Maybe I’m Not as Sane as I Think I Am

For the past few months, I’ve been researching mental disorders, trying to find a classification for my dysfunctional homeless brother to see if there would be some indication of how I could get him out of my life. I thought he was bi-polar since he does suffer from depression, manic episodes of anger, and grandiosity, but he exhibits too many strange, sometimes terrifying, and often irrational behaviors to have a simple mood disorder.

A good indication of his problems has been the names he calls me, and the disorders he accuses me of having. So often people — even so-called normal people — project their problems onto others. And I seem to be my brother’s projection screen. He tells me I have a dissociative personality disorder. He tells me I’m a paranoid schizophrenic. He tells me I don’t care about anyone but myself.

mindSounds like a good place to start looking for what ails him. The closest thing I’ve found to describe him is schizoaffective disorder with some OCD mixed in. Or a paranoid schizophrenic with bipolar disorders and OCD. One of the indications that he’s had a break from reality is his spitting. Such a simple thing to create chills — that ptoo-ptoo-ptoo makes me want to run far, far away. I’ve had a hard time tracking down the symptom since it doesn’t seem to be all that common except in certain cases of bipolar disorder and narcissistic rage (and wow, does he have rage!), but recently I’ve found instances where some paranoid schizophrenics spit for the same reason my brother does, to “get rid of the poison.”

I’ve learned a lot through my researches, especially how prevalent mental disorders are, which makes me feel so very lucky, but finding some sort of name for what is wrong with my brother helps not at all. He’s still swinging from one mood, one personality, one delusion to another. (Though oddly, he seems to save his invectives and delusions for me. He seems to react normally — normally for him, that is — with other people.)

I’ve been taking my blog readers’ advice into consideration and researching various options, but there aren’t many. Current laws say that the most you can institutionalize someone without his consent is 72 hours. Perhaps they could keep him longer, but once the episode passed, they would probably let him go with a prescription for drugs he would not take. And after all the hassle, I’d be back where I started. I could also call the cops, but here they just warehouse the mentally ill and do nothing to get them help. And again, after all my efforts I’d be back where I started because they’d just let him out since he hasn’t really committed a crime except harassing me. In addition, someone who used to be a chaplain for correctional institutes told me the other inmates tend to beat up those with mental problems, so the jails try to get rid of them as quickly as possible. I can understand that — I have my own times of wanting to beat my brother just to get him to shut up and leave me alone, though I’ve been channeling my frustrations into less violent activities such as researching.

As inhumane as it might be to consign him to the garage (it’s not much different than confining the insane to an attic), it’s the only way I can live with the situation. It gives me comfort knowing he is locked out. He won’t break into the house because even at his most psychotic, he is careful not to do anything to anger our 97-year-old father. (He seems oddly protective of the old man, but that is probably just another of his delusions since he thinks I’m trying to strangle our father and inherit this house. But I don’t inherit the house. In fact, once father is gone, I will be temporarily homeless. Well, without a home base. That’s a better way to phrase it.)

I can see, though, that there could come a day when I do run away. He’s starting to get demanding and threatening. Right now it’s “get me a beer, bitch, or I’ll let all the air out of your tires.” I’m not getting him a beer, of course, instead I’m researching portable air compressors. (Most of the cheap ones plug into the car’s cigarette lighter, and I don’t have one in my car.) I’d get a room for the night to give me some respite, but then there’s my father to consider. If I leave him alone, and something happens to him, I could be arrested for elder abuse. Cripes. The situations I get myself into. Maybe I’m not as sane as I think I am.

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Pat Bertram is the author of the suspense novels Light Bringer, More Deaths Than One, A Spark of Heavenly Fire, and Daughter Am I. Bertram is also the author of Grief: The Great Yearning, “an exquisite book, wrenching to read, and at the same time full of profound truths.” Connect with Pat on Google+. Like Pat on Facebook.

Sundowners Syndrome and Other Night Time Horrors

For many people, night is a time of relaxation and rest, especially when it comes time to sleep, but for others, night is . . . well, it’s a nightmare.

For example, Sundowners Syndrome frequently affects people with Alzheimer’s and dementia, and sometimes elderly hospital patients. These people react to the sun going down with confusion, anxiety, aggressiveness, agitation, restlessness, anger, even disorientation and hallucinations. My father had such problems when he was hospitalized for an operation a few years ago, and the inordinate anxiety lasted for months afterwards. It’s one of the reasons I am here to look after him. Although at 97 years of age, he can still mostly take care of himself, he does need someone to do the things he can’t do for himself such as grocery shopping, some cookiSunrise/Sunsetng, cleaning, etc. More than that, though, he needs someone here at night because he is prone to panic attacks when he is alone after dark.

Those who suffer from bipolar disorder or narcissistic personality disorder seem to be afflicted with something similar to Sundowners syndrome, especially when it comes to night rages. These people can often control themselves during the light of day, but as the night progresses, their rage escalates, which makes even the generally well-balanced members of their families miserable, angry, and depressed.

Such night rages are often accompanied by insomnia and sleep deprivation, though I don’t know whether the lack of sleep is the result of the rage or a contributing factor. Although no one knows for sure what causes such night rages, there are various surmises. The rages could be a result of the build-up of stress during the day. They could be a result of fragmented circadian rhythms. Or they could have a biological basis, perhaps due to a disruption in the cholinergic system. (The cholinergic system is the network of nerve cells that uses acetylcholine in transmitting nerve impulses.)

I’m very aware of this nightmarish cycle since so often my dysfunctional brother inflicts his rage on me. He doesn’t physically inflict his rage on me, just verbally, though the fury he focuses on me sometimes feels like a physical assault — his anger is that powerful. Sometimes his anger isn’t directed at me specifically. He has a whole list of people who have “ruined his life” and he nourishes his anger against them as if his fury were a venomous hothouse plant. He seems to have such a stake in this anger that he cannot let it go, but what that stake is, I don’t know. Perhaps his rage makes him feel alive. Perhaps he is afraid of owning up to his own culpability in how he has ended up. Perhaps some sort of inner demon has him in thrall.

This conjecture, of course, is futile. He seems to have at least two cyclical patterns of disorder (bipolar swings and narcissistic rage, though he could have Sundowners Syndrome or something I have yet to identify — perhaps even alcohol-induced dementia), but since he has never been diagnosed, I have no idea that the truth is. All I know is that his night rages are impossible to predict, control, or deal with.

Because of him, my nights have become rather stressful, though occasionally, when his all his cycles wind down, so does he, and peace reigns. I have learned, however, never to take the quiet nights as a sign of things getting better, but simply to be grateful for them.

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Pat Bertram is the author of the suspense novels Light Bringer, More Deaths Than One, A Spark of Heavenly Fire, and Daughter Am I. Bertram is also the author of Grief: The Great Yearning, “an exquisite book, wrenching to read, and at the same time full of profound truths.” Follow Pat on Google+. Like Pat on Facebook.