Supporting family member with severe depression?

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Specializes in ICU.

Hello everyone :). I'm Hollybobs and I work in an ICU currently. I'm pretty new to this forum and this may be the wrong part of the forum to post in? I'm sorry if so. I was hoping for advice from anyone with any personal or professional experience/knowledge of supporting a family member with severe clinical depression.

A brief bit of background..."Rosebobs" has a long standing history of depression and can experience troughs like the one she is currently in for years at a time. Her anti-depressants are not working, there is no difference after a year of increasing the dose. She also suffers from anxiety and struggles to leave the house. She is a very private individual and dislikes speaking about her feelings.

I'm aware of ways to help someone with mild-moderate depression e.g. exercise, CBT, counselling, diet changes but these are not possible/working at this point for the reasons mentioned above. Any ideas or guidance or insight appreciated.

Hollybobs.

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Specializes in Emergency Medicine.

At some point you need you live your life. This person can possibly benefit from an inpatient psych stat for an extended period of time where she can be better observed and helped. Having this much difficulty in daily life is an acute exacerbation of a chronic issue- which an inpatient stay is warranted for.

I know you care, but you also need to worry about your life and job, you worked hard to be a nurse. People can only get on the right path if they so choose to do so. Make sure this person is not holding you back from your own dreams- that can be a toxic relationship.

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Specializes in School Nurse, past Med Surge.

Has she tried a different med, as opposed to upping the dose of the ineffective one?

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Rather than looking into different medications, have you considered a holistic approach to treating the depression? A lack of electroconvulsive therapy in one's life can really shake a person the wrong way.

Maybe arrange an appointment with your care provider and see if electroconvulsive therapy is the answer.

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Specializes in ICU.
At some point you need you live your life. This person can possibly benefit from an inpatient psych stat for an extended period of time where she can be better observed and helped. Having this much difficulty in daily life is an acute exacerbation of a chronic issue- which an inpatient stay is warranted for.

I know you care, but you also need to worry about your life and job, you worked hard to be a nurse. People can only get on the right path if they so choose to do so. Make sure this person is not holding you back from your own dreams- that can be a toxic relationship.

Thank you for your reply, it is really kind. An inpatient stay may be an unfortunate but inevitable option in the future, it is definitely an exacerbation of a chronic issue. I'd like to do all and anything I can to avoid this for Rosiebobs.

In regards to the self-care aspect, despite feeling this way Rosiebobs still supports me, we are friends as well as family members and I couldn't have qualified as a nurse without her. Although I am posting as I wish to help in any way possible, usually it is her that is the giving one and I am, frankly, more selfish and self-centred. Not proud of this but it is true.

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Specializes in Med/Surg, Ortho, ASC.

I'm sure you're aware that TOS do not allow us to give medical advice. Have you approached your sister's care provider to ask for recommendations?

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Specializes in Emergency Medicine.

I'm not giving medical advice or a dx, but from what you've described it sounds like possible bipolar disorder- which takes the right kind/amount of medications and due diligence to take those medications and stick with it. Like I previously said, an impatient stay, or even several, would be most beneficial.

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Specializes in ICU.
Has she tried a different med, as opposed to upping the dose of the ineffective one?

Surely that would help? I thought that too. I don't know what alternative would be best. She is currently on Sertraline/Zoloft but her GP (I think you call it PCP in America?) has simply upped the dose of the ineffective medicine rather than prescribing an alternative :unsure:. Another SSRI or an SNRI? Rosiebobs is now having to go through all the side-effects of a dose change for what seems like no reason at all. Maybe that final dose change would mean therapeutic levels are reached? I feel out of my depth knowledge-wise.

Just wanted to add: I'm a nurse from the UK not America but I understand the terms used.

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Specializes in Med/Surg, Ortho, ASC.
I'm not giving medical advice or a dx, but from what you've described it sounds like possible bipolar disorder- which takes the right kind/amount of medications and due diligence to take those medications and stick with it. Like I previously said, an impatient stay, or even several, would be most beneficial.

Ummm, you just DID diagnose. Edit your response while you can, for your own sake.

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Specializes in Med/Surg, Ortho, ASC.
Surely that would help? I thought that too. I don't know what alternative would be best. She is currently on Sertraline/Zoloft but her GP (I think you call it PCP in America?) has simply upped the dose of the ineffective medicine rather than prescribing an alternative :unsure:. Another SSRI or an SNRI? Rosiebobs is now having to go through all the side-effects of a dose change for what seems like no reason at all. Maybe that final dose change would mean therapeutic levels are reached? I feel out of my depth knowledge-wise.

i agree. And you need to reach out to other, actual healthcare providers for answers to your issues.

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Specializes in Emergency Medicine.
Surely that would help? I thought that too. I don't know what alternative would be best. She is currently on Sertraline/Zoloft but her GP (I think you call it PCP in America?) has simply upped the dose of the ineffective medicine rather than prescribing an alternative :unsure:. Another SSRI or an SNRI? Rosiebobs is now having to go through all the side-effects of a dose change for what seems like no reason at all. Maybe that final dose change would mean therapeutic levels are reached? I feel out of my depth knowledge-wise.

GP's are typically not adequately trained to deal with the spectrum of mental disorders- she needs a psychiatrist- who specializes in prescribing psychiatric medications.

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Specializes in ICU.

I am sorry, I didn't read the TOS properly, that is entirely my fault. It was probably common sense if I had thought about it and I apologise to any poster who may have responded in a similar vein.

I can't approach the care provider due to confidentiality and the care provider doesn't negotiate. I was open to any advice, not specifically meds, although am grateful for any responses.

I don't know how it is best to "be" or what to do. To take all the stress of everyday life away? Would that leave someone feeling redundant or would it be a welcome relief? How to get someone naturally extremely private to open up a little? Any advanced communication? To encourage exposure to going outside and interacting? Or to encourage avoidance of situations which would increase panic and lower mood. This is beyond my skill set currently but i will learn anything I can.

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