[Zaria]

Have a family member newly diagnosed who briefly got on medication, (which seemed to help) but then stopped taking it. This person now displaying psychotic behavior the last several days. Any suggestions (for them or myself) on how to ride this out? Wondering if anyone has experience with this .
Was supposed to see the doc again later this week but is now saying no to that.

[newtus]

welcome. i hope you find the help your seeking.

[gayleggg]

I would take him to the ER, if you can get him to go. He needs to be medicated. If things get too bad and he will not go to the ER I would call 911 and them come get him. I know that is something you wouldn't want to do but for his own safety you may not have a choice.

[allme]

[costello]

Originally Posted by Zaria

Wondering if anyone has experience with this .

Hi Zaria:

I have a great deal of experience with this, I'm sorry to say. You have my sympathy. It's a very difficult situation to be in.

I wish there were easy answers. I've been at this for 8 years now. If I knew at the beginning what I know now, I think I'd have handled it differently. But I'm not sure what I'd do. I've been having this conversation with my son recently. He doesn't like how I handled things - getting him to the hospital and the mental health center - but when I ask what I should have done instead he just says I should have left him alone and he'd have been fine. It's true that after his first break, he refused treatment and he eventually came out of the psychosis and went on with his life for 2 more years. Unfortunately there was another episode after that.

My best advice would be ... hmmm, idk:

1. Less is more. Don't provoke a crisis, if you can avoid it. Sometimes just being calm helps a situation de-escalate.

2. Don't drag him to the hospital unless it's truly urgent. And my definition of truly urgent is much farther out that it was at the beginning. Hospitals are a last resort, because in my experience they aren't that helpful and they traumatize people leading to mistrust. Is he paranoid?

At this point in my journey, it would take a lot to get me to try and get my son into a hospital. Of course, my son has also been really stable for quite a while. I know how stressful it can be when things aren't going well.

3. Don't assume that his fears are all random nonsense. At least with my son, there's always a kernel of truth. If you dismiss his ideas as being mere fantasy, you miss a chance to connect and you create a barrier of distrust.

Does he live with you? Does he work? Has he had a stressful incident recently?

[costello]

It's been a while since I watched this video, but I remember it as being helpful in trying to describe psychosis from the point of view of the patient. Maybe it will be helpful to you.

Mediasite Player Loading

ETA: I've started watching this video again. I have to say that I disagree with some of the comments he makes about the causes of schizophrenia and the need for medication in all cases. Just my opinion.

[faerie_moon_x]

I agree that being dismissive is not the right answer. The first thing I've learned from my own experience in dealing with my own psychosis is that it's 100% real. Even if it isn't real to anyone else, it's still real. I had no way to see that what was going on was only going on for me and no one else.

Having empathy is really important.

[Zaria]

thank you all for your suggestions! much appreciated.
It can be scary and frustrating, not knowing how or when to respond to symptoms.
there is no way this family member would go willingly to the ER. however, that's where he SHOULD have been two days ago. i thought about calling 911 several times but was afraid for him. He is calmer today. still not sure if he will agree to keep his DR appointment which is i a few days, and I am afraid to even bring it up.
i am hoping we can soon get him to agree to give the medication another try.
Thank you all

[Zaria]

Originally Posted by costello

Hi Zaria:

I have a great deal of experience with this, I'm sorry to say. You have my sympathy. It's a very difficult situation to be in.

I wish there were easy answers. I've been at this for 8 years now. If I knew at the beginning what I know now, I think I'd have handled it differently. But I'm not sure what I'd do. I've been having this conversation with my son recently. He doesn't like how I handled things - getting him to the hospital and the mental health center - but when I ask what I should have done instead he just says I should have left him alone and he'd have been fine. It's true that after his first break, he refused treatment and he eventually came out of the psychosis and went on with his life for 2 more years. Unfortunately there was another episode after that.

My best advice would be ... hmmm, idk:

1. Less is more. Don't provoke a crisis, if you can avoid it. Sometimes just being calm helps a situation de-escalate.

2. Don't drag him to the hospital unless it's truly urgent. And my definition of truly urgent is much farther out that it was at the beginning. Hospitals are a last resort, because in my experience they aren't that helpful and they traumatize people leading to mistrust. Is he paranoid?

At this point in my journey, it would take a lot to get me to try and get my son into a hospital. Of course, my son has also been really stable for quite a while. I know how stressful it can be when things aren't going well.

