Q. About a week ago, my sister was hospitalized for a mental breakdown. First I’ll give some background on her. She will turn 40 in 6 months. She has always been highly intelligent, and a highly sensitive person, and until her 20’s her life was pretty normal. When she was around 21, she found out her fiance was gay, so they broke up. We didn’t find this out til years later, but apparently it depressed her. She then began seeing another guy soon after, who she married years later. Although he’s basically an okay guy, I believe her husband is verbally abusive and has some serious anger control problems, and is very controlling. She has said he has never hit her. He does kick and punch objects when he gets angry. He cheated on her about 6 years ago, right when they were going to try to have kids. She was on antidepressants for a while, and they went to counseling, and stayed married. She got a PhD, then had 2 kids, who are now 6 and almost 3. She has been a stay at home mom ever since. A year ago a guy from her 7th grade class who lives in another country found her on the internet and they started emailing. He moved away abruptly during 7th grade right when they started to become friends. Her husband became very jealous and accused her of having an internet affair and threatened to tell the guy’s wife if they didn’t stop emailing. I believe it was mainly a friendship and not an affair, but she did have a crush on him. The guy then found me on the internet to find out how my sister was. She was having difficulties moving on, and the guy kept writing me (to maintain a connection to her). I was trying to help them both get closure, but she wanted me to stop writing him because it was making it harder for her to move on and she was jealous I could write him but she couldn’t. I stopped writing him. She wrote him again to get closure and her husband got mad again and told the guy’s wife (the wife trusted him though). My sister and her husband talked it over, he trusted her to write him again for closure, and she did finally seem to get some closure. They’ve also had money problems, and she was supposed to start a part time job soon, but she was questioning her career choice. Then the Va Tech shooting happenened, (where we went to school), which upset her, and also an old friend of my dad’s recently killed himself which also bothered her. She had been having anxiety all year and was obsessed with her childhood friend. I believe it was an escape from her husband. I believe she got depressed and started having panic attacks and was suffering from depersonalization and derealization. She thought she was channeling her school friend’s dead mother (he had been depressed over his mother’s death). She said she was experiencing things coming through the tv and through her children, as if her kids were the friend’s dead mother or the friend. So then she was hospitalized for depression and psychosis. Before her husband took her to the hospital, he took her to a friend’s house and made her take marijuana and kava kava because I believe he was desperate to calm her down. The hospital has been giving her paxil, valium, and an antipsychotic. She told me herself she thought it was post traumatic stress disorder because of the Tech shooting and the incident with her childhood friend. She also has memory loss, doesn’t always know what day it is, and seems dissociated, talking about witches and spirits. She had been reading a book on religious stuff and wanted to become Buddhist, when we were never religious. She may come home from the hospital soon. She thinks she can take care of herself, but I don’t think she fully understands what happened to her. I think her husband’s anger has had a cumulative traumatic effect on her. We don’t have any schizophrenics in our family, but anxiety disorders and possibly depression runs in our family. My parents have been taking care of her kids. I’m wondering if this is just anxiety, panic attacks, and post traumatic stress disorder with dissociation/derealization, or something more serious. I think she was losing touch with reality before the marijuana, but I know the marijuana couldn’t have helped. She has never done drugs before. Is this something she can recover from with time, or will she continue to suffer from psychosis? Can she be treated outside of the hospital or does she need to be hospitalized, and what kind of treatment does she need? Thanks for your help.
It is difficult to know exactly what is going on with your sister. It could be a combination of disorders and it seems that at least one has a psychotic element. She is overly and inappropriately emotional, hearing voices, talking about witches and spirits, paranoid, and reading religious materials when she is not even religious—these are features of psychosis and maybe even schizophrenia. It is difficult to tell exactly what her diagnosis would be. Getting her in to treatment and properly medicated is the most important step for your sister at this time. With regard to treatment, she could be treated outside of the hospital if she is not currently experiencing psychosis. She would need to be hospitalized if she was psychotic and a danger to herself or to others or is she was neglecting to care for herself or for her children. It is critical that she be healthy around her children and does not incorporate them into her psychotic delusions. The best treatment for her would be a combination of therapy to help her deal with the anxiety, panic attacks and her emotions and medication to control her psychosis. With the proper medications and treatments, she can stabilize and recover (not necessarily be cured) from this situation. There certainly is help and hope for your sister. She will just need help finding the right care and doctors, and luckily she has you. I hope this helps. Write again with any of other questions.