Help for my sister with anxiety

[bisous]

My sister is the smartest, highest achieving, and most moral person that I have ever met. She's extraordinary and she's really suffering from anxiety. I think in retrospect she's always been anxious but she's very high functioning. About 4-5 years ago she started having crippling panic attacks that led her to a psychiatrist and a psychologist. She started meds and some counseling and made tremendous progress. But she always felt shameful about using meds and weaned herself off. Last summer she had another acute crisis where she was just very anxious and unhappy chronically. She started meds again, got better again, and then weaned herself off again. I'm worried about her! I feel like the first signs that I "see" when I talk to her include blaming herself for silly little things that nobody cares about and just the kind of self-loathing I hear in her voice concerns me. She isn't exactly rational when she is feeling acute anxiety. I don't know how to talk to her or how to help her. She is a teacher in Northern VA and she lives alone. I live across the country and we talk often on the phone. I feel like she should stick with her treatment and follow the advice of her doctor. She hates meds. From what I've read, therapy, especially cognitive behavioral therapy can be as effective as meds for anxiety. She told me she hates counseling. It opens up things that are painful for her. This is so interesting to me because I absolutely loved going to a counselor and found it calming and helpful. Is this a part of her anxiety?

What can I do to help her from over here? What can I say? How do I advise her? How do I let her know I'm seeing signs of an impending crisis while she's in the middle of this?

TIA!

[georgiegirl]

What does she hate about the meds? The idea that she’s on medS? It seems like they really help her. There’s no shame in being on meds for any mental health issue. She would never blame your son for needing insulin. If her brain chemistry is off, she’s really going to be more successful on meds than off meds.

Adding: it’s great that you are so supportive and are there to listen to her.

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[pinkmomagain]

Smartest, highest achieving, most moral. Wow. That's a lot of pressure to keep up. Sounds like she is super hard on herself and has created a role in the world that is hard to live up to.

I would be supportive, non judgmental and create a safe landing pad for her to be vulnerable, human, and not perfect. Gently show her the patterns you have noticed of that when she is getting treatment, things seem better, easier for her. Encourage her to seek therapy and if she doesn't like a particular therapist or therapy, to try a different one. Yes CBT is great, but sometimes that's not what a person needs. Meds are sometimes needed, nothing to be ashamed of -- at.all. Be encouraging about this option as well -- if professionals recommend it.

Sounds like she has a caring, supportive sister in you. It must be very hard to want to help and be so far away.

[TwinFoxes]

Smartest, highest achieving, most moral. Wow. That's a lot of pressure to keep up. Sounds like she is super hard on herself and has created a role in the world that is hard to live up to.



I thought this too.

There may be trauma in your sister's life you don't know about that contributes to her anxiety. That may be one reason her experience in therapy shouldn't be compared to yours. Also, I wonder if there's another mental health diagnosis you aren't aware of. (Depression maybe?)

If it were me, I'd reach out to an actual expert for advice in how to help her. I would think that the American Psychology Association or National Institutes of Mental Health would be a good place to at least start.

[bisous]

Thanks all. YES she is SOOO hard on herself. Here's a good example. This summer she took the praxis exam (maybe that's not the name?) that would allow her to teach science in high school. Now granted she has a degree in literature and classics and hasn't had a real rigorous class in science since she was in high school herself. Halfway through the studying she was convinced she'd fail. Absolutely convinced. She passed in the top ten percent of the test takers. She has a totally warped perspective of her abilities. I always say that she is better at absolutely everything than me, but whereas I might think, "wow, I'm really good at that" she's BETTER than me at a task and thinks she's horrible. I can't imagine living like that for so long.

She doesn't like being dependent on medicine for anything. She is very opposed to it in theory but also doesn't like that she gained weight on one medicine and then this last time she tried another med that made her feel nothing. So she dislikes the symptoms as well.

I never even thought of asking a counselor how to help. I wonder what they could tell me without actually knowing her but I can look into it. I appreciate the advice to be non-judgmental. My impulse is to go in an "mother" her and make her see a counselor etc. But she's very independent and would almost certainly hate if I did that. I just know it would do her good!

[marymoo86]

There's strong evidence that use of magnesium can aid in anxiety - specifically Mag Threonate. Opt for the purest/no filler form available. Epsom salt baths are also a good option.

You can also investigate EFT or "tapping" to help as well - another non-med alternative. Perhaps these may be helpful? I completely understand your sister's stance. I would avoid Rx as well if there was any other way possible. Sometimes, there are alternatives, and sometimes there aren't.

Diet can play a huge role in this as well.

[marinkitty]

Suggest she look into Dialectical Behavior Therapy. It isn't as widely practiced, but for people who "hate" more traditional therapy (usually CBT for this), it can be a huge improvement. it really isn't about exploring what's happening and digging deep so much as giving practical hands on coping strategies and helping to correct things like catastrophizing, delusional thinking and other similar behaviors that high achieving people with perfectionist tendencies and low self-worth tend to suffer from. Typically it involves individual therapy along with a skills group that meets weekly for about six months to go over all the different skills.

