Paranoia, extended famliy edition
October 29, 2024 11:20 AM
Do you have experience with a relative who sank into a paranoid delusion or a conspiracy theory to the point that it impacted their life severely? What do you wish you had done differently? What are you glad you did? What would you recommend as general next steps?
Thank you to anonymous's question today as it's prompted me to ask this one. Sorry this is long.
My nephew has crashed with us since September, and as his story has come out I am feeling very out of my depth with regards to his mental health and how to help him. I'm on a list to see a family counsellor but after reading the question posted today about paranoia I am wondering if I'm on the right track.
He is 25, and is a very smart, sensitive, generally kind guy who has been diagnosed with ADHD and believes himself that he is "probably on the spectrum." He also has a very high ACE score. That includes abuse by his stepfather (we did not know the details here; there was earlier abuse we were aware of and intervened in) and going to live with his dad across the country at 12 and then ending up homeless and couch surfing when dad broke up with his girlfriend (which we did know about and helped get him out of that situation.). Dad's work history is spotty.
After my nephew turned 16, he moved in with his older brother and then his older sister. We have always offered that he could come here (5 hrs from his siblings). From 16-18 he had a counsellor he was seeing regularly but that counsellor does not see adults. He probably did a fair amount of pot at that time and drank a lot, and he still does both some.
He finished high school, worked at and left many jobs never getting fired, entered the military and got a discharge, started (jr) college in coding where he did extremely well (high 90s) but quit rather than apologize for a letter he sent the school which was aggressive in its tone and views around the value of his learning vs. what he did in a co-op term. His characterization of his time at college is that he was way smarter than all the profs and everything was stupid. (I would say that might not actually be untrue; this wasn't a university. But there are some flags there.)
After that, in early 2022, despite having only a high school diploma he applied for an information security job at the Canadian equivalent of the CIA, CSIS. Since then he has not been working and his sister and her husband finally asked him to leave their home, which is when he landed with us.
In speaking with him a bit last year, I had understood that he was waiting to hear about this good government job. I thought this was a bit ridiculous but thought it would wear off. I hoped that being asked to leave at his sibling's would shake him up a bit and he would look for work. He's on my downstairs couch here and it is not cushy; my house is busy and full with my MIL living here. We really don't have another room available without disrupting my kids and I'm not willing to do that.
As he's opened up, it turns out his view is that CSIS is 'testing' him for a job as a spy, and that they are actively preventing him from getting any jobs as a survival test. He also believes he can't have friends and hasn't spoken with any during these two years; he got rid of all his social media. He has been self-teaching coding in a scattershot way.
He sees the world intelligence community as the people who run things, not government. He also believes his abusive stepfather works for a competing intelligence agency. I'm pretty sure he was stoned (cannabis gummies) when he opened up about this.
He is adamant that he cannot seek help of any kind, for the same reason he can't get a job - he has to prove his worth to CSIS as an independent operator who can survive anything, and CSIS will know everything.
Up until he shared more with me last week, I have been generally thinking of his actions as a form of learned helplessness and an expression of trauma. But now I am wondering if he has developed something like schizophrenia or another disorder along those lines. And either way I know he needs more help than I can give him. I'm not sure how to get from here to there. We haven't set a time limit on his stay yet. He is going to visit his dad who is in California, but my nephew is not a US citizen and cannot stay there too long.
I am mindful that my kids (13 and 19) are living here too. My nephew is not a chatty type and his behaviour in our home is thoughtful and considerate, although we all pick up on how noise and mess stress him out. I love him tons. He has had a really bad first quarter century.
I will read everyone's answers but am mostly looking for what others have found helpful in terms of professional or other help, or any lessons you have learned along these lines.
Thank you to anonymous's question today as it's prompted me to ask this one. Sorry this is long.
My nephew has crashed with us since September, and as his story has come out I am feeling very out of my depth with regards to his mental health and how to help him. I'm on a list to see a family counsellor but after reading the question posted today about paranoia I am wondering if I'm on the right track.
