Anxiety Disorder Question

[pbthompson]

Hello Everyone,
I need some help with my brother.  He is 42 had sex with a hooker almost two years ago.  He got divorced around that same time, is having a mid-life crisis in my opinion.  He isn't happy with his career and overall feels like he is going nowhere fast.  Now to the root of his problem.  He is convinced he has HIV.  I have read many posts on this site of similiar situations, however he differs in his adamant denial of the anxiety disorder.  He will not take his meds, he will not go to therapy because he doesn't think it is in his head.  He sleeps all day when he is not crying his eyes out.  He can't work, he is falling behind on his bills.  He has been to a mental health hospital twice for two weeks each time and basically that was because he said he would commit suicide if he has HIV.  They said he is delusional, has an anxiety disorder and is a hypochondriac.  He has taken atleast 7 tests all of them have come back negative or non-reactive.  We have taken him to an Infectious Disease Specialist and he said the tests are accurate and he does not have HIV.  How do we get him to believe the tests, take his meds and go to therapy?
We have tried the tough love route, the nice route, the admitting him to the hospital route, NOW what?

[pbthompson]

I am sure he feels guilt for the hooker incident and maybe for the divorce.  He feels bad because he thinks he gave HIV to his girlfriend.  It just goes on and on.

He was never THIS bad before.  He has always been rather needy.  He is used to people doing things for him and I think he floundered on his own for the first time.  He has always had a girlfriend or wife or mother or me to take care of him.

I just don't know what to do for him.  It seems like he is regressing back to being a child.  He is now living with our mother and sleeping all day as he did as a teen.  The bill collectors don't know where he is so he has a nice quiet day, he isn't working but she is providing everything he needs.  I kind of came down on him last night about what he needed to do.  I mean he has been calling me like 9-10 times a day at work, he just cries and goes on and on about what is he suppose to do.  It is heartwrenching.

Thank you for including him in your prayers, he reallys needs it.

[sadinmichigan]

I understand everything you have written about all his other problems, has he always been this way? It sounds to me like he has had an awful lot of things going wrong in his life/marraige which led him to do what he did with the hooker. but..do you think on top of everything else he has have happened..he feels guilt..guilt can destroy a person. And it doesn't matter what kind of guilt..it is an unproductive emotion that if isn't resolved within ourselves..will destroy. just a thought..i will have him in my prayers..

[pbthompson]

Hi,
Thanks for responding.  I asked him and he said that if he had the CD4 or the viral load test he would believe it.  However, I don't believe him.  He believes the state that he lives in has a conspiracy against HIV people because they have to many cases and they don't want to pay for anymore.  
I read him the symptoms for anxiety and he just doesn't believe it even though he has a BUNCH of the symptoms.  He says it is physical and not in his head which I have read it typical of males.  
I just don't know what to do with him.  He says he is exhausted that he can't do anything because he has no energy.  He takes sleeping pills which I can't believe a doctor gave him.  He is complaining his eyes hurt, they are blurry.  He went to the eye doctor for that and was told he has dry eyes...he doesn't believe it.
I have checked into a residental facility for him, they won't take his insurance because they say it is preexisting.  
I'm at a loss.

[JSGeare]

You can try this question:

"If it were really true that you do NOT have HIV, what would it take to convince you?"

And then listen -really listen- to the answer.

If the answer is basically that he cannot be convinved of anything that he KNOWS is not true, you're stuck.

Your only move in that case is to do whatever it takes to get him to a facility where he can be cared for in his delusional state -or, otherwise- relieve him of the delusion.

Worst case scenario: you and other caring family members assemble yourselves before a psychiatrist and lay it all out. You need BOTH to know that your brother is getting every chance he can have, AND to know that you are guilty of NO abandonement. This is a tough deal, and may involve some serious inspection of your own motives and needs as well as those of your brother. Be prepared for the possibility that, in your well-meaning efforts to help him -you may be, at the same time, enabling him. This is NOT easy.

Enough for now. Let us know what you find.