Catch-22 for me

Family
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I’m pretty sure that my closest friend has a schizophrenia related illness. She hears car noises off in the distance that I can’t hear, and is convinced that the noises are made by strange men who monitor her every move and are bullying her on purpose. The sounds torture her non-stop. She tolerates them at times and other times, she starts yelling at them to stop. Occasionally, she’s so bothered that she starts screaming and crying like a wounded, tortured animal. It’s heartbreaking to watch.

She’s been to umpteen psychiatrists and therapists. Most have diagnosed her with some type of PTSD or anxiety. One psychiatrist was adamant that she has psychosis, but she didn’t like his diagnosis.

Lately she’s become very resistant to trying any other medications and she talks about suicide a good deal. I keep suggesting she at least give Seroquel a shot—to give her some buffer. I’m not allowed to acknowledge that the noises could be hallucinatory. I made that mistake once. But since she’s certain that the noises that bother her are real people, she doesn’t think any medication would help. About a year ago, I convinced her to try Abilify, which she stopped after less than a week due to side effects. But in the short period she tried it, she said that she was less bothered by the sounds, so it seems likely to me that an antipsychotic is probably what she needs.

I think medication could probably help her if she could stick with them for more than 1 week, but given how sensitive she is to side effects, and how nasty antipsychotic side effects are, I doubt she would be able to stay on almost any treatment. I’ve also tried getting her to regularly try supplements like Sarcosine, Theanine, and others, many of which help. But even those, she complains they feel like SSRIs, and she’ll only stick with them for a few days. She tried keto for a month or so and actually had the noises clear up, but she didn’t like eating so much meat, and now she doesn’t even remember that the noises had cleared up.

I read up on anosognosia, and a book gave me some tips on how to connect with her better when she’s in the midst of an episode. But unfortunately the tips haven’t helped me convince her that another antipsychotic could be worth trying.

So here I am in a catch-22. Anything that could help, she can’t tolerate. I’m forced to regularly watch my closest friend sink into despair about non-existent, illogical noises. I literally have no idea what to do except pray.

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Hello Nigel, you’re doing a wonderful job of supporting your beloved friend. My son has found a great deal of support in going keto. He mostly eats non starchy vegetables, beans as a soup. He has taken to adding turkey mince as his protein. He is on a very small amount of Olanzapine, which doesn’t do a lot for the voices he hears. The diet appears to be the best form of support. Keep it up. You’re not alone

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Interestingly, my daughter’s inpatient psychiatrist from when she was an adolescent suggested we try a gluten free diet. He was convinced gluten caused inflammation that effected mental health. Years later, to lose weight, she went carb free. She was on a good med regimen, but i swear cutting way down on gluten cleared her mind more.

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She ate fruits and veggies - so it wasnt strictly carb-free - and gluten sneaks in in other products. Think gluten-free diet.

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Great to hear your daughter responded well to the gluten free diet, @mmm61. Roughly how long did it take to see the positive results on her mental health?

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So sorry you and your friend are going through this, @nigel. Are there support groups available for either of you? Or perhaps group therapy for your friend? My son has sz and says group therapy helped him when he was hospitalized. Since discharge, however, he unfortunately doesn’t want to attend group therapy but regularly goes to his Dr. appointments and inconsistently sees his counselor. Your friend is so fortunate to have you in her life.

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It’s hard to remember how long it took. Like the clozapine she was taking, it was gradual - maybe a year. We couldn’t impose the change on her. She cut carbs to lose the substantial weight she had gained.

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What a great friend you are! She needs you but I hear the frustration as you want to help her but feel helpless. *Does she have any family or other friends around her that can help support her as well as yourself? She needs a loving, caring team.
*LEAP is a good process but it has to include the ill person. As you Listen and Empathize with her are there areas you can Agree on with her? What does she think would help her if she’s not willing to take medication? (Unfortunately often one doesn’t get better without the medication.)
*We did write a petition for our daughter to be hospitalized and also ended up court ordered to be medicated. It caused a lot of emotional stress for her and for us.
*I’d encourage you to get some support from NAMI (National Alliance on Mental Illness) which has a lot of resources for you and for your friend. Would she consider attending a peer to peer support group? Again it would have to be her decision.
*You can call 988 to get some support and advise. If you do call 9-1-1 ask for a mental health specialist as you don’t want the regular police force to be involved.
I’m glad you are praying for your friend. Remember to take care of yourself.