Daughters first psychotic episode - please someone help!

I am overwhelmed, hopeless, and unsure of how to handle my daughter. She is 28 and has a diagnosis of bipolar disorder. PTSD from sexual abuse from birth family. She was ordered to complete a prison substance abuse program and while she was there had a psychotic break. She was in isolation for three months before they ruled her mentally incompetent to complete the program and discharged her on Feb 4. She now has extreme paranoia and delusions. After much effort and crisis, she was admitted to a mental hospital. They are releasing her on Tuesday, but she is still paranoid and still delusional. I have voiced my concerns to the doctors and have received no feedback. I have no experience with this behavior. I am scared. She hallucinates. Has called the sheriff to report nonexistent people in our backyard and thinks our beloved friend and neighbor is trying to harm her. She says she is not certain that I am her mother because my face and voice keeps changing. She says I have five different faces. We live in a very small rural town. The sheriff and judge and everyone know her. But it sounds like there is not much that can be done.

I have read on a few posts about people letting their loved ones go because they can no longer live with them safely. But where would they go?

I have experienced several people in my life with Alzheimers. Her behavior is much the same. You would not let an Alzheimers patient go. There are places for them. But where would my daughter go? This is not her fault. She is not doing this intentionally. She is very sick.

I dont know what to do or where to turn

Hi Katee,

Welcome to the forum, I am sorry that circumstances in your daughter’s life have you seeking help.

Your daughter’s diagnosis is bipolar and she recently had her first psychotic episode while in a prison substance abuse program?

It might be that you have not heard from the doctor’s in response to your concerns if your daughter has not signed a release allowing them to speak with you. You can always tell them things, but without a release they often will not speak with you.

Has your daughter threatened to hurt you? Did she live with you before she was sent to prison? A little more information will help people respond to your post.

In response to your post on the other thread, many of our family members who have schizophrenia are unable to realize they are ill and refuse to take meds for their brain disorder. Life can be even trickier if your daughter has a bipolar disorder and substance abuse issues. Some of our families have to get court orders for their family member to have “forced meds”. A judge has ordered them to take medication for their brain disorder. Some of our family members have to receive long lasting injections of meds for the brain disorder. The shot is usually administered monthly. Invega is a popular monthly injectable.

Has someone mentioned schizophrenia is that why you have posted on this forum? It is possible for other brain disorders to experience psychosis.

Thank you for your response. My daughter has mostly lived with me her whole life. Her therapist feels that she has schizophrenia and we are waiting for a diagnosis. She has always taken her medication. But these new psychotic behaviors dont seem to be responding to medication. She has not threatened me, but she has threatened the neighbor, her ex-boyfriend and random people in town. She has said that she is going to burn the town down. She has been abusive to her beloved dog - something that she would ever do before. I signed an emergency detention order which is what got her into the mental hospital. She has been there for almost two weeks. She is still talking about the people back in our town who are after her and how she will be following up with the sheriff to get them arrested. The sheriff is aware of her mental illness. And my daughter signed a release for the doctors to talk to me. I need to know her diagnosis, but more importantly her prognosis. Before the psychotic break, she was getting a monthly shot. She will be getting that again. But I have questions. Should I expect that the medications will work better over time? If not, how do we live? My neighbors are scared of her. Our family and friends are scared of her. Our dogs are scared of her. How do I respond when she is hallucinating? Whst do I do when she is yelling and cursing outside my neighbors window? What do I do when she calls the sheriff to report all of the people in our backyard who are trying to break in?

What do I do?

What medicine was she taking that does not seem to be helping? What meds was she on before, what meds is she on now?

As @NeverTooLate mentioned, they often aren’t taking meds when they claim they are taking their meds. Are they actually taking their meds is the question when anti-psychotics are not having any sort of effect.

You need to remind anybody and everybody that your daughter has signed that release. Keep a copy of it at hand to fax - don’t ask me why the medical world still loves their fax machines. There are apps you can get to fax documents with your phone.

What monthly shot was she receiving before the psychotic break?