3. Don't assume that his fears are all random nonsense. At least with my son, there's always a kernel of truth. If you dismiss his ideas as being mere fantasy, you miss a chance to connect and you create a barrier of distrust.

Does he live with you? Does he work? Has he had a stressful incident recently?

thank you costello.
you said your son has been stable for some time now. Can I ask if he is on medication?
Or if not, did the medication help get him to this point?
my own son is saying that he beleives the meds will cause brain damage.
i realize it is a personal choice, but at this point in time, he is barely functioning. No, he does not work or go to school. or do much of anything else. I do not think he is currently ABLE TO, right now because his symptoms have dramatically worsened and overtaken him. In this case, i don't see how it could get much worse for him, and am hoping he will at least give the meds another try for a longer period of time. he was recently on his first round for just a few weeks and did seem better (to us!)
And yes there has been several traumas in his life, the last of which we believe accelerated the symptoms we've been seeing.
Thank you for your input on hospitalization as well. That helps!

[costello]

Originally Posted by Zaria

thank you costello.
you said your son has been stable for some time now. Can I ask if he is on medication?
Or if not, did the medication help get him to this point?

Yes, he's currently on medication. He takes a small dose (2.5 mg) of olanzapine (Zyprexa) daily.

my own son is saying that he beleives the meds will cause brain damage.

There is some evidence that this is true, but that's with long-term use and/or high dosages. Each person needs to do a risk-benefit analysis in deciding whether to take medication. Some people find the side effects make medication impossible or they get no benefit. Some people get enough of a benefit relative to the side effects to make it worthwhile.

i realize it is a personal choice, but at this point in time, he is barely functioning.

That's the catch, isn't it?

No, he does not work or go to school. or do much of anything else. I do not think he is currently ABLE TO, right now because his symptoms have dramatically worsened and overtaken him.

And he lives with you? I mean, are you able to keep an eye on him?

In this case, i don't see how it could get much worse for him, and am hoping he will at least give the meds another try for a longer period of time. he was recently on his first round for just a few weeks and did seem better (to us!)

What I've learned is that I made myself my son's enemy by aligning myself with the mental health professionals early on. When I realigned myself on my son's side, I made much more headway with him. I know it feels like being on the side of the mental health professionals is being on your son's side, but my son at least didn't see it that way. When he refused medication, I looked into alternatives - which do exist.

Just slowly over the years he's come to trust me and to realize I'm trying to help in my own bumbling way. It's hard to know what the right thing is sometimes, but I try. That counts for a lot. And I listen to him. That's huge, because so many people with psychosis are ignored - even when they're describing their own experiences. (I had a lucky break in that I 'diagnosed' his akathesia - a common and very unpleasant side effect of antipsychotic medication. The fact that I caught that when two pdocs and a pnurse missed it impressed him.)

Psychosis can be a gift. You can grow from it, and so can he. Just don't make the mistake of believing you can simply turn this over to the professionals, and they'll fix it. It doesn't work that way. The professionals are just more experienced and more knowledgeable members of the team. The meds are just one tool in the tool box.

Btw what you perceive as an improvement on medication may not be his perception. I don't understand it, because looking at it from the outside in, the meds seem to help so much. I guess looking from the inside out, they're often not so good.

And yes there has been several traumas in his life, the last of which we believe accelerated the symptoms we've been seeing.

That doesn't surprise me. My son's first episode was precipitated by the loss of his job. (Although sometimes I wonder if he wasn't already in the midst of the episode, which is why he lost his job. )

Thank you for your input on hospitalization as well. That helps!

One thing my son has made clear to me is that the hospital is a terrible place to be. He feels betrayed, I think, that I've ever got him into those places.

[mimi2112]

Zaria: Welcome to pc. Thank you for reaching out for help. I hope things get better for your loved one. I want to emphasize what Costello said above. The trust thing is so important and when it is violated, it is hard to re-establish.

In my experience, I felt betrayed in so many ways for so long that when things got bad for me, most of the psychotic symptoms focused on not being able to trust anyone. I became very paranoid and suspicious. If I were to give any suggestion to you it would be to not break any trust that your son may have with you. He needs unconditional love and nurturing. Even though you may be scared to death of the illness, the best you can do is try to see things from his perspective.
Talking to us here is an excellent step. I believe that recovery is possible and there are many treatments, not just medication and psychiatry.

I thank you again for wanting to do best by your son.