He is 25, and is a very smart, sensitive, generally kind guy who has been diagnosed with ADHD and believes himself that he is "probably on the spectrum." He also has a very high ACE score. That includes abuse by his stepfather (we did not know the details here; there was earlier abuse we were aware of and intervened in) and going to live with his dad across the country at 12 and then ending up homeless and couch surfing when dad broke up with his girlfriend (which we did know about and helped get him out of that situation.). Dad's work history is spotty.
After my nephew turned 16, he moved in with his older brother and then his older sister. We have always offered that he could come here (5 hrs from his siblings). From 16-18 he had a counsellor he was seeing regularly but that counsellor does not see adults. He probably did a fair amount of pot at that time and drank a lot, and he still does both some.
He finished high school, worked at and left many jobs never getting fired, entered the military and got a discharge, started (jr) college in coding where he did extremely well (high 90s) but quit rather than apologize for a letter he sent the school which was aggressive in its tone and views around the value of his learning vs. what he did in a co-op term. His characterization of his time at college is that he was way smarter than all the profs and everything was stupid. (I would say that might not actually be untrue; this wasn't a university. But there are some flags there.)
After that, in early 2022, despite having only a high school diploma he applied for an information security job at the Canadian equivalent of the CIA, CSIS. Since then he has not been working and his sister and her husband finally asked him to leave their home, which is when he landed with us.
In speaking with him a bit last year, I had understood that he was waiting to hear about this good government job. I thought this was a bit ridiculous but thought it would wear off. I hoped that being asked to leave at his sibling's would shake him up a bit and he would look for work. He's on my downstairs couch here and it is not cushy; my house is busy and full with my MIL living here. We really don't have another room available without disrupting my kids and I'm not willing to do that.
As he's opened up, it turns out his view is that CSIS is 'testing' him for a job as a spy, and that they are actively preventing him from getting any jobs as a survival test. He also believes he can't have friends and hasn't spoken with any during these two years; he got rid of all his social media. He has been self-teaching coding in a scattershot way.
He sees the world intelligence community as the people who run things, not government. He also believes his abusive stepfather works for a competing intelligence agency. I'm pretty sure he was stoned (cannabis gummies) when he opened up about this.
He is adamant that he cannot seek help of any kind, for the same reason he can't get a job - he has to prove his worth to CSIS as an independent operator who can survive anything, and CSIS will know everything.
Up until he shared more with me last week, I have been generally thinking of his actions as a form of learned helplessness and an expression of trauma. But now I am wondering if he has developed something like schizophrenia or another disorder along those lines. And either way I know he needs more help than I can give him. I'm not sure how to get from here to there. We haven't set a time limit on his stay yet. He is going to visit his dad who is in California, but my nephew is not a US citizen and cannot stay there too long.
I am mindful that my kids (13 and 19) are living here too. My nephew is not a chatty type and his behaviour in our home is thoughtful and considerate, although we all pick up on how noise and mess stress him out. I love him tons. He has had a really bad first quarter century.
I will read everyone's answers but am mostly looking for what others have found helpful in terms of professional or other help, or any lessons you have learned along these lines.
I hate to say it, but this sounds like it might be the prodrome of schizophrenia (if he's not already there). Early intervention can improve outcomes for people with schizophrenia. Is there any possibility you can persuade him, gently, to see a doctor for a "checkup"? Or resume counseling with a professional? I know it's a nightmare trying to get an appointment with a mental health practitioner in Canada these days, but if he is in some stage of developing a serious mental illness, you don't have a lot of time to waste.
If you can't, you really should at least try to get him off all forms of cannabis. While my understanding is that cannabis-induced psychosis is more of an acute phenomenon, there is some evidence it can also increase the risk of developing chronic problems in vulnerable populations (see links in the article).
Poor kid. Good luck.
posted by praemunire at 11:58 AM on October 29
If you can't, you really should at least try to get him off all forms of cannabis. While my understanding is that cannabis-induced psychosis is more of an acute phenomenon, there is some evidence it can also increase the risk of developing chronic problems in vulnerable populations (see links in the article).
Poor kid. Good luck.
posted by praemunire at 11:58 AM on October 29
My bipolar relative has this kind of paranoia and occasionally it gets so intense that it resembles schizophrenia - there have been several full on psychotic breaks. In fact, he now has a schizophrenia diagnosis on top of the bipolar which the doctors are still kind of arguing about.
