People who don’t seem to get better -Why?

[Ramblify]

Hi, I have lived experience with depression and anxiety. I consider myself lucky that I received good help from health professionals. I knew from a young age (16/17) that I didn’t want to be like my parents; and I wanted more from life.
Recently, I’ve done a basic course in Individual Support (Disability); and have been working with people with disabilities and more recently, people with mental health disabilities. What I see a lot of is people who aren’t able, or just don’t want to, engage in their goals. Most have very bad living conditions - mostly dirt and hoarding. Basically they buy things and don’t clean, or have any organisation system. I also have lived experiences with these issues. The difference I think??? Is I was able to ask for help and if I didn’t get the right help or person I could look elsewhere.
Im just rather perplexed at what happens to people to get in the states’ I’ve been witnessing? Have they given up on life? It seems like they don’t want to get better. Are they medication resistant? They don’t seem to like any doctors, Psychologists or Psychiatrists - they think they’re old dinosaurs and they find them pretty much useless. I have certainly had a few experiences like this myself, but I just found someone else. I guess I am lucky I have openess as a trait?
mother people I have know who have had eg: a diagnosis of anti social personality disorder, and once they got the diagnosis they pretty much decided they were f&$@ed and nothing could be done; and stayed in their bedroom in their parents house for 20 years.
I can’t totally relate to fear of failure (or success), low self esteem, low self worth, being and feeing overwhelmed and paralysed, procrastinating. But I guess I am (by nature??) somewhat resilient. I just wanted to get feedback about the notion of people who have mental illness who can’t be helped (usually because of their mental illness). How do people become stuck? Is it a lack of insight? And personality traits!? Are they just a lot sicker than anyone ever knew… I’m struggling to comprehend.
thnaks

[Hanna3]

Hi Rambifly

Thanks for asking for help with understanding the problems you're encountering in your (very valuable) work.

May I ask if your clients are mainly elderly or are they mixed ages? Are they all hoarders or have other problems as well?

My limited understanding of hoarding is that it's primarily an anxiety disorder and they find it very difficult to part with their possessions.

Are your clients living at home? Do you know if they also suffer from other mental health issues?

I'm not sure from your details if they are reluctant to part with things or have underlying depression or possible dementia.

It's great that you have come here to try to get greater understanding of how to help the people you're caring for!

A bit more information would be helpful if you can?

Others may come by in the meantime with some suggestions.

I hope to come back to you tomorrow. Meanwhile I hope others can make suggestions to assist you.

I'm glad you're keen to help and understand your clients, good on you. I hope people here can help.

🙂

[Ramblify]

Hi Hanna,

Ive worked with all sorts of clients older younger, profound intellectual disability AND complex mental health problems (as it’s difficult for professionals to diagnosis people with intellectual disabilities, especially non-verbal clients, hoarders and non hoarders. But to be more specific, My current regular clients that are mental health related looks like this- one is in their early 60’s, a history of mental health - depression- been hospitalised in the past and has also had electric shock treatment, they’re on antipsychotic medication, and also have a leg injury and they use a zimmer frame. They have some memory lost and can be a bit slower to process things. They live with their elderly mother who is their ‘official carer’ but the mother has memory issues too that she tries to hide. I take them to Drs appointments and they come out of the appointment not really being able to explain why they were in there. This client is easy.
I have another client who has a diagnosis of major depression and anxiety- they’re in , probably their 50’s… have been hospitalised many times. Not a hoarder, but after a long time of cancellations I finally met them and they showed me their house. They had posters of stuff piled up - I went for 2 shifts, and scrubbed their dishes that had been sitting there for 12 months or more - they dried some of the dishers and put them away. They’re not able/or don’t want to engage in the work; also can’t answer any questions. Wants to see what I’m doing so as to know I’m doing things in the correct ‘way’, they have no problem expressing the method in which they want their dishes and kitchen cleaned - but won’t engage much. They also have very up and down moods and partake in self destructive behaviours. This client is frightening for me I feel out of my depth - And I worry I’m being taken advantage of and manipulated. Also the fact they seem hesitant to participate could mean I’m enabling them not to face their issues of not cleaning. The client is very closed to conversations they don’t want to have. They won’t talk to anyone else or let anyone in their house. They really need a cleaner. But now I’m the only person they will talk to or deal with. It’s a heavy load and I’m not sure it’s healthy for my own mental health.

