[DavidPuddy]

Did not know where else to post this, as I don't even know the condition that my Mom has, but it seems to fit in with what I've read about psychosis. Apologies for the wall of text...

Basically, for the last 12-14 months (it could have been longer, but I had never seen the behavior before then), my mom (53 years old) has these bouts of extreme anger where she thinks the neighbors are watching her and judging her. If it makes any difference, she was laid off about 4 years ago, and hasn't worked steadily since then, just odd jobs here and there. Most of the time though she spent inside the house.

When she has these bouts of anger, she can suppress them if I or my siblings are near her, or if she thinks we are not within earshot. She will look out the window or door if she hears any of the neighbors make any kind of noise, or even turn on a light in there house; she will start talking to herself, pacing back and forth loudly, and basically get herself worked up to where I can tell her heart is beating fast and starts sweating. Even when the phone rings, it's enough to trigger her anger. The worst that has happened is that she once was so angered at the neighbors mowing their lawn (or doing something in their yard) that she put her fist through a window while she was looking at them, and ended up with several cuts to her arms.

When I originally told my Dad that this was not normal or even angry behavior but something more than that, he did not believe it (given our culture), just thought it was her personality coming out. Since then though, he has seen these rage episodes and has come around to accept that it really is a problem. He took her to our general practicioner doctor (took a lot of convincing to get her to go), who suggested it could be menopause and the mix of hormones. He prescribed some mild medication (not sure what it was) but it did not really do anything as far as we could tell, or even if she took the pills as prescribed.

This is where we are stuck: she refuses to go to a mental health professional or anymore doctors. She does not accept that there could be something wrong with her mentally, as in our culture there seems to be a stigma to this kind of illness. I converted some articles on mental health to our language and tried to give them to her, but she got angry, ripped them up, and tossed them. My dad bought home a list of doctors that specialize in mental health from his health insurance provider, but she found it and tore the pages up.

Between my dad working full time (and some overtime), and myself living what could be 30-60 minutes away and also working full time, we cannot be at home to monitor her to make sure she doesnt hurt herself somehow, or go outside and start any physical altercations. I try to be home when I can but given my obligations, I cannot be home more than 1-2 days a week. It's gotten so that I have only had 2-3 Saturdays (sometimes Fridays) to myself in the last 8 months, as I go home to watch her on Saturdays when no one else can.

I guess what I'm asking is, what are my options here? I don't think we can sustain this as it is becoming a serious source of stress for myself and my Dad, as well as my sisters (who do not live at with parents either). We can't forcefully take her to a doctor, as when we called the mental health professionals, they said they can't talk to us, they have to talk directly to her. She doesn't speak English though in the first place, and in the second, she refuses to even talk to them. If anything I want her to get a full body workup so we can rule out any physical causes of this problem, like a tumor or anything.

Does this sound like psychosis or some other form of illness? How do we deal with this given her being uncooperative and unwilling to accept that there is something larger at play here?

Thanks for any help or advice anyone can provide.

[faerie_moon_x]

Well, we're not doctors here, so no diagnosis can be given.

But, in my opinion something is going on for sure with your mom. It could be mental illness. It does sound like psychosis to me. However, that can come from a lot of things. And, it would be very good for her to get a fully body check to rule out any physical illness like you say. It could be many different things from schizophrenia or psychosis disorder, bipolar or depression has some psychotic features at times, or even things like dementia or alzheimers can have similar effects....

One thing with mental illness is something called "lack of insight" in which the person suffering the psychosis is incapable of realizing what it is. Learning to determine delusions or even hallucinations is called reality checking, and it's a very difficult skill to learn.

You talk about not speaking English and a different culture, so I don't know if you're in your home country or another county. But if you're in the US you can't do an involuntary stay at a hospital unless your mom is a threat to herself or others. So the question is if she is plotting to do anything to your neighbors or just complains. You say you worry she will get into a physical altercation. Call the hospital and tell them that is your concern and see what they say.

I wish I had better advice, but getting help for mental health when it's not wanted by the patient is almost impossible.

[costello]

I'm sorry to hear about your mom, David. That must be really confusing and scary. It's far more common to have an initial psychotic episode when you're much younger, but I've heard of people having them when they're older.

I agree she needs to be seen by a doctor. A full physical examination would be a good place to start. Btw, does she take any medications?

Since she's resistant, you have more of a challenge. You have my sympathy; I've been in the same spot - only with my son. My advice would be to look for an opening to get her to the emergency room. My son, for example, during his first episode became convinced that he had killed or seriously injured someone over night. He thought that person's friend would come after him. My brother-in-law advised him that he should go to the hospital so he could establish an insanity defense (of course, my son hadn't injured anyone; it was a delusion). And I told him he'd be safe in the hospital if anyone was trying to hurt him. In that way I convinced him to go to the hospital voluntarily.

Another time he was saying the neighbors were spying on him. He said she wanted to kill himself. In the course of the conversation he mentioned he was convinced he had HIV. I told him we could go to the emergency room for an HIV test. Of course, they don't do HIV tests at the emergency room, so when we arrived I took the triage nurse aside and explained the situation.

I guess what I'm saying is that you may have to look for a situation that you can turn to your advantage.

Unfortunately in my experience they don't do much in the way of physical exams under those circumstances. Possibly they'll do a drug test, but they aren't going to look for physical illnesses that might be causing psychosis.

[DavidPuddy]

Originally Posted by dark_heart_x

Well, we're not doctors here, so no diagnosis can be ...

Hi Dark Heart, thank you for replying, appreciate it.

Unfortunately, nothing I nor my dad or my 2 other siblings have said or done been of any help, or convinced her that she needs help. I think part of the reason is that she fears that she will be committed to a mental institution if they find anything off. She does not even want to go to our GP at this point. We've offered to all go with her and stick with her no matter what, but none of that has any effect.