Regardless of the diagnosis, and I agree it sounds like schizophrenia, somehow or other you are going to need to get him to a psychiatrist and he might need inpatient care. You are going to need specific Canadian information here; I know what you would need to do in the States (and it's convoluted, difficult, expensive and may not work anyway) but I have no idea about Canada. You might, however, try to reach out to his therapist. They can't share anything with you but you can share information with them. Tell them you are concerned that his delusions are getting in the way of his daily life. See if they can make any recommendations for you. And also see if they will tell him to go to a psychiatrist - he may believe them and not you. He needs medication.
What I have learned is not to argue. The more you argue, the more they dig their heels in. Just play along. You need them to see you as an ally to have any hope at all of getting them help. I try to sort of gently nod and redirect. "Oh wow, so they own all that property? That's a lot. Did you watch this TV show / what did you think of the doctor / what do you want for lunch?" This isn't easy! If I'm super pushed I'll reiterate that what I'm asking them to do is for their safety. I remind them that I'm there for them and I want them to be okay. And having said all that, it's much easier now that my relative is physically frail. When he was younger this was all much more difficult, but kindness then and now goes a long way.
posted by mygothlaundry at 12:33 PM on October 29
Regardless of the diagnosis, and I agree it sounds like schizophrenia, somehow or other you are going to need to get him to a psychiatrist and he might need inpatient care. You are going to need specific Canadian information here; I know what you would need to do in the States (and it's convoluted, difficult, expensive and may not work anyway) but I have no idea about Canada. You might, however, try to reach out to his therapist. They can't share anything with you but you can share information with them. Tell them you are concerned that his delusions are getting in the way of his daily life. See if they can make any recommendations for you. And also see if they will tell him to go to a psychiatrist - he may believe them and not you. He needs medication.
What I have learned is not to argue. The more you argue, the more they dig their heels in. Just play along. You need them to see you as an ally to have any hope at all of getting them help. I try to sort of gently nod and redirect. "Oh wow, so they own all that property? That's a lot. Did you watch this TV show / what did you think of the doctor / what do you want for lunch?" This isn't easy! If I'm super pushed I'll reiterate that what I'm asking them to do is for their safety. I remind them that I'm there for them and I want them to be okay. And having said all that, it's much easier now that my relative is physically frail. When he was younger this was all much more difficult, but kindness then and now goes a long way.
posted by mygothlaundry at 12:33 PM on October 29
This is all helpful, especially thinking about the urgency.
He's unfortunately not in therapy any more. Here it would be doctor for referral or hospital for referral and those are challenges especially where he's at, but this is helpful, thank you. Agree on the cannabis, but it's tough for a variety of reasons.
Happy to keep reading more answers.
posted by warriorqueen at 1:01 PM on October 29
He's unfortunately not in therapy any more. Here it would be doctor for referral or hospital for referral and those are challenges especially where he's at, but this is helpful, thank you. Agree on the cannabis, but it's tough for a variety of reasons.
Happy to keep reading more answers.
posted by warriorqueen at 1:01 PM on October 29
Just want to reiterate my goth laundry's observation that reality-based arguing is unhelpful and will likely push him away. With my own relative, I have found a need to walk a fine line of 'huh, I haven't ever seen any evidence of the mind control plot myself, but I believe you when you tell me what you have experienced' and 'i think you should see a psychiatrist because it's really important to take care of yourself and keep yourself fit, and that's true even IF the mind control drones are watching you'.
posted by Ausamor at 1:22 PM on October 29
posted by Ausamor at 1:22 PM on October 29
I agree you may as well treat this as a situation requiring urgent or emergency psychiatric health assessment, because there is good reason to think there is a meaningful risk of his condition rapidly worsening. You might want to take a look at this list of urgent psychiatric health care resources. It is possible to access psychiatrist help (which he needs, GP is not enough for this) without referral through urgent/emergency care. If he does see a GP, they would ideally refer him to an urgent care service like those listed because ordinary referrals will be extremely slow.
If you happen to have the kind of relationship where you think he would take this well, stopping cannabis is probably important. But it's also probably self-medicating and not trivial to stop, so pushing this point might be counterproductive and really what he needs is medical care.
