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My mother is crazy -- what can I do?

Dear Cary,

My mother is a strong-willed, street-smart woman who is ascending into the madness of a mental illness. I do not know how to "save" her. I read your previous post to someone that sometimes you have to "detach with love." This is where I am at now, but I feel it is the wrong thing to do. See, my mother has a persecutory delusions. She firmly, fully believes that people in the city she lives (where she was born and raised) are out to get her, in a real sense. She is convinced that television shows are about her -- where "buzz words" and uttered phrases are a code for the city she lives in to pick up and use "at her." Movie titles are code names too -- people who innocently use a certain phrase have no idea that they have set off a maelstrom of anxiety and anger in her. What are they after? I ask her -- to which she replies, "They want me to apologize for being out there," or, "They are tired of me, and they want me to end it." She even thinks that my brother is getting beat up at school because the kids know who his mother is and they're trying to punish him for her.

This persecution disorder started (or at least I became aware of it) when I was about 11 years old. It's getting out of control, and I feel like a selfish child letting her mother die without being dead. I feel I am mourning her death while she is still alive. I can't let her go on like this, and yet I don't know how to help her. My sister lives a thousand miles away. My brother is in high school, living with her, escaping when he can. I can only imagine what his life is like with her.

What can I do, Cary? How can I carry on? How can I let her die silently, while she has so much life ahead of her?

Crazy Mom's Daughter

Dear Crazy Mom's Daughter,

Your mother needs psychiatric evaluation. Whether you drive her to a psychiatric clinic to be evaluated, or persuade a clinical diagnostician to come to your house and see her, or get a social worker involved, or find some other method, it needs to be done. Someone trained in diagnosing mental illness needs to meet with your mom and render an opinion about what sort of mental illness she has and what the options are for living with it. Then the family will need to set up and maintain a program of care for her. And she will need to care for herself as well. She will need to be active in her own care.

And of course she lives in a dense mesh of family. So whatever her problem is, it is the problem of many. Her husband sounds like a volatile person who may not be depended upon to help, who may be in fact more of a problem and an obstacle to recovery or stabilization than an ally. But it must be said that people do change; in the mesh of family, when some sane, stable element enters, sometimes others rally. Your dad may simply have only one way of dealing with what he feels to be a chaotic and unbearable situation; if your mother's condition can be improved, it may tend to improve everyone. Likewise, your brother, who is in high school, cannot be expected to run the household; he needs a stable environment in which to continue growing and studying. There are many things that will have to be dealt with one at a time. Although it is frightening, it is time to begin.

That said, knowing what must be done and doing it are very different; in its general outlines your letter reaches me in a personal way. I have watched parents move from lucid to distant, strange and ultimately unfathomable depths, to private worlds off limits to their children, and I have noticed how long it takes children to grasp what is happening, and then how difficult and sometimes impossible it is, once what is happening becomes apparent, to deal with it in a forthright, sane and effective way.

So I do not blame you if you feel unable to act. In dealing with family members who seem to need help but deny that they need it, we encounter obstacles not just of their making but of our own invention, because there is a terrible truth at the heart of their trouble that we can scarcely face. We will naturally find ways not to face it. We will encounter obstacles to action whose power we cannot foresee, and whose source we cannot understand, because we ourselves have blocked ourselves off from understanding the power and the source of these obstacles. What is in front of us seems nearly unbearable, yet it is also just the natural course of life, something that millions of people face every day. Likewise, these obstacles must be seen for what they are, or they can prevent us from doing what needs to be done, but they are also our friends in a way. They protect us from awful knowledge. We can feel gratitude for them even as we move them to the side of the road, knowing we must push on to see what is ahead. It is as though guards stand at these crossroads warning us, saying that our parents have deputized them to warn us not to go any farther.

It is hard to countermand the authority of a parent when we still regard them as powerful. Often, though, we only remember the parent as powerful. In reality, when a parent has reached a point where he or she needs help, the parent is weak. We only imagine that dire consequences await us if we countermand the parent's commands. In reality, no consequences arise. The parent has no real power anymore. The parent is helpless. So we do what needs to be done.

Why do we resist admitting that the parent has no real power anymore? Well, if the parent has no power then the parent can no longer save us. Knowing the parent is powerless means we are finally alone in the world. We are truly responsible for ourselves. So sometimes we prefer to believe that we still have to fear the parent, because that means the parent is still powerful and vital.

In short, you feel something needs to be done but do not know how to go about it. I would go about it by contacting professionals. Learn as much as you can. And set up a program. It is a relief to have a clear program to follow. If you think of all the steps to follow, you might feel overwhelmed and incapable of action. The alcoholic, for instance, though legendarily complex of feeling and mind, must boil things down to simple procedures: Just for today don't take a drink, meet with another alcoholic, etc. Likewise you can boil things down to very simple procedures.

So make a phone call today to a psychiatric clinic near your mother's home and speak with someone about the situation. Make an appointment.

That you can do. You can take small steps. Keep taking small steps and stay on the road.

I'll see you back here, on this corner, in about a week or so.