Very Needy Father Calls Me with Suicide Ideation

[kitsch]

My father is near 80 and I am one of his main supports.  He now resides in a retirement community that is very engaging, affordable and has many resources and just about a mile from my house. My Dad exhibits many of the characteristics of a personality disorder- he has very extreme thinking, is most often very emotionally needy and draining on my who family. He has been like this most of my life, but as he gets older, is single and retired, he has A LOT of time on his hands to have destructive thinking and really even leans into it, despite opportunities to engage and socialize with members of his housing community and also engage with other systems of support. Most of my family does not know how to deal with him so they ignore or avoid him, at best they tolerate his calls and pleas for visits though the monthly visit or dinner. My father, like some people with personality disorder have a horrible time maintaining healthy relationships. So while I am very empathetic to my father and his feelings/mental health issues, I have to keep  close tab on my boundaries, take breaks from him. Regularly I have a lot of feelings of my own about my dad, I get depressed about the way my dad relates to me (swings from treating me like I am his admin staff to being told I am the only one that understands him).  My Dad, in addition to living in a supportive housing community has a therapist and psychiatrist, but still on a regular basis I am faced to deal with him and his cryptic emails and voicemails where I am not so sure what to do – I have done different things in the past – call him back and talk, respond to his email and tell him my boundaries, ignore him, call his therapist, I have even called 911 at times to do a wellness check. This is the email I received last night and I just feel confused or stuck in a lose- lose situation

"PLEASE call me. I just seen Lyn Tuesday. And I can't get over the feeling that I just want to die. Maybe if you talk with me I'll feel better ?

Love Always,
Dad"

I am planning to call him back, this time discuss with him the option of intensive outpatient. This will not be the first time that I have this discussion. I dunno, have others experienced this level of neediness and cry out from one of their parents on a regular basis? What do you do? How do you manage it? How do you balance not cutting your parent out of your life because cutting them out all together would be likely even harder?  Thanks in advance for your reading!

[zachira]

If you think he is suicidal, it is important to notify the staff and his psychiatrist immediately.
My heart goes out to you having to deal with such a difficult elderly parent. You sound like a very kind person, who does not like to hurt people, and certainly have done everything you can for your dad.
I too have an elderly parent with BPD: my mother who is on endless psychiatric meds and with whom I can not have much of a relationship due to her terrible behavior. One thing I have learned that has been very helpful. She will always be nicer to people who are not the immediate family, as she like many borderlines has certain people she wants to impress, and would never show her worst behavior to.
As much as you can, let the staff take care of your father, and keep doing what you can to limit your contact with him.
It sounds  like you have taken on most of the responsibility for him, while other family members stay away.  I am one of those family members that does little to help my mother and have almost no contact with her. I realize for others, this is not an option, and you have to do what feels right for you.

[kitsch]

Thanks for your response. I think I will forward to his psychiatrist and therapist. Last time they did a wellness check/ called 911 when he alluded to suicide as he left them a voicemail. But then he was put on a geriatric psychiatric ward for near two weeks where there were not any groups and he did not even see a doctor. I do know that he often has suicide idealization and it's a real thing. I do also know that he does state things like this to get a response. It's hard as suicide is a serious action he could take action. UGH. Though the hospitals certainly do not help him. In fact I think they make things worse when he goes.   

[zachira]

You say that he does not seem to get much help with his problems. This is sometimes because people with long term mental illness are regularly denied any kind of long term therapy and only given medication. Short term therapy for people who need long term treatment mostly opens up the pain, and usually does not lead to much long term change. You might find someone who is a really good listener (doesn't have to be a therapist) who will just sit with your dad and be there for him. That might result in less sudden crisis, less emails and phone calls. Just a thought.

[kitsch]

Thanks zachira ! I totally agree that most people do not get the treatment they need. My dad has a therapist as well as a psychiatrist that he sees regularly. I actually have been in contact with them about his email and in general about his treatment just a few minutes ago. 

Because of my father's chronic issues and wanting to ensure that he would not be alone too much-  I helped him move into where he lives now - a retirement community - so he has many people around him daily who see him including a pastor who comes to his unit to talk with him weekly. I know this does not make loneliness disappear, but my family and I all agreed and worked with my Dad to include him in all the planning of his move because of how much interaction that seems best for him.  Now he has been at the retirement community for 4 months and he insists that "everyone has dementia" and he cannot engage with the residents because they are "too old and not with it".  He says he doesn't want to go on outings because again - "everyone is old" T

This belief he now has is simply not true, but it is real for him and it seems like he needs to constantly be redirected. My Dad is actually pretty easy to redirect, however, I am not able to keep up with his needs because I literally would not be able to do anything but tend to his needs if it were up to him. I am trying my best to engage him with several outlets, but it really seems never ending.

[zachira]

You are amazing! It sounds like you are doing everything you can for your dad while trying to take care of yourself, which is an unbelievable challenge. You dad is old enough that things will not stay the same as they are, and hopefully the changes will be for the better!

