Dads Mental Health issues - Advice Sort
Discussion
Background info
My farther about 30 years ago had a mental breakdown. He basically refused to get out of bed saying he had things stuck in his head all the time which he couldn't stop thinking about. Always random stuff but he said it was like no matter where he looked or turned whatever it was that was stuck in his head he was obsessed with. . I was only young at the time and didn't really understand but my grandparents basically looked after him 24/7 until he recovered (about 8 months before he was able to function in any way)
About 10 weeks ago my dad started to feel the symptoms coming on again. (He only told us 2 weeks ago) He tried to arrange an appointment with the doctor but had to wait 3 weeks. They have diagnosed him with severe depression and OCD. At this point he was prescribed flouxitine 15mg and diazepam. He assures us he is taking the flouxitine (Prozac I believe) but is only taking the diazepam when his symptoms get really bad as it makes him feel woolly headed and weird (his words). A bit of googling says the pills take up to 4 weeks to start working but 4 weeks later he still felt no better so booked another doctors appointment and they doubled the dose of Prozac. So he has been on Prozac and diazepam for about 6-7 weeks.
At the moment he simply won't even get out of bed other than to use the toilet. I am in the armed forces and live away from my dad and my brother lives in London (dad lives in Nottingham) my mum although being divorced from my dad there still good fri nds and goes round every day to bring my him cigs and make sure he at least has something to eat although he won't even he out of bed for that.
I'm at my wits end, work for me have been great and said take as much time as you need and my brother is self employed but comes back every weekend to help but the situation is only getting worse.
I tried ringing his doctor but they won't speak with me at all about my dad. They (mental health people) arranged to have a telephone consultation with him but he refused to speak to them saying they were doing his head in.
I totally understand that he is ill but last time I was over I was within a nats cock of exploding at him. He literally sits in his room smoking sixty fags a day and stinks. Refusing to wash or do anything just mumbling to himself and staring at the tv. We're all running around trying to help him but it seems like he doesn't want to help himself.
I have suggested to the family that we stop enabling this. Refuse to fetch his fag, refuse to cook his meals so that he has to at least leave the house (god forbid he has no fags) but my brother and mum are worried he might do something stupid thinking we don't care.
I'm at a loss. Anybody got any advice. The doctors won't speak to me, my dad won't let me be there for his doctors appointment, he doesn't want to go out at all because it makes him feel worse.
He has no money worries, his health prior to this was okay for a 69 year old man (some statins for blood pressure and omerprizol for stomach acid), he has friends who he now refuses to see even when they offer to visit or just turn up saying it's doing his head in and a family that visit regularly.
Help please!
My farther about 30 years ago had a mental breakdown. He basically refused to get out of bed saying he had things stuck in his head all the time which he couldn't stop thinking about. Always random stuff but he said it was like no matter where he looked or turned whatever it was that was stuck in his head he was obsessed with. . I was only young at the time and didn't really understand but my grandparents basically looked after him 24/7 until he recovered (about 8 months before he was able to function in any way)
About 10 weeks ago my dad started to feel the symptoms coming on again. (He only told us 2 weeks ago) He tried to arrange an appointment with the doctor but had to wait 3 weeks. They have diagnosed him with severe depression and OCD. At this point he was prescribed flouxitine 15mg and diazepam. He assures us he is taking the flouxitine (Prozac I believe) but is only taking the diazepam when his symptoms get really bad as it makes him feel woolly headed and weird (his words). A bit of googling says the pills take up to 4 weeks to start working but 4 weeks later he still felt no better so booked another doctors appointment and they doubled the dose of Prozac. So he has been on Prozac and diazepam for about 6-7 weeks.
At the moment he simply won't even get out of bed other than to use the toilet. I am in the armed forces and live away from my dad and my brother lives in London (dad lives in Nottingham) my mum although being divorced from my dad there still good fri nds and goes round every day to bring my him cigs and make sure he at least has something to eat although he won't even he out of bed for that.
I'm at my wits end, work for me have been great and said take as much time as you need and my brother is self employed but comes back every weekend to help but the situation is only getting worse.
I tried ringing his doctor but they won't speak with me at all about my dad. They (mental health people) arranged to have a telephone consultation with him but he refused to speak to them saying they were doing his head in.
I totally understand that he is ill but last time I was over I was within a nats cock of exploding at him. He literally sits in his room smoking sixty fags a day and stinks. Refusing to wash or do anything just mumbling to himself and staring at the tv. We're all running around trying to help him but it seems like he doesn't want to help himself.
