Q: My 19 year old sister has been having some mental problems for a year and a half now, but wont seek help. She has heard voices, withdrawn from social life, wont listen to any authority figure and more. Lately she has taken to going poop in the bathroom sink. When questioned she denys that she did it. What could be going on? We have been trying to get her help but cant because she isn’t a minor. She still lives at home and mom my is very worried. She says maybe its ADD but I know that its not. My daughter has ADD and also I am a school psychologist. Its just that my training is fairly limited and I have no idea what to do. Any advice?

A: I can’t offer a diagnosis on the basis of a letter but I can tell you that your sister’s behavior is not typical of ADD. It sounds to me like she is in serious trouble. I don’t know if this is a mental health problem or if there is a medical issue that is showing up as bizarre behavior. She needs to be evaluated.

Your sister is not a minor but she is living at home. If she were my daughter, I would use whatever bribes and threats I could come up with to get her to the family doctor to talk about what has been going on. I would also insist on going with her and sharing the family’s concerns. Sometimes people who love each other need to do what is best for the person they love, whether or not it is appreciated and even if it risks a breakdown in the relationship for awhile. Better to have her mad but get some needed help than to let this go for the sake of peace and then maybe find out that something got far worse than it would have if there had been early intervention.
I wiah you well.
Dr. Marie