He was really mean today.....and that is not something he has ever been

Family
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So, for those of you that don’t know the experience with my son, he is 20, and in his second hospitalization. His first was in Jul '16 while in college where he was unwilling to take medication, deescalated during his short stay, and because he was no longer psychotic, he was discharged home. He remained unwilling to follow a discharge plan, unwilling to allow HIPPA auth, unwilling to take medication, and after 6 months of Sz decline, I pursued guardianship and ultimately he unraveled to a point where we petitioned the court for an involuntary hospitalization. Where we live, once hospitalized, there is an additional hearing for involuntary medication and that occurred. He received oral doses and had his first Invega shot last Thursday. He is continuing with oral doses, and they plan on giving him another injection on Thursday. This is the first regular medication he has had in this journey, he has been hospitalized for a month, and there is not a discharge plan yet.

I have been told that he is an individual that significantly suppresses/dissimulates symptoms (I agree), and he is so skilled and practiced at hiding his issues that the more severe he became, and in the month before we had him hospitalized, he was nearly catatonic and lost in his head most of the time. He would rotate out of that and into severe agitation, sleeplessness (among many other things) and was alcohol and drug seeking to resolve the layers of his discomfort.

His doctor said that cases like his drastically change when they start medication. He said that he is likely to appear like he has become much more ill…and we expected that, but I did not expect what we have had this week. Today, he was not only arguing his long standing fixed beliefs and delusions, he came out with new things and was simply mean. I didn’t know how to receive him. I struggle to say this about my son, but he was almost creepy in the way he tried to intimidate me in some of the strange things he was saying, his eye contact was bizarre and had a language all in its own…and he was entertained by my emotions. “Go ahead an cry you liar…the devil loves you.” Although his comments didn’t make sense to me, he would continue to look at me and say hurtful, rude, or mean things and I have never known him to be anything like what I saw today. Bizarre stories, sure. Odd line of thinking, sure…but this was so personal.

I wondered if it was because he has suppressed anger related to me, suppressed delusions that he has never spoken out loud related to me? Have any of you experienced something like this? I know enough not to take it personally…but it was so hard to handle, I told him that I wouldn’t tolerate him treating me that way and left. I decided to give the medication more time and take a break from visits. I don’t know if hat is the right decision, but I struggle to shoulder what I experienced today. Any thoughts?

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The sicker my son gets, the more of an urge he has to tell people about his delusions, so it’s a little different for us.

But, I’ve also seen my kind son turn mean and say awful things. It’s hard not to take it personally, especially at first, but you get pretty good at hiding your feelings after awhile. If my son acts like that, I try to never show any emotion - especially anger or crying, and I walk away when I can.

If I were you, I’d still go to see him, because his behavior can change day by day or even minute by minute. You can always cut the visits short if you need to. Other people would tell you to take a break - so there’s no right answer. You just have to do what feels right for your situation.

My son would sometimes tell me that he’d would get angry and I was the safest person to take it out on - even though he’d be sorry later. He also gets very angry about the meds because, as he sees it, nothing is wrong with him - so why should he have to take drugs to be something that someone else wants him to be?

My son is on his 3rd shot after the initial 234/156 mg combo your son is in the middle of now. Let me tell you, when they loaded him up on orals, then gave those two shots, it was like night and day. He cleared up and it was great - then it was not so great. We’re still working on getting his dosage right because the 117 mg maintenance shot just wasn’t enough.

Hopefully, Invega will go more smoothly for your son - I think it does for most people. My son always seems to need the highest dosages of everything so I haven’t given up hope just yet. It’s been a miracle drug for many.

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I’m so sorry and have experienced similar from my son. He tends to do it when I’m not able to “see” what he sees. This week has been bad. He has put his hand on me to grab me and shook me because I can’t see the marks on his body that he says are marks of the beast that only he can see. He wants me to respond, to do something etc. He also gets mean if I can’t meet his demands for the things that comfort him such as drives. He called me a bitch the other day and sounded so hateful. He never does that. I feel for you I really do and I hope your son gets better soon.

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Yes I have experienced similar. My son 25 was hospitalised in June 2015, discharged after 3 weeks, with no care plan , refused all meds etc. Basically kept going until another hospitalised stay for 5 months that time. March 2016 till Aug 2016.

At first he refused meds, they were gentle and caring and for two weeks tried to coax him to take meds. Then they got a bit tougher telling him if he didn’t then he would be forced to . He started on oral liquid risperidone.
Near time to discharge they did think he would comply with meds so he was put on a CTO , community treatment order. He has a depot of paliperidone every month. 9 now .

Yes though pre meds he would rant at me, insult me, come out with derogatory quite rude words, he would relate mathematics to me and a dr if you know what’s I mean. I would cry he call me a drama queen etc.