[Kindra178]

Suggest she look into Dialectical Behavior Therapy. It isn't as widely practiced, but for people who "hate" more traditional therapy (usually CBT for this), it can be a huge improvement. it really isn't about exploring what's happening and digging deep so much as giving practical hands on coping strategies and helping to correct things like catastrophizing, delusional thinking and other similar behaviors that high achieving people with perfectionist tendencies and low self-worth tend to suffer from. Typically it involves individual therapy along with a skills group that meets weekly for about six months to go over all the different skills.

Yes to this. This kind of treatment started as a way to treat folks with bipolar yet has moved to anxiety and depression and anger management.


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[bisous]

Suggest she look into Dialectical Behavior Therapy. It isn't as widely practiced, but for people who "hate" more traditional therapy (usually CBT for this), it can be a huge improvement. it really isn't about exploring what's happening and digging deep so much as giving practical hands on coping strategies and helping to correct things like catastrophizing, delusional thinking and other similar behaviors that high achieving people with perfectionist tendencies and low self-worth tend to suffer from. Typically it involves individual therapy along with a skills group that meets weekly for about six months to go over all the different skills.

I have never heard of this but will mention it to her. Thank you.

[StantonHyde]

Reach out to your local NAMI chapter. They focus on helping caring family members. They have lots of great ideas.

I have been on anxiety meds for over 20 years. The amount of energy I expended on managing withdout meds left with no energy for anything else other than work and exercise and other self care. I am able to live as my full self when I take meds. There is no shame.

As for counseling, DBT would be very helpful for your sister in her crisis state. Once that works she can go to CBT. I have worked my a$$ off in therapy and it hurts-but we do lots of hard things. That work allowed me to rebuild myself into who I am today.

I still see a therapist once a month for maintenance.

Maybe it would help your sister to talk to someone who is a couple steps ahead of where she is. NAMI could connect her. And sometimes you have to keep trying meds till you get one you like.

Good luck!!

[bisous]

Reach out to your local NAMI chapter. They focus on helping caring family members. They have lots of great ideas.

I have been on anxiety meds for over 20 years. The amount of energy I expended on managing withdout meds left with no energy for anything else other than work and exercise and other self care. I am able to live as my full self when I take meds. There is no shame.

As for counseling, DBT would be very helpful for your sister in her crisis state. Once that works she can go to CBT. I have worked my a$$ off in therapy and it hurts-but we do lots of hard things. That work allowed me to rebuild myself into who I am today.

I still see a therapist once a month for maintenance.

Maybe it would help your sister to talk to someone who is a couple steps ahead of where she is. NAMI could connect her. And sometimes you have to keep trying meds till you get one you like.

Good luck!!

I want her life to be like yours! I will try that organization.

[azzeps]

My husband has depression and anxiety. It's so great that you want to help her. Keep reaching out to her and encouraging her, is what I'd say. DBT is amazing. There is a class, and also she'd need to find a DBT therapist... at least that is how the program my DH was in went. Sometimes you have to keep trying different therapists until you find one you like. It takes time. Also, the meds sometimes stop working, or the dosage needs to go up or down, or another med can be added. It's hard when there is such a stigma against medication for mental health problems. I struggle with it myself... I think sometimes I could benefit from some anti-anxiety meds. I have managed it with essential oils and exercise so far, but I really should try medication, I think. Anyway, if you can help remind her of how well she did when she was on medication, that might be good. Gently, of course. And she needs a good psychiatrist or mental health nurse practitioner... those are hard to come by, I've found! But their expertise is worth seeking out.

Hope that helps!!

[magnoliaparadise]

Following, also for helping a loved one. I have never heard of some of these things (DBT and Dialectic therapies). Thanks for posting.

I just did a quick google and here is also some helpful things on what to say or not say:

https://thebodyisnotanapology.com/magazine/10-things-to-say-to-someone-who-has-anxiety/
https://rightasrain.uwmedicine.org/mind/mental-health/what-say-and-not-say-someone-anxiety
https://upliftconnect.com/8-things-not-to-say-to-someone-with-anxiety/
https://www.bustle.com/p/11-things-to-never-say-to-someone-who-has-anxiety-61031

Actually, I'm just realizing how many articles there are like this. If you google "Things not to say to very anxious person," many come up.
I realize that you are looking for more than just this, but even just knowing what to say/not, I have found, is helpful.

[mackmama]

Yes to this. This kind of treatment started as a way to treat folks with bipolar yet has moved to anxiety and depression and anger management.


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DBT actually started as a treatment for Borderline Personality Disorder (not bipolar). CBT is the gold standard for anxiety. DBT has been shown to be effective for PTSD.

[Globetrotter]

I understand she Doesn’t want to take meds, but it can really be life-changing, These meds should not be stopped suddenly. That can cause more complications, so she really needs to continue the treatment and if she wants to wean, she has to do that with the help of a doctor.
I have seen it in my mom. Before she agreed to get treatment and things were very bad, due to other complications, I went to therapy myself to deal with the stress and also to understand how to help her. NAMI has Support groups, though I have never been to one as they are a bit far from me, but there’s also an online forum for families. It’s not very active as it seems they had moved from another site. It’s worth a look!

I think severe anxiety probably requires meds, but therapy can also be very beneficial. my mom Has incorporated breathing techniques into her daily life.

Your sister is very lucky that she has such a thoughtful, caring person to look out for her.