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TherapistMarryAnn, Therapist
Category: Mental Health
Satisfied Customers: 5809
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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My year old sister has always been a vivacious energetic

Customer Question

My 69 year old sister has always been a vivacious energetic woman. As her younger sister (by 9 years), I tried to be like her and she got me to do things I would not have done on my own. Like being the first to jump in the lake in the spring, or spontaneously decide to build giant snowmen. She would get fixated on doing something and sweep everyone up in her enthusiasm. This ability to get people up and involved served her well in her career as a community health nurse running several clinics for the elderly.
In the past several years however, this behaviour has become a concern to her family and friends.
She is always 'UP', unless she is sound asleep, which she can do anywhere. She calls them her 'power naps' and a bomb could go off and she would not wake up. I have seen her fall asleep with her clothes on following almost immediately after a period of high-exuberance/high-activity.
During these 'UP' periods, she often talks incessantly, mostly about herself, her life, her activities, but in a way that excludes others from getting a word in and about events or people that are out of context. Because she has a big personality and always has, we have only begun talking as a family about occasions when her behaviour has become inappropriate or embarrassing. It's as though she is losing her ability to edit what she says and this is most acute when there is an audience.
The exception is when she is in nature, but even then it takes a while for her to stop talking and just enjoy the beauty.
The sad part of this is that she has gone from being the life of the party to being excluded because of her tendency to dominate the occasion with various attention-seeking antics. For those of us who love her, it's been a gradual change, but those meeting her for the first time have a much different perception. She appears to them as weird and makes them feel uncomfortable. She tries to force them to do what she wants to do and they are refusing, whereas those of us close to her would get pulled in, sometimes in spite of our objections.
Our immediate concern now is for her safety. She takes her grandchildren on outings and we worry about her 'power naps' happening while they are in her care. Or putting herself and others at risk with her need for 'adventure'. Also, her love of 'community' may be compromised if her behaviour causes her to be excluded from things.
Our father suffered from several mental illnesses, depending on the doctor making the diagnosis. Depression, obsessive compulsive disorder, combined with alcoholism, he was treated in hospital on many occasions. My sister however, never seems to be 'down'. She is always 'up' and it's exhausting to be around her, so it must be really hard to be her. Help us please!
Submitted: 6 years ago.
Category: Mental Health
Expert:  TherapistMarryAnn replied 6 years ago.

Hi, I'd like to help you with your question.

It sounds like a couple of possibilities. One, your sister has a physical problem that is causing her to act like this. Thyroid problems, hormonal imbalances, the beginnings of dementia are all possibilities. She definitely needs to see her doctor for a full exam. If she is unwilling to go to see her doctor, you may want to contact her doctor to let him/her know what is going on. They will probably not be able to share anything with you because of confidentiality, but you could certainly tell them what is going on. The doctor may also be able to provide you with an idea of what might be the problem from the symptoms you noted.

The other option is a mental health problem. Given her age, the chances that she would suddenly develop a mental health problem is rare. OCD, such as your father had, would have manifested itself throughout her life and you would see obsessions and compulsions with her behavior. She does not sound depressed at all and you did not mention alcohol use so those are ruled out as well. Mania, related to Bipolar disorder, is a possibility but she would have shown signs of it before the age of 69. What might be a possibility is she has had a diagnosis all along and did not share it with anyone. She might be developing other problems now and it is affecting her disorder and it is no longer under control.

The best options are seeing her doctor and getting a full mental health evaluation by a Master's level or Ph.D. level therapist. She could also see a psychiatrist.

Is there anyone she respects within her friends or other family members that could talk with her about getting help? Since you have tried and she refused, maybe someone else who she looks up to could speak with her, maybe a doctor at her job or other nurse. You should also keep trying to suggest she see her doctor, at least. You could also try to get several family members together and all of you talk to her at once. The pressure could help her change her mind.

I hope this has helped you,

TherapistMarryAnn and other Mental Health Specialists are ready to help you
Customer: replied 6 years ago.
Thank you for this. I didn't mention about the alcohol.
She does also sometimes drink alcohol, mostly wine, in situations where it is not necessary. This seems to make her more exuberant but only for a short period of time, then she can get really quiet. Maybe she is using it to calm down?
Expert:  TherapistMarryAnn replied 6 years ago.

She might be using it that way. But unless she is abusing it, I don't think it would affect how she is acting now. Alcohol is a depressant so it should slow her down considerably. If she was drinking to the point of alcoholism or alcohol abuse, you would see the opposite behavior that you see now.


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