Desperate to help my sister

My sister is 42, a doctor, married and has a 6 year old daughter. She was diagnosed with schizophrenia 5 years ago, she thinks her husband wants to torture her, take her daughter away, spys on her, everything that she sees or reads is an agenda created by her husband to destroy her.

My parents moved her to their house and she made a full recovery. Remembered all she had done and being a doctor herself decided to stay on medication, she went back to work and her husband.

After 5 years she stopped taking her meds and relapsed. I have always tried to calm her down by agreeing with her delusions but that has always been over the phone and the times I have visited she was calm. This week I was visiting because she is very unwell and one afternoon she was asleep after taking her meds and I walked into her room and she got startled and screamed like she had seen a ghost. I got very scared myself because I saw her face change into someone I didn’t recognise and she looked at me like she had seen a ghost. However she calmed down immediately and said she wanted to see a doctor and she is worried for her daughter.

Though the medication has been reinstated two weeks ago and an injection was administered 4 days ago, she is still calls me numerous times a day and talks about how she thinks she should die or why is it that she is under attack and nobody is bothered.

We are keeping her daughter away from her as much as it’s possible, but today she told her daughter that there is a spy kid in her class and he will try to approach her daughter and if he does, she will change her school. My mother immediately intervened and removed the kid from the situation.

But how long will the meds take? Will she normalise soon? I am scared of her, how do I get myself out of this feeling? Should we keep telling her lies and making up fake scenarios just to calm her down? How do we manage her daughter? It’s so heartbreaking and painful

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Hello MM88

Welcome to the forum
a lot of people who understand here

I have a 41 yr old sister with this illness

your sister might be fine probably within a week or two
is any of what she takes now is the same as worked before or not?
if it doesn’t suit - maybe it will take longer but it seems to me like she will be back soon I hope
even in worst psychosis the right medication will normally help

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Per your questions: medication effective levels vary per person, per medication, per time spent away from treatment. In a week or two you should see some improvements, and in a month or two she may start to stabilize. You don’t say if this is a drug she’s been on before or if she has the same or new psychiatrist. Sometimes new drugs come along while people go on ‘drug holidays’ and psychiatrists take the opportunity to restart with something better, or a new psychiatrist may have ‘pet drugs’ he or she (or their drug rep) prefers to use. I don’t have any experience with injectables, so you may want to find out what was drug prescribed and look things up yourself. Data and studies are readily available on the web for most drugs. As a lay person you won’t be qualified to understand everything on the sheet, but looking at the data and statistics of the studies might give you a better sense of what you might expect. Talking to her doctor wouldn’t hurt either if possible.

I do not recommend lying to her. If she finds you out you may lose her trust and any possibility of influencing her future decisions and risk destabilizing your relationship. Better to listen, understand and, empathize with her feelings about what going on with her. Be noncommittal and vague if she asks for you to agree with her delusions. The idea is to delay and get more information by keeping her talking, and say you aren’t sure unless pressed.

I’m often confused when caregivers say they are scared of non-violent people under their care. Are you scared of what she may say? Are you scared of what she may do? Because she seemed like a different person when you startled her? Most people act differently under stress, yourself (and myself) included. SZ has a tendency to kick in the fight or flight response, senses are sharpened, danger seems around every corner. Think of what it feels like to wake up in the dark to a strange noise in the dark that you don’t know what it is, and then think what it’s like for that feeling to persist for hours, days, months and years. You’d be scared too. Her fear is likely much more than yours and you say you are scared by her.

The way to get over your fear is empathize with her. See where she’s coming from. Think of her past history and your relationship with her. At her core she isn’t that much different than that, and may return to a stable state like she did before if you give it time and don’t freak yourself and her out.

I understand actions taken and words spoken while delusional and psychotic can be hurtful. I told my mother I didn’t want to speak to her because she was a ghost when I had a psychotic break. At the time, I thought she had died along with most of my family aside from one sibling in an elaborate delusion. It would have been even more hurtful if I described in detail the ‘events’ of the delusion, so after it faded the next day after I spent a night in the hospital, we didn’t speak about it again.

Per her daughter, I’d limit her interaction with her and only comment on her state if questions are asked and in terms she’d understand. My tack would be that she’s unwell and confused and isn’t sure if she’s pretending or not and that we are trying to make her better.

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I am so sorry that you are going through this with your sister. It is scary when someone you love is acting out. Try to remember that she is perceiving a different reality (very very real to her) than you are perceiving. Especially if she feels paranoid, she will act scared and be startled easily.

