How to help my mother work through extreme anxieties?

Question

My mom has had anxiety issues for as long as I can remember. It used to be sort of quirky and not disruptive of our lives, including (but not limited to):

• Touring each room of the house to make sure everything was unplugged if not in use
• Feeling the oven/stove to make sure they weren't hot, even if nothing had been cooked that day
• Feeling around on the light switch (presumably to make sure it didn't feel hot)

However, over the years (especially since I have moved out) this behavior has escalated. Her old behaviors still persist, but there is a new behavior which (I feel) is inhibiting her ability to live a normal life. This is as follows:

• Never leaves the house (with the exception of work) without someone at home to watch her dogs. She says she's worried the house will 'burn down with them inside' or that some other wild event will befall them.

  She has even almost passed out while driving home from work because she saw a smoke plume in the distance (not even in the direction of our house) and convinced herself it was our house.

  Both dogs are young, ~2 years old, large dogs, with no medical issues. She will not even run a 20 minute errand if it means they will be alone in the house.

Here are the reasons why this is making such an impact (least to greatest):

• She is secluding herself, and doesn't seem happy about it.

  I understand some people are happy being alone a majority of the time, but my mom doesn't seem to be. My dad is often running his own business or out farming, and my mom constantly complains that she's always alone at home by herself.

• When I am home, we can't go anywhere.

  My mom expresses how much she'd like to be able to go pick up a pizza together, or go shopping, but that she 'just can't leave the dogs' to do so. Even 15 minute ventures are off the table.

• Her actions make my dad and I feel belittled and untrusted.

  My dad has offered to stay home to check in on the dogs every couple hours but this wasn't good enough. I've wanted to be home on days my mom is working and this isn't allowed because she is concerned I'll leave something plugged in, leave, and the house will burn down with the dogs inside of it.

• She gets really upset when I won't come home, but she won't come visit me.

  I live 1.5 hours away (which is considered 'close' where I'm from), and am constantly (bi-weekly/monthly) asked to make the trek home because she misses me so much. She hasn't visited me in over 4 years now. Any time she 'plans' to come visit, she finds dramatic reasons why she can't at a late notice and instead asks me to come home.

  Additionally, there aren't official dog sitters where she is located and she cannot bring her dogs with her to visit me as my apartment complex would not allow it. Sneaking them in is not an option as they do not listen very well, so I'm almost positive they'd cause damage.

My mom and I's relationship is being strained lately because of this. Ultimately, I'd like for my mom to feel free to go wherever she pleases without having so much anxiety about her dogs spontaneously combusting while she's away - with a focus on her ability to visit me.

Unfortunately, neither of my parents have a strong belief/interest in the importance of mental health, so I'm not sure how to go about addressing my concerns. This also makes talking her into receiving professional help seem like a long-shot.

Given these circumstances, what can I say/do to help my mother through her extreme anxieties?

Other things you might want to know:

• I'm an only child

• My mom is in her early 50's

• My dad is not a viable option in helping me with whatever route I choose to pursue, as he doesn't think her anxiety is a real mental barrier, and that she can just "choose to stop feeling that way"

Answer 1

Wow, this is a difficult question, and I hate to say "There's nothing you can do," but that's about what it will boil down to.

I can say, sit down and have a rational discussion about everything that's going on, but anxieties of that kind are difficult to have a rational discussion about, because they aren't rational.

Given these circumstances, what can I say/do to help my mother through her extreme anxieties?

The best thing you can do, though you stated it's unlikely to happen, is to talk your mother into seeing a psychiatrist, or lacking that, her family doctor, to be put on a medication that helps with obsessions (which are what your mother has; she obsesses over chosen fears.) And yes, there are medications that help a great deal.

You can read about all the things that do help anxiety: meditation, journalling, etc., and help her learn the techniques. I highly recommend Jon Kabat-Zinn's book, Wherever You Go There You Are. Living in the moment you find yourself in is a lot more peaceful than living in fears of what might happen in the near future. That's a real possibility for help. You might be able to take short outings and have her meditate through her fears, taking progressively longer outings.

Or, you can learn everything you can about something called Obsessive Compulsive Disorder, in which people are controlled by their fears. I'm not diagnosing your mother, but knowing about OCD can lead to some productive discussions with your mom about the existence of irrational fears and what people can do about them.

There's a technique with children who catastrophize ("What if we get into an accident and the car explodes?") of scaling down the catastrophe into more manageable steps (What if we got a flat tire?/What if the dogs run out of water?) Sometimes giving someone more realistic fears to deal with can help to replace the catastrophic ones.