You should take these threats seriously and notify the police.

She can also be arrested for animal abuse. Make sure the dog is safe.

Some meds do take longer to work if they are actually taking the med.

Are they afraid of her because she is in a psychotic state? Is she wandering around yelling and threatening them? She needs to taken to the hospital and readmitted. Or call 911 and tell them she is threatening to harm the neighbors.

When the sheriff shows up to check out your backyard let your daughter talk to him. “Outside” documentation can be useful.

The sheriff MUST take her when she is threatening herself or others.

Again as @NeverTooLate mentioned - don’t let them release her to you in a psychotic state. You don’t even have to take her in a non-psychotic state.

How much help you can get from local authorities depends on where you live. Don’t place yourself or others in a dangerous situation.

People on this forum who are familiar with meds can help you more if you provide the names of the meds your daughter has been prescribed before and now.

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hope-

Dr. Amador was mentioned by me because this mother may be busy reading as many of the other postings here on this site as she can to learn. She may come across those that advocate and promote his views and actions.

I wanted this mother to know there is someone here who doesn’t necessarily share his course of actions. To let her know in our situation his advice was not remotely helpful in dealing with our daughter. If we had tried staying with his advice and chose not to be so aggressive to the extent we were…we would not have accomplished so much with our daughter.

Just me choosing to share my viewpoint. Once again some may find my post offensive…but I also find Dr. Amador’s advice to be limiting.

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Welcome @Katee to the site. We understand. All of us have stories of confusion, grief, small successes, big losses, etc. Each person is different when this illness hits them. Schizophrenia is often not diagnosed until the person has been seen medically for over 6 months for their psychosis. My daughter had 4 diagnoses over 3 years, including bi-polar, before schizophrenia was diagnosed. She was paranoid delusional and talking to voices the whole time, but could have “moments” in front of others where she seemed normal, including in front of her doctors.

It took 3 years and 5 hospitalizations to get my daughter onto meds that worked, and it almost drove me nuts myself. I became a mean, cynical person for a while. I never slept well, I was insulted by police, my daughter, my friends and relatives, as I tried to find a solution to her odd behavior. I built a studio apartment into my home for my daughter and put noise makers and fans in my hallway to drown out her screaming. We had the police here 40 times (I’m not kidding) in the 12 months before she was last arrested and forced onto a long term medicine through judge’s /doctor’s order.

I couldn’t put her out, there was no where for her to go, nothing is set up for unmedicated psychosis in my area. Medicated, yes, unmedicated, no: nothing long term. I believe wholeheartedly that with her serious psychosis, only forced hospitalizations at any threat, and my communicating blindly by fax and telephone to doctors, got her on the right meds. It made me super tough, I had to steel myself against my own self-hate for “doing this” to my daughter. But right now, I have hope that the meds will keep working, the side effects will be minimal, and the future may just work out OK. Today, my daughter acts almost as she did pre-psychosis. It was a long, hard road, and I hated myself for a lot of it.

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Thank you so much for your response. I manage her meds for her and have her take them in front of me. I am lucky in that she is compliant with that. In prison, they took her all of her meds because they were too expensive and deemed unnecessary. She was receiving a monthly shot of Abilify plus oral doses of trileptal and buspar and prazosin. So in essence, she had been off her meds for 5 months when they released her from prison on Feb 4. She has now been back on all of her meds in the hospital for almost two weeks. However, the new psychotic behaviors have not stopped.

Unfortunately, the sheriff is at her house quite a bit. Neighbors have called. Boyfriend has reported threats. I have called. She also posted threats on Facebook. Fortunately, the sheriff and the judge are helping her to get help. She has had two 72 hour holds since she came home. It is the hospital here in town who is letting us down as they do not have the capacity to handle her as they have no psych unit. The first time she was on hold, they apparently called 18 mental hospitals and none would accept her. My daughter has Medicaid. Finally the county mental health crisis team got her admitted.

Tomorrow I am going to call everyone at the mental hospital and tell them that she is still unstable and cannot be discharged. Dont know where that will get me. But if they release her on Tuesday i guarantee the sheriff will be back at our house that very night for one reason or another.

