Howdy. Here's a possibly neurodegenerative puzzle. Any guesses?
 

Greetings, NeuroTalkers. I have a puzzle for you, and I genuinely need a clue. I’d be grateful for any guesses, educated or not. What's wrong with this lady?

The story starts in the mid-1980s. The lady had a challenging, demanding, rigid personality, but it was arguably within normal range. She tended to accumulate clutter in a few places in her house, but it was also arguably within normal range.

By the mid-90’s the cluttering had advanced to the point where you could legitimately call it hoarding disorder. She also exhibited some irrational thoughts, such as blaming her husband for irrational reasons (“You failed to predict the future and take steps to prevent this accident, so it’s your fault.”)

By the mid-2000’s the hoarding had progressed; the couple lost the use of multiple rooms in their house. It had caused several tripping accidents and a few injuries. Her personality had become more aggressive, hostile, and paranoid. I began to wonder if she had a personality disorder. After reviewing the diagnostic criteria for cluster B disorders, I remember thinking, “Is all of the above one of the choices?” I began to suspect a long-term, degenerative organic brain disorder.

By the mid-2010’s, she had become increasingly aggressive, hostile, paranoid, and threatening (“I’ll call the police and accuse you of [[crimes you haven’t committed]]. I’ll call Child Protective Services and have you removed from the home.”) Her husband filed for divorce, and with legal help and a judge’s approval, got the kids out of the house. By this time, the clutter prevented the normal use of any rooms in the house, and about half the house had been abandoned.

Now it’s 2020, and her condition is even worse. The police and other authorities have been called several times this year. She was hospitalized, held for 72-hours, and given a diagnosis of “psychosis, with extreme delusions and paranoia”. She spent two 10-day periods in a residential psychiatric facility and was given addition diagnoses of “bipolar disorder” and “schizophrenia”. A neighbor had a restraining order issued against her, after she broke into her neighbor’s house and started babbling nonsense.

So the puzzle is, “What could be wrong with this lady?” Whatever it is has taken 35 years or more to get to this point, and has caused consistent, progressive psychological, emotional, and cognitive deterioration, and eventually, social isolation. I suspect it’s something organic.

Do you have any guesses?

Welcome Positronicus. :Tip-Hat: Others will be along.

Kitt

I would be interested to know what medications she takes. Often times medication is the problem more than the Cure

Hi Positronicus

Welcome to NeuroTalk :).

The lady reminds me of my mother-in-law. She was a hoarder and I never dared to discuss Australian politics with her.

She died from Alzheimer's Disease and my wife and I had the unpleasant job of sorting through the junk in her house (her husband died earlier from a heart attack).

I don't know if a diagnostic label was helpful for her or whether it was simpler to accept that she had a "difficult" personality. My wife has worked as a clinical psychologist.

Hope this helps.

She saw a psychiatrist a couple of times in the mid-2000's. He threw some drugs at her for a while, mostly some kind of anti-anxiety remedies. But she did not take them reliably, and so the cure wound up being worse than the disease, and she stopped taking them. Given her new 2020 diagnoses, she's taking new stuff, but I don't know what it is.

The long, 35 year arc of her decline cannot be explained by drugs, since for 99% of the time, she wasn't taking any.

It would have to be an extremely early onset of Alzheimer's -- the symptoms started in her early 30's and became progressively worse over time. Is that possible?

Or it could be some other kind of Alzheimer's-like disease ... ???

Welcome, Positronicus!

Based on what you say, it sounds as if this woman's problems are worsening and she needs more medical attention than she's getting.

I do agree with blufox9654 (welcome, blufox9654!) that any medicine she's taking should be carefully investigated. It might be as simple as adjusting the dosage of one of them.

But you say this has been going on since the 1980s. The chances are that she'll need a thorough workup--a physical exam as well as a psychiatric evaluation by someone who is known to be conscientious and careful.

Some psychiatric "diagnoses" are made in a shamefully unprofessional way, though. There are psychiatrists who will diagnose someone as paranoid schizophrenic after an interview of only 10 minutes.

So I hope that she will be willing to get COMPETENT help, and soon. Maybe you or someone you know is able to encourage her to do that. I hope so.

Children are mentioned but not their ages or what happened to them after they were removed from this woman's care. Their situation would need to be carefully considered as well.

Positronicus I do not know what your relationship with the lady is.

Somebody could take out over her what is called an Enduring Power of Attorney here. This must be done while the lady is aware of what she is doing, It means that somebody can act on her behalf on all financial matters.

Somebody can also take out what called an Enduring Guardianship over the lady, Again this must be done while the lady is aware of what she is doing, It means that somebody can act for her if she becomes incapable of making decisions about her health.

Both "Enduring" documents are important and should be kept in a safe place.

[QUOTE=Positronicus;1290426]It would have to be an extremely early onset of Alzheimer's -- the symptoms started in her early 30's and became progressively worse over time. Is that possible?

Or it could be some other kind of Alzheimer's-like disease ... ???[/QUOTE


My mother-in-law and her brother both died of Alzheimer's Disease. Possibly they both inherited one or two copies of apoE4 from their parents.

Welcome Blufox9654. :Wave-Hello:

Kitt