So over the past year, my older brother has had a series of tests for several different reall donditions- He's engaged now and unhappy with his job, his fiance is looking for a job and he's a bit dpressed about his work situation and his pain in his body. He's had continual stomach pain. He had problems with his eyes, feet, head/migraines, chest, hip, leg/knee, and shoulders. He has always been a worrier. ten years ago he was depressed and anxious and went lon medication after a couple of suicide attempts. He apprently got better and tapered off- but now went on some new anxiety meds and we're all hoping things get better. But he needs to seriously look for another job and think about seriously going to a therapist because besides his psycho somatic related illnesses- he also has a shizoidal personality of some sort- we all as a family worry about him and have tried to get through to him. Now I was just talking to mhy mom and have only realized how bad it's gotten. My mom's worried because of all these issues that the marriage wont work out and all these other worries. I studied Psychology and I see these things in him, and now apparently we've decided that if anyone's going to get through to him, it's me- I can be like him, stubborn in not wanting advice or help- but I don't have as many worries in my life as he does- I'm wondering how to go about this. I'm thinking of going to see him and sit down with him by myself, but then I'm not sure what to say. I tried to talk to him the other day when I was down there visiting, but he didn't let me finish explain it, he thinks we're just saying it's all in his head. No, we're saying because of his worries and stress he's actually conjuring up real illnesses and pain, he needs to work through this, but he won't listen to anyone. Anyone going through something similar? Any advice at this point would be great.

[Perna]

That's a tough one. I don't know that you can just tell someone, "quit stressing" and have that get anywhere. And, it could be working the other way around, his physical illnesses could be causing depression and anxiety (lots of physical illnesses have that side effect) so I would see if I could convince him to get to a regular doctor for blood tests and physical and see if the doctor can help him worry less if that's the problem or can find a physical problem that he can treat if it's the other way around. But other than listening to and supporting him as best you can, I don't know that there's much that family members can do. Doesn't sound like, if it hasn't worked the rest of his life, that just talking to him will work?

[lonegael]

I know of a lot of people who have migranes who seem to get hypersensitive to pain in general.It's not a purely psychosomatic problem, it just means that overuse sets the nerves into a sort of short circuit where the mechanisms that dampen pain get bypassed. the same thing can happen with depression, which is why a lot of people get put on antidepressants when they have chronic pain.
That said, there are things he can do to better manage his pain, and these are relaxation excercises, CBT therapy to work through the anxiety, also mindfulness, a type of mental discipline, is very effective with this. These will not cure his pain, but they will help reduce the anxiety and the other psychological factors that keep him where he is. He needs to be reminded that closeness and intimacy do not mean losing himself in the other person or being "taken over" by the other. THAT will take a lot of time and work on everyone's part and is better takn on by a professional.
Good luck, but for your own self; You can only help him, you are not RESPONSIBLE for him getting together. That is up to him. The best love you can show him is respecting your own boundries and his. This is not something you are going to solve in a few good talks.
Best to start with the position that his pain is REAL, probably caused by central nervous system sensitisation by his migranes, bu that the other problems are making it hard for him to handle it.
And, make sure he has a thorough physical work up. He will take you more seriously if he thinks you are taking him seriously. HUggsss, and the best of luck!

[Ascension]

I agree first the physical, something far easier to diagnose, should be addressed. Then you can go from there. Sometimes when a person won't sit and talk, it is best to write them a letter/email. This way they can read it in their time. Sometimes when a person isn't healthy they using unhealthy coping skills like being overly defensive, disconnected or aggressive when people try to help. I hope your brother and your whole family can find some peace in all of this.

After the series of tests, was your brother treated for any of the physical conditions you refer to? Does he continue to receive treatment for any of the conditions? Has he been told by a physician all or some of his physical symptoms are psychosomatic?

My point in asking these questions is with respect to getting a physical. If your brother currently is being treated for the physical problems, the question becomes his prognosis for recovery. If the treatment is not progressing well, are there other treatment modalities that should be considered.

If your brother has been told his physical conditions are psychosomatic, perhaps another physical to get a second opinion might be a viable option.

Were the anxiety meds prescribed by a treating physician or a psychiatrist? I wonder too if your brother thinks the doctor(s) he is seeing also think the physical conditions are all in his head? Perhaps the impetus for therapy could come from a referral by a treating physician as a helpful adjunct to the current treatment?

Your brother needs to have confirmed that you and the rest of the family are not his enemies, that you believe something serious is going on and that you would like to offer your assistance in helping him through the tough time he is experiencing. One thought is to remind him that the treatment he received ten years ago helped him to get back on track.

In the end, all you can do is to offer to help. If your brother refuses your offer, you might tell him if he changes his mind the offer still stands. In the interim, phone calls and emails to remind him you care and hope he is doing better would be useful.

Good luck.

Thanks everyone., my brother went to the doctor and now he is on anxiety meds and has been doing much better. Thanks!

[lonegael]

I'm so glad to hear that. What a good sib you are for taking him seriously and standing by him! HUGGGGSSS!

[snapdragon928]

I don't get this psychosomatic pain thing. I am not in pain because I am depressed, my stomach pain they say is the depression is Caused by the medication, its in the fine print. I also have GERD which is a real condition and mod to severe arthritis in my lower back and severe arthritis in my neck. Which may be causing me pain in my arms and legs she said. Ani-imflamatories do no good.. It's real stuff, I have exrays. So why do they want to blame it all on the depression and not treat me for the pain? Last doctor appointment she considered lamictal for pain, then backed off that and said, I think it's your anxiety, and changed my anxiety meds. Ok=pain still here. I beleive that psychosomatic is a good term for we don't know what's wrong with you so we can't treat you.

[lonegael]

DO you have rheumatic arthritis? are you taking medication for that which is getting your stomach riled up?

[IceCreamKid]

Originally Posted by snapdragon928

I don't get this psychosomatic pain thing. I am not in pain because I am depressed, my stomach pain they say is the depression is Caused by the medication, its in the fine print. I also have GERD which is a real condition and mod to severe arthritis in my lower back and severe arthritis in my neck. Which may be causing me pain in my arms and legs she said. Ani-imflamatories do no good.. It's real stuff, I have exrays. So why do they want to blame it all on the depression and not treat me for the pain? Last doctor appointment she considered lamictal for pain, then backed off that and said, I think it's your anxiety, and changed my anxiety meds. Ok=pain still here. I beleive that psychosomatic is a good term for we don't know what's wrong with you so we can't treat you.

I got a fairly good explanation from a nurse once about how doctors go about addressing a problem. I told her the (first) treatment for my (real, physical) problem did not help so I did not go back to the doctor. She told me that what he did first was an appropriate treatment, but that I was shortchanging him and myself by not telling him 'hey that didn't work!'. Your doctor may be working under a similar idea: maybe she has seen far more patients who are helped with that anti-anxiety drug and that is why she wants to try it. I do hope you will give your doctor another chance and schedule some time to discuss just what you have said here.