I have a questions specifically about how delusions are being treated.
My young adult son has been inpatient for 9 days now for his first psychotic episode. I did not have a mental health diagnosis or was on any meds prior to this.
He was sounding better on the phone in the last few days, calmer, and talking about the groups he participates in etc.
There was some sort of mixup where someone told him on Monday that he would be discharged on Tuesday. He really wants to come home, has been since he got there but we were always able to talk him into staying. I feel so bad for him that he was convinced he’d be discharged and now it is not happening.
But anyway, during our video visit yesterday we noticed that he seems just as delusional as he was when he got there. He was asking to check social media and watch CNN to find out how “this whole thing” is affecting the world since he had basically prevented a school shooting. Before this he thought he could undo the pandemic by switching back to the old iOS on his phone. We were in shock, realizing that he is not better at all.
So, my question is how does a person get treated for this? What are the methods to bring someone back to reality?
I’m suddenly very scared that he might never get out of this. I want him to be able to go home since he is so unhappy there. I’m heartbroken.
I have a questions specifically about how delusions are being treated.
The bottom line is, do you want happy or healthy? It’s good to be our loved one’s advocate for best care possible, and psychiatric units aren’t warm and fuzzy places (although other treatment can have a much more comforting environment), but my son’s longer term health was more important than his short term happiness. It was in some of those places that we had to go through the process, repeatedly, until recovery eventually became possible.
It can take many months for some medications to reach full efficacy. You can research that info online on the manufacturer’s website.
The bottom line is that I want him healthy. And happy too. The stress of someone telling him he can go home when he can not is certainly not helpful to his recovery.
I was specifically wondering about what it actually is that brings a person back to reality. Whatever meds he is on, and I have called more than once to talk to the doctor and find out, don’t seem to have any effect as of now.
I understand your frustration with the inpatient staff. This illness is difficult enough without added cause so I’m sorry about that. We hurt so much for our loved ones! I looked up some info on First Episode Psychosis (which also references delusions). I hope this is helpful: How Should We Be Treating First-Episode Psychosis? | NAMI: National Alliance on Mental Illness
It takes time for antipsychotic meds to work. It is also a trial and error process until the best meds and dosage are found that work for him. Sometimes use of drugs or a trauma can precipitate an episode. If he went involuntarily to the hospital the maximum number of days he can be hold is 3 in most states. Your son may hate you for keeping him in the hospital but do not give up.
Antipsychotics don’t work like a switch, nor do they blot out the experiences leading up to the delusional system. Even with highly effective antipsychotics, delusional beliefs tend to fade somewhat gradually, similar to how the delusional system was built, one “clue” or “revelation” at a time, over time.
I like to use the analogy of belief in Santa Claus in children. They may hear other kids say he doesn’t exist, yet disbelieve it. Over time they may question some inconsistencies, yet since they were taught to trust their parents they may be hesitant to change their beliefs, or double down out of embarrassment that they’d allowed themselves to be fooled. Over time, they come to accept it, but it tends to be a gradual process.
The goal of hospitalization is usually to stabilize patients so that they experience less distress and can follow up with outpatient treatment. This is a chronic disease, so it’s typically managed, not “cured”. There are plenty of delusional people walking around in the world every day and many undiagnosed and untreated, but unless you hit hot-button subjects of their delusional systems, you might never know.
@Maggotbrane Thank you for that insight. He was actually discharged yesterday. And yes, the doctor said he is not as stressed and his delusional thoughts and not taking over his brain and keeping him from doing normal things and therefore he can go home on his meds and follow up outpatient. His first appointment is in two weeks though which is sooner than anything I was able to get prior to his hospitalization. He is on zyprexa and trazodone and got about 7.5 hours of sleep last night I think. He wants his phone with really has caused him so much stress before with social media. He was having delusions about people posting bad memes about him.
What to do about the delusional talk? Gently try to dismantle it?
Generally no, don’t try to dismantle it. Listen to him, sympathize with him, ask him to clarify his point of view so you understand it. Don’t agree with him. Take a that’s interesting, “reporter” type stance but try to avoid conflict and arguments.
Where possible, distract him with things that comfort him. If he asks about access to social media, see if you can discourage it or make someone else like his doctor or the hospital or anyone else but you, the heavy. In short, things you might do to distract a child who’s acting up and trying to get his/her way.
Spot-on advice from @Maggotbrane !!! Do a search on this Forum for “How to Respond in a Helpful Manner to a person with disturbing beliefs”
You had some great advice on dealing with delusions or false-truths. My son is non medicated and slowly adapting to life on his own. He is better and I see him every day.
