And the ride starts again

Family
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They say it’s possible for the voices to go away for some on meds, for many, the meds “quiet” the voices down. The CBT therapy is supposed to help them deal with the voices and delusions.

My son has no insight and suffers from paranoia. When he hears mean voices he believes its whoever is closest to him saying mean things to him.

The man with scz that spoke to our FtF class talked about the voices that they like. I had suspected that my son had voices he liked. I heard him laugh delightedly once and say to the empty chair next to him “How do you know these things?”

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Hope, if your son has no insight, what was his reasoning behind seeing a therapist?

I ask because my son will see a new one this Thursday. She’s actually a case worker & will do all kinds of things for him, but they have a similar goal oriented approach.

He rejected the last one flat out but is open to seeing a new one. However, he doesn’t quite understand why he would be seeing one. When I told him that they could help with all kinds of things based on what he does including being able to go out in public & feel comfortable, he said why did he need a driver for that? just give him the car keys & let him go.

He has a driver’s license, but I’ve been reluctant to let him drive because he doesn’t always seem like he’s paying attention.

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Jeb said he needed someone to talk to when he asked if he could go see a therapist. He asked because the therapist he wanted to see was not covered by his Medicare/Medicaid.

Why he chose a therapist that specializes in CBT - I don’t know. Maybe coincidence - maybe her looks - that was how he chose therapists in the past. Always female, always good looking. He has worked with different therapists over the years. Most had dropped him when he refused to cooperate with job search homework. I think they all saw him as a person with low work motivation. He is actually the opposite, he loves working. This is the longest he has worked with a therapist, so something is working. She takes his phone calls when he can’t drive. He is good about not driving when he is unable. Maybe she did pay attention to my anonymous letter in the beginning or maybe she is that good.

My family to family teacher said insight can fluctuate. Maybe there’s a chance he picked a CBT person on a good day that had some insight?

I just wrote a long rant about my call with the state mental healthcare provider then I deleted it. It was pleasant enough a phone call, but all has to start with him walking in their door and filling out an application asking for services. He will look their name up on his phone - if he actually goes there after I tell him they will help him make a report for cyberbullying and sexual abuse - snort with derision and leave.

If they are expecting him to check the mental illness box to qualify for services, well, that won’t happen. I will give it a go though. At least its something new to text to him when he is raging at me. They also gave me an 800 number he could call.

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My son likes female therapists too - good looking or not.

He really liked a former case manager. She was average in looks, but a very kind, warm African-American lady.
So, since he rejected the white male case manager they just assigned when he entered the ICT program, they are going to see if he’ll work with their new part-timer. She’s younger, but African American & she sounds on the phone very much like the other lady.

We’re white, but he seems to be more comfortable with non-white people sometimes. Not to sound racists, because this is a good thing to say, but a lot of ethnic groups are more accepting of differences than the white people in the upper-middle class area where we live. Not everyone here is upper-middle class, but there’s an awful lot who are and act like they’re just a dollar short of wealthy.

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We have lived in multi-ethnic neighborhoods since Jeb was two. You could always count on Jeb to be the guy that reached out to make a potentially exclusive situation, inclusive.

Schizophrenia took that away from him. He is now fearful of everyone. One of the initial alarm bells for me years ago was a statement he made about Hispanics “not liking him”. Later, in a different job, he said the same thing about African Americans. Jeb’s a white guy also. He wasn’t a person that “didn’t see color” he saw color and embraced it. He saw everyone as a potential friend. Even as a baby he was that way. On the list of things scz stole from my son, one was his love of people.

The fluctuating insight explains why there have been days when he has explained he is not sick while there were other days he has explained quite earnestly that he can’t take additional dangerous meds on top of the dangerous meds he already takes. He did really well in chemistry at university - he knows about all of the drugs and their chemistries. We aren’t taking him to court for forced hospitalization treatment until we know we can win it.

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46

Does he take meds for other health problems?

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Around 14% of people with sz become violent. Did you know that in legal terms threats are considered a form of assault? The percentage is higher if there is also substance use disorder or APD or ODD.

Most of what we here are worried about is the even more rare violent response to hallucinations and delusions.