Is there a reason she can't take her dogs with her wherever she goes? I have three dogs, and they often accompany me on errands, doctor's appointments, etc. As long as the sun isn't hot, they're fine in the car. (In the summer, I leave the car on and the AC running.)

Her actions make my dad and I feel belittled and untrusted.

It sounds like you think this is a mental illness. If so, it's your choice to have hurt feelings about your mother's lack of trust in you, because this isn't about you! It's about her. Its as if I were a judge, and I were to get insulted if a paraplegic didn't stand when I entered the courtroom. That sounds ridiculous, but it's an apt analogy. The fact that the paraplegic doesn't stand up for me does not reflect upon me at all; he can't stand up. It's about him, not me and his showing respect for me in a traditional manner. The same is true of your mom.

She gets really upset when I won't come home, but she won't come visit me.

This is an issue you need to set a healthy boundary for. You have a right to a healthy relationship with your mom; if she can't do her part, you need to protect that part of your life that you can. Read about boundaries and how to set them. Know that you are not responsible for her feelings when you set a reasonable boundary (most people don't get this. Understanding that she won't get it is important. You can talk about it, but you're not responsible if you can't convince her that you have a right to a healthy lifestyle.)

This is a very difficult situation, and I wish you the best. Taking care of yourself is as important as helping your mom; there has to be a balance.

_{I saw a woman once in the ER who thought she was having a heart attack, which is the only reason she left her house. She hadn't left her house in close to 4 years, and missed all her daughters' plays, etc. Luckily, the ED was slow that morning and I had a lot of time to talk to her. By knowing about OCD, I was able to convince her that this was psychological, and that there was medication for it. She left the ED with two prescriptions and an appointment to see a psychiatrist. About five months later, I received a wonderful letter from her. She had just accompanied her daughter on a school field trip. She was leading a relatively normal life. I was very grateful to have been a small part of her recovery.}

Answer 2

Most of the answers seem to be suggesting that your mother should see a therapist. If your mother is willing and is responsive to therapy than that would definitely be the best long-term solution.

However, as someone with a similar pattern of anxiety/OCD for whom therapy was unproductive, what really helped to mitigate my anxiety was installing cloud cameras in my house. It is extremely reassuring to know that whenever I need to, I can check in and make sure the house isn't on fire/no one's breaking in.

If the rest of the family is uncomfortable with the idea of having always-on cameras in the house, you could try installing internet connected smoke detectors to alert you if there is a fire. Pet doors could also be installed to allow the dogs to have an escape route.

Another possible solution(though most likely extremely expensive) would be to install a sprinkler system.

This might not be the most interpersonal of solutions but, for myself, having a way to "check in" periodically goes a long way.

Answer 3

However, over the years (especially since I have moved out) this behavior has escalated. Her old behaviors still persist, but there is a new behavior which (I feel) is inhibiting her ability to live a normal life.

Don’t worry about the dogs; they are a manifestation of an issue but not the core issue.

First and foremost: This has utterly nothing to do with the dogs; your mom has latched onto them for other reasons. It’s a manifestation of something… What that thing is? I don’t know. But please read on to hear how I can relate to you and what my advice is.

I grew up with a somewhat similar experience: My parents—who have passed away—are Holocaust survivors and they each suffered from varying degrees of PTSD and OCD behavior. My dad was more functional than my mom. My mom was simply afraid of tons of things happening. The apartment catching on fire, me not coming home at night after hanging out with friends and such.

To be honest, a lot of her PTSD had a tangible and immediate trigger: We lived in a crappy apartment in a poor neighborhood and both my parents worked crappy factory jobs that put them in crappy neighborhoods during the workday… And this was all in New York City back in the 1960s to 1980s.

Working with your Dad.

So enough about me, more about you; especially when you say this:

My dad is not a viable option in helping me with whatever route I choose to pursue, as he doesn't think her anxiety is a real mental barrier, and that she can just "choose to stop feeling that way"

You need to think differently about this situation with your dad since your best bet to help your mom is to have an ally in your dad. He might think she should just “hoose to stop feeling that way” and you might be upset about it, but it is clear you are both stressed and his reaction is—honestly—valid in it’s own right. Remember, your dad loves your mom and that is why they are married and that is why they had you.

With that said, I would encourage you to reach out to some local social worker about this. The context—at the most positive level—is this is all the manifestation of someone with severe OCD or someone with high functioning autism now degrading for some reason. When you meet with a social worker, you should focus on her actions and not attempt to figure out what a motivation/cause might be.

