - her therapist will include the family when it's appropriate.  For now, you need to work on getting your mom to start talking to you, as you need to talk with her, about the feelings on both sides so that it can become safe for everyone to be more open and willing to listen.

I hope things work out, please feel free to contact me again if you need anything further.