Brother-in-law is acting bizarre

By Dr. Marie Hartwell-Walker

My brother-inlaw has been taking depression medication and has been removing car sideview mirrors and urinating outside in planters? His has been arrested for this and has been sent to the hospital a couple of times for evaluations but no one can help and they just release him out. He denies that he does anything like that and will not talk about it. He does not want help and will not stay in a facility. Sometimes he will walk to a local 7/11 and steal a beer. He will not get drunk but must have a beer or two each day. He also will mumble a few words if he does not think anyone is watching. We are uncomfortable around him and feel he might start doing something worse or act out with anger. How can we get him help or find a facility to keep him longer and find out if he has other problems than just depression? We need help, please.

A: I’m very glad you wrote. Since you are 60, I’m guessing your brother-in-law may be somewhere close to your age. I’m also guessing that he has been taken to a psychiatric hospital for his behavior. It’s very possible that the problem is medical, not psychiatric. The way the American health care system is currently organized, a psychiatric facility probably didn’t check him out medically. Their job is to stabilize someone, review his psychiatric medications, and get him home.

Your brother-in-law may be less resistant to seeing his doctor than going back to a facility. My best suggestion is that you get him to his doctor for a complete physical. Believe it or not, there are a variety of medical issues that can cause this type of behavior. Problems with the heart or bowel, for example, sometimes show up as delusions and depression. A sign of early dementia is erratic behavior. I’m not an M.D. and I don’t have anywhere near enough information to tell you what the diagnosis may be. I only mention those possibilities to demonstrate that psychiatric symptoms sometimes have medical origins. As for the beer: He may be self-medicating. The alcohol makes him feel better so he goes for it.

You will get a better assessment if the family keeps careful notes of exactly what your brother-in-law does, how often, and with what intensity for a few weeks prior to the appointment and present the information to the doctor. Otherwise, the doctor will only have what his patient reports – which you already know is unreliable.

Your brother-in-law may not appreciate it but he is a lucky man to have concerned family. Whatever the problem may be, early diagnosis makes a difference. By getting him to a doctor, his family may well give him the chance for a much better – and longer – life.

I wish you all well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 16 Nov 2009

APA Reference
Hartwell-Walker, D. (2009). Brother-in-law is acting bizarre. Psych Central. Retrieved on October 31, 2014, from http://psychcentral.com/ask-the-therapist/2009/11/16/brother-in-law-is-acting-bizarre/