I have suggested to the family that we stop enabling this. Refuse to fetch his fag, refuse to cook his meals so that he has to at least leave the house (god forbid he has no fags) but my brother and mum are worried he might do something stupid thinking we don't care.
I'm at a loss. Anybody got any advice. The doctors won't speak to me, my dad won't let me be there for his doctors appointment, he doesn't want to go out at all because it makes him feel worse.
He has no money worries, his health prior to this was okay for a 69 year old man (some statins for blood pressure and omerprizol for stomach acid), he has friends who he now refuses to see even when they offer to visit or just turn up saying it's doing his head in and a family that visit regularly.
Help please!
I think you need to try again to share your concerns about your father, to your family, and vice versa.You're going to need to support each other's decisions on this one.
I would also say, rather than his doctor, have you contacted the local mental health services and explained the situation? They are their to offer advice to families as well as the sick.
It must be very difficult to see your father that way. Best of luck to you.
I would also say, rather than his doctor, have you contacted the local mental health services and explained the situation? They are their to offer advice to families as well as the sick.
It must be very difficult to see your father that way. Best of luck to you.
Prof Prolapse said:
I think you need to try again to share your concerns about your father, to your family, and vice versa.You're going to need to support each other's decisions on this one.
I would also say, rather than his doctor, have you contacted the local mental health services and explained the situation? They are their to offer advice to families as well as the sick.
It must be very difficult to see your father that way. Best of luck to you.
Thanks prof, we decided as a family (me, brother, mum, stepdad to at least keep making sure he is eating. I called his doctor again this morning and whilst he couldn't discuss specifics about my dad he has said give it a couple more weeks and see if his latest dosage increase helps as it will take a while for the higher dosage to take effect. We have agreed this morning that to carry on enabling his current behaviour for two weeks to see if the mess take effect, although in my opinion enabling him to stay in bed all day is not helping, the rest of the family think it's best so I will go along with the majority. I would also say, rather than his doctor, have you contacted the local mental health services and explained the situation? They are their to offer advice to families as well as the sick.
It must be very difficult to see your father that way. Best of luck to you.
I'm going to see if I can get in contact with the mental health people and arrange a home visit over a telephone conversation as I don't see how they can assess him over the phone if he won't speak to them.
I don't think they need to assess him as such mate. I think they need to advise you at what point you should decide to take control of his medical care.
He doesn't sound like he's a danger as it stands, so nothing dramatic, but if he can no longer take control of his basic care, I'd question how he can be adequately be informing his acting carers of his situation and treatment.
Just a thought.
He doesn't sound like he's a danger as it stands, so nothing dramatic, but if he can no longer take control of his basic care, I'd question how he can be adequately be informing his acting carers of his situation and treatment.
Just a thought.
sounds really quite depressed - lacking energy (anergia), inability to derive pleasure from previously enjoyable activity (anhedonia), annorexia, disturbed sleep ?, self-neglect, demotivated, irritability, etc.
can you decipher the "mumblings" at all? - this could be a bit more complex. is he responding to otherwise unseen stimuli do you think ?
initial treatment with an SSRI is what GPs are advised - therapeutic elevation of mood can be several weeks and titrating the dose upwards usually takes a few weeks more (in addition to the initiation phase).
what area are you in ?
paul
can you decipher the "mumblings" at all? - this could be a bit more complex. is he responding to otherwise unseen stimuli do you think ?
initial treatment with an SSRI is what GPs are advised - therapeutic elevation of mood can be several weeks and titrating the dose upwards usually takes a few weeks more (in addition to the initiation phase).
what area are you in ?
paul
paulmakin said:
sounds really quite depressed - lacking energy (anergia), inability to derive pleasure from previously enjoyable activity (anhedonia), annorexia, disturbed sleep ?, self-neglect, demotivated, irritability, etc.
can you decipher the "mumblings" at all? - this could be a bit more complex. is he responding to otherwise unseen stimuli do you think ?
initial treatment with an SSRI is what GPs are advised - therapeutic elevation of mood can be several weeks and titrating the dose upwards usually takes a few weeks more (in addition to the initiation phase).
what area are you in ?
paul
Hi Paul,can you decipher the "mumblings" at all? - this could be a bit more complex. is he responding to otherwise unseen stimuli do you think ?
initial treatment with an SSRI is what GPs are advised - therapeutic elevation of mood can be several weeks and titrating the dose upwards usually takes a few weeks more (in addition to the initiation phase).
what area are you in ?
paul
It's difficult to understand/decipher the mumbling. I asked him about it and he said it's things like making lists of things he is obsessing about or counting things. He said he can hear things all the time too. I'm not sure if the mumbling are his responses to what he can hear as well or just counting stuff. I find it very hard to comprehend/understand what's going on really.