[Ramblify]

I have another client also in their 60’s who is reclusive, their house is very dirty, but they don’t care, their hoarding isn’t that much of an issue- there’s places to sit down. They’re on antipsychotic meds and have been in and out of hospital- they believe people are stalking them. They also cook things in the oven and forget about it for months - then find it rotting. Or put things in their bag and forget about them until they open their bag and it’s covered in goo. That is not really a problem; the problem is they don’t want to engage in activities or really do anything. Somethings they do want to do are unusual, not logical and not thought out well or something isn’t getting through.. I don’t really want to give an example incase it compromises their identity. But I can say their thought process is out of order and either they don’t understand certain aspects or just don’t want to. They also don't like or trust their doctors. I’ve been working with them for approximately 6 months and not much progress - they don’t have a goal so hard to know. I can’t get them engaged in anything.

[Hanna3]

Hi Ramblify,

Thanks for that information, it sounds like you have a challenging job. I wonder does your employer give you any advice or assistance with managing your clients? Do you have any training in working with people with mental health issues?

Just a thought, I wonder if it would help to listen to some podcasts about hoarding and Google about it, as it's a recognised mental health disorder. It would be something that's very hard for you to deal with alone I think.

We have talked here on BB about how much people with mh problems struggle with housework. We haven't found a solution! There is quite a bit on the internet about depression and housework if you google that.

I don't know that I'm much help to you and other people may come up with some ideas for you, but it does sound like these poor people are struggling with severe mental health problems which make coping with everyday tasks difficult and often overwhelming.

It sounds like they really need more help than you alone will be able to provide, which makes things hard for you.

Are you able to discuss these things with your employer or other employees? It really sounds like these poor people need more support than they are getting, but I'm well aware mh is under-funded.

I know they do need kindness and compassion. You sound like you are very concerned and trying to do your very best for them, which is wonderful. Just be mindful that you don't want to get too burnt out from it all yourself.

Depression can sap people's motivation, and as housework and cleaning are neglected and pile up it becomes overwhelming. It's really their mh that needs treatment first.

I also wonder if the one with food rotting has dissociative disorder of some kind or dementia? Periods of dissociation, or losing time, can result in things like this.

I really think a chat with your employer or your clients' mental health team would be a good idea.

I hope others will come up with some ideas for you here on BB.

You sound very caring and I really hope we can give you some support in what sounds like a challenging job.

BB may be a bit quiet over Christmas but I really hope others might have some suggestions for you.

Let us know if any of this helps or not! Good luck with your wonderful work! 🙂

[Hanna3]

Hi again Ramblify,

I have to make separate posts because of the word count!

Reading about these poor people made me feel sad that they are so alone and neglected and in need of help. It's wonderful that you care enough about them and yourself and your own mental health that you've posted here on BB.

Do you have support yourself? Is there any assistance for you with your employer? What about at home? Dealing with people with these problems and disabilities must be an emotionally challenging job.

I used to dissociate as a child due to trauma and my mother used to find rotting sandwiches in my school suitcase and got very angry about it, but I honestly didn't know they were there. Dissociation can be a way of dealing with trauma.

It does sound like a professional cleaner is needed too, and I don't know if that can be organised for these people?

I feel sad that our society leaves people like these so neglected. It shouldn't be happening.

It shouldn't be all down to you to try to fix it all either.

Mental health is deplorably under-funded and as a country we should be ashamed of that.

I'm so glad you've posted here and I'll come by again later and see if others can come up with suggestions to help you.

Cheers my friend! 🙂👍

[Ggrand]

Hello Dear Ramblify,

Depression, can have a huge impact on our bodies as well as our thought pattern ina very over tired mind....it isn’t just the mind.

Then add on top of depression, anxiety, fear of people, PTSD or other mental or physical problems...It gets extremely hard to manage everything each day....and a feeling of totally being overwhelmed with every aspect of life, might take over ourselves and it’s hard even to get out of bed some days, and surviving daily becomes really hard.

I have a huge want, to get well as I think at different times everyone struggling with mental health does....and they try hard to...only to be knocked down again, to start all over again....Depression is so complex and different for everyone.

