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Rafael M.T.Therapist
Rafael M.T.Therapist, Psychotherapist
Category: Mental Health
Satisfied Customers: 3189
Experience:  MHT-MHRS-MS-MA Integral Psychotherapist & Life Coach
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Hello, My brother has been in the house for about 9 years.

Customer Question

Hello,

My brother has been in the house for about 9 years. He has severe anxiety issues and was diagnosed with agoraphobia. He has severe anxiety issues on a daily basis.

We have been trying to get a doctor to come out to the house since day one to prescribe him medicine. We have called over 250 doctors and none of them will come out to the house even if you offer them $3,000 + for 10 minutes of their time, even though one is 5 miles away from his house.

All we need is to know is the medicine he needs to take to start to get better. He's been on lexapro and it hasn't helped at all and I am not even so sure he should be on a depression medicine for these issues, but I am not a doctor.

We have had a family history of issues like this and my cousin takes xanax and another medicine and he seemed to of beat this quickly where my brother decided not to take meds until now.

Now that my brother is finally ready to take meds, what should he start with?


A little more about him and his daily routine. He wakes up and sits for about 2 hours in the morning, he asks my mom to go into a different room when he does come upstairs into the kitchen. He claims the light hurts his eyes, puts him into a stage that he feels stressed and causes anxiety issues if my mom is in the room talking to him. After about 30 minutes of sitting in the kitchen he then proceeds to get on xbox live and play until he is ready to go to bed.

My brother is 27 years old and is 5' 8" about 5' 9" and weighs about 190 lbs. He was in great shape for years working out daily and running. Prior to this he drove on a daily basis. He claimed that prior to getting to the point that he didn't want to come out of the house that his arms were going numb, light headed, and he felt zoned. He got many heart tests and nothing was wrong at all.

A state psychiatrist diagnosed my brother at his house and found him to have the issues about 4 years ago, but wouldn't tell him a medication, because he was there for state issues not his. We tried to contact that same doctor, but he wouldn't come back out to the house for patient purposes.

He is interested in a house call, skype call, phone call, anything. If there is a doctor in Ohio that is on here, that would be great. We are looking for a miracle at this point.

If you see my brother you would think he's 100% normal and wouldn't even know he has an issue. He's good about holding in what he has. He does break down here and there, but for the most part is strong about all of this and very smart.

I know this is a lot of info, but I wanted to give as much as I could, he is getting worse by the week now and I fear that there will be a point of no return if we don't get help for him quickly.

What are our solutions, meds, etc? Any help is greatly appreciated.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Rafael M.T.Therapist replied 1 year ago.

Rafael M.T.Therapist :

Hello, I am Rafael. Thanks for asking your question - I'm here to support you. (Information posted here is not private or confidential but public).

Rafael M.T.Therapist :

I am very sorry to know about this situation.

Rafael M.T.Therapist :

Reading your message it is very frustrating to know you have not got any psychiatrist to see your brother for all this long.

Rafael M.T.Therapist :

I just wanted to say the scenario you depict is very serious, once you describe a young adult who is not physically nor mentally disable but who suffers of anxiety disorder with agoraphobia, obesity, and who has been living for long period of time mainly doing no productive activity at all but basically playing xbox.

Rafael M.T.Therapist :

Any anxiety disorder requires of psychological treatment. Psychiatric drugs could some times help numbing anxiety plus causing multiple side effects and numbing psychological processes, but such drugs cannot change the anxiety nor the core issues causing and reinforcing it, for that only concrete work on himself, psychologically, emotionally and improving his life at multiple levels is what would provide real chances for rehabilitation, otherwise it would be hopeless.

Rafael M.T.Therapist :

Does it make sense?

Rafael M.T.Therapist, Psychotherapist
Category: Mental Health
Satisfied Customers: 3189
Experience: MHT-MHRS-MS-MA Integral Psychotherapist & Life Coach
Rafael M.T.Therapist and other Mental Health Specialists are ready to help you
Expert:  Rafael M.T.Therapist replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Rafael M.T.Therapist replied 1 year ago.

I am very sorry to know about this situation.

Reading your message it is very frustrating to know you have not got any psychiatrist to see your brother for all this long.


I just wanted to say the scenario you depict is very serious, once you describe a young adult who is not physically nor mentally disable but who suffers of anxiety disorder with agoraphobia, obesity, and who has been living for long period of time mainly doing no productive activity at all but basically playing xbox.
Any anxiety disorder requires of psychological treatment. Psychiatric drugs could some times help numbing anxiety plus causing multiple side effects and numbing psychological processes, but such drugs cannot change the anxiety nor the core issues causing and reinforcing it, for that only concrete work on himself, psychologically, emotionally and improving his life at multiple levels is what would provide real chances for rehabilitation, otherwise it would be hopeless.
Does it make sense?


Regarding the psychiatric drugs and bringing a psychiatrist from out of state, you need to remember that for such professional to be able to provide services there, he-she would also need to be licensed at your state, otherwise it would be illegal. Thus please please make sure you locate a psychiatrist licensed in your state too for this to work.


Around psychological treatment, he would need a professional psychotherapist with expertise in anxiety and mood disorders. It is not easy but in many places professionals with private practice and even those working for community mental health clinics do provide services through home visits. It would be a matter of contacting the county mental health department and asking for referrals to local clinics where he could get such support.

On the the hand he needs professional support for his obesity, as a medical condition, it requires of a doctor specialized on eating disorders, a nutritionist and psychological support too, once many times obesity is a comorbid disorder that could be caused by anxiety or depressive disorders, or worsened by them, so necessary psychological support is necessary too.