I would not assume this is schizophrenia, but it is certainly possible and in any case I'm fairly such symptoms would be considered as urgently requiring care by psychiatrists.
posted by lookoutbelow at 1:36 PM on October 29
If you happen to have the kind of relationship where you think he would take this well, stopping cannabis is probably important. But it's also probably self-medicating and not trivial to stop, so pushing this point might be counterproductive and really what he needs is medical care.
I would not assume this is schizophrenia, but it is certainly possible and in any case I'm fairly such symptoms would be considered as urgently requiring care by psychiatrists.
posted by lookoutbelow at 1:36 PM on October 29
You might the book I'm Not Sick, I Don't Need Help to give you some helpful advice on how to deal with this situation including how to to talk to your nephew when he is being paranoid.
posted by metahawk at 1:44 PM on October 29
posted by metahawk at 1:44 PM on October 29
Very sad to agree with the vices above saying schizophrneia.
This sounds a lot like the grad school years of my late cousin, who was diagnosed as a paranoid schizophrenic around that time.
posted by DirtyOldTown at 2:02 PM on October 29
This sounds a lot like the grad school years of my late cousin, who was diagnosed as a paranoid schizophrenic around that time.
posted by DirtyOldTown at 2:02 PM on October 29
Yes, I would avoid arguing against his delusions. In fact, I'd recommend framing your requests around them. E.g. I'd say, "The CSIS will be happy when they see that you're taking care of your mental and physical health, because that will make you a productive employee. Let's go see a doctor. I'm sure CSIS would like that."
Here are videos explaining this technique: https://leapinstitute.org/learn-leap-online/. These talks are given by the author of the book "I'm Not Sick, I Don't Need Help!"
When he sees the psychiatrist, I recommend going into the appointment with him, and making sure he explains all of these symptoms to the psychiatrist. Sometimes the patient has self-awareness that these thoughts sound "crazy" and they hide them. They'll just tell the psychiatrist "My family insisted I see you because I feel a bit sad sometimes" and then get misdiagnosed.
posted by roastbeef at 2:27 PM on October 29
Here are videos explaining this technique: https://leapinstitute.org/learn-leap-online/. These talks are given by the author of the book "I'm Not Sick, I Don't Need Help!"
When he sees the psychiatrist, I recommend going into the appointment with him, and making sure he explains all of these symptoms to the psychiatrist. Sometimes the patient has self-awareness that these thoughts sound "crazy" and they hide them. They'll just tell the psychiatrist "My family insisted I see you because I feel a bit sad sometimes" and then get misdiagnosed.
posted by roastbeef at 2:27 PM on October 29
If he thinks he's being tested for this government job, perhaps that could be a spur to stopping the cannabis? I'm not sure what the best way is to suggest that to him, though. The whole situation sounds very very difficult and I'm sorry.
posted by altolinguistic at 2:51 PM on October 29
posted by altolinguistic at 2:51 PM on October 29
You might the book I'm Not Sick, I Don't Need Help to give you some helpful advice on how to deal with this situation
Co-signed, a very good book. This is a difficult situation. My partner's son has schizophrenia and a lot of these general delusions sound very familiar. And just to be clear, NAMI is also in Canada. They have been a lifeline for my partner. Also agreeing, no sense in arguing against the delusions which are real to him. You can have conversations, keep it vague, change the subject.
I think a thing you may want to do with your kids and MIL is have a frank conversation with them about the situation in an age-appropriate way. You want to make sure they will let you know if your nephew is saying something that makes them nervous, and make sure they know it's okay to tell you. It's good to know the difference between delusions, which can sound scary, and something that may indicate there is a safety issue. I've found some of the resources around Mental Health First Aid (I've been trained for my library work) to be helpful. Here is one: 10 Ways To Help Someone Who Is Struggling With Their Mental Health.
Feel free to reach out to my partner who is 61170 if you'd like to talk to someone who has been there.
posted by jessamyn at 2:54 PM on October 29
Co-signed, a very good book. This is a difficult situation. My partner's son has schizophrenia and a lot of these general delusions sound very familiar. And just to be clear, NAMI is also in Canada. They have been a lifeline for my partner. Also agreeing, no sense in arguing against the delusions which are real to him. You can have conversations, keep it vague, change the subject.
