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What to do when a patient is not ready to go to the psychiatrist?

Q: My brother is under depression for quite some time. My brother and I are 34+ and still unmarried. My father expired when we were too young. Now our family comprises of my mother, my brother and me. The major reason for his stress is recession in his business and the resulting financial crunch, another reason is delay in my marriage. He is intelligent and educated and has healthy knowledge in every field. His symptoms are as follows: Too much fluctuation in moods, he hears voices and believes that god is talking to him, couple to times he has written incredible things on paper. He is brave and strong but these days he fears a lot. He says that someone is trying to grasp him. He feels that the dreams he sees are signals from god to solve our problems. He believes that dreams foretell the future and what should be done. He asks everyone to analyse them. These days he is too lethargic and sleeps a lot. If we tell him to get up he becomes too aggressive. Sometimes he says that he is getting better by the medicines we give him, but sometimes he says, what's wrong with me? He is reluctant to go to a psychiatrist. He has stopped speaking much these days. We had given him homeopathic medicines prescribed by a doctor. The situation is getting worse day by day. What should we do? How to cope with him and which medicine should we give him?

A:I appreciate the difficulty that you must be experiencing in trying to cope with your brother's illness. From the symptoms that you have outlined, it is imperative that psychiatric treatment is taken. Medication will be crucial to progress in your brother's treatment. Often patients are resistant to consulting a psychiatrist and under these circumstances we advise the family to meet with the doctor to give a detailed history. On the basis of this some medication may be prescribed that is then given to the patient, with or without his knowledge, depending on his readiness. Once the patient becomes better he can be encouraged to visit the doctor himself. So please do not waste time and see a psychiatrist immediately.

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