Psychiatry & Psychology--General/Depression

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My sister in law is hard for me to understand as she can go for a good length of time very responsive in conversations and she is unbelievably great to talk to then SUDDENLY she sounds unresponsive, critical and down in her voice.  The change is so sudden that I am taken back by it and have to just bide my time until this different mode of hers ends.  I am equally taken back when suddenly she returns to her vibrant self.  As I have never experienced such I find it very hard to understand. She has agoraphobia and what she names clinical depression.  No outside influences to cause.  Has everything..good marriage and family support.  It seems to me to be a change in her brain or system.  

Myself I suffered domestic violence involving multiple concussions..perforated ears...black eyes...busted lips...strangulation attempts and finally Ataxia muscle weakness balance problems co ordination problems but I have never had depression.  I was busy surviving.  I would have good reason to have this problem BUT she is the one who has it and for years.  Can you help me to understand her problem as I feel helpless in helping her.  Perhaps all I can do is wait for it to pass. When I raise the matter with my brother he quickly changes the subject.   Same with his adult children who are parents themselves.  It seems the taboo subject.  Why?  Can you answer my queries while I am waiting for her to "return".

Answer
These are good observations that should be passed on to her therapist or psychiatrist. There are many circumstances that could cause this type of issue. You should ask her is you can pass this on to her treating provider.  I assume the family has just grown used to it, so are no longer bothered by it.  

Psychiatry & Psychology--General

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Daniel S. Harrop, M.D.

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Dr. Daniel S. Harrop received his B.A. and his M.D., both from Brown, and his M.B.A. from the Edinburgh Business School, Scotland. Board-certified in adult and geriatric psychiatry, he is a past president of the R.I. Psychiatric Society and a member of the Committee on Medical Quality of the American Psychiatric Association and the Committee on Continuing Medical Education of the R.I Medical Society. He serves as a consultant to four of the top five major medical management companies, including OptumHealth/United Healthcare, Magellan Behavioral Health Services, ValueOptions and APS Healthcare, and maintains a private practice in Providence, R.I. He also serves as chief psychiatric consultant on the Medical Advisory Board at the R.I. Workers Compensation Court. He was formerly on the faculty at the medical schools at both Brown University and Harvard University.

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