Need some advice, mother in law with anxiety

[apple1981]

Hello, firstly it's not me that has anxiety, I hope it's OK for me to post here, but it's my Mother In Law (MIL) that has been diagnosed with anxiety. She's been ill for over 6 years, although we're struggling to remember when it all started really.

It's really hard to know where to start with all this as there is so much I want to say, so bear with me.

When I say 'we' I mean me and my husband. We only found out it was anxiety (I'm assuming GAD) about 6 months ago when my husband went with his mum to one of the sessions to speak to a psychologist, and she gave him more information in that hour than his mum had told us in 6 years.

She's had her good days and bad days, but lately she's got worse again and I've taken it upon myself to try and help her resolve the issues, but I honestly don't know where to begin or how to help.

I've started by reading up on anxiety, but from our point of view it's hard to see if she fits the classic anxiety symptoms. As an outsider the main issues we see are slight OCD tendencies (when she comes over she checks the kettle several times to see if it's leaked and she often dries it with a teatowel (even though there's no spillage). She also has constant worries that our daughter is ill/hurt/going to get ill/hurt because of things she has done. I could go on forever, but some examples have been that MIL thinks she's dropped her pills and that our daughter has or might find them and eat them. This could be even when she hasn't even brought her pills around to ours. And it was also when our daughter was 1 day old...even when I was pregnant she would worry about the pills she might have dropped when I was 3 months pregnant and my daughter eating them.

Another example is when she leaned over the baby in hospital her scarf brushed over the baby's face. My MIL went on for months about this and if my daughter was OK because of it.

Other examples are "did I leave the tap on, did I shut the door properly, did the plug get wet..."

When she has one of these scenarios in her head she then phones us constantly. On a bad day this can be 20 times in a day.

So is this anxiety?

The advice we were given by the psychologist was whenever my MIL asks about something that needs reassurance, e.g. "I didn't drop and pills did I?" then we're to respond with "What did your psychologist say?". We've been told to never say "No of course not", "Don't be silly" etc or to try and rationalise it with her e.g. "You didn't even bring your pills, so how could you have dropped them?". But it gets very hard. Especially after the 20th time. I feel like I'm having to block her/ignore her and that's heartbreaking to be quite honest. Now if I knew it was doing good, then fine, but we're just not seeing any improvement.

The other advice was for her to do more stuff (she's retired, mid 60's), so she has joined a couple of volunteer jobs a couple of afternoons a week and she also looks after my daughter with my mum a couple of afternoons a week. For a while things seemed to improve, she started going out a bit more with her husband (before he was having to leave her at home as she wouldn't leave the house - she'd make herself ill at the thought of going).

But lately things seem to be getting worse again and that's where I am now...trying to find a way to help her get better.

I think I'll leave it at that for now, see what you guys think.

[apple1981]

Thanks Kev,

You pretty much reiterated what I already knew, which is great, thank you. I've done lot of reading over the last week and I suppose I just wanted another opinion.

So when my MIL is looking for reassurance on things such as "Did the baby go into the bathroom?" which her latest one that she phoned up 3 times about last night in the space of 10 minutes, should I continue what the psychologist said and basically remind her each time that she has to deal with it. Or do I comfort her and rationalise with her about the fact that the baby goes in the bathroom all the time and it's a safe place because I've removed all the dangers from reach?

Will it be help to her do you think if I take some time alone with her to talk about it, to let her tell me her worries and maybe try and see if there are any worries I can physically help with to reduce the load on her anxiety, such as money worries?

[apple1981]

Thank you again. You've been a great help. I feel like I understand a bit better and hopefully that will help me help her a bit.

[alankay]

Apple sounds like OCD more so but anxiety often work with or is accompanies by anxieties. Is she truly complying with the meds as prescribed? Often times lack of response to meds is due to folks not taking meds as the should. Alankay.

[apple1981]

Apple sounds like OCD more so but anxiety often work with or is accompanies by anxieties. Is she truly complying with the meds as prescribed? Often times lack of response to meds is due to folks not taking meds as the should. Alankay.

I have no idea. I don't know what she's taking or if she's taking them. It doesn't help that some of her friends are saying "The pills are making things worse, why don't you stop taking them". I'll have to speak to her about it and see what's going on.

It's interesting how there seems to be a bit of a fine line with anxiety/ocd etc. I guess we all have it in us, but it's where it becomes a problem I suppose. My MIL has always had a few OCD things, like checking plugs are switched off consistently. She's also been a hoarder. Their house is full of stuff, they don't seem to throw anything away. They have dinner sets from the beginning of time because when they do buy new, or get a gift they don't sell/throw/give away the old ones!

[alankay]

Apple, well OCD is an anxiety disorder. See folks feel they have to do certain things to avoid/reduce anxiety. They know it's not right but they can't help it. Like a person who fears tiny spiders. They understand and agree they shouldn't but still do. They are often frustrated and ashamed about it all but truly made anxious/panicky by things and feel they need to check/double/triple check or still feel anxious. It must be hideous.
An anxious patient is anxious about certain things/circumstances. An OCD patient is anxious about doing certain things, objects and/or rituals/actions to avoid/reduce anxiety. It seems they feel they have some control over anxiety that way but don't.
Anyway it is true starting SSRI meds can increase symptoms at first. Often they are started at a low dose and slowly taper up to the point where anxiety obsessions are in much better control. Often a short course of a benzodiazepine is used to keep anxiety low when starting an SSRI for this reason.
In your MIL's case after a proper diagnoses, a sort of an intervention might need to take place carefully. The worst thing to do is ask/propose sweeping changes. First she needs to recognize the problem and be assured that the whole idea/goal is to help with her suffering. She has to be on board with this all. Then she needs a doc to coordinate and prescribe the course of treatment/meds(she cannot as we've seen what that leads too but she will want to treat herself anyway so to speak). Friends cannot advised her on meds. They are not doctors or therapists. So she needs a docs treatment with which she must comply(meds). The doc and therapist must be the source of info., not pals. The family must become an extension of the docs(to a degree). My Dad was bipolar and having us kids learn what he needed was key. The family needs to help her comply with/take meds and tell the doc what's going on as the patient will often say they are "feeling better"(even though they may not be). The family must be united on this as the patient may work to undermine the whole effort. Only with the patients cooperation and continuing good communication between the patient/family and docs can treatment be successful. Often the patient doesn't comply with meds. or gives the doc bad info. with out the families presence during office visits. There's where it often goes badly and leads to "failed treatment".
So unless this can be followed through, if the patient has too much say/doesn't comply, if the family will not be united and resolute, if therapy cannot be continue long enough, treatment will often fail. If all can be carried out a reduction in symptoms will almost certainly follow. It's not often complete remission of symptoms are achieved but big improvements can indeed be made.
If this cannot be done, you may be in for a losing battle. I hope the family can become one united front(in front of her at least) to get her to comply with treatment/communicate with docs to maximize results. Usually one family member must accept a lead role and inform the others on what he learns. PM me any time. Alankay.