I think a thing you may want to do with your kids and MIL is have a frank conversation with them about the situation in an age-appropriate way. You want to make sure they will let you know if your nephew is saying something that makes them nervous, and make sure they know it's okay to tell you. It's good to know the difference between delusions, which can sound scary, and something that may indicate there is a safety issue. I've found some of the resources around Mental Health First Aid (I've been trained for my library work) to be helpful. Here is one: 10 Ways To Help Someone Who Is Struggling With Their Mental Health.
Feel free to reach out to my partner who is 61170 if you'd like to talk to someone who has been there.
posted by jessamyn at 2:54 PM on October 29
As another data point - one of the therapists at the VA here was saying that they have been seeing a number of patients who have concurrent mental health conditions that have been exacerbated by strong marijuana use who are presenting with unusually strong paranoia. If he is still using that heavily, that might be something to consider; if not, other advice likely applies.
posted by corb at 2:55 PM on October 29
posted by corb at 2:55 PM on October 29
A lot of this reminds me of someone I know with bipolar.
Keep in mind that if things get really bad, going directly to the mental health emergency department is an option. I'm assuming that these exist in Canada even if it's hard to get non-emergency appointments. Find out where your nearest one is both for during the week and for weekends and what the procedures are.
There are a lot of ways to get someone to voluntarily get in the car with you and go to emergency mental health treatment that don't require them to agree they need treatment. Don't feel like they need to understand exactly why they are going when they are not capable of understanding what's real and what's not, if there is some other reason they are willing to go just stick with that. In the US it is a good idea to be prepared to wait with someone for many many hours in the waiting room, bring some food and a water bottle.
posted by yohko at 4:22 PM on October 29
Keep in mind that if things get really bad, going directly to the mental health emergency department is an option. I'm assuming that these exist in Canada even if it's hard to get non-emergency appointments. Find out where your nearest one is both for during the week and for weekends and what the procedures are.
There are a lot of ways to get someone to voluntarily get in the car with you and go to emergency mental health treatment that don't require them to agree they need treatment. Don't feel like they need to understand exactly why they are going when they are not capable of understanding what's real and what's not, if there is some other reason they are willing to go just stick with that. In the US it is a good idea to be prepared to wait with someone for many many hours in the waiting room, bring some food and a water bottle.
posted by yohko at 4:22 PM on October 29
As others are saying above is true. There is more and more research that proper treatment for first break psychosis improves lifelong outcomes so doctors and hospitals are becoming increasingly aware that initial hospitalization/ initiation of treatment at onset is incredibly important. So the threshold for admission for people in this young adult range (16 to 24ish but this isn't a hard limit) has lowered in some respects and the likelihood of admission from an ER visit is higher and less difficult than it used to be for young adults with symptoms. This might not be true for your specific area but I've certainly seen it to be true where I've worked in the last 10 years.
That being said, if you know of a clinic or hospital that specializes in young adults with a diagnosis like schizophrenia that's exactly where you want to be.
I will say that clinically assessing someone for schizophrenia and related diagnoses doesn't require a patient that is fully honest with the clinician about their symptoms ( even though it helps! ) the are plenty of different less talked about symptoms that can be present that help confirm a diagnosis. Collateral contact is often used.
No one can diagnose your child's over the internet. There are multiple possibilities for a diagnosis, including things like delusional disorders, substance induced psychosis, schizophrenia, schizoaffective disorder and also mood disorders with psychotic features. It will take a full professional assessment to figure out what is going on and what treatment is the most appropriate for him.
posted by AlexiaSky at 6:05 PM on October 29
That being said, if you know of a clinic or hospital that specializes in young adults with a diagnosis like schizophrenia that's exactly where you want to be.
I will say that clinically assessing someone for schizophrenia and related diagnoses doesn't require a patient that is fully honest with the clinician about their symptoms ( even though it helps! ) the are plenty of different less talked about symptoms that can be present that help confirm a diagnosis. Collateral contact is often used.
