Desperately need help for my brother

I am the sister of someone who we suspect strongly has some degree of paranoid schizophrenia, and I'm posting here because I simply don't know what to do.

My brother's had a lot leading up to these recent years. When he was born, his lung collapsed, leaving him without oxygen for a time. When he was young, he was put on some kind of medicine (I think they were anti-depressants, but I was a child at the time as well, so it's hard to remember) that made him "head bang" constantly. He is incredibly, brilliantly intelligent, but he has always had trouble with being happy. A few years ago, there was an incident that, though he was innocent, led to him getting arrested. I know the event was extremely traumatic, and he's never been the same since.

He started shutting up inside his room, painted the walls dark, keeps the curtains drawn, wears earplugs because he can't stand sound, and goes around wearing welding goggles to block out light. I was going to college at this time, so I only saw him when I came back during breaks, but around this time, I started hearing him ranting in his room - seemingly to no one. Being a gamer myself, I assumed for a while that he was simply raging at people over ventrilo or some other voice client, but it's become apparent over the past year that it's much more than that.

He bought a gun and somehow managed to get a concealed carry permit. I hear him ranting a lot about people scamming him - and it sounds like he's talking to people, but there's no one there. Last summer, he became convinced there was a roach stuck in his throat and actually drove across the country (telling my parents he was going on a road trip) to try and find a doctor who would help him. Of course, no one could because there was nothing there.

He smokes, which I understand is a common thing because it helps dull the senses. Last night I heard him out in the back yard practically screaming at whatever nightmares are haunting him.

My parents have been keeping a journal of their observations, and they took it to a very good psych doctor, who brought up the possibility of paranoid schizophrenia (though it also could be severe OCD with depression, or even PTSD). I feel awful thinking about what he is going through, knowing that to him, this is all so real. It must be frustrating and terrifying to have no one else believe him. It's tearing me apart because I have no idea what to do to help. It frightens me that he has a gun, especially when my parents told me about how he stalked a woman to her home (supposedly a girlfriend he broke up with) and waved the gun warningly at her because he was convinced she was plotting to kill him. The police showed up at my parents' house after that, but they never did anything.

He refuses to get help, and no amount of pleading or even bribing has been able to get him to go to a doctor. Since he's not a minor, we can't force him; we can't even get him to give up his gun. At this point it feels like we're just waiting for him to either hurt himself badly enough that he has to go to the emergency room (at which point we can ask for a psych evaluation), or he hurts someone else and... I don't want to think about that. I don't know what to do, and I was hoping someone, somewhere out there on a forum like this could maybe help. Maybe you have some suggestions to try. Maybe there is actually hope.

I am having such a hard time finding it right now.

When your parents went to the psychiatrist, was that recently? What did the Dr. say about what can be done?
I am sorry that this is causing you so much worry. Do you know if there are any support groups in your area? I know that NAMI has groups for people that have friends/family with mental illness.
Does your brother live at home?
I wish I had answers for you. It sounds like you are really struggling. It also sounds like you are reaching out for support and that is great, I hope you continue to reach out.

So what about meds...I know I needed meds to even really understand how sick I was, was he offered meds by the psychiatrist?

If he's living at home still you can force him. Get your parents to say they have a no gun rule in the house and if he wants to keep the gun then he can find his own place. Most people don't take the steps to get a gun, they just think they've killed people or want to so the gun thing scares me.

He lives with my parents, yes. My parents went to see the psychiatrist fairly recently, but my brother has not talked to anyone (refuses), which means we can't get him the medication he may need to even realize he's sick. The doctor said there's not a whole lot we can do aside from either getting him a psych evaluation if he happens to have to go to a doctor for an unrelated reason or... somehow get him to go on his own. It's my understanding that a lot of people with schizophrenia do not even have the ability to recognize they are sick (without meds), so my parents have tried both asking him to go for their sake (emphasizing that it doesn't mean he's admitting to being sick - he would just be doing it for them) as well as bribing him with things we know he enjoys (pets and grilling food, mostly).

I wrote and gave him a note before I left home, letting him know that if he ever felt distressed, I would always be there to talk to, and told him about my own fight with depression. I'm hoping that offering myself as a listening ear, as well as him hearing from someone other than my parents that something seems to be troubling him, he may open up... I don't know. It seemed like a good idea at the time, but I keep worrying that maybe it will end up with him not trusting me either.

Ultimatums are frightening. He can't hold a job in his condition, and he has no money. If they had to kick him out, he would end up living on the street. I can't imagine doing that to my brother. Do ultimatums have a good success rate for these kinds of situations?

I have no idea about the ultimatums working or not but what I'm saying is you(or your parents) do have control and responsibility and sometimes you have to protect yourself. If he's not getting help and he is dangerous you're putting peoples lives at risk letting him keep the gun. Here is the tricky part, if the psychiatrist thought he was a danger he would have locked him up already so maybe there is nothing to worry about but you're depending on the opinion of one person for your safety and that of others...was the psych informed of the gun waving incident. I don't think its unreasonable to have rules in the house, and I think that no guns is a reasonable one. As far as treatment, some people advocate forced treatment. I am not a fan, it is a huge breach of trust---if he's not hurting anyone let him come around to the option of treatment on his own, provide it as an option, ie if he complains about symptoms you can bring it up as a possibility.

be careful about lying to get him in.
whether he ends up doing better or not that stuff is on peoples records.

IDK. im not for forced treatment or lying to get people into hospitals. that does break trust. that severely traumatizes them when they are mostly likely already trauamtized. and if they DO get better there will be a host of things they may or may not be able to get away from on their records. especially with something like schizophrenia.

thats what i got from being lied about and forced treatment on ME. and ive heard that from others who had the same.

Here is one approach

I Am Not Sick I Don't Need Help: How to Help Someone with Mental Illness Accept Treatment [Paperback]

Xavier Amador (Author)

Thank you for the book link, Sometimes. I'm going to read it; hopefully it can help.

He probably feels very alone and maybe he wants to be treated like everyone else. A little trust goes a long way. Sick people like us do not like to feel like everyone is scared of us. Befriend him like you would anyone else and when he gains your trust that would be a good time to get help for him. A short term stay in a hospital would do him wonders. Explain what would happen in a hospital- they will not keep him- only long enough to regulate meds. He will feel safe in there with others like him. If he admits himself he should be able to get himself out if he feels trapped- find out the policies before hand.

Hope this makes sense

Actually your parents can have him involuntarily committed to a hospital. If he has a delusional outburst or threatens violence your parents can call 911 and have him brought to the ER for an evaluation. I've had to do this to both of my adult children. It sucks and is hard to do, but it gets them the help they need.

Look into the laws in your state. Each state has a name for an involuntary admit. I've had to do in two states myself.