In terms of area he lives in Nottingham.
He's fighting for control. His final control. Bewildered and unreasonable maybe but he's still fighting.
Try to take a step back and be objective if you can. Don't get bogged down.
My Dad passed through Parkinsons/Alzheimers/Cancer. Fook all you can do but maintain your own sense of perspective.
We are all dust....
Try to take a step back and be objective if you can. Don't get bogged down.
My Dad passed through Parkinsons/Alzheimers/Cancer. Fook all you can do but maintain your own sense of perspective.
We are all dust....
checked the commissioning for nottingham and it appears that access to mental health services is always via primary care - that is, GP referral. some areas allow for direct entry through "entry" or "access" services but seemingly not in notts.
there are psychological teams that an individual or family member can approach without GP referral. they operate outside of secondary care but sounds like he may not be amenable at the moment - google "IAPT" or "talking therapy" in nottingham. they deliver cognitively based interventions for those with mild-moderate depression, anxiety, ocd etc.
there are "crisis" MH services in notts but only available for known service users so of no help at this stage.
treatment has been started so, all things being equal, if there is some support within the home and risk is not present then allow a couple of weeks to gauge response to the increase in the anti-dep.
remember that a similar episode in the past was successfully resolved and your father recovered seemingly fully; no reason to assume that this won't be the case again. recurrent depressive episodes are really quite common.
regards
paul
there are psychological teams that an individual or family member can approach without GP referral. they operate outside of secondary care but sounds like he may not be amenable at the moment - google "IAPT" or "talking therapy" in nottingham. they deliver cognitively based interventions for those with mild-moderate depression, anxiety, ocd etc.
there are "crisis" MH services in notts but only available for known service users so of no help at this stage.
treatment has been started so, all things being equal, if there is some support within the home and risk is not present then allow a couple of weeks to gauge response to the increase in the anti-dep.
remember that a similar episode in the past was successfully resolved and your father recovered seemingly fully; no reason to assume that this won't be the case again. recurrent depressive episodes are really quite common.
regards
paul
i've just realised (covering bases etc) that i've assumed low risk.
if there is real/immediate concern about safety then, worst case, the "nearest relative" can request a formal Mental Health Act assessment (the definition of the nearest relative and their right to request is set out within Section 13(4) of the Act). the request would be to the local authority - ask to be connected to the AMHP (Approved Mental Health Practitioner) service
as i say, worst case, but few families or carers are aware of this right
paul
if there is real/immediate concern about safety then, worst case, the "nearest relative" can request a formal Mental Health Act assessment (the definition of the nearest relative and their right to request is set out within Section 13(4) of the Act). the request would be to the local authority - ask to be connected to the AMHP (Approved Mental Health Practitioner) service
as i say, worst case, but few families or carers are aware of this right
paul
Thanks for the help and advice so far. It really is appreciated so very very much.
My brother is looking after him this weekend. He still appears very down and disinterested. He still hasn't left the house in 4 weeks, only really leaving his bedroom occasionally. The go has agreed to come and see him on Wednesday to check on his progress.
My brother is looking after him this weekend. He still appears very down and disinterested. He still hasn't left the house in 4 weeks, only really leaving his bedroom occasionally. The go has agreed to come and see him on Wednesday to check on his progress.
Sounds more like a case of mild/medium psychosis rather than anxiety/depression which the prozac/valium will only dampen in the short term. Plus there is the risk of withdrawal symptoms if he is not taking them in consistent doses which will make things continually worse, or lead to reliance.
But OP - the one thing I would say is stop looking at his behaviour logically/objectively 'he's not doing anything to help himself so why should I'...
Thats now how mental illness works. He may be a fraction of the person he used to be.
But OP - the one thing I would say is stop looking at his behaviour logically/objectively 'he's not doing anything to help himself so why should I'...
Thats now how mental illness works. He may be a fraction of the person he used to be.