[kitsch]

Well, my dad ended up in the er and getting evaluated now as he told the social worker at 4pm today where he lives that he was feeling suicidal and she called me.  I know he's in a safer place now, but feel aweful. Like I'm so jarred by his regular neediness that if I responded to him every time he wanted I would have no life. Still, I feel bad.

[No-One]

lynnmaryk:
I'm so sorry about the problems you are having with your dad. It's a tough situation.  I can tell you care about your dad and that you are doing your best to help him.  Even if you took personality disorders out of the equation, it's common for the elderly to fight depression.  

What does you dad like to do?  :)oes he have any interests or hobbies?  Just throwing out an idea.  Some communities have volunteers who will come out and visit elderly people, just to spend some time with them.  They may watch a movie with them, read to them, play a card or board game, etc.  Basically, they just spend some time with them and hopefully interact with them in some enriching way.

I was searching the Internet awhile back regarding assistance for the elderly and happened upon an online organization that paired up elderly people with some need with volunteers who have a desire to help.

Perhaps it's something to discuss with the pastor that visits.  Perhaps the church has some members who might be interested in making periodic visits to share some time with your dad.  

If you dad doesn't want to interact with "the old people", perhaps he might like an opportunity to interact with some younger people.  What do you think?  Would you dad be too difficult for volunteers to stick with it?

[kitsch]

Thanks No-One for your response. This site has been really helpful for me as I realized that there are so few people that understand what it is like to be a caregiver for someone with personality disorder and then of course the layers that come with having aging parents too.

My dad has had issues with depression since I can remember and for the last 20 or so years he doesn't engage in many hobbies, but he is quite extroverted. He does actually engage in bingo and movies at the retirement community and used to have many hobbies when I was a kid. This is why my siblings and I all thought that him living in a retirement community would be best- because there are SO many activities available. He's someone who hates being alone. It seems that him seeing older people engaged makes him even more depressed now.  He and my mom divorced about 16 years ago and he still holds onto their marriage. So this past Nov. he finally had to sell the house that he and my mom bought together and I grew up in. His psychiatrist says he thinks he is now grieving the loss of the house. He couldn't live alone anymore because mainly of his mental health and he started making poor financial choices.

I think the idea of a buddy or companion could be helpful, especially a younger one or someone that would go out with him off site from the retirement community. If someone came over and did an activity with him that could be helpful for all. Though he does have a tendency when he is not depressed to be very needy in a way where he wants people to complete basic tasks for him more like an employee. He had a teenager do his housework when he lived in the house, that worked well in many ways including provided a type of friendship, but in other ways it was dysfunctional. It could though be an outlet and something that could be helpful in a way, especially as a relief to me. I think I am struggling to balance taking care of myself and helping my dad. Sometimes I'm just so tired and emotionally feeling burdened. I hate feeling like this, but it's how I have been feeling about my dad. I'm trying to change my approach to helping - learn how to be more compassionate and help with grace,  idk.

Thanks again so much for your input and thoughts. I really appreciate the perspective.

[No-One]

lynnmaryk:
Just sharing some more thoughts for consideration.

Perhaps you could share the link below with your dad's therapist.  The link leads to a DBT Self-Help Website, specifically to a worksheet to help people learn to "Improve the Moment".  Perhaps he makes his own unique list and looks at it periodically to remind him of options.
www.dbtselfhelp.com/html/improve_the_moment_worksheet.html

You, and other family members might have some ideas to get a list started.
i.e.

• Watch funny YouTube videos (perhaps you share links and get others to participate)
• Get him interested in watching some live camera links to nature sites (i.e. eagle nest, bears catching salmon, etc.)
• Listen to favorite upbeat music
• Find a friend at his retirement facility to share some time with
• Can he have a pet where he lives?
• Is there an opportunity to have someone with a dog to visit? Perhaps someone who volunteers to make visits with a therapy dog, or could be family, friend or someone from church.

Perhaps it could help if you dad had a monthly calendar to look at, so he could see weekly activities planned.  (i.e. Bingo Day, Movie Day,  Visit Scheduled With "A", Visit Scheduled With "B", etc.).  It could, also, help to have a personal "Improve The Moment" list posted somewhere where he lives.  If he can have something visually to remind him of upcoming opportunities for him, he might feel less of a "fear of abandonment".

One option could be for him to have a suicide hot line phone number, as a saved number in his cell phone (or visible to him in some other way).  A call to a hot line doesn't have to be one where they call out an emergency response team.  It could just be an option to talk to someone and possibly change his mood and reverse his suicidal thoughts.

You will likely have to radically accept that many things in regard to your father are out of your control.  Getting him oriented to options could bring you some relief. If you can't find volunteers to assist with providing enrichment activities, perhaps there is a way to pay someone who might be willing to make periodic visits and interact with your dad. (Perhaps someone from a local church, who wants to earn some money?)

[ijustwantpeace]

I have been so badly abused by my parents that if either one offered to kill themself now, I would just tell them to go for it!

Not saying you should do this at all, but one of two things will happen.

1.  They will kill themself
2. They won't kill themselves and they will have to find a new way to get attention.

People with a personality disorder do not know how to get healthy attention.  They always go for dramatic BS.