Why you need to be concerned.

On the other end of the spectrum, back to my family and similar experience: When my mom passed away it’s because she basically had a stroke and was not exactly in a coma but not exactly “all there.” Prior to her death the family had her do a CAT scan and there we saw something: She had suffered TONS of strokes throughout the years and never had them looked at. Her final death blow was simply one stroke too many.

Sometimes when people have a stroke, it manifests in some loss of motor function. Other times it’s often small enough to just be felt as a “headache” in some people and they shrug it off like this. At the end we all knew she ignored small health issues regularly and then this happened.

And when it comes down to her getting at least some basic medical help near the end of her life it came down to getting my dad to cooperate.

So my recommendation is to meet with a social worker and explain that you would like to get your dad onboard in getting your mom to seek help. A social worker might be able to have someone meet with your dad who can explain what might be happening.

But at the end of the day, if you just show up with a social worker out of the blue say “I love you mom, you need help!” you might do more damage than good. Your dad could feel more defensive towards your mom and see you as “meddlesome.”

So best of luck in dealing with this. And most of all, best of hopes… The dogs might appreciate the effort as well!

Answer 4

This may sound like it's coming from way out in left field, but try to keep in mind that while her fears may seem ridiculous to you, they're really very real to her.

My mom has been in a bad way for a lot of years. Early onset Alzheimer's/dementia. I've slowly learned to roll with it, because I know I can't fix it. I'm not trying to say that your mom is that far gone, just saying it can be a useful interpersonal skill to develop before it goes that far.

I guess I've learned to play my part in her delusions, so that I can redirect them when they become too difficult for her. Sometimes she thinks I'm one of her brothers, sometimes she thinks that I'm my father, and/or her ex-husband. Family resemblance is hard like that.

Every time I pick up my mom from her residential care facility, she thinks I'm covertly breaking her out. I choose to play along because it's easier for her in the moment.

Me: it's all good, Ma. I got the code for the door, so we can get out.

Her: Are you sure I can leave with you? They don't let me leave. How are we going to get past the nurses?

Me: It's all good Ma. I know people who know people. They'll never know you were gone.

It absolutely breaks my heart to have to do this, but I know it's easier for her if I play along than it is to challenge her perception. She's paranoid, she doesn't remember all the other times we've played this game, so rather than telling her that she can't trust her own mind... I take the hit and "sneak her out, and back in again"

---

I guess what I'm getting at, is that, doctors and psychologists can only take you so far sometimes. Sometimes you have to be able to maintain a relationship with someone despite their ability to view the world the way you do. If that means playing pretend occasionally, you're doing them a huge service.

I empathize in a strange way. I know what it feels like to not trust my own mind and I know how much harder having other people pointing that out can be. Understanding their fears can make you an ally when they feel like the rest of the world has turned against them. It's just a matter of being willing to say...

It's ok. We're on the same team.

... until they're ready/able to get help.

Answer 5

I believe there are a few things you can do to start helping her recognize odd behaviour and move toward alternative thinking. To orient ourselves with what you're most likely dealing with, I noticed from these points some strong indicators of OCD:

• Touring each room of the house to make sure everything was unplugged if not in use
• Feeling the oven/stove to make sure they weren't hot, even if nothing had been cooked that day
• Feeling around on the light switch (presumably to make sure it didn't feel hot)
• Never leaves the house [because of worries about dogs' health, even though there is evidence that this is contrary to reality]
• [Our] relationship is being strained lately because of this
• Her actions make my dad and I feel belittled and untrusted

OCD used to be categorized in anxiety disorders as it has a close relationship to them, but now has its own category (list of DSM-V changes from DSM-IV to V, p5). I won't list all the diagnostic criteria that is available but the main features are:

Compulsive, obsessive, and repetitive behaviours. There is always a highly specific obsession present, which leads to compulsive, ritualistic behaviours that cause distress and impairment in significant areas of life and in relationships. While a desire for organization and cleanliness is normal, it becomes abnormal when it becomes dysfunctional, distressing, deviant (far too different to be simply eccentric), or possibly dangerous to self or others (your mom seems okay RE that last one).

Examples of obsessions are germs and contamination, religion, symmetry, and death or injury in a particular manner.

Examples of compulsive behaviours are counting, checking, organizing, praying, and avoidant behaviours. Sufferers indeed isolate themselves, more so if they begin to experience more anxiety.

