Illicit intervention
Question
My brother is taking antidepressants after suffering a severe bout of depression. He's been on the tablets for a while now but in the past few weeks seems to have slipped into a manic state.
We've looked into the 'manic spectrum' and he's definitely exhibiting symptoms. But no matter how much we talk to him about it he just says we're the ones who are depressed and we're just not happy now that he is. He also maintains he feels so much better than before and wants to stay that way.
He's got a review coming up and we're worried he won't tell his doctor the full story about what's happening. So I was wondering if one of us could go and see his GP and talk about how worried we are. And if we did do that would it be kept a secret or would his doctor have to tell him?
Answer
It sounds like you have been going through a difficult time with your brother and clearly, you're very concerned for his mental wellbeing. And although it's great to hear he feels much better, it must be terribly worrying for you to see him exhibiting 'manic' symptoms - particularly as he believes it is you, his family, that are unwell and not himself. It might be helpful for you to find out more about mania/manic depression, and if you'd like to do so you can visit the Manic Depression Fellowship website.
Although you mention your brother-in-law has been on antidepressants for six months, you do not mention any other form of treatment. Depression of any kind is traditionally treated with antidepressants and a form of talking therapy, such as counselling, psychotherapy or Cognitive Behavioural Therapy (CBT).
It's not clear if the review your brother is having is an informal one with his GP or with another mental health professional, such as a psychiatrist. Either way, it's important he is honest with his GP to ensure he receives effective treatment and support. Any consultation with a GP is confidential. A GP can't divulge a patient's medical history, even to their closest family, without the patient's permission.
Going to see his GP is an option, a GP can listen to what you have to say and take it into account. Alternatively, you could contact his local community mental health team (CMHT) and request an assessment from them. They are obliged to carry one out, but bear in mind that if your brother is resistant to an assessment, the CMHT may start moving towards sectioning him in order to assess him. You may wish to consider the impact this will have on your brother in law and the family. In both cases, it is best if your brother's nearest relative takes the lead (i.e. his wife, a parent or you), as they have more power in the eyes of the law.
As an alternative source of support to you, your brother or any member of your family that might need it, SANELINE offers confidential emotional support and information to anyone experiencing mental health problems. You can talk to them in confidence on 0845 767 8000.
Updated: 05/06/2008
Question answered by SANE
