[spiritual_emergency]

Elsewhere, a sister had asked how she can help her brother. He hears voices and it's impacted his daily function to the degree that he can't work. He had been prescribed Zyprexa in the past but is no longer using it.

That particular environment is having a problem with trolling and I just don't feel like putting an answer out there so someone with no insight can come along to make suggestions such as, "Just kill him." (The mods at that site have been asked to remove that member for consistently cruel comments but it doesn't appear to be a concern for them.) So... I'm responding here where I know others won't make those kinds of comments and I'll redirect her accordingly. If anyone else has some suggestions for her, please add them.

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To Sister:
I'm assuming that you're in a position of influencing treatment but not determining treatment. For that reason, here's what I suggest you try:

- Most people are aware that something is amiss. They might not use the labels others say they should use, but they often are aware that they're distressed, that they're anxious, that they're frightened, that something is happening to them that is out of the ordinary in some way. It can be less threatening to them to use the terms and labels they come up with.

- The issue of medication is a complex one. For some people it works very well, for some people, it doesn't. Sometimes lack of med-compliance is presented as a symptom that people don't realize or haven't accepted that they're ill but this isn't always true. People may have some entirely valid reasons for coming off of a med (i.e., Zyprexa is linked to weight gain and diabetes) and they need to have their concerns heard.

- People may also be open to trying another medication or another class of medications even if they have had a bad experience with one. It might be helpful to educate yourself (and the rest of the family) on the options that are available. These might include anti-psychotics; anti-convulsants/mood stabilizers; anti-depressants and anti-anxiety agents. Two sites I recommend for those researching meds are rxlist.com and askapatient.com. Ideally, you'll review them together but if he won't read them, you still can. At least that way, one of you will be informed.

- Also, your brother might be more open to trying a medication trial if you set a time-frame for it (i.e. three months). Research the med togther, decide what side-effects will be considered intolerable and then set a time frame for the trial. If they are helping he might be more open to continuing with them; if they're not helping, he might be open to exploring other options that might help restore stability and function.

- Ask your brother to let you know what his goals are. For example, if he wants to get back to work, help him make that happen. It may be that he'll lose that job too but that might help him realize that he needs to take some different actions the next time around, such as pursuing some form of treatment.

- Voice hearing is not always a symptom of severe mental illness. Some people report relief using psychotherapeutic approaches. Intervoice and the Hearing Voices Network are two resources you could check out and share with your brother.

- Even if your brother did have a form of psychosis, depression, mania, anxiety, etc. that doesn't mean he'll have them forever. Some people make full recoveries, other people are able to find a combination of treatments that restore them to full function. Try to find examples of people who are doing well so your brother won't feel his situation is so hopeless.

- People who are deeply distressed may turn to forms of self-medication, notably alcohol or recreational drugs. More often than not this complicates the issue, bringing on psychosis or triggering manic or depressive states. It may be helpful to minimize his exposure or access to drugs and alcohol and/or encouraging him to stop using them.

- Take this time to investigate your local resources in terms of hospitals, treatment programs and professionals who might be available. Naturally, larger cities will have a greater pool of resources whereas small or isolated towns may have none. If you know what your options are, that will help guide you in making a decision at the point you have too.

- Take this time to investigate state/county/provincial laws regarding forced treatment and legal rights. You may not ever need to act on it but if you do, you'll already be familiar with the legalities.

Ideally, your brother will seek out his own forms of treatment but he will certainly benefit from the support of people who love him while he does that.

~ Namaste