Finally, taking into account your whole story, I'd carefully assess how much codependency is a core issue - addiction fueling the other disorders. In case he has been affording his life style with his own savings from past work and has enough money to perpetuate this unhealthy life style, then his chances would be deeply undermined unless he acknowledges how dysfunctional such approach is and starts working on necessary changes with professional support. In case he has been receiving financial -material support from family to create -keep this life style, then codependency is a core issue without doubt, and all family member directly involved would have to work on essential changes with professional psychological support in order to rehabilitate from this addiction, in order for your brother to have a real chance for rehabilitation, one which would not be possible in case codependency happens to be a core issue here and remains unchanged.
Customer: replied 1 year ago.

Hello and thank you for your response.


 


I do a have a question regarding the codependency, what would some of these be? Would this be him living at home getting meals from us, us picking up food for him? How far do these go? What should myself, my mom, all of us be doing for him and what shouldn't we be doing? I don't want to be a cause to this issue, but at the same time I don't want to see him not have something he needs.


 


Have a great day.


 


 

Expert:  Rafael M.T.Therapist replied 1 year ago.
An adult person with panic disorder with agoraphobia is overwhelmed by anxiety specially triggered by leaving home, what could deeply undermine or limit his very ability for a normal job, social life, and other regular activities every adult needs to do outdoors in order to create a healthy and fulfilling life.

If there is no physical or mental disability affecting him, what he should be doing in order to develop a healthy life is mainly everything every adult needs to do within the limitations his anxiety disorder presents, taking full responsibility of his life, choices and actions. That would look like looking for a job he could perform from home. Nowadays there are many people who do work from home using phones, computers, emails, and many other forms of communication and technology. It does not matter what the activity but what is essential is for him to start living as a real adult and not as a disable person. In the mean time until he finds such a job, he should be focused on working with all necessary house chores a person his age could perform, thus he would work taking good care of personal needs and house chores in order to gain the right to receive housing and food while there, plus paying for his portions of bills.

Once he gets a job allowing him to have an income, then his activities at home should be adequately managed in order to take good care of such job, while not neglecting all his other basic personal responsibilities at home plus helping with house chores as time allows.

As with every healthy and responsible life style, he would have time to have fun, relax and do whatever he likes after complying with all his responsibilities, and that could include xbox or any other game, but again, in healthy responsible ways, as an adult and not as a spoiled child, even less as an addict, once the behavior you reported depicts a person addicted to such a game. If he happens to take full responsibility for his life, from bills to daily needs and then chooses to play 1, 2, 3 or more hours a day taking it from his sleep time, no problem, that'd be his choice, and he would be fully accountable for it, including all the consequences they create.

As you see, key factors here are responsibility, respect, daily productive life, collaboration with family responsibilities, among others. Family support, should become real "suppoort", meaning behaviors-decisions leading to promote his health, rehabilitation, accountability and maturity, and not any form of spoiling, codependent enabling of what is dysfunctional, unacceptable, addictive, neglectful or abusive.

I recommend family joining a support group for codependency and ideally to get family therapy in order to work on eradicating such addiction and to develop healthy ways to truly support your brother and cope with the challenges this situation presents.

In case you still have a tough time finding necessary local professional psychotherapeutic support for him, I would recommend considering online counseling as an alternative to get adequate initial support. Again, he is the only one with the power, so the responsibility to start and make his rehabilitation process work, but he needs healthy and assertive support. Any form of codependency would just continue to undermine every chance - effort for improvements here.

Hope it brings some light on this situation.
Customer: replied 1 year ago.

Hello,


 


Can you recommend an online source for counseling online? My brother is very smart and turns and twists what someone says in every possible way. He thinks he can truly treat himself.


 


 


Do you do counseling online?


 


Have a great day and thank you for all your time.


 



Have a nice day.

Expert:  Rafael M.T.Therapist replied 1 year ago.
There are many websites pffering online counseling services, somce ofering supprot via text chat, audio chat, phone or video chat. You need to take enough time to assess at least 3 -5 so you could make a better selection of what seems to offer the most professional -confidential services.

I do work face-to-face and online too, and that's why I am not allowed to make any specific referral to websites offering these services, but I invite you to make a search online using search engine like Google for "online counseling" and you will find many of these sites.

I believe your brother is as you say, very smart, but mostly intellectually smart, and deeply codependent enabled by family, and that's why he may be an expert manipulator, but that only gets as far as there happens to be ppeople willign to play his codpendent game. Emotional intelligenece, maturity, assertiveness other core skills are very different from exlcusive intellectual skills and codependent manipulation.

Thank you for your trust, take gentle care and consistent action.
Customer: replied 1 year ago.

Hello Rafael,


 


Thank you very much for your responses


 


How can we contact you to chat online with him? Possible skype? He's truly looking for a voice chat on Skype if you do them.

So far we called all local mental hospitals, local mental clinics and none of them send anyone out, however. We came up with the idea to call SSI and ask for a new evaluation so it forces a psychiatrist to come back out to the house and maybe they can diagnose him and give him some meds. Even if they tell him the meds, we have a local doctor that said he will write them for him if a psychiatrist tells him which ones to write. So I guess this is a start if it works out.


 


He is still going to need to talk with someone like yourself to get better. There are things I don't even know that goes on with him that he won't even talk about, because he said I may start to think that way myself. So maybe he would talk to you about them I hope.


 


Have a nice day.


 


M

Expert:  Rafael M.T.Therapist replied 1 year ago.
I am glad to know you were able to figure out the possibility for a new SSI evaluation and that you got a doctor willing to prescribe adequate medication as necessary. Hope everything works as planned.

I would love to support you more but I am limited to use this interface since JustAnswers does not allow exchanging contact information with customers. But I feel hopeful you would be able to find professional support looking online as suggested before.

Please seriously consider all recommendations shared about this situation in order for you to take good care of yourselves and offer only healthy support.

Thank you for your understanding,

Rafael

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