Dear Dr. Archer,
I'm in my 40's, and my mother has suffered from severe depression much of my life. It was really bad when I was in middle and high school. During my senior year she spent a month at a psychiatric hospital, and has spent most of the years since on Prozac or Paxil, which helps her tremendously.
She's a very spiritual woman, and several times during the past 20 years she has tried to take herself off her medications because she believed God was going to heal her. Of course, things went downhill quickly and she'd have to get back on them every time. Recently things have taken a rather frightening turn.
She has expressed to me that she was having thoughts of violent ideation, of wanting to hurt others instead of herself, which was often the case. She didn't trust herself to go to public places without someone with her because she was afraid she would act on those impulses.
She told my sister and me because, in the past, she has often spent time alone with our young children. She no longer feels safe doing that. She told her medical doctor, whose response was that he couldn't see her doing anything like that. My mother is very sociable and likable. She makes friends easily and is very talkative.
She visited a Christian healing center where she hoped for an exorcism to remove a demon, which never happened. She told me yesterday that even though she hasn't been having those violent thoughts as much anymore, she feels like she's at a dead end, a downward spiral with no bottom.
She doesn't entirely trust medication, and strongly believes that there's a spiritual aspect to her issue. I am skeptical of this, myself, even though I am a Christian. But mom is much more extreme in her views. She's not happy with the place she finds herself and doesn't see any way out of it. I'm at a loss as to what to do.
I no longer leave my children alone with her. I live about an hour away; my sister lives in the same town but is rather consumed with her own life at the moment. I'm not sure how to help mom or where to direct her. I would appreciate any psychological suggestions you could give me, although I don't entirely think mom will follow traditional medical advice.
Obviously if she actually acts on these thoughts then we will have much bigger problems to worry about. What do you think? Thank you for your time and consideration.
Jennifer
Dear Jennifer,
Your mother could be suffering from a few disorders, I don’t know, I haven’t evaluated her. BUT, the number 1 predictor of violence against others is TALK about commiting violence.
If your mother is worried and thinking about this, you should be worried as well. I am at a loss as to why her psychiatrist is not taking this seriously.
Some who experience psychosis also experience violent thoughts which must be addressed, because these hallucinations and delusions can potentially be very dangerous; even more so when they include voices saying, "He is after you, you must kill him before he kills you”. These are called command hallucinations and can lead to murder.
RED FLAG: Hallucinations and delusions coupled with speaking thoughts of violence against others are always high risk! Take these as absolute threats!
Your mother needs to be on the correct medication, which will clearly be more than just an antidepressant -- probably at least one antipsychotic. Talk to her treating psychiatrist and tell him what your mother is experiencing and has been discussing.
Let him know that you no longer feel comfortable leaving your children with her. If he refuses to believe she is capable of violence, then it's time to find a new doctor who will address these symptoms.
The most important thing I can emphasize to you AND her doctor is: Take what she says very, VERY seriously. She needs treatment. I wish you all much success.
Dr. Archer
