I suspect he is not actually the child of novelist Robert Parker.

March 22, 2009 6:49 AM

Has my brother completely lost his mind? And if so, what do I do now? Before 9 PM today I was prepared to ask about biodiesel cars.

My brother, in his mid-twenties, appears to be having a psychotic break in a distant city, and I'm not sure how to proceed. He called me yesterday and rambled for 3 hours about all manner of things in a completely crazy way--including the fact that he had located our long-missing older brother, but that Brother #2 was using a fake name, perhaps because the Feds are watching and there was a private investigator outside his house yesterday and he might actually be the son of novelist Robert Parker and perhaps he and I don't have the same father and is Brother #2 the same child our mother miscarried 27 years ago and when he tried to buy a computer at Best Buy the other day they switched them on him and and and. It went on like this for three hours. When I spoke he did not actually respond to the things I said, but continued in this vein.

My suspicion is that it is schizophrenia. He's the right age for it. It might also be a very long bender, because he also says that he has been using heroin until recently. Next week is also the anniversary of our mother's death. He says he is mad at his friends because they are telling him he's "crazy." The friends I managed to track down tell me this started about a week and a half ago--but that at the time he was mostly ranting about money and the stock market, not this insane baroque family shit. He also says he is getting on a plane to go to New York on Monday to see a girlfriend who told him it was probably not a good idea. I could not convince him otherwise.

What the fuck do I do, Metafilter? He keeps saying, unprovoked, that he's not going to hurt himself, so I think that EVEN IF the New Orleans police took me seriously they would ultimately not intervene. Who can I call? Will they even let him on a plane? Should I try to go to New Orleans? To New York? How can I help him? I'm worried sick.

posted by liketitanic to health & fitness (25 comments total)

Call the cops anyway. They can at least have him evaluated.
posted by St. Alia of the Bunnies at 6:55 AM on March 22

I would probably get on a plane. It sounds like there's nothing you can do unless you're physically with your brother. Until you can look him in the eye, you probably won't know whether it's drugs, schizophrenia, or something else (like the distant, distant possibility that he's not crazy or on drugs and the things he's saying are true).

Good luck.
posted by nosila at 6:56 AM on March 22

I would both call the cops, and get on a plane. It doesn't sound like without intervention, this is going to end well.

You have possibilities he could hurt himself, or this girl in NY, or a random person he believes is a PI outside his house. I would be prepared for not being able to actually "do" anything, but if it were my brother I would try.
posted by mazienh at 7:06 AM on March 22

Contact a social worker in your area.
posted by Ironmouth at 7:13 AM on March 22 [2 favorites has favorites]

Uh, even if the OP does "get on a plane", what would happen after he (I assume it's a he from the hilarious "gender" given in his profile) arrived in New Orleans? What could he do if it turns out his brother is crazy/schizophrenic? Bring him home? Have him committed? What?
posted by amtho at 7:15 AM on March 22

Call him back. Record the call. Then call the police and the local mental health department too. I would not get on a plane without a very specific well thought out plan.
posted by JohnnyGunn at 7:35 AM on March 22

In people who are predisposed to schizophrenic episodes, heavy drug use has been associated with the onset of symptoms, so it's not "crazy OR heroine."

On the other hand, nicotine has been found to help people experiencing schizophrenia sort-of "come down" and find some balance. An old friend of mine who began acting like this in his mid-twenties is certainly much closer to reality when he's got a cig--not that I'm recommending anyone take up smoking.

But if I'm just trying to get him to dial it down enough to hear my words for a few minutes, a walk and a smoke do seem to help.

-
posted by General Tonic at 7:48 AM on March 22

Louisiana's Office of Mental Health has a 24-hour COPE LINE: 1-800-749-2673. They should be able to talk you through options more thoughtfully than we can here. Please call.

I'm curious what folks suggesting he call the New Orleans cops think the cops will do upon receiving that phone call?
posted by mediareport at 8:07 AM on March 22 [5 favorites has favorites]

I would start by contacting the rest of your family. Do you have other brothers/sisters? Where's the dad?

There are just too many other details that you couldn't possibly share with us for us to have really good advice. Your family should gather together to put together a (very quick) plan. Obviously, you need and want to do something to help him, and quickly. I'd look to other family members, though, for deciding what that is.

As a family, your plan might look something like this:
1. Someone goes to him, to see if they can quickly determine if this is drug/alcohol abuse or a possible other mental problem.
2. The family member takes him to a professional (the type depending on what the family member can discern from seeing him and his surroundings) for evaluation.
3. The professional talks to you about the options, and you make the decisions about how to move forward.