No one can diagnose your child's over the internet. There are multiple possibilities for a diagnosis, including things like delusional disorders, substance induced psychosis, schizophrenia, schizoaffective disorder and also mood disorders with psychotic features. It will take a full professional assessment to figure out what is going on and what treatment is the most appropriate for him.
posted by AlexiaSky at 6:05 PM on October 29
I think a thing you may want to do with your kids and MIL is have a frank conversation with them about the situation in an age-appropriate way.
Thanks for thinking of this - I already talked to them (my kids; my MIL is dialed in and a retired nurse) but it is important and the kind of nuance easily missed. And thank you everyone. Still reading and creating plans to see if we can get him in to see someone using much of the excellent information here.
posted by warriorqueen at 6:19 PM on October 29
Thanks for thinking of this - I already talked to them (my kids; my MIL is dialed in and a retired nurse) but it is important and the kind of nuance easily missed. And thank you everyone. Still reading and creating plans to see if we can get him in to see someone using much of the excellent information here.
posted by warriorqueen at 6:19 PM on October 29
If the logistics are feasible for you and your family — which I recognize is a very severe constraint — see if you can get him to give up wheat for a couple of months.
posted by jamjam at 8:01 PM on October 29
posted by jamjam at 8:01 PM on October 29
Nthing what everyone else is saying—especially early intervention, the right psychosocial and medical supports, the corpus of research into first psychoses pointing to that "the earlier you can treat this, the better the outcome"—all true.
The tough part is if they are resistant to treatment—especially due to delusionally-based beliefs bolstered by delusionally-fuelled rigid thinking—it's difficult to counter that. Xavier Amador's book (I Am Not Sick...) is helpful in providing a toolbox full of context and strategies, and it involves mostly listening to what they (i.e. your nephew) are describing in their symptomatic (but very real to them) world, empathizing (e.g. "that sounds like a difficult situation; that sounds scary; oh that's interesting"), and then using the "vocabulary" provided by your nephew to partner with them—not as a coach or a taskmaster, but as a fellow, caring, curious traveler-on-earth—toward a direction of "Wouldn't life be better if you could do something about that?" The book is a lot more useful than what I just typed, in describing how you get from one step to the next, but one of the real important pieces of the puzzle is that they are aware that you are on their team and are listening, not judging, not in an adversarial mode, not denying their reality—the underlying message being that they have your support unconditionally is in and of itself helpful in figuring out where the stumbling blocks are and then navigating around them.
Support groups for people caring someone with a mental illness can help bolster your own fortitude during this arduous journey full of trials and tribulations. Canadian-NAMI is a great place to start (but just poking around, it looks like Canada has a lot of resources like that locally and nationally). One of the things that really helped me, not only in a psycho-educational way but also in connecting me with other people in the same boat, is a program that NAMI has called "family-to-family": a 12-week, once-a-week course where you, along with a dozen or so other families in attendance, learn through readings, discussions, and exercises, about the wide landscape of mental health issues, how they present and what you and professionals can do to help. The course provides context, but also the knowledge that you are not going through this alone, and that there is a network of support systems and ways to make connections with others. F2F is a great place to start IMHO. I still attend a monthly group for "parents of adult children with psychotic illnesses", even when I'm not in crisis mode. NAMI's groups in particular are usually well-moderated, too.
NAMI's and others' support groups have also helped me in terms of brainstorming granularly or broadly, but also just having a group of people to talk to who understand what you're going through in terms of guiding your nephew toward help—it's extremely reassuring. And, when things are going well for you and your loved one, in attending a group you can also help others in crisis in an advocacy role. While mental illness is shedding some of its stigma, people still don't talk about it like they would if you were helping a relative deal with a different kind of chronic illness like Lupus or something, and the support groups are a safe place where you won't be peppered with, "What you SHOULD be doing is ___" kinds of advice, or doomer talk, or misinformation, or being judged yourself. Of course, people are going through a LOT, but they all know that you are, too.
