Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Good Afternoon, I am in need of some guidance on how to handle a situation with my younger brother. He is 33 years old. He has a history of drug and alcohol use and has been admitted into a psych hospital on two different occasions in the last ten years from a drug induced psychosis. When he was released last year after a 7 day stay, he did not follow up and continue with counseling and medication. My father was diagnosed with a form of schizophrenia at a young age of 25 and the doctors did say that my brother most likely has a form as well. In the last 2 weeks he was evicted from his apartment for not paying rent or bills. He admitted to me that he was spending all of his money on alcohol and POT and pill popping as well. He said he is drinking a bottle of bourbon and a case of beer in 2 days. I took him in under the condition that he would get help. 10 days ago I took him to Luzerne County Drug and Alcohol where he finally spoke to someone and he was approved for a 14 day detox facility. That day he was all positive about going for help however after a few days went by he said he was not going. He now has lost his job, has no money and is in a desperate state, he is not psychologically with it. He stole percocet from my husband and replaced them with aspirin. He is in a very angry way and I am very afraid. He is not in his right state of mind and I think he is on the verge of another psychosis incident. Is there anything I can do to make him go somewhere or does it have to be on his own will. I believe he is a threat to himself but I am not sure what to do.....
Hello I believe I can help you with your concern
I am so sorry that you brother has been exhibiting these symptoms, I can imagine how worried you are about him
Yes, I am very worried and my mother who is 71 is not in good condition over this situation. I can tell you that he shows no emotion at all. It is like he is lifeless.
Now you mentioned that you believe that he is a threat to himself and this does meet the criteria to get him involuntary committed in every state
Well the no emotion can be called a "flat affect" and is associated with most psychotic disorders.
I think he is in a deep depression, he keeps talking about his regrets....
That is a sign of a deep depression as well and the use of the substances can be his way to self-medicate.
If you feel that he is going to hurt himself than you can call the local authorities to bring him to a hospital where he will be evaluated for a danger to self
I really think that is the underlying issue. When he went to the drug and alcohol facility to meet with a caseworker, they said the underlying issue could be a high level of anxiety and/or depression.
I think he feels that there is no way out. And he keeps telling me that he is tired of people telling him that he needs to get help, but I also cannot have him living here with these behaviors.
It is possible, may I ask was this a strictly drug and alcohol treatment facility or a dual diagnosis facility as well?
It was strictly a drug and alcohol facility, it was not a medical facility it was just at the county office where he met with a caseworker to see if he qualified for county assistance because he has no insurance.
If he will not seek help voluntarily and if he does not meet the criteria for involuntary commitment then you may have to kick him out until he his ready to admit that he has a problem and needs help
Well he should go to a dual diagnosis facility where they treat the mental health disorder (depression) and his addiction issues too
what I am afraid of is if I kick him out and he feels there is no where to go that he may do something drastic and possible commit suicide or something, that is what I am trying to avoide.
the detox facility that he was approved to go to is a dual diagnosis facility I just cannot get him to commit to go.
I understand that, but that means he must be willing to go get treatment though because you cannot enable him to continue this lifestyle of his
Well, I was going to give him an ultimatum tonight that he either goes willingly to the detox facility or I will call the police and have him taken in for an evaluation but I am not sure that is the right thing to do.
Well the calling the police for an evaluation may make him more resistant to treatment and those detox facilities to not typically allow for involuntary commitments, unless it is court ordered. Also the involuntary commitment will only be for a short while and he will just end up back where he started.
this is a terrible situation......
It is and I am so sorry. But I do believe that you cannot enable his behavior anymore and that he should go to treatment or he will no longer be allowed to live with you
I really feel bad for other families that are going through this, we opened our home to him, he has it really nice here and we want to help him but he doesn't want to help himself. We told him he can live here rent free and that we just want him to take care of himself and get himself straightened out.
If that is the case and I commend you for your generosity to help him through this, but he needs to be motivated to get the help that he needs
Also these books may help you better interact with him too
Thank you so much for your insight....I really do appreciate it and you are correct I am enabling him. I think I am going to tell him that he either needs to go for help to the detox or he has to leave.
thank you, XXXXX XXXXX definitely going to get the books and study more about this.
This is a difficult situation, but without treatment he will not get better and in fact he may get worse, which is not good for all parties involved.
Try to show him that you are all in this together and that you will be there for him to help support him, so that he does not feel alone in this
You are right....I am hoping he is hitting rock bottom and decides to really get the help he needs.
I hope so too
Is there anything else I can assist you with today?
No, not at this time, you have been very helpful...thank you so much.
Anytime, I am happy that I was able to help you today. I hope that he chooses to get help that he needs. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.
You are most welcome :)
Also this book may be helpful for your younger brother that I use with patients that is really successful if he is interested in it