I know this is pretty basic and vague, but really there's no other way. He may or may not have a mental problem, or a drug problem, or whatever. There's no way for us to know. I can only say that I think your first instinct (get a family member to him) feels right to me, too. I'd only add that you should gather as much immediate family as you can into this, so you can work as a group and not have to shoulder all of it yourself.
posted by Houstonian at 8:19 AM on March 22

Houstonian, there really is no other family. Our parents are dead. We have one much older brother who may be able to help but is not yet totally understanding what's happening here.
posted by liketitanic at 8:24 AM on March 22

Wow, that's hard with both parents dead. I think you are on the right track to go to him, though. If it were in that situation with my sister, that's what I would do. I would think, "She's lost for some reason, needs help, and deep down is probably scared." To me, that's intolerable -- there's no way I'd let my sister be lost and scared. My family's pretty tight like that, though, and I know that not all families are the same. But yes, I'd go in a minute, to see what I can find out from observing and then contact whichever professional I'd think was right after I'd seen it first-hand.

So, again if it were my sister, I'd call her and say, "Hey, you seemed pretty upset and I'm coming to visit you. I'll be there this afternoon." Then, I'd get on a plane, take a taxi from the airport to her, and be in front of her within the day. If it's heroin, I'd be on the phone with drug counselors tomorrow. If it's a mental problem, I'd be on the phone with psychiatric counselors in the area. But again, that's me.
posted by Houstonian at 8:49 AM on March 22

Yeah, if you can get to New Orleans before he leaves for New York, I think it might be a good idea. Because if his drug problem has gotten out of hand, or if he is having a schizophrenic episode, or if both are true, he will probably need to spend some time in a hospital. He needs you right now to do the research, take him to see a professional and/or call social services, pack his stuff up for the hospital, and then be there for him when he is in the hospital. He will be angry -- super angry -- but he'll get past it. And he'll need things while he's in the hospital. He'll complain about the shampoo, the soap, the toothpaste, the clothes, etc. You can help with all of that.

You're being a good brother. Definitely clue your older bro in on what's happening here, though. You shouldn't have to deal with it alone if you don't have to.
posted by brina at 8:58 AM on March 22

PS. If you can't get to him until he gets to New York, I have a big ol' list of resources for people here. MeFiMail me if you need to. I hope all goes as well as possible.

::hug::
posted by brina at 8:59 AM on March 22

Buy a plane ticket today to go down to New Orleans and then contact Thresholds about crisis intervention for psychiatric patients. They're a group out of Chicago that specializes in inpatient and outpatient treatment of psychiatric patients with a focus on independent living for patients and support for their families. They are excellent and they may be able to put you in contact with social workers in New Orleans who may be able to intervene with your brother. You need to involve professionals here and, as someone from New Orleans, I'm not entirely sure what sort of response you'll get from the NOPD. There may, indeed, be nothing they can do unless he injures himself or someone else, or is an obvious threat to his own or someone else's safety.

When my family member suffered his psychotic break, the police could not arrest him and involuntary committal was not an option because of state laws. It took a two hour telephone conversation with a therapist (a long-time family friend) to convince him to voluntarily commit himself to state hospital, which he did.

Try not to freak out; I know it's scary, but you may have some time. It may be possible to honor his delusions and buy yourself some time to get down to New Orleans and have him seen by a psychiatric professional with you there as support. This means going along with his paranoia and convincing him that you're on his side and have his best interests at heart. Whatever you do right now, please don't try and talk him out of his delusions; you can't. That's his reality right now, it's not his fault this is happening to him, and he can't control what his brain is telling him. Above all, try not to blame him for being sick and treat him gently until you can contact Thresholds and formulate a plan of action together.

Best of luck.
posted by TryTheTilapia at 9:04 AM on March 22 [1 favorite has favorites]

First off, let me say that I am not a medical professional of any kind, but one of my best friends was diagnosed with schizophrenia a couple of decades ago. If that is what is going on (or at least part of it) then maybe what I have to say will help a little bit.

It is a horrible helpless feeling to witness this kind of thing happening to someone you care about, especially from a distance. You want to help, but you don't know how. I think it's important to have the mindset that there's no one right thing to do that will make everything OK, that you can help, but you can't control the situation. It is very easy to lose yourself in this, and ultimately it doesn't do any good.

