Just really confused how to help my twin sister who is in inpatient care. She is currently really depressed and wants to end her life and tells me that letting her die would be the kindest thing to do.
When she was at a mother and baby unit the doctor said that ECT wouldn't work for her as she doesn't stay depressed (she gets better and then severely blips). But now she is in inpatient care a doctor said ECT would help. She is also not getting better as quickly as before and seems to be staying depressed. Maybe that is good if she gets ECT as I think she needs radical treatment.
I can't really get second opinions as she is sectioned but really feel that the right doctor could make a difference. Not sure if we should consider going private - but this would be a lot further from home, now she can see her baby every day.
Just feel so lost, no one seems to understand her. I hate to see her so depressed and suffering but have hope that something must make her better.
All your posts and replies are really helpful - but not sure how to help my twin sister and feel so helpless.
I am also not sure how to look after myself.... I want to do research to help her all the time, be there for her... but now I also need to be strong for a long time to be there for her and my family and myself... but so hard to know what to do when you watch your loved one suffer and are not sure if the treatment she is getting is correct!
Thanks
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Chaource
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oh gosh Chaource I’m so sorry your family and your sister are going through this. Perinatal disorders are so severe and so so awful. My heart goes out to all of you.
Whatever you do - do NOT let her out of the hospital and out of sight of the professionals. If she is suicidal - she needs to be in house. I was let out too early from the first hospital (after only a week) and became suicidal (have never been suicidal or severely depressed before in my life) and was telling my family how their life would be better without me - to please not forget me.. but I “knew” that I had to “end it all.” This is all the disorder talking. Now that I’m better - it feels very strange that I behaved like this. As if it wasn’t me but some zombie that took over my brain and body. I was sectioned again and stayed for longer at a different hospital… until I got stable.
Your sister will get there. Don’t believe what she is saying. She is not herself. That is not to say don’t take her seriously. She means what she says. If she is talking out in the open about suicide then that’s the state she is. It’s actually good she is talking and not keeping her ideas to herself - because you can clearly see she is unwell. Instead of her pretending she is ok and then acting on it.
She needs to continue staying in the hospital. I would ask the doctors about mood stabilizers (like Lamictal or even Lithium - I heard that was good too) as well as continuing Olanzapine - which is an antipsychotic but helps in treatment -resistant depression. Or if they discontinued it for good reason - May be another antipsychotic? ECT is another avenue to try.
In the meantime - perhaps you can reach out to gynecologists or her GP or even ask around at the hospital she is in now - for a referral to a perinatal psychiatrist or even just a regular psychiatrist who has experience with perinatal patients. A second private opinion can’t hurt. (I had 3 separate doctors at the hospital then had 2 different psychiatric nurse practitioners treat me until I found my current psychiatrist who I will stay with.)
If you decide to transfer her to another hospital under a care of a different doctor - make sure this is done by an ambulance. While she is in this very vulnerable state (feeling actively suicidal) - you can’t bring her home or leave her unsupervised even for a second; don’t attempt to do this by yourself. Professionals need to handle her. This will also give you peace because you know she is safe while you and your family gather energy to help her.
A lot of us on here have been suicidal. We have all healed. And look back on this like a horrible nightmare.
Please stay strong and take care of yourself. Get sleep. Take sleep aids if you have to. I know it’s hard to feel helpless - so when you do have the energy during the day - find second opinions; reach out to Jenny at APP and other APP admins - I believe there is a psychiatrist doctor who specialized in PPP (post partum psychosis) who may be of help to you. Women have reached out to him for second opinions. Unfortunately I don’t have the contact and I’m also in the US. But I think I remember posts on here about it.
Whatever you do just keep her at a hospital - in the current one or transfer under professional supervision.
Also I didn’t see my baby for weeks. It’s not allowed for babies to be brought into a psychiatric unit in hospitals in the US and we don’t have MBU’s here.
It’s not ideal but it’s ok. The priority right now is to give your sister the best treatment to get her to start feeling better. But once again if you decide to transfer her to a different facility - make sure this is done by professionals; in an ambulance, etc.
I’m praying for you that ECT works. And hopefully she starts feeling better at the hospital she is in now.
another thing I was thinking - if you do find a private psychiatrist who you like and seems to have different ideas of how to help her - can he/she visit the current hospital she is in and provide additional guidance? This is how it works in the US at least - a consult physician can come in and give advice.
Dear Chaource, I am sorry that you are so understandably concerned for your sister. A patient u dear section would normally be closely monitored. I think it can be so difficult with mental health recovery, it can be such a balance with medication and symptoms and recovery can be so up and down and take time. Are you her Next of Kin on her record or does she have a partner to attend any meeting with the medics. I wonder how long your sister has been under Section, having read that after three months if she is not in agreement with her treatment it can be possible to seek a second opinion, there is the possibility of a SOAD, Second Opinion Appointed Doctor or your sister could have entitlement to an Independent Mental Health Advocate. Also have you considered the hospital organisation PALS for advice. I do know how difficult it is to see a loved one suffer and hope you have good family and friends also in support of your sister and yourself. This is a lot to carry on your own, try to share with those you trust and are kind. Don’t forget to take care of you, especially if you have your own family to think of. Wishing your sister well soon.
Thank you Judith this is extremely helpful - really really appreciate this. Do you know where I can look into requesting a SOAD? Would this be a private doctor or NHS or either? Thanks so much
Dear Chaource, I hope you got some sleep and that this will be a better day for you and your twin sister. Not an expert by any means, I just typed into the search engine ‘second opinion when under mental health section UK’. There I found SOAD. cqc.org.uk/guidance-provide... and other information. Lillybeth also has very useful information, Mums have successfully sought help from Cardiff. So many Mums here bravely willing to share their very difficult Postpartum story to recovery, each one similar yet unique. So sad for you and your twin but she can come back to you, with time and care, as the sister you know better. Thinking of you, hoping and wishing for health and peace for your twin sister, you too, take care of yourself.