Now on meds it’s nowhere near perfect but he has humility for us, he doesn’t talk rude or swear nearly as much. He cringed the other day when I mentioned couple of things he had said last year etc. He’s called me a psychotic bitch, cocaine bitch etc. Called his dad a satanist etc , said is he his real dad etc .

So yes it’s normal if that’s the right word. Good luck in your sons recovery journey.

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How does someone get a Community Treatment Order? Who initiates it? Police? The hospital? A judge? Other?

We’re trying to make a plan, so our family member can be allowed to come back home with us after his involuntary hold is done. He has consistently refused all meds.

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It was decided by drs as a term of his discharge from hospital. It was for 6 months initially and now for another, but dr can revoke it any time he feels it’s not necessary. We were asked for our input and lots of information from us was taken into account as his parents who he lives with.

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That’s all common with people with schizophrenia. Mine has Schizoaffective and he can be the greatest asshole of all time sometimes. It gets to the point where he’s really deluded. If you look through my posts, a long time ago I posted something he posted on a blog that he had and sent to me. It’s all rambling and hurtful things. Yesterday he said I made him feel suicidal and then 2 hours later he said he was fine and just hugged me. Last week I had to call the police because he was going to walk 8 miles to a homeless shelter because he claimed I was lying about something, he still believes it, but the police mediated the situation and then he started crying saying he loved after he broke up with me. Previous days before that he said I was an evil malicious spirit and a parasite, then a couple hours later he called his mom to tell her “[name]'s smile is the best thing ever.” The eye thing and creepy stare is very common too, also shaking and tremors.

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By the way, about the Community Treatment Order, what country do you live in?

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Not sure if you’re asking me or someone else Doctor, but I did find out that a CTO is called an AOT (Assisted Outpatient Treatment) in the US, where I live. I’m assuming an AOT is initiated by the hospital as well? It’s seems like it would make sense…

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I was asking JMarie, but that information is superbly useful, so thank you very much! I am in the U.S., so that’s why is asked. I know we have people from all different countries, so laws and regulations can be different. :grin:

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The hospital might initiate the AOT, but the court has to order it - just like the court has to approve the involuntary hold at the hospital.

I’ve read that in places where they use AOT’s, it can be used in place of an involuntary hospitalization, and a lot of people are saying that AOT’s should be used more often.

I don’t know anyone in my area that’s been given AOT - that’s just from reading.

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Thank you, that’s really good to know! I’m bookmarking both your post and Day-by-Day’s! :+1:t3::smile:

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There are people advocating for increased use of AOT’s instead of hospitalization so I’m sure Google will show you a lot.

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I didn’t know that, but I’m sure there are since a lot of the times the hospitals just keep letting them out or won’t take them in. I’ll look into it; I appreciate you telling me! :slight_smile:

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Yes it sounds like AOT in the usa, we are in the uk.

It means that my son has to adhere to the meds, which he wouldnt have otherwise.
His early intervention in psychosis nurse will visit each month and give him the depot ,
She also comes out in between to see him… Not that he interacts much with her.

It means that if she or the DR think his mental health is deteriorating he can be recalled back to hospital (that would be in rare circumstances) as they do try to keep people at home where they can.

So its been a Godsend and without it I don’t know where we, or my son would be today.
When he was discharged last august it was initially for 6 months, the cto,
Then lots of reports by his nurse, dr etc when it came up for renewal in february it was to continue. The psychiatrist and nurse and us and son (he didnt attend) the hearing to find out if it was to be extended. Of course there were independent people there , bit like a court hearing and the DR and nurse etc had to prove that they thought he was benefiting and should be kept on it for the time being, which they all thankfully agreed to.

Its so different here and yes we have been lucky, but mental health overall in the uk is epidemic. I think with my son the reason he got the help and attention (albeit it went on for a few years) was because of how much of an impact it had on us whom he lives with.

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Thats what they did in 2015 with my son, he refused treatment and walked out the hospital at discharge after 3 weeks. Fast forward 8 months and he was back in again this time for 5 months.

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Yes and its not really that easy here either . It took a lot of input from me and my husband and to be honest my son didnt help himself much with the way he really wouldnt co operate with them, he had the chance , they knew he needed the help as did we and that made it slightly easier to get the cto. It was the hospital that stipulated that was a condition of his discharge, though we did say he couldnt come back and live with us unless on medication .

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That sounds great! Did he live with bad people before? :confused:

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No but things got so bad with him refusing treatment that we had to make the hard decision of telling him he had to get a flat, when I think how bad it really was in order for me to say he couldn’t live here anymore makes me realise how far we have all come in this journey.

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Oh, that makes sense. And yeah, my fiancé’s family kicked him out too because he was on drugs and they felt threatened by them after failing to hospitalize two times, he would just get back out each time and more angry.

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