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help me help my sister

August 7th, 2023

Q: From Australia: I really need some advice to help me help my younger sister,who is 19. About eight months ago she was diagnosed with anxiety and put on medication for it. She also began seeing a psychologist. However, her anxiety is worsening and a severe depression seems to be setting in. We (my family) have had to bring her home from university in another state to try and help her. Although she is now home and close to those that love her her depression is still in control of her. We took her to another doctor who changed her medication to Zoloft and who will be keeping an eye on her, he also gave her sleeping tablets because she does not sleep well. My sister cries constantly and I mean really cries like she feels she has no reason to live. I don’t know what else to do. She cant be alone because that is when she is at her worst.Although I am a counsellor and deal with mental health regularly none of my knowledge is helpful when it comes to helping a family member who i love so dearly. I feel like there is something I am missing. My sister has a loving family, boyfriend, a beautiful home, a great job, does well at uni but she remains continually unhappy.

I generally understand depression and how it effects people but I cant get through to my sister on any level. She is so depressed that she seems unable to do anything to help herself. She does not want to see her psychologist any more because she said all they do is breathing exercises and she wont take the sleeping tablets because she is scared how they will effect her. She is also sick alot and has been in hospital a few times this year for allergic reactions to medication. I am so scared for her and I want to help her so badly but I am running out of ideas. Do you have any suggestions for what I could do to help her please? Everyone is saying to give it time but i worry that she does not have time. She has lately been saying alot that she cant do this anymore. Thank you so much for your time.

This is so very hard. I can only imagine how helpless this situation must make you feel. Unfortunately, I know nothing about services in Australia. I can only tell you what I would suggest here in the U.S. Maybe it will give you some direction at least.

First, I strongly urge you to get her to her doctor for a complete medical workup. This all started with a bout of anxiety. There are many medical conditions that can create symptoms that look like anxiety. If what is going on is an undiagnosed medical problem, the medications she is taking are at best pointless and at worst masking the real problem. I would also review her medications with her doctor since she is apparently medication-sensitive. It could be that she is having an adverse response to SSRIs and her medication is making her worse instead of better.

Clearly, your sister isn’t connecting with her therapist. The psychologist needs feedback from you so he or she can take a different direction. You could also talk to your sister about whether she wants to find a different therapist to try a different approach. Often when people are suffering, they don’t have the energy to look for a different doctor even when they know they aren’t being helped.

Finally, I would consider an inpatient stay to provide a safe place for working out which medications might be helpful and to provide a couple of weeks of intensive treatment. I trust your instincts. Not only are you in the mental health field but you know your sister. If you worry that she doesn’t have time it may well be that she is seriously at risk. She may need the protection of inpatient care while her doctors figure out what is going on with her.

I wish you well.
Dr. Marie

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