Psychiatry & Psychology--General/My nephew is dying

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There was a time in my life when there was nothing left for me to live for. There was no life in me. I attempted suicide, was hospitalized several times, and placed on several types of medication. I was diagnosed with schizoid personality disorder and depression. I have no children, no husband and I felt like there was no reason for me to exist. I was crying one night this time I brought a gun and I was going to do it the right way, the pills didn't work and I wasn't taking any chances. I heard this voice telling me "it's going to be okay" I still remember it after 9 years it scared me. That night I kept thinking who said that and then I tried to convince myself that I didn't hear it, but there was no way I could, I know what I heard. One week later my nephew was born. His mother was on hard times and my brother was stationed in Iraq and deployed several times when he later returned he fell on hard times suffering from PTSD and depression. I was living with my mother at the time and not working so my nephew lived with my mother and I raised him. At first he was a burden but he kept me so busy I didn't have time to be depressed. Then before I knew it, I was caring for him but he was caring for me. He became my reason for living. I loved him as if he was my son I've never felt that way about anybody. I got a job and I brought everything for him. I went back to school and got 2 degrees, I've never cared much for that stuff; and on the weekends I watch him and my other nephews and nieces. I help him with his schoolwork and discipline him when he was acting up in school. Every weekend and summers he wanted to be with me. These pass 9 years were the best years of my life. I love life and I wanted to be the best person I could be to set a good example for him. Sure I have other nieces and nephews, a loving mother and brothers but I have never felt a connection and love for someone like I do for him. I never thought it was possible I don't feel a connection with anyone. Last month I was driving back from taking him to the zoo and he had a seizure and everything changed. That night the emergency room doctors scheduled him emergency appointments with a neurologist and a cardiologist. The neurologist ordered a same day EEG and the cardiologist ordered a EKG. If this wasn't bad enough he had another seizure a week later and his blood work results came back. His white blood cells are extremely high, as if he was fighting an infection but there was no infection in his blood. They don't know yet until they run more test but they'll warned us he either has heart disease or leukemia or both and they don't yet know why he is having seizures. People keep telling us to be optimistic but there's no way any of this can turn out good. Of course whatever happens I'm going to be here for him, visit him, take care of him. I just don't know what do I do when he's gone. I feel like all I've accomplished and done for him was a waste of time. I don't understand how a kid can go from being so healthy and athletic to being practically given no chance at a long healthy life. I feel like he was given to me to help me through the most difficult time in my life and maybe not now or years from now he'll be taken away from me; what was the point. Then comes all the questions he's asking about his illness and how sick is he. How do I answer him I don't want to lie? What do I do when he's gone? I desperately want to go with him.

Answer
First, let me try to answer your questions as directly as you asked them.

Right, you don't want to lie to anybody and you don't want to give a 9-year-old medical information. Tell him you're not sure, but you expect there's reason to anticipate good results, and he should ask a doctor when they're around. (They are trained in how to answer.)

If and when he's gone, what you do is remember how you improved his life, and thereby the lives of others including yourself. (Which means there will probably be other opportunites for you to repeat this good period.) And that it was lucky that the person who was so devoted to him was the one in charge when the first seizure happened.  

Then you might try to do two things. For now, try to hold it together during this trying time. You are not the only one concerned and possibly soon to be mourning. You want to provide support, not require it yourself.

Second, perhaps when things settle down, you should try to get carefully diagnosed and treated. Your depression, if clinical, can be medicated, but if it is situational (that is, if it's anormal response to being in a depressing situation), you should work on learning how to change what can be changed. (The SPD can be a kind of catch-all phrase for people who are difficult to treat, and may not mean as much as you might think.)  Clinical depression is rather common, and for most sufferers, the best treatment is a combination of medication and supportive therapy.

To do this, I would think you'd benefit from an occasional visit with a psychiatrist (they're best at diagnosing and prescribing) but the right medication is often a matter of trial-and-error, which takes time plus your reports back. Then, a more regular series of visits with a clinical psychologist can teach you effective coping strategies.

I don't know what kind of mental health resources are available in your community and how they might be paid for, but if those become the issue, get back to me and I might be able to make some suggestions. Meanwhile, Pam, try to be strong and thereby to help a lot of people who will increasingly need you.

I'm glad you asked us, and wish you all the best at this troublesome time. I'm sure you're stronger than you think.

Alan  

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Alan Auerbach

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Taught psychology for 30 years, authored four textbooks. Specialize in introductory and industrial/organizational psychology, but will tackle wider range of areas.

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