mental health worries

Discussion in 'General Parenting' started by Marguerite, Dec 25, 2010.

  1. Marguerite

    Marguerite Active Member

    It's early morning Boxing Day here. That's the day after Christmas Day. Public holiday plus weekend. Here, it's public holiday until Wednesday.

    difficult child 1 & daughter in law just left. She's not in good shape and we are really worried about her. We love her to bits but she is not well. Long story cut short - she has a diagnosis of chronic fatigue syndrome, plus past hx of epilepsy (controlled with medications). She also has anxiety/panic issues and WAS on zoloft for this. Main problem for years has been fatigue, but recently this condition has upped the ante to include an increase in myalgia and arthralgia. She also has had restless legs thrown into the mix and is often in so much pain she can't sleep.

    So - she finally is seeing an immunologist who said that with CFS, Zoloft is not the best choice. He changed it to moclobemide. Initially this seemed to give her an energy boost but then she became increasingly depressed/suicidal at times, and manic at other times. She knows this is not her, it's the pills. She spoke to the specialist who said to persevere, it would stabilise. Just before Christmas it had seemed to settle, we had a lovely day with them at the mall. But her energy levels are a sham; when she flags, it can be sudden and extreme. Physically she has to rest, but lately she can't sleep. Either it's pain, or her legs twitching. Then her mind starts racing and difficult child 1 has said he has found her looking up data online to find out how much of her medications she can take, to end it all. She is very distressed.

    They had planned to stay with us for another day or two, but have headed home after another sleepless night, so hopefully in her own bed she can sleep. I suggested a trip to the local ER, but they've done that - their advice was to DOUBLE the moclobemide. Because this will take the dosage over the recommended amount, apparently it also brings some dietary restrictions so she hadn't yet increased the dose before Christmas, so she could eat normally with us. However, she's not eating well, I heard her telling easy child 2/difficult child 2 last night that she feels sick if she eats, and feels sick if she doesn't.

    I've suggested to difficult child 1 that he take her back to the ER. However, they've got a 50:50 chance, on the long public holiday weekend/week, of finding someone with a brain, or some idiot. I think suggesting she double the medications was idiocy, if the medications are what is causing her mental state to be so disordered. I've told them to call me if they go to the ER and I will try and get there too, to yell at doctors if needed. As daughter in law just said before they left, the doctors are trying to use the moclobemide to treat the fatigue and ignoring the mental health aspects of the whole regime. She wants to go back onto Zoloft - that was helping her anxiety (which she had long before the CFS) and off the stuff that seems to be messing with her head. difficult child 1 is worried about her to the extent that he has chucked in his apprenticeship and is only working on a casual basis so he can stay home with her if he is afraid to leave her alone. They can't go on like this.

    So - any ideas, folks?

    The specialist probably won't be available until after January. The GP is not available until after January. All she has is the hospital and hopefully, a functioning mental health team. Or not.

    Has anyone heard of similar problems with moclobemide? I was put on it years ago (for similar pain issues) and had weird reactions. It made me very depressed, plus I had racing thoughts and was almost manic at times. I was told this was unusual, but now I'm not so sure. I remember saying to someone, I reckon Stephen King must take this stuff... my problem was, I could sleep but my dreams were so nastily vivid, I didn't want to.

  2. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Is she seeing a Psychiatrist? If not, can you make an appointment with one?
  3. susiestar

    susiestar Roll With It

    This is a class of medications called MAOI, right? I have been a member of support groups for both chronic pain and depression/bipolar disorders, and each group has a substantial size. I am only aware of 3-4 people in the combined population of BOTH of these groups over several years who have been put on these medications. Doctors here do NOT rx them if there are any other choices because of the side effect and diet/drug interaction profiles. So I cannot offer any useful advice other than that maybe she needs to keep going to the ER until she gets a doctor who will take her off this medication and put her on another medication or combination of medications.

    Do you know how slowly she will need to be tapered off this medication? If so, she may choose to go with-out medications rather than to keep taking this one. I KNOW how hard it is to keep choking down medications when they make you feel constantly sick to your stomach and miserable in other ways also. Has she thought about trying to be on no medications until she sees the docs who can help her? Is that an option or are her original problems worse than the side effects of the medication?

    Whatever happens, it is really wonderful that difficult child and the family are all rallying around to help her. Esp for difficult child to step away from his apprenticeship. I know a LOT of men who would NOT NOT NOT be that aware, understanding and supportive of a sick wife. He is truly a good man. Not that he needs my praise, but I do know how hard it is to be in his position (and in hers), and I know how many men simply do not even recognize the need for the kinds of care and support that he is giving her. If it is appropriate, give him a pat on the back from me.

    Has she ever considered seeing a qualified herbalist, if one is in your area and can be afforded? When we lived in OH I found a wonderful herbalist who really knew her stuff. She understood both the folk uses of the medications and the chemical nature of what the various herbs/plants/etc... did. The history and science, so to speak. I was able to use very very minimal traditional medications for my health problems and the medications she recommended were more effective than most of the other things I have tried ever even thought of being. I was heartbroken when she had to move because a family crisis happened. It was the closest to healthy I had ever been as an adult. I went back to traditional medications because it is very very hard to find a qualified, scientifically trained herbalist who can cut through all the hype and nonsense that can surround herbal medications here in the US.