Don't feed into their BS IMO.

I would never tell anyone to kill themselves, but I am not going to allow someone to abuse me anymore either.


I didn't know about any of the sick twisted up games these people play.

My mother goes through "drama cycles" where she likes to triangulate and put different family members into conflict to get attention.

Around 2010 I needed to move and was thinking of going west to California, and all of a sudden she can't pay for her house, and needs me to pay for it.

I told her I can't live with you and you drive me insane.  She said she would move out, and never did.  It took 2 to 3 years to get her out of the house.

It was living hell for me.  I made sure she got an extra 20k to buy a trailer and she blew it.

Now she got a settlement from and accident and she will blow that.

Point is like your dad she can have the perfect accommodations, but that does not matter.

They just keep the drama going to get their fix of emotions.

[Kwamina]

Hi lynnmaryk

Well, my dad ended up in the er and getting evaluated now as he told the social worker at 4pm today where he lives that he was feeling suicidal and she called me.  I know he's in a safer place now, but feel aweful. Like I'm so jarred by his regular neediness that if I responded to him every time he wanted I would have no life. Still, I feel bad.

I am glad your father told the social worker and was getting evaluated. Dealing with suicdal ideation in a family-member isn't easy and it really helps to get professionals involved.

This whole experience is unsettling. Trying to find the right balance between caring for another and taking care of someone can be quite tricky, but considering how you've been feeling, I think it's very important that you are mindful of your own well-being as well.

When it comes to BPD and extreme behaviors, it can be helpful to keep in mind what Dr. Blaise Aguirre says:

Another thing I find interesting about the work of Blaise Aguirre is that he is reluctant to use the word manipulation to describe the behavior of people with BPD:

"The effect of feeling manipulated, doesn't mean that the intention was to manipulate."

Though he concedes that actual manipulation does indeed occur, he argues that a lot of the time you're probably dealing with repeated and learned behavior. Basically that if people do the same thing over and over again and notice that they get the same results, they keep on repeating that behavior because they've learned that it leads to certain outcomes. What do you think of this whole idea of manipulation vs. repeated and learned behavior?

“Another thing is this, and Marsha Linehan has talked about it, if they're so good at manipulation, then why do they end up in hospital all the time? Why do they end up in treatment all the time? Well, very good, if they are manipulators, they are terrible manipulators.”

Another thing he talks about is that the symptoms of ... .with BPD traits tend to be based more on skill deficits rather than intentional "acting out". He suggests that it's not so much that they are intentionally misbehaving but more that they lack certain skills that would allow them to behave differently.

[kitsch]

Thanks No-One. I really appreciate your suggestions and could help him implement some too to help with a bit of relief to me and assist him better. I especially like the idea of having a suicide hotline number posted for him. I have suggested this before and he did use a suicide number and it helped, but that was one time when he used before he moved to the retirement community and having panic attacks about moving. I suppose now that he is living in a more engaging and safe environment I think my family and his therapists thought his mental health might improve, but this last suicide ideation was the worst one yet. I do hate how talking about suicide ideation or “feeling like dying” gets pushed into immediate admission into the hospital because it gets so risky to know if someone can be safe. But yet the hospitalization never seems to address my father’s feelings of worthlessness (which has increased since moving and having a more stable home).

I have been trying to engage a bit more with my dad’s therapists this last week. And at the same time, I cannot help but think that DBT and cognitive behavioral interventions may be necessary for him to progress. I do like the idea too of sharing the worksheet you shared with his therapist because it really hits the nail on the head of his issues. I don’t want to overstep my bounds with my Dad and his treatment, but the therapist asking my Dad to rehash his week does not seem to work. I have been to his sessions a handful of times and they surround a lot about processing how he is feeling. Now that my Dad is not living in a house alone, with very little regular stressors, I am seeing that he may not have the fortitude or insight to work through his feelings in regular therapy. I am thinking about suggesting intensive outpatient, but I am not sure if he will actually attend.

My dad has a lot of flexibility in the retirement community - can have pets, says one is too much responsibility for him, has a calendar of events- but says everyone that engages is too old and has memory loss and even has a paid person that comes by to spend some time with him that carried over from his old house.

I do think I am at a new crossroad of radically needing to accept things with my father I cannot control. It’s one of the reasons that I rejoined this on-line forum because like so many others who have loved ones with BPD the work can be never ending and it’s important too for me to cherish and live in the moment and notice some of the positive things that happen. I also realized that I need help in letting some of the feelings of responsibility go, that I cannot do everything and run the show for his life.

Some things that I have felt relief about in this past week are:
-   This was the first time my dad was admitted into the ER quickly without having to wait hours.
-   The social worker and the nurse at his residence communicated to me swiftly about their concern for his well being
-   The nurse transported him to the ER verses me having to coordinate.
-   The hospital he is in seems to be better than the hospitals he has been in in the past

I very much am using this forum to regroup and heal myself from what I feel like is burn out. Thanks all for suggestions and direction, it’s helpful.