58-year-old mother’s sudden mental health decline — looking for guidance and hope

I’m writing this about my 58-year-old mother. I’m her only son and live/work abroad. She lives in India with my father. She is still working; my father is retired.

Last November, when I visited home, I noticed she was very low on energy and motivation. Initially we thought it might be vitamin deficiency or general weakness. But before I left, she started showing strange symptoms — hand shaking and mouth movements like puffing/gasping air.

After I returned abroad, things worsened. Mornings became especially bad. She had extreme emotional dysregulation — anger and aggression toward my father, followed at times by over-the-top affection. She also started disrobing, saying she felt hot, which was very unlike her.

I made an emergency trip back. Getting her to see a psychiatrist was very difficult because she is extremely anxious and resistant to doctors. The psychiatrist diagnosed depression with psychotic episodes. Because some symptoms didn’t fully add up, especially the disrobing, we were advised to get MRI and PET scans to rule out dementia, brain damage, or neurological causes. Thankfully, both came back clear.

She was put on antipsychotic medication and has taken it more or less regularly since January 2026. I eventually returned abroad. Her medication dosage has since been reduced. She still had depression-related symptoms, especially morning lethargy, but was managing to go to work.

Now in June, it has been extremely hot and she started staying home more. I’m back in India for a two-week visit, and I’m worried because some symptoms seem to be returning.

In the mornings, she seems highly resistant to doing anything, almost like her nervous system is on high alert. She has mentioned negative thoughts related to a recent untimely death in our neighborhood. By evening she improves, and by night she can seem almost normal.

Another confusing part is that she seems able to control herself around other people. I don’t know if that’s because she meets them later in the day when she is already better, or if she is masking her symptoms.

She also seems burdened by her health and by taking so many medicines — psychiatric meds along with blood pressure and cholesterol pills. Her thoughts feel scattered. She struggles with simple planning, like organizing travel to our hometown, and has a lot of inhibition/resistance around decisions.

This has been very hard on my father and me. My father has patiently handled this for six months, and I feel terrible for him. It’s also hard for me because I live in a different time zone and have visa/work complications, so I can’t easily come back during every crisis.

The whole situation feels like a bad dream. We feel helpless, especially because convincing her to see doctors is itself a major challenge.

Has anyone dealt with something similar in a parent? Could this still be depression with psychotic features, or should we push for another psychiatric/neurological evaluation? Is it common for symptoms to be much worse in the morning and improve by night?

I know no one here can diagnose her, but I’d really appreciate guidance, similar experiences, or even some hope. Is there light at the end of the tunnel?