You can approach this from a couple of directions simultaneously. At this point your brother may be separating people into two groups--those he feels he can talk to and trust, and those he cannot. Telling him he's crazy or needs help, having the police or similar authorities show up without warning, and things along those lines may cause him to put you into the latter group and he'll cut off contact with you. If others have already done that, it might be better if you try to retain his trust at this point instead. There needs to be at least one person he's still talking to, and maybe that can be you. It's a difficult position to be in and I have no idea how to make it any easier.

At the same time, you can be finding out what the legal options are. Some police departments have people who specialize in mental health cases and they may be able to tell you what the procedural requirements are to get someone into treatment involuntarily. You might even try the local public health department to see if they can refer you to the right person for help with this. Which is not to say this is definitely what has to happen, but it helps to know what would need to be done and to do some of the early steps in the background, so to speak. There may come a point where this is obviously the right course of action, and at that point he may stop talking to you if you're the person signing documents or whatever that end up forcing him into treatment.

If you do end up being the one person he still talks to, you'll probably find you become the communications channel with all his friends and family who want to know how he's doing. This is difficult as well, but you may be able to get some emotional support from them that will help you out. You may also be able to get them to do some of the administrative stuff (if it comes to that) so that your brother continues to talk to you.

The friend I referred to in my first paragraph is now on the right medication and is leading quite a happy and normal life. We're still friends, too. So, the situation is not hopeless by any means.
posted by FishBike at 9:05 AM on March 22

Thanks, all. Tried COPE and a couple other resources.

Guessing I should . . . NOT trust the sibling who thinks Young Crazy is "just going through some heavy shit" and should "come hang out at [his] place for a couple weeks"?
posted by liketitanic at 11:56 AM on March 22

Actually, if your other sibling can convince him to come hang out that might not be a bad starting place, as long as he/she is not going to be obstructionist as you try some of the other interventions mentioned above.
posted by nax at 1:11 PM on March 22

Here's the problem, though. Other sibling lives 4 hours from the airport where Young Crazy Brother thinks he is headed. YCB has to a) reveal an actual itinerary for the flight he plans to take to New York, b) manage to get to the airport, c) manage not to get TSA's attention at the airport, or c1) on the plane, d) manage to get out of the airport and either meet someone or negotiate travel himself. That's what worries me.

And yes, You Are Not My Anythings, and I'm pursuing other avenues . . . this is just one of them.
posted by liketitanic at 1:19 PM on March 22

- Do you have proof that he's getting on an airplane? Until you have proof, you have no way of knowing if this is an actual plan he's made or merely a delusion. You and your brother need to figure out whether or not he's actually made flight arrangements. Have your brother call and say he heard he might be on his way to New York and he'd like to meet him at the airport - anything to get concrete info out of him.

- Let's put the schizophrenia quasi-diagnosis aside for a moment. If he's in withdrawal from heroin use, what about trying to get him to go to a hospital for a medically supervised detox? I can tell you that they will be able to diagnose him pretty quickly if he's delusional and perhaps get a psych consult which will lead to a proper diagnosis.

- Can you convince his friends to really examine the resources they have? Is it possible that any of them knows a doctor or a social worker or a drug counselor who could talk with him about a medical detox? Someone trained in dealing with psych patients or drug abusers is trained to deal with them while they're in crisis - they might be able to convince him that his health is in danger if he doesn't get to the hospital ASAP.
posted by TryTheTilapia at 2:28 PM on March 22

liketitanic, I've been in a similar situation--family member experiencing psychotic break in a distant city. I would NOT have encouraged my family member to get on a plane. He could have and probably would have ended up in the wrong destination, possibly even a different country (happened in my family), and susceptible to more harm or unfamiliar legal/health regulations if far away from familiar surroundings.

Encouraging your brother to go stay with your other brother might indeed be a viable course, but he should be escorted from door to door. Depending on his state, he might not even make it onto a plane, though, as you suspect.

I nth those who say you should go to him, even if all you can do is assess the situation. Talk to police and social workers where he is. Prepare for what you will do if he goes missing, gets arrested, or winds up in a public hospital.

This is a tough, tough situation and I feel for you. Please let us know what happens if you're able.
posted by ImproviseOrDie at 2:29 PM on March 22

Ah, I'm so sorry to hear this. My brother-in-law went nuts for the first time during a trip to Europe a few years ago, when he was 20 or 21 or so. The tentative diagnosis right now is bi-polar. My aunt is also bi-polar. It's very, very stressful and saddening to witness when they have psychotic episodes.

If at all possible, you need to get to him yourself. The fact that he says, unprovoked, that he's not going to hurt himself worries me, because to me it says that he has possibly been thinking about hurting himself. Also, the things that people do when they're crazy are worrying; my brother-in-law ran his car into a brick wall because he wanted to prove to the CIA that he was worthy of joining him. You just can't predict what direction their mind will go in, and who they think is watching and listening to their thoughts.

