Help: My Son is Decompensating

So here’s the story: My son was diagnosed with schizophrenia about 15 years ago. He did the revolving door of inpatient treatment and group homes. But he was not compliant with his medication. He lived alone without a car and wandered the streets of his town, delusional and paranoid for years until one day a minor scrape with a police officer landed him in jail. He didn’t even know me phone number or his siblings’ phone numbers. The judge was savvy enough about mental health to mandate him to treatment, which ended up being injections of risperdal. My son began to get better, accepted his mental illness, and for the next 8 years lived a highly functional life: maintained his apartment, cooked, paid his bills, did his laundry, and did garden chores for family members. But the medication did throw him into diabetes, and he gained weight, which he hated. He was strict about his diet and walked an hour a day. He lost some weight, but not enough to make him happy. So, to address his weight gain fatigue, he decided to stop ALL his meds. We saw him gradually become manic, disoriented, and downright nasty over the holidays. He has cut off all contact with us. And the last conversations we had with him were all over the place. He talks about the Natzis. He has made up a new name for me – he’s decided I’m not his mother. He won’t even open the door for his sisters or the Access Mobile Crisis Unit. The last time my son-in-law was allowed into his apartment, he discovered that my son is heating his coffee with a blow torch. And since he now has an old car his sister gave him during his last recovery, he is out driving all day, maybe even into the city of Philadelphia. We are understandably worried about his safety. He is vulnerable. But our hands are tied to do anything until/if something drastic happens. It’s not a good place to be. And we are beside ourselves with sadness. Dorothy

You might could make a good argument in court that he is “a danger to himself or others”. I’m sure you know that is the criteria for a mandatory commitment. I can sympathize with him about the weight gain. I have the same problem. He has to stay on his med’s, though.

Somewhere during that time he relapsed, prior to, he was lacking a strong family support. If he gets the family support and possibly someone who is qualified to look after him he will be okay. Medication can make you want to eat but he was walking. He must have felt alone and abandoned to get off his meds after doing so well. Talk to him and let him know you are there for him and that you will help him with his illness and weight gain. Offer to take him to a qualified schizophrenia doctor to get meds, psychiatrist. Take him to his regular doctors to get a check up, physical and medicine for his diabetes. Ask the doctor for a group for weight loss.
He has an illness and it’s a disability. Possibly the doctor can offer a med to not gain weight.
His health, exercise and support is important to recovery. Talk to him with gentle kind words that are questions. How are you feeling why don’t we go to the doctors and get you new meds or help and psychotherapy. I will make sure we get you help for your weight gain and diabetes. We can have someone look after you when we can’t make it. I hope things work out and getting him back on track is important.

Thanks for your post. Unfortunately, he has not threatened himself or anyone else yet. The laws are pretty strict about what “a danger to himself or others is.” We have already explored that possibility with the Crisis Team.

Thanks for your post. I appreciate the time you took. However, Todd had very strong family support. His sister, brother-in-law, and I live about 2 miles from Todd, and he was part of our lives almost daily. Although he was walking, he was still unable to lose all the weight he wanted. I’m not sure there are any antipsychotics on the market that do not cause weight gain. We have already talked to him. We have already asked the questions. And he because angry. He doesn’t believe he has schizophrenia, a belief that is part of the illlness itself. He now won’t take calls from the family or open his door for anyone. For a while, we were visiting, just to be sure he was ok. He would only talk to us on his front porch. He is becoming paranoid.

Abilify takes time but helps with negative aspects like depression, but is an effective anti-psychotic for a lot of people. It is a partial agonist of dopamine which means it won’t completely block or sedate him and isn’t yet shown to worsen or cause diabetes to my knowledge. If he is not taking very good care of himself you can always call in someone to check with him or get him into a program that can help him manage better. He is probably in both stages of denial because psychosis can be somewhat addictive for some people. If he has more resources to overcome the hallucinations and delusions that would help.

You could get him into a book or some hobby. Something that will refresh his mind and memory. Sometimes simple activities are more effective than medication esp if it’s not available.

My boyfriend came over and had dinner with my mom, for instance, because she is at home and is currently being asked to seek treatment and avoid a fine for trespassing on someone’s property and calling them names. She has a psychotic disorder but is also so delusional and void that she can’t recognize it much. It’s been eight years and she’s starting to come to terms.

They interpreted those laws pretty loosely with me. I hadn’t threatened anyone either. They might just be trying to save the state money by not committing your son. Maybe if you were persistent you could get him in the hospital.

Try getting him into a psych hospital. He seems paranoid.

Karl: He lives by himself. Won’t open the door to family or crisis unit. It would be impossible for me to get him to a psych hospital. He doesn’t believe he is ill.

Crimby: Crisis hotlines are pretty straightforward about a 302 commitment: danger to himself or others.

Starry Night: He actually takes very good care of himself right now. Apartment is clean (although no one is allowed inside right now), he is clean. He is very delusional, but he goes to church and keeps himself busy writing letters that make little sense. Everyone in the family has received one.