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Saving my mother from depression using skills I learned in pharmacy

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I did not realise that I could be more effective in helping my mother through her depression as a pharmacist than as her daughter.

I was oblivious to the extent of my mother’s suffering until I started to piece together small and seemingly insignificant behavioural changes. She began to avoid going anywhere by herself, and after a while she would not go even when I had offered to accompany her. A drastic behavioural change came when she stopped walking the family dog. Her favourite part of the day was taking Bobby around the park and I was taken aback when she did not feel as though she could even do that.

Over the next few months, I observed her slow breakdown in communication with those closest to her: her friends, her sisters, my father, my siblings and eventually, me.

I intervened at this point, but my approach was too strong — a little bullish and definitely unsympathetic. My support strategy was devised from my own feelings and not hers.

I found it difficult to get through to her, even though I felt that I was being supportive and understanding of the challenges she was facing. After I accompanied her at several doctor appointments and watched her grow upset and frustrated, I realised that I had not been helping. So I changed my approach.

My mother’s citalopram was swapped for mirtazapine, and the GP added diazepam to control her panic attacks, which were becoming more frequent. My mother asked questions about the new medicine she had been prescribed, and we began openly talking about the medicines and how they make her feel. It was an easy conversation and different to the strained conversations we had been having at the time. Over several days we discussed lots of different things — how the medicine worked in the body, side effects, treatment outcomes and long-term effects of the drug on the body. She was eager for information and willing to talk about her therapy. But I noticed that she would not direct the conversation towards her feelings.

To keep up our engagement, I asked her if she was suffering from any side effects and if the medicine was still suiting her. I employed the same communication techniques I use with my patients in a pharmacy, and she was happy to answer these questions freely.

Removing my feelings from the scenario and taking a more professional approach to the matter was having a positive effect on our relationship.

After two months of taking the medicine, she was eager to discuss small behavioural changes; for example, she had been able to walk the dog for half an hour by herself without feeling anxious or panicked. We spoke about these victories and recognised their importance, but I was careful not to get too emotional. I wanted this to be about her and to give her the space to talk about things at her own pace. I regularly communicate with my patients in this way, especially those who are initially reluctant to speak about their medicines.

It is approaching one year since my mother’s medicine was changed and I have witnessed a huge transformation in her health and mental well-being. Her confidence has grown — so much so that she is doing things she would not have previously. She is always willing to talk about her feelings and she often volunteers information when she is feeling down, even on bad days.

We are still working together to help build her in to the individual she wants to be, and I know that she wants to come off her medicine eventually. I am certain that if I had continued to behave bullishly, her progression over the past year would be incredibly different.

This journey has been and will continue to be a learning process — as is my developing role as a pharmacist — and I have recognised that being open to changing my approach will have a positive outcome on my patients. As my mother’s daughter, I am happy that she is so much stronger, and it feels great to know that the skills I have learned as a practising pharmacist have contributed to her progress.

 

 

Readers' comments (1)

  • It is indeed crucial for a health professional to secede from one's position as a relative to a patient(though not always feasible), so an optimal treatment approach is arrived at. As a peditatrician I have fortunately came to be able to do that with my children to a big extent.
    Herein, changing to a different type of medication allowed for the patient's improvement, which made way for further communication, boosting her improvement further. Particularly in depression, different patients respond to different medications, which is where advanced imaging techniques may be helpful in drug selection, and luckily here the writer hit the right target without need for further procedures.
    Of note here is that depression being a biochemical imbalance, conversation and advice alone are mostly insufficient to cure a patient, which drives the care-taker only more frustrated. It should be realized that while antidepressants are a two-edged sword, to be avoided to the utmost when plausible, there are times when they are pivotal in achieving recovery.
    May I finally pose a query here; how old is the writer's mother, Is she close to menopause?! If so, this makes her state explicable, and may implicate approaching her from that perspective.
    Dr Hana Fayyad, pediatrician
    (Maria Jasmine Freeman)

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