Anyway, feel free to MeFiMail me offthread if you want to pick my brain; my son (29 years old) has been dealing with severe schizophrenia for well over a decade now, I've been the single-parent trying to keep my son's and my own head above water throughout, and we've been through a lot together (or, in adjacent realities to one another). There are times when I get burnt out, and times when I am very hopeful, and it can be a barrelling rollercoaster between those heights and nadirs. But the earlier you can lead him to treatment, and if you can project that you are partnering with them to deal with the hell that's in their head (and in their perceptual reality), and you get the right supports and self-care for yourself (important), the less scary that rollercoaster can be. Good luck!
posted by not_on_display at 8:07 PM on October 29
The tough part is if they are resistant to treatment—especially due to delusionally-based beliefs bolstered by delusionally-fuelled rigid thinking—it's difficult to counter that. Xavier Amador's book (I Am Not Sick...) is helpful in providing a toolbox full of context and strategies, and it involves mostly listening to what they (i.e. your nephew) are describing in their symptomatic (but very real to them) world, empathizing (e.g. "that sounds like a difficult situation; that sounds scary; oh that's interesting"), and then using the "vocabulary" provided by your nephew to partner with them—not as a coach or a taskmaster, but as a fellow, caring, curious traveler-on-earth—toward a direction of "Wouldn't life be better if you could do something about that?" The book is a lot more useful than what I just typed, in describing how you get from one step to the next, but one of the real important pieces of the puzzle is that they are aware that you are on their team and are listening, not judging, not in an adversarial mode, not denying their reality—the underlying message being that they have your support unconditionally is in and of itself helpful in figuring out where the stumbling blocks are and then navigating around them.
Support groups for people caring someone with a mental illness can help bolster your own fortitude during this arduous journey full of trials and tribulations. Canadian-NAMI is a great place to start (but just poking around, it looks like Canada has a lot of resources like that locally and nationally). One of the things that really helped me, not only in a psycho-educational way but also in connecting me with other people in the same boat, is a program that NAMI has called "family-to-family": a 12-week, once-a-week course where you, along with a dozen or so other families in attendance, learn through readings, discussions, and exercises, about the wide landscape of mental health issues, how they present and what you and professionals can do to help. The course provides context, but also the knowledge that you are not going through this alone, and that there is a network of support systems and ways to make connections with others. F2F is a great place to start IMHO. I still attend a monthly group for "parents of adult children with psychotic illnesses", even when I'm not in crisis mode. NAMI's groups in particular are usually well-moderated, too.
NAMI's and others' support groups have also helped me in terms of brainstorming granularly or broadly, but also just having a group of people to talk to who understand what you're going through in terms of guiding your nephew toward help—it's extremely reassuring. And, when things are going well for you and your loved one, in attending a group you can also help others in crisis in an advocacy role. While mental illness is shedding some of its stigma, people still don't talk about it like they would if you were helping a relative deal with a different kind of chronic illness like Lupus or something, and the support groups are a safe place where you won't be peppered with, "What you SHOULD be doing is ___" kinds of advice, or doomer talk, or misinformation, or being judged yourself. Of course, people are going through a LOT, but they all know that you are, too.
Anyway, feel free to MeFiMail me offthread if you want to pick my brain; my son (29 years old) has been dealing with severe schizophrenia for well over a decade now, I've been the single-parent trying to keep my son's and my own head above water throughout, and we've been through a lot together (or, in adjacent realities to one another). There are times when I get burnt out, and times when I am very hopeful, and it can be a barrelling rollercoaster between those heights and nadirs. But the earlier you can lead him to treatment, and if you can project that you are partnering with them to deal with the hell that's in their head (and in their perceptual reality), and you get the right supports and self-care for yourself (important), the less scary that rollercoaster can be. Good luck!
posted by not_on_display at 8:07 PM on October 29
Going against the grain, I give you permission to set an end date to his stay. You are not responsible for coordinating his health care. It is kind to help him, but it is fair to put your nuclear family first if you must.
posted by shock muppet at 8:29 PM on October 29
posted by shock muppet at 8:29 PM on October 29
I'm pretty sure he was stoned (cannabis gummies) when he opened up about this.
There is such a thing as cannabis-induced schizophrenia. I have an ex-boyfriend (still kind of a friend ... I've known him since I was ten) who goes to AA to stay off of marijuana, but he falls off the wagon sometimes. While off the wagon, he has said things to me like, "The plants in my front yard are connected via electrical circuits", and, "Today I saw 100 military aircraft fly in formation overhead; I think there is something going on in the government." When he goes back to AA and gets back on the wagon, the schizophrenia goes away.
