I am a 42 yo woman who is living with bipolar II disorder and OCD. I’m married and have 3 children, aged 11, 13, and 18. Life is a struggle for me even when things are going smoothly and now I find myself in a situation that is putting stress on me in a way that is becoming increasingly more difficult to handle. I am hoping you might be able to offer some needed advice. In May of this year my father passed away and my mother was devastated. They had been married for 59 years and this was a monumental loss. There are 5 siblings in our family, 3 brothers and my sister and I. Two of my brothers live 4 hours away, one is close to home but works on the other side of the country 3 out of 4 weeks per month. My sister lives in the same town as Mom but works 12 hour shifts as an RN. I live in another town and am on disability. Immediately following the death Mom didn’t want to be alone (which is completely understandable) so my sister and I took turns sleeping over at her house. After a month or so of this it became too difficult to manage so we stopped. We did however continue to do everything under the sun to help Mom through this difficult time. My sister took her out every single day on her days off and I have spent every single evening up at Mom’s. I am not supposed to drive due to the medication I am on so my husband also spends each evening up there with me. He works full time and is growing tired of the constant visiting. Both my sister and I are beginning to burn out. My sister calls Mom twice a day and I call several times. My brothers usually call once a day. Although we are bending over backwards to help Mom, she repeatedly says she’s always all alone and it’s all she ever thinks about. My sister and I cannot be there 24/7 as we both have lives we also have to attend to. We’ve tried kindly explaining this to Mom but it’s as if she doesn’t hear us. She says we are abandoning and/or neglecting her. Direct communication just doesn’t seem to help. She is having a really rough time now and neither of us know how to help. I’m scared of slipping into a deep depression myself and ending up in the hospital. Mom is extremely shy and is a very private person so over the years she hasn’t developed any friendships outside of our father. She is resistant to developing any now. She only wants close contact with her children, especially my sister and I. My brother asked her to come visit for a couple of weeks and she refused. We suggested getting a pet but she doesn’t want one. My sister took her to the doctor’s but she doesn’t want medication to help with the extreme anxiety. She also refused grief counseling. All that seems to placate her is if someone is always there at her house or is taking her out for hours every day, then visiting in the evening. Even spending an hour alone reduces her to inconsolable tears. I am desperately needing to know what I should be doing in this situation. My own well being is starting to be affected. The guilt of leaving Mom alone in her state of grief makes it hard for me to pull away.
- Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
- Dr. Dombeck intends his responses to provide general educational information to the readership of this website; answers should not be understood to be specific advice intended for any particular individual(s).
- Questions submitted to this column are not guaranteed to receive responses.
- No correspondence takes place.
- No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Dombeck to people submitting questions.
- Dr. Dombeck, Mental Help Net and CenterSite, LLC make no warranties, express or implied, about the information presented in this column. Dr. Dombeck and Mental Help Net disclaim any and all merchantability or warranty of fitness for a particular purpose or liability in connection with the use or misuse of this service.
- Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.
You’re doing a whole lot right here. I want to start my comments by pointing that out. With the death of your father, your mother has suffered a massive loss, which is compounded, it seems, by her particular privacy-seeking personality and the social network deficits that have grown up around that personality. The gigantic hole that would be in her life anyway, faced with the death of her life partner, is that much larger for her lack of other close relationships in her life. At an advanced age she is now forced to start a new life without your father. She is grieving actively and isn’t coping at all well. You and your sister are doing the hard work of keeping her buoyent. This effort comes at a particularly high price for you because you yourself are dealing with your own rather significant psychiatric issues that make you rather more fragile emotionally than might otherwise be the case. You should feel proud of yourself for what you are trying to accomplish.
<p>The flip side of the pride I hope you allow yourself to feel is that you also feel very guilty for not being able to be the ultimate support that your mother requires now. Though very seductive, such guilty self-expectation messages are not very realistic or possible to fulfill. You probably recognize that though you can and should support your mother, you cannot fix her. She is so wounded right now that she is not terribly rational or responsive. Her capacity to feel devastated will far exceed your capacity to comfort.</p> <p>Then there are the other limitations that you are working under, the first being your own rather significant illnesses, and the second being your role as parent and wife with regard to your own family. It would be one thing if you put yourself into the hospital and had no dependents yourself. It is an entirely different thing when considering your role within your own family.</p> <p>Given the limitations of the situation (e.g., that there is no easy fix here, that you can't provide a permanent fix, that you could easily become ill yourself and then be of no practical use to your mother or your family), what might make the situation more workable is for you to set some limits on what you can provide to your mother. She is very needy right now and seems likely to continue to be that way for some time. However, since you (and your sister) cannot be there every waking moment to provide care, what needs to happen is for you (and your sister) to find ways to distribute the load. You have three other siblings all of whom can be asked to help out. They need to know that you are overloaded and really need their direct assistance. Since you have picked up the ball they may be laboring under the convenient delusion that you've got it covered, when you really don't. Dispel this delusion by direct communication. Your appeal may be better received if you and your sister can make it together.</p> <p>There are other ways besides family to help distribute this sort of caregiving load. One of them is regular counseling sessions for your mother. It is fairly normal to be distressed and upset months after such a significant loss. However, given the ongoing intensity of her emotion and her relative isolation, professional help seems merited anyway. Helping her connect with someone she can confide in during this time when she is so out at sea will almost certainly prove beneficial, provided she can get past the initial relationship formation issues she is likely to encounter. A professional grief counselor can help normalize this difficult transition for her, and also help assess and monitor her for safety (which you can do as well). She may be a suicide risk, for instance.</p> <p>Many communities will have grief support groups that might be an additional source of support. Given your mother's privacy issues, it would be reasonable to accompany her to any such groups and expect that she might not want to talk at all the first couple times she attends. If she clicks with the group you locate, she might want to attend without your support.</p> <p>Even given whatever help you can marshal, you may still be called upon to do most of the work. So, you will need to figure out what kind of help you can provide and what kind you cannot. Working at being a caregiver 24/7 is not going to be something you can sustain. So you may want to set some time limits or "days off" with your mother and sister (rotating those days with your sister). Hopefully, the need for days off will be something that everyone can agree upon. However, if they cannot agree, you still may need them. In such a case, you will simply have to assert your right to set such limits in the same (hopefully benevolent) way that a parent sets limits with a child "because I said so". You simply must take the rest time you need for yourself to keep your own life in balance or you will not be able to provide care for anyone. If you have your own counselor, it would be a good idea to spend a few sessions working on setting such boundaries with him or her.</p> <p>Given her historic shyness, helping your mother to have opportunities to socialize is going to be important over the long term. I would think about programs at senior centers and community centers, and contemplate alternative living arrangements that are designed to enable more social time. All of this is in the future for now, but it is worth mentioning.</p> <p>My final thought for now is to call your attention to the literature on emotional resiliency. Bad things happen to good people all the time. A collection of factors labeled emotional resiliency has been noted to influence how well these good people recover. You can read more in our <a href="http://www.mentalhelp.net/poc/center_index.php?id=298&cn=298">Emotional Resiliency topic center</a>. You can't make your mother more resilient, but knowing something about how resilience works can help you brainstorm ways to help her along.</p>