Depression and therapist, does it help?

Hello Everyone! Does anyone take your loved one w/PSP to a psychologist or psychiatrist to help with the depression? My sister has on numerous occasions has crying spells mostly concerned with fear of dying and the absence of our mother, who died in 2005. The first time she got upset and wanted to know what it would be like to die and that she was so afraid, I just about lost it. I wasn't prepared to have an answer for her, I talked to her and reassured her I would be there for her, no matter what. It seemed to help at the time, at least she calmed down. Anyway, I thought that a psychologist might be able to handle her fears better than I can. Any thoughts out there?

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  • Hi - yes my wife has been seeing a psychiatrist to help with depression and anxiety .Talking about it for her is not a great help as she has cognitive impairment /dementia and gets very frustrated not being able to find the words to express herself . She has been put on a drug called Mirtazapine which doesn't completely resolve depression etc but does help a little . We have seen different psychiatrists over the last two or three years and I have to warn you some of them have been quite potty ! Get a good one and they seem to be transferred to other places such are the vagaries of the National Health Service .Good luck !

  • George did you get the CHC? X

  • Still waiting to hear .

  • George I just can't believe they are taking so long to get back to you!!!!

  • Three to six weeks and we are on four and so it rolls on .

  • Our Hospice offers counselling . If she is able to talk that would help.

    A psychiatrist would prescribe medication if she needs it.

    If she can talk then I would get her some counselling as soon as possible. If she then doesn't talk [ my husband didn't] at least she has had the chance.

    Its normal to feel scared and depressed.

    love, Jean

  • My man has not been depressed so far, but I think talking to a hospice nurse might help. They know more than most about the act of dying and how to relate to any person who knows their life will end shortly and is frightened or depressed by that knowledge. That will be my first place to look for answers when we need them.

  • Never thought about it other than for my black dog days when exhausted. Never offered. Do you think it does any help?

    Best wishes Tim

  • Hi Tim,

    I`ve been twice for counselling at my local surgery and I must admit I don`t feel any benefit apart from talking to someone impartial about P`s/my situation. All she said was that after listening to our story, she felt like crying too !

  • Oh what a dark comedy, NanBabs .After reading your post, I giggled and felt awful at the same time.

  • I must admit it matches my sense of humour too !

    Xx

  • It is very difficult to find an effective psychologist. Most are broken themselves and are attracted to psychology searching for a cure. Finding a good one is expensive and exhausting.

    Mum took a small dose anti depressant, which did help keep her perfectly understandable anxiety under control.

    Might she be deficient in vitamin D? Most of us are, and that can make depression worse. It is important to get out of the house (remember sun hat and dark glasses)

    I used to reassure mum, in the early days, that no-one dies of PSP. That the challenge is LIVING with PSP. I used to point out that none of us ever know whether we will still be alive tomorrow, and that none of us were alive 100 years ago, or will be here in another 100 years time. Wherever we were 100 years ago will be the place we all return to. NONE of us will get out of here alive! Trite, I know. But true. We must all revel in the sunshine while we can.

  • We have a winner! I have read all the posts so far and Formercarer, yours is the one that answers anyones anxiety! You are right It's living with PSP that is challenge.....

    AVB

  • A lot of those things that you have written in your post, former carer, are the sort of things that the neuropsychiatrist has said to my husband in the past but I expect he was paid an enormous amount for saying them!!!!!

    DenB x

  • A counsellor would help the sufferer or carer explore their anxieties. A psychologist works at a deeper level and I don't think that is what is needed in this situation.

    As a counsellor with a psychology degree I would disagree that we are all "broken".

    I had counselling free from our local carers place. It is also offered free by the hospice. They are trained to explore the sort of issues we are facing - not to explore your psyche. Its an opportunity to off-load fear and anger.

    Would recommend it, Tim !

    love. Jean x

  • About a year ago I had two 12 week sessions with a counsellor, provided by our hospice. They were an invaluable opportunity to talk about my very complex feelings surrounding D's diagnosis. Feelings of loss, resentment, fear and lack of control are very debilitating and not something it is easy to talk to family or even close friends about in any depth. Talking to a sympathetic stranger certainly helped me to acknowledge and tackle my own thoughts - a sort of anchor in a rough sea at a time when everything was chaotic. The counsellor was very good and I liked her personally which helped a lot. I know I can always contact her again if struggling so that is reassuring too.

    Vicki x

  • Yes. My guy had three visits with the Pschologist at the VA, and it helped us both. He did say things to her he hadn't said to me. I was surprised at how much comfort he got out of it.

  • Hello Gracie_Girl

    It's so hard to see someone we love suffering like this.

    Writing as an ex-pychological therapist (NHS) with much experience of this sort of thing.

    Please treat these as comments rather than anything authoritative. Its not really that safe to offer advice on someone I have not met.

    If you are in the U.K. - A psychiatrist would most likely try one of the selective serotonin reuptake inhibitors (SSRIs).

    nhs.uk/conditions/SSRIs-(se...