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I am so sorry - I was just reading a mom’s story about her son with schizophrenia and her son was also taken off his psych meds while he was incarcerated for 4 months. I am just sitting here shaking my head. The crap we have to put up with while trying to keep our family members stable.

Can you go back to the original judge who issued the emergency detention order to ask for assistance in keeping her in the hospital?

I am really so very sorry. Our son used to circle our house at all hours yelling at us to stop tormenting him. It was terribly frightening.

I’m glad your sheriff is helping you. All we ever heard from our local sheriff’s department was “its not against the law to be crazy” when we called for help. So very frustrating.

Make sure you get the screenshots (or whatever) of the threats on Facebook.

I think you have a good plan. Make them talk to you. Is it close enough you can go there in person?

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Yes, the hospital is about an hour away. I will do what I can!! Thank you again.

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Good luck! I hope they listen to you.

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Yesterday I called and pitched a fit at the hospital. The caseworker called me back and gave me lots of info and education. She has called me several times today as well to answer more questions and give me info etc. The a**hole psychologist finally called me this morning and told me that he thought that I was the one making my daughter paranoid and delusional because he was seeing none of that behavior. I was soooooo furious. My daughter had told me that the psychologist was a jerk and she said he was constantly trying to convince her that she should not return home but go to a homeless shelter. She said the MD and the caseworker were both good and not to listen to the psychologist. I bit my tongue while he went on and I said nothing. The caseworker called me a bit later and asked me how the phone call went. I told her not very well. She laughed and said she expected it. So obviously she does not have a high opinion of this guy either. Anyway, last night and this morning, I had the most normal conversations with my daughter since she was released from prison on Feb 4. Her boyfriend reported the same. I’m beginning to breathe a little easier. I think the meds are beginning to work a little. I know things wont change overnight but I am allowing myself to feel a tiny sliver of hope. She gets her Abilify shot today. Thank you to everyone who responded and supported my post. She is coming home tomorrow if she tolerates the shot. I am ready now and feel much more equipped to interact with her.

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I am so very happy to hear you survived the psychologist and that your conversation with your daughter went well! I hope the good news keeps coming!

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Hello. I am sorry you are experiencing this. You are not alone. Could you travel to receive help? We went to a hospital about an hour and a half away. Fortunately we were able to receive services closer though. I do believe, through trial and error, you can find the right meds. You also need a trusted family doctor for her and counselor / psychiatrist. These relationships help so much - we had a case worker coming to our house in the early days and these trusted relationships helped my son to stay on his meds and gain insight into his illness. She can feel good and behave in such a way that she can be somewhat independent. As her perceptions are right now, she could not be and she can be better, I believe. My prayers to you and never quit researching or reaching out for help. There may be something closer to you that will work. Do you have a resource hot line in your community that can refer you to resources?

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Hmmm, I never thought of looking for a resource hotline. What is that exactly and how do you find one?

Interesting …

It definitely shows …

Do you have schizophrenia in your family?are you or your family schizophrenic?

My partners parents has no schizophrenia in her family history…

Sometimes it’s genitic?

Can they test for that?

Have you ever seen the scholfields on dr phill?

Do you believe in the dopamine hypothesis?

Many things sound similar to my son – e.g. the paranoid delusions. He’s stable now with 15 mg of Zyprexa (Olanzapine), but it took a few months. Off and on during the past 1/2 year he’s also been on anywhere from 75 mg - 400 mg of Quetiapine ( Seroquel ). Plus 2 bipolar drugs, which got tapered down to 1/3 after his diagnosis was changed from bipolar II to schizoaffective disorder.

He still hears voices almost every day, but no delusions. The voices appear to slowly be getting better and, at any rate, he doesn’t give them any authority over him (I don’t think).

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In my community I believe it is 211 on the phone. They will refer you to everything on their database. My son also calls there and can speak online to a supportive person if he is feeling down. I would think most communities have something like that. Like a help hotline.

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