Dementia and agoraphobia!

Dear Annie: I have complex PTSD from the first 18 years of my life involving sexual abuse and witnessing violent abuse on my brother and mother.

I have found a wonderful therapist and have quieted a lot of the guilt, shame and night terrors but I continue to have low self-esteem, anxiety and depression that I choose not to medically treat because of being 54 and not wanting to increase my chances at dementia. Because of this trauma, am I likely to get dementia because of the damage that was caused from years of abuse? — Concerned About Consequences

Dear Concerned: I am so sorry for what you went through and so relieved to hear you have a therapist whom you like. You raise an important issue. The available scientific research does indicate that the stress of PTSD can increase one’s risk of dementia. A review published in September 2020 found that people who suffer from PTSD are up to twice as likely to develop dementia later in life. The exact reasons for this are unknown. A 2018 study noted that PTSD increases levels of cytokines (proteins that trigger immune responses), which cause inflammation that may damage the brain. So, it’s important that you get appropriate and comprehensive mental health care. Talk to your physician and your therapist about what the best course of treatment might be. (c) Annie Lane @

Wow. I was happier five minutes ago before I read this. Psychiatric meds are linked to increased dementia? Perfect, just perfect. That tidbit of news really makes my day. Based on the number of psych meds I take, I’ll become more demented than the most demented dementia patient to ever live.

I’m not much of a scientist, but I believe that we intuitively know what’s right for us and what isn’t. I was prescribed Effexor once, and I researched it and didn’t have a good feeling about it, so I didn’t take it. Is that drug okay for other people? I sure hope so.

And my former best friend was once prescribed some sort of hardcore pain reliever, and she felt off about it given her unique circumstances and the fact that the prescription was written before she got in to see the doctor (???), and they diagnosed her as having fibromyalgia based on a casual comment she made, which she didn’t have (???). Yeah, what a mess. She rightfully rejected the prescription.

I think that voice speaks up and says, “I don’t really need that drug.” The drug I rejected, Effexor, was a really strong antidepressant with a reputed difficulty if you try to withdraw from it. I’m sure most of you know that depression isn’t something I wrestle with, but that I do struggle with going off antidepressants. The drug was prescribed to me by Dr. Quack, my family’s primary physician; and I hate the guy. Total quack.

So it’s possible that the letter writer knows that she doesn’t really need medications. It’s equally possible that she really does need medications and is terrified of dementia. I’m not sure, but I think there’s an intuitive inner regulator that speaks up about these things. If the inner voice is concerned about side effects or longterm effects to the point of not wanting to risk it, I’d guess that the person in question is largely functional and content without needing the drug(s).

I also think that if she were to go on meds, she’d just worry all the time about getting dementia. What fun would that be? It’s almost counterintuitive–take something for depression and anxiety, and become more anxious. Epic fail.

For those of us who absolutely must take our meds to preserve the wellbeing of everyone around us, we don’t waste time worrying about longterm effects of the drugs. There’s nothing we can do about it, anyway. If you were from the future, and you were to tell me right now that I’d get dementia unless I go off my meds, I’d keep taking my meds. Sorry, but I’ve been down that road, and it never ends well. Not. At. All. You might think, well, yeah, but couldn’t you just exercise more and eat more fruits? And I’d be like, “You’re too stupid to live, but thanks for the suggestions.” (Ideally, I’d say it in a nicer way than that.)

My point is that there’s a distinction between needing meds and preferring to take meds. And that distinction is important for people who make case-by-case decisions about their own priorities. But if I were this letter writer, I’d do more research. The truth must be out there somewhere. Pharmacists are an amazing resource, for starters.

DEAR ABBY: I can’t travel too far by myself because I’m agoraphobic. I’m having my house painted, and I asked my brother if he could pick up some paint because I needed more. He brought the paint to me and I reimbursed him. He then accused me of being needy and using him because I mentioned I was short on gas money for the trip.

Abby, when I ask him to do things for me, I pay him 90% of the time. I don’t ask for his help often, but that time, he argued with me about gas money. Needless to say, I gave him $20.

My brother isn’t struggling financially. He has money. He’s supposed to be a deacon in his church and calls himself a good Christian. He really hurt my feelings, and he said other mean things about my health issues. What should I do about this? — IN NEED IN THE EAST

DEAR IN NEED: Your brother may have been in a bad mood the day you asked him for the favor. Have you told him that he hurt your feelings? If you didn’t, rather than nurse hurt feelings, clear the air. If this has happened more than once, find a “better” Christian to ask.

Here’s what I’m thinking. The letter writer was trying to take advantage of her brother by not paying him for getting her the paint. It’s hidden between the lines that she was going to stiff him for his time before he finagled $20 out of her. (I think she reimbursed him for the paint but wasn’t going to reward him for his time until he raised the issue.) And instead of just owning that in her letter to Dear Abby, she went on a rampage about how he’s a Christian. And yeah, Jesus said to turn the other cheek, but come on. Having a religion that’s perceived in a virtuous light shouldn’t subject someone to being taken advantage of. Her brother should’ve been paid!

She should’ve offered to pay upfront (and then paid him), or asked him to do it as a favor if she had a way of returning the favor. Having health issues doesn’t give someone a pass to not reimburse someone for their efforts.

She does convince us that she pays him 90% of the time, so I think Dear Abby’s assertion that he was having a bad day is quite credible. But I really think she ought to pay him all the time.

My guess is that he critized her agoraphobia because she was using it to play the victim card. I’m sure agoraphobia’s a [bleep] to live with, but that doesn’t give her the right to play the victim in an effort to avoid reimbursing her brother. Good grief.

If this has happened more than once, find a “better” Christian to ask.

Interesting. Because if the letter writer considers getting someone else to help her, the first thought that’s going to cross her mind is, ugh, I’ll have to pay the other person 100% of the time! Why won’t my brother let me take advantage of him? He’s a good Christian, after all. 

I rest my case.

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