I tried to tell my husband and father-in-law that they needed to watch him more carefully and not let him drive, but they just didn't get it through their heads until that happened; they just couldn't see him doing anything like that. I had prior experience with my aunt but they thought I was overreacting. He very well could have died or killed someone else because they didn't want to accept the extent of what was happening to him. In other words, it doesn't matter if your brother is normally non-violent and not at all suicidal (if that's how you're thinking) he's still a danger to himself and others right now; his brain will provide him strange and confusing rationale for doing things that he once thought unthinkable. They don't even need to have murderous or suicidal thoughts to accidentally kill themselves or others. My brother-in-law drove like a maniac while psychotic even before he decided to crash his car.

So please, if you're anything like my husband's family, recognize that this isn't just something weird and confusing, it's an emergency. I know it's hard to take off work, I know it's hard to travel, and all these other things that are probably difficult to arrange. But if you have things in perspective, this is worth losing your job over if it comes to that to get the time off, it is worth selling your belongings if you have to in order to afford to travel, whatever you have to do to babysit him is worth it. It's really a life or death situation. Really. You can deal with the fallout from these things a bit later. If you have better avenues available by all means use them, but you should be prepared to face some difficult decisions if necessary.

You're going to have to find a psychiatrist to visit with your brother. It will, in all likelihood, be difficult to get him to go there, so the resources others have suggested should be helpful in learning how to talk to him. If there are friends of his in the area who are willing to help you until you can get there, do everything you can to be in contact with them. But they'll have to be pretty great friends to take on that big a burden, which is why you're almost certainly going to have to go there yourself.

Good luck, I hope everything turns out alright. Your next battle will likely be keeping him from stopping his medication, and that could last years. *hugs*
posted by Nattie at 3:21 PM on March 22 [1 favorite has favorites]

I had a room mate go through a couple of psychotic breaks (after the first, she was diagnosed with severe manic depression, and it took a few tries for doctors to get a proper drug cocktail that kept things under control for more than a week or two at a time). With her, from the beginning of the break to the point where we had to call the cops (the hospitals in Seattle couldn't do non-voluntary admission unless she was a threat to the roommates, our property, herself, or her property) took between 24 and 72 hours. I think your brother is lucky, in that respect. But, everything else sounds exactly like what my roommate went through. Started with some spirited talk about school and the weather and gradually moved to prophesy-style talk about everything in the world and the heavens (she was very religious before the break). The second time we had to call the cops, she had begun clawing at her face. The cops were pretty phased by that, too.

One thing that the doctors told us was that manic breaks usually involve outrageous spending or travel. Many people disappear during their first manic periods are found on international flights or in exotic places like Brazil, we were told. Or they go through extremely uncharacteristic shopping sprees. With our roommate, the night before we realized something was not okay she came home with an armload of fancy dresses and shoes from Macy's; she normally wore thrift store clothing. She also went purchase-happy on Apple's website, buying just about everything she could find on the site. Luckily she only had a debit card, the daily limit of which was maxed out pretty quickly, and Apple was very understanding about the returns.

Definitely, definitely seek the help of professionals, as it seems you are doing.
posted by msbrauer at 6:00 PM on March 22

Thanks, all. We have reached a momentary detente. I convinced him to stay put until I could get there. I think he actually really wants family there and realizes something's wrong, but can't verbalize it. He has agreed not to go to the airport and a friend is with him. If he makes a break for the airport, friend is to call the police. Yes, there really was a plane ticket. I got the flight info from his email. (When you know someone 24 years, you know all their secret question answers. . .) I will be on an airplane in 6 hours, and we'll see.
posted by liketitanic at 12:28 AM on March 23

Wow--any updates, LikeTitanic?
posted by LarryC at 11:50 PM on July 21

Someone asked me about this at the nola meetup last weekend . . . um, mixed bag. Two hospitalizations in the first month, about 6-8 weeks following of acute suicidal ideation for which there was no point in going to the hospital--he'd just owe them double since he has no insurance, and would be maybe marginally improved--a wrecked second property that the city wants to condemn, a lot of lost money, 5 or 6 different kinds of prescriptions from p-docs, and, apparently, a hard drug problem. But he seems to be improving a little--has a job, making some positive steps--and I'm going home in a month. With my new dog and kitten! Now I just need to sell that second house for as much as we can get as quickly as I can.
posted by liketitanic at 4:25 AM on July 22