My sister has schizophrenia. It tends to kick in when people are in their early twenties. Some people can function quite well when they are on medication. When she is off medication (happened recently due to a doctor's malpractice) she becomes very, very, very delusional and mentally ill, but when she is on medication, while she isn't well enough to work, she functions amazingly well; the difference is night and day. It is absolutely miraculous what medication can do.
When my sister first became ill, my mother turned to NAMI for guidance, and they were a big help.
posted by SageTrail at 9:24 PM on October 29
There is such a thing as cannabis-induced schizophrenia. I have an ex-boyfriend (still kind of a friend ... I've known him since I was ten) who goes to AA to stay off of marijuana, but he falls off the wagon sometimes. While off the wagon, he has said things to me like, "The plants in my front yard are connected via electrical circuits", and, "Today I saw 100 military aircraft fly in formation overhead; I think there is something going on in the government." When he goes back to AA and gets back on the wagon, the schizophrenia goes away.
My sister has schizophrenia. It tends to kick in when people are in their early twenties. Some people can function quite well when they are on medication. When she is off medication (happened recently due to a doctor's malpractice) she becomes very, very, very delusional and mentally ill, but when she is on medication, while she isn't well enough to work, she functions amazingly well; the difference is night and day. It is absolutely miraculous what medication can do.
When my sister first became ill, my mother turned to NAMI for guidance, and they were a big help.
posted by SageTrail at 9:24 PM on October 29
I went through something similar with a friend recently. You're asking what worked and what we learned, so I'll tell you that full-time, in-patient, very serious and extended medical psychiatric care is what staved off an even worse crisis. Situations like these often end in death and violence — to your children or in self-harm — and I cannot overstate loudly enough what a bad situation this is.
Everyone's here talking about "speaking reasonably to them" — and there is lots of good advice in this thread, sure — but in three weeks when you have a fully delusional person in your kitchen with a knife in each hand you're going to wonder why you missed the signs.
posted by RJ Reynolds at 6:22 AM on October 30
Everyone's here talking about "speaking reasonably to them" — and there is lots of good advice in this thread, sure — but in three weeks when you have a fully delusional person in your kitchen with a knife in each hand you're going to wonder why you missed the signs.
posted by RJ Reynolds at 6:22 AM on October 30
I would just like to say that is a really unpleasant, appalling, outdated and false stereotype you are citing here, RJ Reynolds. I have dealt with my relative in full psychotic break. He has never laid a hand on me even when he had no idea who I was, who he was, where he was and the reality he was in was vastly more terrifying than the one I was inhabiting. Delusions don’t automatically immediately change kind gentle people into ravening monsters. Believing that you’re secretly a spy doesn’t mean you’re going to start charging around with the cutlery. Most crimes and murders and senseless acts of violence are perpetrated by perfectly “sane” people. Narcissists and psychopaths aren’t schizophrenic, by and large.
Severely mentally ill people are often really frightened. They may act out if they feel threatened. You can see that as aggressive, I guess, or you can treat them like the human being you love and know well.
posted by mygothlaundry at 8:15 AM on October 30
Severely mentally ill people are often really frightened. They may act out if they feel threatened. You can see that as aggressive, I guess, or you can treat them like the human being you love and know well.
posted by mygothlaundry at 8:15 AM on October 30
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I've personally dealt with a similar situation. The delusion of being tracked daily by a government agency is one of the two most common paranoias I've seen from people with schizophrenia or similar disorder. The other common delusion is about people being cloned, i.e. their own face being used to create a humanoid clone, or tricked by clones who are impersonating their loved ones.
If I were in your situation, I'd try to get him medicated before he has a major episode (i.e. a breakdown where he becomes unable to function or completely detached from reality). I've been told by psychiatrists that each episode makes medication less likely to be effective. After enough episodes, some patients get to a state where there are no longer any effective medications. Also, as the patient descends into paranoia, they become more mistrustful of medication, doctors, and their own family, and it gets harder and harder to get them to a doctor. It often is a huge challenge getting the patient onto medication at any stage, but that would be my focus.
Good luck!
posted by roastbeef at 11:55 AM on October 29