He is 31 and diagnosed PSZ.
One question I had was your son’s age. The late teens and 20’s tend to be the worst time period for this disease.
Thanks again, @Maggotbrane. I will re-iterate this to the rest of my family as well.
I think he can tell when we are trying distractions. He bought some hard lemonade when he went grocery shopping with his dad today, and apparently my husband didn’t notice until they go home because they had split up at the grocery store. He was self-medicating with alcohol a few times a week before the hospitalization, and I know it can disturb the gaba-glutamate balance or something like that, and cause or contribute to a psychotic episode that way. I was on his second bottle before I saw it. I might have him convinced to stop for now at least. By the time he takes his bedtime meds, the alcohol should at least be out of his system.
@doc503pir My son is 24. This is his first psychotic episode and it has all of us very worried.
Each case is as different as individuals are different. Along with the medication must come therapy from a mental health professional well versed in sz. Be prepared for your son rejecting medication. Rejecting therapy. This is why a professional is so important. Your love for your son might get in the way. You may see the side affects of psycho active drugs and wonder if it is worth it as the changes take affect. They will dull the personality of your son. They will change him just as the disease has changed him.
I say all this as a person not knowing you or your son. He has not received an official diagnosis yet, correct?
I apologize if my words seem harsh. After more than 10 years of caring for my son, I may be a bit hardened.
The diagnosis on the discharge paperwork says major depressive disorder, in the first call with the psychiatrist he said it looks like bipolar disorder. So I really don’t know. He seems more manic than depressed right now.
Delusions are a symptom and they will go in time with the right drugs…they maybe different for every patient. Left with anxiety that feeds into his emotions.
Isolation can be very difficult, staying in .we try hard to go see him , take him out…he lives by himself and copes well
My son was 8 months in a psychitist hospital .I had seen every day the changes in behaviour, psychosis…you have to work through , listen believe what they are saying… meds sometimes didn’t have a very good life line…as in when it got to 4pm daily .you see the thoughts the psychois distorted thoughts , laughing to himself come through…
I do see a big change in over a year 9 months now .
Symptom free…it takes alot of work , understanding, trust.no alcohol
Drugs going in at the correct times…9am and 5pm and minerals. Taurine = gut brain link…
A vegan fish omega oils.
Neurofen x 1
Look at anything inflammatory, helps with this… ashwadgma
Superfoods green foods…
The tiredness he feels on the clonzapine 100mg morning
And most important 5mg of ariprizole…
Bloods have to be monitor weekly to begin with the x 2 weekly. Now monthly after a year . He now on them 1 year eight months
Get them to believe in their strength… they feel secure.distractions into art , music…movies. tv…anything that just keeps them in the present short walks to help with cardio…my son vapes 10ml strength nicotine…Nik salts different flavours. He Likes writing poetry…the delusions psychosis was hell to see what he was now he has improved.
But always reserved space that he could go back… his journey was drugs recreational alcohol…
all the same psychosis no different and seen him in two .he 25 years and picked him up university had been left in psychosis for over a year…uni never report his absence to family and we just got calls from him to say he was ok one letter went home addressed to him…he made contact his grandmother after she opened uni letter. Breached the confidrntity letter addressed to him…crazy the grandmother never told myself or my ex husband her son …all she said make contact to him to her.,
he did but of course she didnt know how psychosis was like on a call. I suppose it difficult to know this… what a traumatic journey…
Nac are also good, do lots of research gut brain link. Reward park of brain…
Always good to do look at new research
I wish you all the best…sometimes they leave hospital too soon and not on the right medication… I do believe the eight months showed me x 4 kinds on meds
Heart tablet does need to be taken with clonzapine and salvation can be a issue too heavier breathing too…
So not s great journey of physical health ECG etc, health checks you need to keep in top of…
If anyone is in a ward and is being treated, that is the best place for them in the long term. I’m having the opposite problem for my sister. She lives with my elderly father, assaults him regularly as she believes he’s spreading her medical records over the internet - and her doctor feels she’s not ill enough for sectioning despite threatening to kill me and herself! We’re trying to get someone to listen!
My son became psychotic after being with a pastor who died. For one year, while responding to medication, he misses feeling God’s presence. He thinks he isn’t forgiven by God because God didn’t forgive a fallen Angel, and he wants to know the reason he was with his friend. Even with counseling, he doesn’t change this belief. He’s on Risperadone, working part time, but does admit depression sometimes. Occasionally he expresses this same belief when I ask how he’s feeling. It is frustrating he is still holding onto this delusion. I’ve been hoping it would be gone by now. I appreciate reading the posts above on how to respond.