However, most people with this illness, if they weren’t violent pre-illness, will not be violent even when under delusions or hallucinations. Medicines can take a while to wear off, or to kick in again. It is best to not argue at all about the perceptions your sister has. You won’t be able to convince her out of her delusions. It is best to find what you can agree on, especially something constructive.

I’m hoping that she will get back on her medication and stay on it. I’m sorry for her relapse, it must be so hard on you and your family.

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I guess when i say i am scared is because when she got scared of me i could not see my sister. It was like someone else has taken over her and i could see her in so much pain at the same time. I felt incapable of helping her. its heartbreaking to see someone who literally made me the person i am today to not be in control of her mind. I wish i had a magic wand.

Thank you for your such a detailed response. It gives me hope for us. I will educate myself more about this illness and learn from everyone here.

One of the best pieces of advice I got on this site (and there were many “best pieces of advice”) was to read the book by Dr. Amador, “I’m not Sick, I don’t Need Help”. The LEAP method of communicating is pretty easy to master, and I used it to help calm down one situation at a time in our lives during my daughter’s psychotic years. That book is not the reason my daughter accepted medication for an illness “she doesn’t have”, but it IS the reason for many improvements in our lives that were made as a compromise between her delusions and my reality.

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Try taking bifadus low histamine only, see if that knocks the episodes down, and be sure gut is optimized. My sigif other has been ill for 6-7 or more years, but now that he started taking bifado the past 3-4 months he is truly recovering. His true recovery is coming via taking Megasporebiotic probiotic, with the related formulas of prebiotic and the mega mucosa, he is MUCH better and returning to his old self. The mega mucosa has helped him especially just recently as he is not having any more reflux or episodic reactions from wheat and sugar. Reading about bifadus bacteria, it may help along with other good gut bacteria to digest wheat and avoid allergies! He is also taking undecylic acid to put down Candida fungus, which gives off terrible toxins, apparently even if you load up on good bacteria, causes of dysbiosis must be put down to truly shift gut health. He has suffered from leaky gut for at least 20 yrs, and this bifadus protocol showec immediate results in the midst of an episode, within 30 minutes calm and clearer thinking came about. He suffers from horrible panic attacks and paranoia. He tried niacinamide which worked for a short time but did not change things, and I read a reference that niacin treatment may make histamine imbalance worse. The histamine sickness is likely caused by gut problems in the first place, in that an enzyme DAO which normalizes histamine in the gut can’t be produced without a properly functioning gut. A properly functioning gut is caused by lack roundup ready exposure that interferes with the Shikimate pathway which not only kills plant but also good gut bacteria in humans, also exposure to pesticides antibiotics, and stress which in the mental disturbance is a never ending cycle. I have learned all these things via the internet, listening to the microbiologist who formulated Megasporebiotics program at Microbiome Labs. I have seen the results in my significant other in the past few months that I never thought I would see. The gut controls the mind via the Vagus nerve that can be blocked by a toxic gut and cause neurotransmitter disruptions as I understand it. The but controls the immune system, and general health. I personally had no idea! Try bifadus and see if there is relief from anxiety, paranoia, better energy, etc. The product we have taken is a low histamine version called Lifted from Amazon, make sure and get the low histamine version because some probiotics can aggravate histamine and make things worse before they get better. We also are taking HistaminX from Seeking Health which has L Plantarum in a low histamine combo, one can read about the benefits. There is a blue label Lifted low histamine product with L Rhamnosis which is good for quelling anxiety and panic attacks also, or the LIfted low histamine product we started on is all bifadus. We all need bifadus and apparently as we age it is greatly diminished. After seeing what bifadus did for my significant other, I decided to try it, because I was developing horrible anxiety and PTSD from the years of suffering, and I could not believe how much it helped me after ONE capsule, to be more calm and improve coping skills . A person may be depleted in bifadus via exposure to toxicity in our world today, stress, or just not being breastfed as an infant! Some people may be genetically predisposed to a weaker gut, with aggravation from pesticides especially Shikimate pathway interference. This is where my significant other saw the biggest relief ultimately via the Mega Mucosa product, after taking the Megasporebiotic for 3 or 4 months perhaps. Refer to Microbiome Labs and watch the detailed videos on the website, and also google the founding microbiologist for further talks and add’l info, I got add’l tidbits from watching each and every video. I hope this helps! I think the healing the gut, getting rid of Candida overgrowth, and balancing histamine could be the answer for many people!!!

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