The best you can do besides bringing her to an experienced professional:

Slowly, and definitely not all at once, I think you can incorporate these things into your future dialogues with her while being patient and kind:

• Ask her if she actually wants those thoughts (many people with OCD finally enter therapy after realizing they do not want these annoying thoughts any more)
• Ask her if checking actually helps
• Ask if she feels powerless against these ritualistic behaviours
• Gently point out how much time her behaviours detract from her life and relationships
• Gently point out how distressed she seems
• Gently point out how other people do not experience this kind of worry, and give carefully chosen examples of what normal is
• Gently ask that if she could, would she choose to be free of these anxieties/worries? (Purpose being: to open her mind to the possibility of experiencing something different, and turning her mind to the question of how to experience something different)
• Be understanding and supportive to ensure you remain a trusted emotional influencer to her
• Not necessarily mention OCD or anxiety if you feel she will automatically disbelieve you or be defensive

Other ideas I have that might be useful but might be totally terrible:

• Read out articles you find on OCD, but instead of using the term OCD, refer to sufferers as 'a certain subset of people'. This is so she becomes more educated about symptoms and how they can be dysfunctional, and hopefully develops a curiosity about why only some people are this way.

• Have a few documentary nights to bond, and then slip in a short documentary about OCD before moving on to something else, not making a big deal about it

I still believe you can be of help in the interim, absolutely. However, she definitely needs a professional to fully excise her entrenched anxious thinking since she seems to be getting worse. This amount of constant stress is REALLY hard on the body, especially someone at her age. You can definitely get her to come around if you have a working relationship with her, I believe it just takes some sensitivity on when to back off and change the subject.

Answer 6

I don't know whether your mother has Obsessive-Compulsive Disorder (OCD), but as others have said, there are some indicators in your post that suggest that it might be helpful for your mother to be evaluated for OCD. Unfortunately, it's not clear that your mother would cooperate.

This is a situation somewhat analogous to that of a parent of a child with OCD (I am such a parent). There are a couple of differences:

• An adult has a greater capacity of rational understanding than a child.

• The son or daughter in a relationship has less direct influence on a parent's medical consultations and treatment than a parent has for a child.

However, there is enough common ground here, that I think the analogy can be useful, and I will take inspiration from my experience with a child with OCD, and try to adapt it to your situation. The rest of my answer will be based on the unconfirmed assumption that your mother is suffering from OCD. In other words, I will take an OCD diagnosis as a working hypothesis for my answer.

Learn about OCD and how it is treated. I have two sources of information to recommend, that have been particularly helpful for me -- but there are lots of other materials out there.

• The International OCD Foundation

• Articles by Fred Penzel

  Here's a Penzel quote, taken from Living With Your Loved One’s OCD: Some Advice For Significant Others:

  If you have already fallen into the trap of participating in numerous compulsions, you will need to gradually withdraw. In many cases, this may require the help of a trained therapist who will explain to your ill partner why this is necessary for their recovery, and outline some gradual steps by which this can be accomplished.

This leads me to a classic solution to a classic problem:

If you are suffering in a close relationship with someone who refuses to go to therapy...

Seek therapy for yourself.

If your therapist is interested in family systems, s/he may invite your loved one in, to provide background information.

This might open the door a chink for your mother and/or your father to seek treatment, but even if it doesn't, it could be very supportive for you, on its own sake, especially if you are able to find someone who has had some training in modern exposure methods of treating OCD. I know from experience, the "trap of participating in numerous compulsions" can suck one in with the power of a shopvac -- because one is pedaling like crazy just trying to get through life with the person with OCD.

There is another way to open a chink that might be helpful -- but you have to step very gingerly with this. If one of your parents has any physical health concerns that they would like your support with, you might be permitted to accompany them to a regular doctor's appointment, and this might give you an opening to communicate your concerns to the doctor. If you want to try this, I suggest using a very calm, neutral tone, and starting with a clear prologue along this lines: "I'd like to share a concern with you about my parent. I don't want to cross any boundaries, so I won't be asking you for information -- I just want to share some information with you." Then give three succinct example of limitations your mother is experiencing, pause to answer any questions the doctor may have, and then hand a one-page synopsis to the doctor.

Important note: In some areas it is difficult or impossible to find a therapist with training in Exposure and Response Prevention (ERP). If there is no one where you live, consider telephone/Skype therapy (some insurance companies approve this, some don't), consider commuting, consider asking the IOCD for names of therapists, and consider asking someone local to attend an IOCD training event.

Optional: If you are interested, here is a post I wrote that included some information about my son's ERP treatment.