Worried about my friend

I'm thinking he has some type of delusional disorder. Hes 20 years old. He used to be a normal person and I've known him for at least 10 years. But for the past year or so he cant stop talking about such crazy things to me and our other friend that he never used to talk about.

He tells us hes "the one" sometimes, and we ask him what hes talking about he just says you'll see eventually. Every coincidence that happens in his daily life is a "sign" to him. For example he was playing a video game and it was storming outside. The power kept flicking off and on and he turns to me and says the power keeps going out when i get angry at this game. Its a sign that i need to stop getting mad. I tell him the power would be flickering regardless because of the weather and he says no, you just don't understand.

Another example, he wanted to call his mom on my friends phone so my friend gives him the phone. He finds out his mom was locked outside her house so he hangs up and seriously looks like hes going to cry or something and says guys when i called her it was 9:11 at night, 911 that means emergency and she was locked out. I knew i had to call her. He keeps rambling on about how every coincidence is a sign that is telling him something or to do something.

Anytime we tell him its just a coincidence he just tells us we just dont understand and that we dont think the same as him. Theres more obviously but im trying to keep this short.

On top of that he used to be a fun outgoing person and now all he does is sit at his house all day only going out on occasion, with no job and does pretty much nothing. His dad is very sick and he says everytime he leaves the house his dad has to go to the hospital and that they have a connection and we just dont understand which isnt true but to him it is. He also says his dad is going to tell him something before he dies that is supposedly amazing and special and just no one understands but him.

He also gets paranoid around people he doesnt know when we are at a party or something on the rare occasion he goes with us. And he thinks people he doesnt know want to fight him even when there showing no signs of anger towards him.

I' very worried about him as this just started happened only 6 months ago and is not normal. I dont know what to do and he refuses to admit he has a problem. He never has told me he hears voices so im not sure its schizophrenia but it has to be something.

Sorry about the long read and thanks for the help in advance.

Sounds to me like he's psychotic.

Do you have a relationship with his mother at all? Maybe you could talk to someone in his family about your concerns. They may already have the same concerns that you do. This is especially important if he has ever talked about harming himself, or others. It does sound to me like he is delusional and possibly psychotic, which could point to certain mental illnesses that might be treatable if he chose to do so. But convincing a person in that state that they need to seek treatment is a difficult task, and it's very hard to watch someone you care about seemingly slipping into an unreality that you can't reach. I'm sorry this is happening, and obviously you care about him. If he is being deeply emotionally affected by his delusions he clearly believes these things, not just suspects them. I hope he will seek medical help. Perhaps you could convince him to see a counselor at least.

You're being a good friend and there is only so much you can do from the outside, and you're not a doctor. So remember, no matter what happens, he makes his own choices, and nothing is your fault.

Best of luck.

That's a good point. I've sometimes wondered what my son's friends think about how he acts. One clue I have is that all of his friends have cut him off.

I remember during his first episode - when he was 20 btw, a common age for this kind of thing to start - he became convinced he'd done something awful at a party but he couldn't remember what. He kept calling everyone he knew asking them what he'd done at the party. No one could answer his questions, so he became convinced they were lying to him. He told me that one of his friends finally said, "You're starting to sound a little crazy." Not one of his friends made any effort to contact me about any concerns they might have had.

I'm not totally sold on the medical model of mental illness. If I had it to do all over again, I wouldn't be so quick to get the mental health people involved. I was listening to a Madness Radio interview with Paula Caplan yesterday. Much of the interview is about depression, but when asked about more extreme states of consciousness like paranoia, she comments that behind paranoia is often absolute terror.

You don't share much about your friend, but you do mention his dad is critically ill and that he thinks that somehow what he does effects his dad's wellness. He's also clearly very concerned about his mother's safety. It seems clear to me that this young man is terrified of losing his parents and psychosis is his way of trying to make himself feel safe or more in control. There's meaning to what's happening to him. It's not random misfirings of his brain.

Sadly, a mental health professional would be very likely to give him a dx of psychosis and hand him a bunch of pills and ignore the very real psychic pain he's dealing with. He'll be told he has a brain-based "disease" which is biological and genetic and for which he'll have to take medication for life. The medication - probably an anti-psychotic - is a tranquilizer may take the edge off his terror, but it won't help him cope and grow through this experience, and it will very likely cause serious side effects.

Your friend seems like a prime example of someone who should be kept away from most mental health professionals, because what they will do to him will hurt not help.

I don't know what to advise you except to say that I hope you continue to be a friend to this young man no matter what. One of the predictors of good outcomes in sz is having friends and social contacts. I've listened to and read a number of psych survivor stories, and it's amazing how many of them mention how having a friend was key to their success.

Good luck.