I’m so sorry you are struggling with your own health in trying to find help for your twin sister who is in inpatient care.
As mentioned, there is a second opinion psychiatry service (CUPS) based at Cardiff University at app-network.org/get-help/ta.... Their aim is to assess and advise clinicians and patients in diagnosis and management. If you would like a second opinion from CUPS then you will need to discuss this with your sister’s clinical team.
I had postpartum psychosis twice, followed by severe depression many years ago. Like your sister I had intrusive thoughts and ideas of suicide and was sectioned to mixed general psychiatric care for my own safety via A&E. I was completely shut down and medication alone was not working. I was in a very frightening place in my head.
ECT was suggested and as I was so ‘switched off’ my husband agreed to the treatment. I have to say that for me it was a life saver as I was on a path of self destruction. I had 7 sessions at first in tandem with medication which made such a difference. Then with more sessions I began to recover and had so much to live for.
Your sister will be safer in hospital than she would be at home. Also, I imagine it’s hard for you to sleep with worrying but it would be even harder if your sister was discharged to your care. She is very poorly and her thoughts are not her own but her illness.
I hope you will be able to find the help you need. Please take care of yourself as you have a lot of stress but we are here to support you and your twin sister. 🌻
I am guessing you are all well now which is amazing! This gives me so much hope... I just hope she can get ect quickly in the NHS (the doctor now thinks she may need it but we are not sure if she will be able to get it quickly) otherwise we can go private as she is suffering so much.
I'll also look into getting a second opinion with Cardiff. Thanks again and so glad you got out of this x
I’m very glad my experience has given you hope. Thankfully I am well now as my episodes were so long ago.
I hope your sister’s care team will be able to access the care she needs as soon as possible. I think the CUPS team offer consultations via Zoom. I had the privilege of meeting Prof Jones and his team during his research before he was based in Cardiff. He was so kind and reassuring.
So sorry your sister is feeling like this. It sounds like the professionals are suggesting treatments and I really hope they help for her. I never had ECT but it was suggested to my family and my perinatal nurse swears by it.
It looks like a lot of other comments have useful suggestions about second opinions etc.
Your sister is in the best place at the moment.
I don’t have any advice but just want to say you’re a fantastic sister! Please try and share the load with any other family or partner. My PPP was absolutely horrible for me but also terrible for my husband and family to witness. Look after yourself and if you can try and get some professional help (even through an EAP through your work if you have one) to talk things through.
Sending lots of best wishes to you, your sister and her little one x
i’m sorry to hear how tough things are. You sound like a wonderful twin sister and i’m sure your twin will take comfort from your support.
As others have said, your sister will get better and the priority is her safety. I experienced very strong suicidal ideation when I had PPP. I didn’t have ECT at that time but when I had a psychotic depression in perimenopause I didn’t have ECT and it felt like a miracle as I recovered from my psychotic depression so quickly and so well.
Once the psychiatrist has recommended ECT the waiting time should be quite short.
I'm so sorry you, your Sister and your family are going through this.
May I please ask what medication she is currently on? Have you tried switching medication? It could be she's having negative side effects associated with this? Have you also tried possibly adding an antidepressant to help her mood?
I'm not a medical professional and just someone who's sadly had PPP so I don't know what is best for your Sister but I'm just trying to offer another insight as many medications have side effects - some people get none whereas others can get them all.
I'm so sorry to hear about your sister, and how poorly she is. It must be so hard to see her so depressed, and wanting to end her life. I'm so glad you can reach out to us here.
There are many of us who felt suicidal like your sister, and we recovered and got through it. Your sister can get through it.
I know you have already received some good replies, including someone mentioning the second opinion service in Cardiff, which is generally where we signpost people to for second opinions. They are specialists in postpartum psychosis and Bipolar.
I didn't have ECT myself, but know many people who do, and they say that it helped them tremendously. It can be scary to think of, as there are a lot of misconceptions about it, but everyone I know who has had it do say it saved their life. Perhaps this is something your sister could consider? it sounds like the psychiatrist in the unit she is in is suggesting it?
I hope you can somehow finds ways to get support yourself, and to look after yourself. It is a lot to support someone who is struggling so much.
Take care, and know you can write to us here about anything
I am sorry to hear that your sister continues to struggle with suicidal ideation. That was my experience also. It continued for years, actually, and medications they put me on were not terribly effective. I have since learned that this is often the case with PP. At the time I was ill, which was over 20 years ago, they did discuss ECT with me, but I refused it because I didn’t want to risk the side effects. I’ll never know if that was the right decision. Now I wonder if it may have been better than staying on medication for so many years, as they were not terribly effective and greatly affected my long term health. With the advances they have made in the safe administration of ECT, if I had to do it all again I think I would try it.
I am always in favor of a second opinion if you can get one. Two minds are often better than one. Sometimes it leads you to a third opinion, if the first two differ greatly, because then you don’t know what to believe. But if the first two are similar, it gives me peace of mind that I’m doing the right thing.
You must take care of yourself, and that includes not researching and being anxious all day long, every day. (I know how hard this is because I have to stop myself also.) This is for your own mental health. Your mind needs breaks, or you could be subject to a health crisis yourself. You must stay well so that you can be there for her. Get out in nature, if you can. Do something sensory, like art, or a hot bath, or meaningful exercise, at least once a day. Your body and your mind need this for you to stay healthy. If she is in the hospital, you can’t help her every minute, so take a few minutes to tend to yourself. I know it’s not easy, but try.
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