I used to buy ornaments to comfort myself, some buy clothes, trinkets, books, etc....I ended up with ornaments every where....It’s the same I think as comfort eating....Buying something lifts us for a few seconds just like comfort eating, trying to get the little feeling of pleasure that comes with it.

I also have different depths of depression, the deep dark place is impossible to do anything except to try to survive it...other times, I’m fine with cleaning, looking after myself etc.

I have a mental health support worker, I told her my goal over 2 years ago, which was and still is...to be able to go out shopping in my big town on my own or to be able to walk anywhere without feeling so much vulnerability and fear....She promises to take me here and there...but it doesn’t eventuate....she doesn’t follow through with it....slowly my trust for here is disappearing..I couldn’t be bothered to even try now...even though my want is big in doing it....my depression, anxiety, ptsd takes over and tells me...it mustn’t be that important if my support worker constantly let down.

What I’m trying to say...is mental health... depression, anxiety etc..is just so complex, different for everyone...and even if you could jump inside their thoughts....It still will be so hard to understand what a person with mental health diagnoses is actually going through, thinking of behaving within themselves.

Most times it’s because of not wanting to get well....but it’s more like, wanting to just exist and get through each day the best they can..

I do hope you find out what your looking for....but everyone’s depression is different and needs to be treated and supported as such...

These are words of how my mh can effect me..

Kind thoughts Dear Ramblify..

Grandy..

[Guest_1643]

Hello ramblify

I found this post a it upsetting, but that's OK. I think being trauma sensitive would help in that we can understand not what's wrong with ppl, but what happened to them, which leads to this. It's not laziness etc or bad qualities of character.

I've met many ppl whomlive with their parents in their 30s and 40s during my stays at hosptial.

It's different in each circumstance,

Also, privilege of having someone to believe u and support u, helps.

I also feel that this being a mh forum, some ppl here may also be I the potions u mention, do u ask for data from us? Each person is their own world and universe. We are complex and most ppl in such positions have never had anyone love, believe in, or see them. The first step for my healing and getting unstuck,mwas being believed.

[mmMekitty]

Hello Ramblify,

I'm somewhat reluctant to try to answer the questions you have. I am concerned that with the 'basic course in Individual Support - Disability', that you are working with clients who are difficult to engage, &/or have complex needs. At the very least, I hope someone is supervising your work until you have undertaken much more study & training, & have more experience.

This last paragraph of your first post in this thread, "I can’t totally relate to fear of failure (or success), low self esteem, low self worth, being and feeing overwhelmed and paralysed, procrastinating. But I guess I am (by nature??) somewhat resilient. I just wanted to get feedback about the notion of people who have mental illness who can’t be helped (usually because of their mental illness). How do people become stuck? Is it a lack of insight? And personality traits!? Are they just a lot sicker than anyone ever knew… I’m struggling to comprehend." I'd like you to think more about & try some exercises in empathy.

What do you think it feels like to have no self-esteem, no sense of being worth the time of day, or a kind word? What do you expect someone to want to do when, for them, everything feels 'too much'? How does it feel to be afraid. whatever you do, when failing means you're really the loser you were always told you were, or when success could feel undeserved, or lead to expectations you don't have any confidence in being able to deliver?

I am curious, of the clients you see, how many of them actually asked for someone to come into their home, or was your imposed upon them? That in itself makes a huge difference.

& I think, such significant problems as you've outlined could not be taken on all at once. It may be more useful to take one small step at a time. & try to find out what the limitations of any help you might offer might be.

Oh, & is 'electric shock treatment' the appropriate term?

Finally, how do you regard your clients - as patients, clients, a set of diagnoses, or people? As I read, I wasn't sure.

mmMekitty

[Guest_1643]

Hi all,

Re ect sadly I do think it's still called that. I don't agree with that treatment.

There is a diagnosis , a personality disorder in cluster c of the three clusters, called OCDP. A person may not have all traits to be doagnosed with it, but one of the sympoms can be hoarding. Like a lot of personality disorders, it can be linked to trauma. Maybe reading about this might help u?

Trauma in general has a huge impact on ppl...and myself having trauma means I often feel trapped and alone. People's pasts can shed insight on their struggles, in my opinion.