I don’t want to increase stigma in any way, but here are the warning signs: Red Flags: Warnings Signs of Violence That You Should Know - Pete Earley

Uncomfortable subject, but many people with different neurological injuries and disorders become aggressive and/or violent. It’s not limited to mental illness.

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48

He takes immunosuppressives for a kidney transplant every day. People who receive kidney transplants have to take immunosuppressives as long as the graft is working.

It’s powerful evidence that he can make his own decisions about medications. He has kept that kidney going for 8 years. After we realized he had scz, one of my realizations was “yeah us - we got someone with scz through a kidney transplant!” Believe me it was not easy. We thought the scz prodromal stuff was from the kidney failing - it didn’t make sense at the time because his numbers weren’t that bad. His transplant team was quite puzzled.

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We have to remember that scz can be dangerous. While its good publicity to paint them as “rarely violent” it does a great disservice to the families who are in jeopardy.

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Even people who get Alzheimers may become violent when they were never that way before.

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I understand how frustrating that would be. I’m glad he is compliant with meds. I wish my son was.

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Totally different this but my mother in law was a quiet, shy lady never heard her get angry or shout. She suffered from vascular dementia and declined over a slow slow period of 10 years, the last few years were the worst.
When we visited in the care home then later the hospital some times we could hear the foul language as we approached the ward . One time she was stroking my hair then the next she would try to pull it or slap my face.

I think of my husband going through that and now , different but going through this. Absolutely ironic but the hospital his mum was in back in 2011-2012 is now changed to the mental health unit and it’s where we go to see my sons psychiatrist .

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Thanks for posting this. Helpful to have since my son has been violent recently. I am puzzled though since he is compliant with meds. Wondering if the meds aren’t strong enough or aren’t right mix? However, he is throwing alcohol and pot into the mix so I guess that throws everything off. I have tried to talk to him about it to no avail. I talked to his former therapist yesterday and her solution (to his violence) was for me to look up “mindful meditation” for him on the Internet. I was thinking “Yes, that would be helpful when he’s throwing things, cursing, threatening…we can all sit on the floor and do the Downward Dog position.” LOL. Have to laugh, right? Appreciate everyone’s input and thoughts. This group is so awesome. So glad I found you all.

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As hard as it will be to do, you have to get the alcohol & especially the pot out of the picture.

Even people without MI are more prone to violence when they get drunk, and the pot will work directly against the psychiatric meds. I’m not anti-pot by any means, but to me it’s like alcohol. Some people can drink, some people can’t. Same with smoking.

Even caffeine can become a problem, and smoking makes some people metabolize some drugs too fast.

Still, it could be that he needs a dosage increase or a change.

Is the violence isolated or frequent? Do you know what triggers it?
The morning he woke you up, had he been up all night stewing about you kicking out his friends? Did they text or call him & say something that worked him up more? Does he only get violent after he drinks or smokes?

It’s like a huge puzzle & you have to put all the pieces together, and still it can be hard to understand.

I’ll share something with you. When my son was 18 and had his third break, we kept him at home instead of hospitalizing him. He still had insight at this time and would take anything to make the psychosis stop. During those times, we would fight over him wanting to take too much of the meds rather than not wanting to take them at all.

They tried Seroquel at first, and it didn’t work, but they quickly went up to about 900 mg/day before they switched him to something else. On the last day, he took everything he could find just to try to sleep. He had a joint hidden in his room & smoked it – we didn’t know until it was too late. His dad went out to lock up the garage & our son jumped up, grabbed the biggest knife we had in the kitchen and crouched down behind the kitchen door because he was sure his dad was going out to get a gun to shoot him as soon as he opened the door to come back in.

I talked him out of the knife & we removed everything sharp out of the house including butter knives & shish-ka-bob sticks. Thankfully, they changed him to Zyprexa the next day & we saw an improvement at about 36 hours (that’s when his mind still cleared quickly) - but he could easily have seriously hurt or killed his father that day.

And, he had never been violent or threatened violence before that day. He was in fear of his life and thought he was acting in self defense. I think the pot turned that paranoia switch on for him that day.

I smoked pot as a kid, and it makes me paranoid, so I get it - and I’m usually never paranoid.
My husband, on the other hand, can be paranoid just in general and pot evens him out so he’s not paranoid.
It’s all in how your brain chemistry works.
But, the best bet for anyone with psychosis is to just not smoke.

