Family and Caregiver Schizophrenia Discussion Forum

How likely is that a second episode will happen?

Can a woman, my sister, who had only one schizophrenic episode due to marijuana abuse (early 20s) accompanied by a suicide attempt and diagnose of bipolar when discharged from a psychiatric hospital, lead a normal life without any treatment AT ALL since?
She suffered childhood traumas, today 35 years old has always been difficult to relate emotionally unstable and accumulated several conflicted personal relationships in all aspects of her life. How likely is that a second episode will happen? She does not accept psychological help and distance herself when the family tries to help. Any advice for family members?

It’s hard to help someone who doesn’t want your help. Some people go to extreme lengths to sabotage unwanted help from others, no matter how good your intentions might be.
I’d say the likelihood of a second episode is very high, if left untreated, unmedicated and away from the support of family and a doctor.
However, a person can’t be forced to comply with the common sense steps necessary to prevent episodes and treat a disorder. Not without involuntary commitment, which requires threat to health and safety as a prerequisite in the eyes of the law.
It would seem as though most people who are diagnosed with a disorder don’t want to acknowledge that they have a disorder, but when they do: choose to bury it under solitude and substance abuse.
I think it’s reasonable to say that most of us have witnessed this kind of behavior.

You can provide a sympathetic ear. You can offer sound advice. You can recommend treatment options. But, if the diagnosed (DX’d) person doesn’t want to use that help, you can only throttle back and wait for them to decide that they are ready to try.

This is a very common, very real struggle for most of us with family members who suffer from a disorder.
There is no one right answer about how to provide support and get help. Each person with a diagnosis is their own person, with individual needs. Continuing to be encouraging of positive behavior and providing sympathetic, positive listening helps.
But a diagnosed person has to want help in order for help to do any good at all. Otherwise, it’s just more frustration and stress for everyone.

Hi. As far as I know, there’s no such thing as a “schizophrenic episode from marijuana use”. You either have schizophrenia, the life long illness, or you don’t.

Maybe, when she was much younger, your sister was experiencing drug-induced psychosis. Maybe your sister was experiencing the beginning of bipolar, but the THC in the marijuana added an episode of psychosis. Maybe your sister’s original diagnosis of bipolar was accurate, but she’s been able to slide by without meds. Maybe your sister has borderline personality disorder.

If she has schizophrenia, I think you’d know by now. It’s a whole different ball game.


The statistic I have seen is that 50% of persons with SZ diagnosis and 40% of persons with BP diagnosis have anosognosia, or “lack of insight” (their brain tells them that they are fine and NOT sick) either completely or to some degree. We cannot MAKE the person do anything but we CAN communicate with that person in a way that may lead to the person doing what WE want not because they are sick, but for a reason that is meaningful to him/her. We may also have things that we can use as leverage to help the person comply with medication, treatment, therapy, or other situations as well. Marijuana does not CAUSE SZ but it can trigger it or make it worse. In regard to the extent and frequency of illness, each person is different. However, if she really had SZ, I would have expected additional breaks. Since she was only hospitalized once, it is possibly she has something else or multiple things going on (like bi-polar as you suggest), or PTSD.

She had one episode of psychosis and was diagnosed with bipolar disorder. That is very possible. (You don’t have “one episode of schizophrenia”.) It sounds like you don’t like her much. Some people don’t treat their bipolar disorder. It’s really not ideal but it’s true that people with BP don’t always get repeated episodes of psychosis. As long as she’s not a danger to herself or others, she’s free to live like that. If she wants a more stable life, she’ll eventually ask for treatment. She may only need mood stabilizers.