    Just a thought.

    Many hugs to all of you - I hope she is able to get some real help very soon.
  4. Marguerite

    Marguerite Active Member

    Thanks for the feedback, folks.

    Yes, she is seeing a psychiatrist, but like her other doctors, the shrink is not available over the break.

    Due to her anxiety issues, she does need an antidepressant and was doing well on Zoloft. But apparently it can be a problem with the fatigue, which is why the change was made. However, she has not made the change well. Her immunologist, who made the change, told her to persevere. But she was suicidal, getting weird symptoms and other problems and I don't think the doctor got the message. I've told her next time to take me along too, because I know CFS as well as this medication (as well as the specialist!) and I might be able to get to the heart of the issue.

    Update on her today - back home, she and difficult child 1 managed to get some sleep. They rang us up and asked what we were doing, could they come back to visit. Of course! So they came out, arrived about 4 pm. I knew daughter in law wanted a swim at the beach so a lot of us went down. I think it did her good to get to the beach, have a swim and exercise in the water.

    She's OK at the moment. But she seems to be on a very precarious balance point, it doesn't take much to tip her over into "I'm not coping." And normally she is a fighter, someone who won't quit and who doesn't whine. That's what has got us worried about her.

    Our health care system is a good one, she is covered for all conventional medical treatment. But herbalism - it costs. I'll make enquiries, though. I know of a very good local therapist; if we can get the right paperwork, she might be able to even get a herbalist's care on our health system. Meanwhile - sunlight is good. So is sun exposure (safe sun exposure). And sleep, of course. At the right time and in the right amounts.

    I'll keep you posted.

  5. SRL

    SRL Active Member

    Marg, I had RLS for a time and it threw me for a curve--sleeplessness, anxiety, a feeling of unwellness, etc. When did hers onset? Mine was triggered by medications for high blood pressure but even when I discontinued that medication symptoms didn't completely disappear until I'd been off of caffiene completely for 6 weeks.

    One thing that did help was a weighted blanket on my legs.
  6. Marguerite

    Marguerite Active Member

    It's summer here, so weighted blanket could be an issue. Thanks for the tip, though. Her restless leg problems were not associated with any medications, I don't think, although I do think the new antidepressant has made it a lot worse. She doesn't have caffeine, doesn't like coffee and doesn't drink cola. I don't think she does anyway.

    We're about to head for bed - still at mother in law's, difficult child 1 & daughter in law are watching TV here, I'll need to chase them out of here to go home, or make them stay at our place overnight. But this TV has to go off soon so everyone staying here can get to bed...

    The weighted blanket - it could help difficult child 1, he used to like to sleep in a weighted vest.

    We'll have to see how it goes and hope she can hang in there for the net few days, at least until Wednesday. Public holidays tomorrow and the next day, so the ER is likely to be crowded and not terribly helpful. Although you never know.

  7. smallworld

    smallworld Moderator

    Hi Marg, because of potentially lethal dietary and drug interactions, MOA inhibitors have historically been reserved as a last line of treatment, used only when other classes of antidepressant drugs (for example SSRIs and tricyclics) have failed. However, Moclobemide is a newer MAO that doesn't have the same dietary restrictions so it is being prescribed a bit more frequently. But you won't ever see it used in the pediatric population so folks here won't be all that familiar with it. Both insomnia and increased anxiety are listed as side effects so it's quite possible your daughter in law is experiencing those symptoms from the Moclobemide. I'm not certain why the doctor feels an increase would make the side effects better (and not worse).

    Just so you know, 26 years ago, my mother took an MAO (not sure which one) for depression, became delusional and took an overdose to end her life. Fortunately, my father found her before it was too late. So it can and does happen. At the time her psychiatrist didn't listen to my parents either (and my father's a doctor). So I would urge your son and daughter in law to keep pushing until a doctor believes them that the medication is causing side effects that are harmful to her mental health. She should be switched to a medication that is better for her overall mental health.

    I'll be holding a positive thought for your son and daughter in law.
  8. Marguerite

    Marguerite Active Member

    Thanks, smallworld, that's the sort of problem I suspected. I told them last night as we left, to call me if/when she's going to see a doctor so I can go along and nag on her behalf. Her own mother isn't much help in this - she's of the "pull yourself together! Stop being lazy!" school, and my daughter in law is definitely not lazy. Her mother has done a lot of damage to her over the years. Besides - her mother has now 'left home' and moved to a beach cottage on the north coast. Everyone has heaved large sighs of relief. I quite like her mother (believe it or not) but she is definitely socially dysfunctional.

    I'm not sure when we'll see difficult child 1 & daughter in law again, maybe for new year (I hope) although for us, new year's tends to be rather dreary, and they're probably visiting friends (their own age). It's been really good for mother in law to have the kids Around, she has really chirped up and lost a lot of the querulous old woman aspect. I've got to have a serious talk to her, but I don't think it will do any good.