We are in the US (IL, been here for 20+ years) so involuntary hospitalization is not an option, as you mentioned. I don't think she's a danger to others as her outburst seem to be more or less limited to within the house and slamming doors, windows, dishes, yelling, etc, but then I don't know if this is going to continue to get worse to where she might be a danger.

[DavidPuddy]

Originally Posted by costello

I'm sorry to hear about your mom, David. That must be really confusing and scary. It's far more common to have an initial psychotic episode when you're much younger, but I've heard of people having them when they're older.

I agree she needs to be seen by a doctor. A full physical examination would be a good place to start. Btw, does she take any medications?

Since she's resistant, you have more of a challenge. You have my sympathy; I've been in the same spot - only with my son. My advice would be to look for an opening to get her to the emergency room. My son, for example, during his first episode became convinced that he had killed or seriously injured someone over night. He thought that person's friend would come after him. My brother-in-law advised him that he should go to the hospital so he could establish an insanity defense (of course, my son hadn't injured anyone; it was a delusion). And I told him he'd be safe in the hospital if anyone was trying to hurt him. In that way I convinced him to go to the hospital voluntarily.

Another time he was saying the neighbors were spying on him. He said she wanted to kill himself. In the course of the conversation he mentioned he was convinced he had HIV. I told him we could go to the emergency room for an HIV test. Of course, they don't do HIV tests at the emergency room, so when we arrived I took the triage nurse aside and explained the situation.

I guess what I'm saying is that you may have to look for a situation that you can turn to your advantage.

Unfortunately in my experience they don't do much in the way of physical exams under those circumstances. Possibly they'll do a drug test, but they aren't going to look for physical illnesses that might be causing psychosis.

Hi costello, thanks for replying (btw, my username, DavidPuddy is just a character from Seinfeld , couldn't think of anything else).

Sorry to hear of your situation, you also have my sympathy. I hope things are better for you and your son.

The thought has occurred to me to call emergency services to pick her up, but I don't know if that would make things worse if they find nothing wrong with her * physically* and release her, and she ends up not trusting me or the rest of the family members. The other thought I had was to say that I will not visit her (right now, I stay overnight at my parents house 1-2 times a week to watch her while my dad goes to work) until she agrees to see doctors and get tested, but I don't know if that's going to push her further towards the edge.

She does not take any medications, in fact she does not even take medicine when she is sick, we have to force her to. She does not (and never has) smoked, drank or done any drugs.

I don't know her entire history from when she was a child or teenager, but given societal "norms" in India during those times, I'm sure there was a certain amount of disciplinary abuse, but do not know the extent or harshness of it).

[ickydog2006]

Has she been preoccupied with what the neighbors are doing in the past. Like others mentioned, the best thing is to try and use things to your advantage when they happen.And always pull medical professionals to the side and explain. A lot of them are willing to run tests they wouldn't generally run, like hormone level, or elevated white blood cell count. Has she gotten in physical altercations with neighbors before. or does she stay inside and be angry from there.

[DavidPuddy]

Originally Posted by ickydog2006

Has she been preoccupied with what the neighbors are doing in the past. Like others mentioned, the best thing is to try and use things to your advantage when they happen.And always pull medical professionals to the side and explain. A lot of them are willing to run tests they wouldn't generally run, like hormone level, or elevated white blood cell count. Has she gotten in physical altercations with neighbors before. or does she stay inside and be angry from there.

I personally never noticed this behavior up until about 14 months ago. However, from hearing her talk while she's aggressively ranting, it seems like it's been going on for about 2 years, or longer. She was laid off about 4 years ago, so it probably started shortly after that when she started being home all day.

Prior to that though, she was perfectly normal with the neighbors, where she would wave hi, or smile back if she saw them walking or working in their yard and whatnot. No physical altercations as of yet that I know of, she mainly stays inside the house and yells and shakes her fists or whatever else she has in her hand at the time. This is what I'm most afraid of though, that one day it's going to turn into a physical confrontation, but my dad refuses to believe that she will go out of the house like that.

[costello]

It's a very difficult situation, David, if your father won't take it seriously. My concern is that she has some kind of medical condition that needs immediate attention. Does she have a doctor? Has she had a physical recently? Maybe it's time to suggest she have one - and call the doctor ahead of time and tell him about your concerns. He can't share confidential information about your mom with you, but he can always listen to any information you have to share.

Also, see if you have a local chapter of NAMI. They may have some ideas.

[JennTom]

Hi Davidpuppy,

I am not a doctor but I wanted to tell that you are a very nice loving son, your parents are very lucky to have you. I want you to know my heart goes on you and your family esp your mom. All she need is to be seen by a doctor. Is it possible that you can get a doctor that will visit your house for a period of time and pretend to be friends and observe her? I am sure a doctor can give an initial diagnosis from her observations and from your accounts. Well just a thought, I don't know if my idea is even acceptable, sorry. I know it is different in US. If she can't go to mental institutions why not one of the doctors pay a visit and just do a casual talk and visit and that way she can be observed without any hysteria. I hope to God this is possible so you can finally get an answer and your mom can have help she need. There is nothing wrong with being overly concerned but if it will give peace to everyone why not? My thoughts and prayers are for you.

[Victoria'smom]

I know when I'm paranoid I can not be convinced to go to the dr. If I'm "convinced" to go no one can get me to speak. There is no way I would have gone if I didn't go through intake, psychiatrist and therapist appointments as support for my husband for a while. Maybe therapy would be less scary or going as a support to you or your siblings or your dad. Voice you mistrust of the neighbors and how they stress your mom out. If she's willing to be a support it may whittle down her mistrust.