I know telling you to keep him off the pot & alcohol is almost as bad as telling you to look up mindful meditation, but I guarantee that if you can make it happen, it’ll do way more good than anything else.

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I had a few of those useless suggestions as well @LisaS. It was so incredibly frustrating because in the end it just left you with this feeling of, ‘my God, does no one get this’! I wish that the answer was as easy as that. First and foremost, the meds have to be figured out first, at least in my experience. I could not even begin to tell my son what he should and shouldn’t be doing to self medicate, when he was still in those states of psychosis. Since stabilizing with the meds my son started slowing down himself on both the alcohol and the pot. I have still not found a way to get him to totally stop but as with any person out there with a need for these things, that decision in the end is up to them. They have to want to stop. An impossible thing when psychosis is involved. Just my 2 cents for what it’s worth.

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He has really cut back on his cigarettes a lot and we had gotten him a vape for his birthday. It got broken in the free-for-all the other night. :frowning: He only had it for about a month. For those of you who aren’t familiar with vapes, the “juice” comes in varying levels of nicotine. My son is only at a 3, which is one of the lowest levels available. Just passing that along if you’re trying to get your child to reduce their smoking. A vape can be a good option. They can taper down their nicotine level gradually. Anyhow, the violence is haphazard. We had an incident in May, but the one prior to that was in Feb. Things set him off. Like the one in May was he wanted/needed cigarettes. I was home from work sick in bed with a migraine. He expected me to get out of bed and go get him cigarettes. I told him no. Things escalated from there. He wouldn’t leave me alone; I had to call his dad at work and have him come home. He and his older brother got in a fist fight (older brother was defending me). Just ridiculous over some cigarettes. But in his mind, he HAD to have them, that minute. He thinks they calm him down and if he is having a bad day, he HAS to have them. His dad will usually give in to him, but I don’t especially in that situation when I was ill. I told him he could wait until his dad came home. (He doesn’t drive yet; has a learner’s permit, but we don’t feel comfortable with him driving. He’s very uncoordinated and distracted from his ADHD, and the thought of him driving scares me, frankly.) The incident where he woke me up, I don’t think his friends had anything to do with it. They seemed okay with me throwing them out. They knew they weren’t supposed to be there. I think maybe he had been up all night and had gotten himself more angry about the situation as time went on. He was probably smoking pot. His dad wasn’t there either, so I think without another adult there, the gloves were off so to speak. He even said he was getting “even” with me for throwing his friends out.

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My son has an assortment of e-cigs & e-liquid.

Right now, I’m trying to keep him to one pack of regular cigarettes a day, then he can vape as much as he likes.
I don’t know if it’s the same for other meds, but it’s the tar & not the nicotine that makes you metabolize the Clozapine he’s on now too fast.
The change seems to have worked well.

I order his stuff online for the most part which is a lot cheaper than buying it in the stores.

I make sure I always have an emergency pack of cigarettes somewhere just in case though. We’d probably have the same fight - and the smoking does seem to calm them down somewhat. I know it’s terrible for him, but I try to limit everything else, so I won’t take that one pleasure away from him.

It’s good he’s not violent all the time - maybe a good mood stabilizer would help him.

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It’s so funny what people say. Someone suggested my family member “journal” during an episode of psychosis. Can you even imagine what the journal would contain?

Psychotic episodes are medical emergencies.

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I got that one too @Hereandhere, from a counsellor I was going to. Just so out of touch with the hell that both our family members and ourselves are going through. They are a walking medical emergency at that point and aren’t likely to stop and take a deep breath, meditate, journal or do a downward dog!!! At this point they are completely out of their minds. They should all live in a situation where someone is in full psychosis for a few days even, before they open their mouths to offer advice on it. It leaves the family member in a worse spot than when they walked in to get the help.

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I understand the fear and hopelessness that comes with caring for our ill children and little to no support. It’s been since 2003 for us and by God’s grace My daughter is stable although still semi psychotic. Our loved ones, even though they are mentally ill need boundaries, even if it means they have to be removed. We’re not doing any good by being paralyzed by fear. I’ve been guilty of that far too long. I’ve not seen much difference in the treatment of mental illness since I began this journey but I am beginning to see some doctors view it with a different lens and advocate for a different approach.

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