Marvtec said:
But OP - the one thing I would say is stop looking at his behaviour logically/objectively 'he's not doing anything to help himself so why should I'... .
I understand that, I would like to clarify that I don't resent my dad or looking after him. I just want in some way to force him to do something for himself. To get up and get out of the house. After 50 years of smoking the one thing I know my dad can't go without is fags and even a walk (100m) to the corner shop is a positive achievement. if his living conditions are not good, not cleaning, not cooking or washing, once we had social services pay a visit, they was very helpful with what care we could get, and helped with putting our parents in the right place as they were not coping. not sure if that intervention would help your dad. good luck
Well it's been an interesting afternoon. They gp couldn't get for the home visit but I managed to persuade him to go to the doctors so it's the first time he has been out the house in 6 weeks. He had a bit of a wobble in the reception area and wanted to get up and leave as all the noise was upsetting him but we (me and my mother) managed to get him to stay. Just. Although he wouldn't allow either of us to go into the dr office with him which I was a bit disappointed with but can understand.
They have changed his medication because it's getting on for 8 weeks on the flouxitine (Prozac) and he feels no better at all. He's now on Clomipramine so hopefully that will start to work and still has diazepam for when he is feeling really bad.
He got a phone call from let's talk (outsourced mental health provider for Nottingham) as well who carried out another telephone assessment with him while I was there. They have assessed him as low risk and are going to arrange some cognitive behavioural therapy for him starting in the new year but has been returned to care of hims GP until then.
Again thanks guys. I'm using this now as a sounding board for myself as well as taking on your advice. It almost bought a tear to my eyes this afternoon just getting him out the house is brilliant although he did feel a little down/stressed after we got home. Anyway I got him fish and chips which his is favourite which he wolfed down. He has lost a lot of weight over these past 10 weeks due to having no real appetite.
They have changed his medication because it's getting on for 8 weeks on the flouxitine (Prozac) and he feels no better at all. He's now on Clomipramine so hopefully that will start to work and still has diazepam for when he is feeling really bad.
He got a phone call from let's talk (outsourced mental health provider for Nottingham) as well who carried out another telephone assessment with him while I was there. They have assessed him as low risk and are going to arrange some cognitive behavioural therapy for him starting in the new year but has been returned to care of hims GP until then.
Again thanks guys. I'm using this now as a sounding board for myself as well as taking on your advice. It almost bought a tear to my eyes this afternoon just getting him out the house is brilliant although he did feel a little down/stressed after we got home. Anyway I got him fish and chips which his is favourite which he wolfed down. He has lost a lot of weight over these past 10 weeks due to having no real appetite.
I would like to add as well that today when I turned up he was shaven and dressed all be it still lying on his bed and the pots had been done. Bins empty, ash try emptied. So maybe, just maybe there has been a small improvement, -although I'm not getting my hopes up and realise he could go backwards as easy as forwards. Today has been a good day and is a reason to :-) !!!!
Thanks for the advice Gareth, I don't think we're at that point at the moment. He is lucid and understands what is going on. He is just struggling with life and everything about him. He is fully aware that the things he is hearing in his head aren't real and there just things he is fixating on. My brother and I did discuss it but at this point he fully understands everything, it's just that it's all too much. I personally find it very difficult to describe his mental state. It's almost like he is talking to himself, fully aware he is doing it but is using it as a coping method.
Thanks for the advice and if the situation warranted it then we will look at it in the future.
Thanks for the advice and if the situation warranted it then we will look at it in the future.
I see no mention of a Doctor looking for any underlying medical conditions that could be causing this.
There is a wide varied range of medical conditions that could be causing all this and they usually get overlook due to someone having problems in the past.
Worth a check IMO as I've been there and the news wasn't good.
Best of luck mate.
I have wondered about this, brain tumour etc effecting his mental health but as far as I am aware there is no indication of anything else. As far as my dad has told me there not testing for anything else and treating it as a relapse/ reoccurrence of what happened about 30 years ago.
Doctor patient privilege is a real pita as far as I am concrete as the only info I get is what my dad passes on and I'm not convinced we're getting 100% from him or even if he is taking it in 100% but of course the doctors won't talk to me. Barmy.
Doctor patient privilege is a real pita as far as I am concrete as the only info I get is what my dad passes on and I'm not convinced we're getting 100% from him or even if he is taking it in 100% but of course the doctors won't talk to me. Barmy.
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