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Brother Not Coping Well

Question:

My dad died 9 yrs ago..my brother moved into Mom’s to help her out. He is single, now 38yrs, on disability, drives mom all over. He has obsessive behaviors -washes hands for years- has been staying up all night pacings, sleeps all day, makes poor judgment decisions , behavior seems to have worsened since the New Year,had an explosive argument with mom he hopped in truck and is gone..no word for days. He bought all pricey items: laptop, truck, dog at his side drives into the sunset..with no word he is the youngest of 10 – he was quite explosive to Mom – somewhat spoiled.. Do I have reason to worry that he is more on the edge or just wants to get on with his life?. His disability is not one that would limit him to live someplace else. He does not drink, drug he is actually a good son but his life perhaps is not where he imagined to be at 38. Do I have cause to be concerned for him? and how do I help him? If we should see him again..I think he is mad at all of us as he might feel abandoned that though he moved in with Mom on his accord, most of the responsibilities fell to him. Perhaps he can not handle?

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Answer:

Your gut is telling you that your brother has reached his limit as a helper and doesn’t know how to handle the situation, and I’d say, inasmuch as I understand what is happening, that that is probably a reasonable assumption. If your brother is truly OCD, he will have a more difficult time than most at managing life in the first place. It will be difficult for him to be a caregiver even if he wants to. It is, in fact, difficult for anyone to be a caregiver. Caregiving is a lot of work.

Not knowing your brother’s situation, I’d wonder if OCD is the only diagnosis that he may be coping with. When someone gets suddenly explosive and then goes out and spends like money grew on trees, it is reasonable to suspect that a manic episode may be occurring, which would point to a possibility of a bipolar disorder diagnosis. Bipolar and OCD can co-exist although this is not a particularly common occurrance. Of course, such a binge of consumption may simply represent “acting out” behavior; the satisfaction of desires that have been suppressed and damn the consequences. If true OCD and/or other conditions are present for your brother, I would hope he is taking care of himself and following the recommendations of a psychiatrist. If he is not, you might suggest that seeing a doctor would be a good idea, which might result in some symptom relief.

Whatever the case, it appears that your brother could use some help in caring for your mother. You can give him that help by taking over some caregiving responsibilities to the best of your abilities. This will be more difficult if you live far away, but even if you are distant, you can still communicate with your brother that you want to help, and are available to provide respite care for him when he needs a break. If it proves necessary, you might need to coordinate with your brother so that he can move out and have a life of his own, and the two of you can still provide for your mother. Visiting nurses and other sorts of eldercare resources are available and should perhaps be utilized. You might also just ask him how things are going and try to have a heart to heart conversation about how things are for him. I’ll bet he would benefit from that.

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