    Your G.P. should do the same as that is what is specified in the NICE guidelines. So really GP should be first port of call.

    If you want an assessment from a Psychologist then your route would again be through your GP for the referral.

    SSRIs are good for easing the dwelling thoughts and lessening the depth of emotional pain in the moment. They are not a 'cure' but they can give someone enough of a break to get a little more perspective.

    Talking therapies with s Psychologist: For talking therapy to be effective the patient needs to be able to retain the information and reflect on it sufficiently to learn and then change their perspectives and in turn their thoughts. This applies equally to all talking therapies including the Behavioural group such as Cognitive Behavioural Therapy which would be the first choice for many therapist for this issue.

    PSP most often comes with slowed processing and difficulties in learning and changing thoughts and behaviours. It that will be the therapists key focus in the assessment. Processing 'loss' and 'fears' requires the patient to learn.

    Other things to consider:

    Does your sister have a degree of emotional dysregulation. E.G. Could it be the PSP and brain changes driving these spells? If so you might try giving her a hug affirming the pain and sadness and changing the subject.

    Tiredness: Folk can me susceptible to being more emotional when tired. Some reassurance a hug and a nap might help?

    The theme that should run through all conversations are that the loss and fear of dying are real and understandable.

    I am cautious to go into the 'fear of dying' part without having had face to face contact. Death and our beliefs surrounding it is such a varied and personal thing. Does she have any beliefs in this area? A talking book, author reading their book on the subject of their own belief system might be supportive?

    I do hope there is something her which is helpful.

    Hugs to you both.

  • Really good comment, Kevin. Clear and concise and helpful.

  • As always , very informative K1, thanks

  • Thank you easterncedar and abirke - appreciated. Trying to get this stuff right for me n Liz too

  • How does the book "A talking book" explain fears of death. The summery said it is about how black people/Americans look at The Bible. I always try to dig deeper into information about a book before I read it. Who wrote it?

  • My husband has been seeing a neuropsychiatrist since the beginning.

    We have both been given so much help and support from seeing him every 6- 8 months and having visits from a neuropsychiatrist nurse who visits every 2-3 weeks to keep him up to date with anything that is going on with my husband. Anything that has been prescribed has been closely monitored and altered as need be.

    The neuropsychiatry nurse has become a life- line, as is this site. We have seen her more than any other medical professional and her help, support, knowledge and advice have been invaluable.

    It was our then GP, that put us in touch with these lovely people.

    DenB x

  • Thank you all for your replys and helpful answers. I did take my sister to a psychologist and I believe he will be able to help her some. In addition to her fears of death due to PSP, she has problems dealing with guilt concerning the death of our mother 10 years ago.

    In the last couple of weeks she has been getting extremely combative and won't listen to my help to keep her from falling. When I suggest that she not do something, she goes as far as laughing in my face. During one of our psych sessions, it came out that she does this to make me mad, she thinks it is funny. Well, needless to say, I haven't handled my feelings well. I've had a couple of intense crying jags and unfortunately, I ashamed to say, have yelled at her when she does something stupid that would definitely cause her to fall. Since I have been caring for my dad and her nonstop for the last year, my cousins have urged me to take some time off and get some respite help. So, I finally made the decision that I am not Wonder Woman and I can't do this by myself or for an extended time, I made plane reservations to Florida to visit with my best friends. It surprised me at what a relief it was that I made that decision. I guess I was in some serious denial or fear that noone could take as good of care of them as me. Just shows my own insecurities, I guess. Now, I fear the confrontation at telling her I'm taking time off. I told Dad and he is all for it, even if he is uncomfortable at having someone else here. I don't think she will be that easy. But, today's the day that I tell her. The only saving grace is that one of her good friends has volunteered to stay with them for a week and do all that needs to be done. And my cousins are chipping in with some time too. That God for family and friends!

    Sorry to be so wordy. I really just wanted to thank all of you for your support and advice. God bless.

  • Enjoy your much needed break. It will help put things into perspective for you both.

    Jean

  • Enjoy your break! Try very hard not to feel guilty, there is NO NEED!!! Who would look after your Dad or your sister, if it wasn't for you. Like you say, you are not Wonder Woman, nobody asked whether you would mind taking care of your family, you are not trained, you do it out of love, like the rest of us. Don't be ashamed, because you yelled at your sister, it won't be the first time you will have done this, I hope it's not the last. We live in an abnormal life, but we still have normal feelings, frustration, anger, sadness, heartbreak, need I go on? Everyone of us shouts and screams at our loved ones. I know for a fact that S would much rather have me ranting and raving at him, than some silly little care assistant, going " Aahh bless!" (English expression for patronising!!!) so please, go away with your head held high, knowing you are doing a brilliant job and have earned a well deserved rest!!!

    Lots of love

    Heady

  • Thank you so much for your words of encouragement! It really helps to hear it from all of you, since you have been in the same horrible boat.

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