Family and Caregiver Schizophrenia Discussion Forum

How to talk to son

My son was diagnosed with Schizoaffective disorder bi-polar type about a year ago. He has used meth for 12 years (age 33). He started paranoia, hearing voices, hallucinations about 4 years ago but they were rare. In the past year it’s been about 50% and lately nearly all the time. Primarily when he is alone in his apartment. He is terrified of the visions and is sure he’s about to die, police are in on it, etc. Police have been called twice due to his screaming, taken to MH ER but released immediately once they learned he uses meth. At this point symptoms occurring no matter how long since meth use. He used to recognize these things are not ‘real’ but no longer can. I realized now that I should not try to convince him they are not real, or even that they are real to him but his brain is creating them. He sees no reason to go to hospital or get emergency care since it’s real. He no longer sees his therapist and he hung up on the prescribing psychiatrist the last appointment (video) for meds check. I have no idea if he is still taking his antipsychotic med or even what he is taking. I do know he has a prescription that helps him sleep but not what it is.
How do I talk to him? Get him to help? Have committed him twice but they never will keep him, though he’s not ever been close to this bad. He had to move after the two police calls late last year and I fear he is going to end up shot by police or in jail. He is not violent, just terrified. He recently started a restaurant job but after only two weeks is starting to hear the voices there as well.
Does anyone have advice about how to get him to help? Or resources that can help me learn how to talk with him? Thank you.

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Oh, sigh, I am so sorry that your son is going through this terror.

You are right to not try to talk him out of his hallucinations or delusions. They are real to him, so you cannot talk him out of them.

I had success reading “I’m not Sick, I don’t Need Help” by Dr. Amador. The methods in his book need to be adjusted to your own son’s situation, but the LEAP method described in that book can be used to success, not just to get someone onto meds, but to help them change life situations in general. I paid to download it off the internet.

I’m not familiar with meth or it’s effects on someone, but I know that when the police or the hospital wouldn’t help my daughter, it all changed when I reported that she was threatening self or others. At least here they have to send someone for involuntary hold for at least 3 days of evaluation in the case of threats of harm.

Try to be hopeful, get educated as much as you can on hallucinations and delusions and schizophrenia, and do read Dr. Amador’s book.

Thank you so much for your reply. I have ordered the book. Was considering it but you convinced me. We have the same 3 day hold here but so far he always denies any intent to harm.

My son also has schizoaffective disorder and history drug abuse mostly cocaine and heroin. He is 26 years old. For years he denied he had mental illness, probably anosognosia. He went on and off his meds, had involuntary commitments, fired therapists and many psychiatrists. He only took meds consistently, when he was court ordered. Then everything changed for the better. He wanted to get clean, he checked into a rehab and they kept him for 6 weeks, then set him up with intensive outpatient for 12 more weeks and housing in halfway house. He got more effective and longer treatment from substance abuse world than mental health world. We found it best to say bipolar with psychosis, the label “schizophrenia” closes the door to many outpatient and transitional housing options. I did call during his first rehab admission to stress to his clinicians his antipsychotic medication is critical to his well being.
Our son has been clean 6 months. He has lived in transitional housing for 15 months which he pays rent with his social security. This is the first time he’s lived out of our home. Its highly structured, work required, chores, curfew…He works part-time. He willing takes his antipsychotics so he can work and live on his own. There are multiple sober social events he has access to. He just moved to next level of transitional living and can have his dog with him on weekends. He manages all his own health care and consistently takes his medication, participates therapy and has increased awareness of his mental health challenges.
Lessons learned:

  1. He needed to want to get clean, highly motivated to participate in drug rehab vs us requiring it
  2. Important inpatient place treats dual diagnosis mental illness/substance abuse
  3. There is variable quality in transitional housing from people serving their time as opposed to prison to those who want to get clean. The drug users know the best group homes to get clean or to continue “using”
  4. The structure of group home helped him heal both drug issues and optimize mental health
  5. I second the recommendation of Xavier Amador book I’m not sick…
    6 He did ask us to attend naranon meetings, we did for a while. Now when he asks for something (rides, money…)we respond: “we don’t want to enable you, how can you do it for yourself?” There is a fine line given complexity of mental illness… but the less we do for him, the more he does for himself. ***His antipsychotic meds work very well for him, so at this moment we can encourage him to be more self sufficient.

Best of luck, know on the darkest days there is hope!

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Thank you for this. Encouraging and very helpful. I’m so happy for your son and for your family. You’ve had a long journey. I appreciate the advice and especially about saying bipolar with psychosis. I can imagine that making a big difference in many situations. I think my son would very much benefit from the group living when he is ready. I have done much better the past few years and not handling everything for him but I can improve and really like your phrasing - how can you do it for yourself. That empowers him and I’d think it would feel good to him.
Thank you <3

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What a great post @Elsa , thank you for sharing your experience and I’m so glad your son is doing well on his own with the help of the group home.

And @mmom5587 please remember to take good care of yourself too while you are working on a better life for your son. I let myself wear away physically and mentally during my struggle to get my daughter stable into a “new life” and looking back at how beat up I let myself get, I should have taken more “me” time.

The State of Florida Vocational Rehab office was a great resource for us once my daughter started wanting to hold a job again. They didn’t flinch at her schizophrenia diagnosis, which I told them about. However, some doctors called it bipolar so I’m not sure which diagnosis was in her state records. They had her evaluated by several outside doctors/organizations and then did a “test” job with her at a non-profit warehouse store, then found her the job she’s now had for 8 months under the supervision of a job coach from Boley Centers. The Voc Rehab office would have helped her to get disability/SSI also, but she wanted to work as many hours as she could so doesn’t qualify for money help any longer.

Find and use any resource that seems to be able to help. NAMI meetings are also great support. Good luck and we’re all hoping for your best success at getting your son on the best path for him.

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I’m so happy you found that resource for your daughter. Sounds like Florida has some support we don’t have here in Iowa. I took the NAMI Family class a few years ago but thinking it might be time to revisit for more updated info. Thank you!

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My daughter has had similar experiences as your son. Same diagnosis and former meth use. Her medications don’t completely erase the voices. Her voices tell her she’s a failure, a whole, a loser, an addict. when she goes into a situation that is new or challenging, the voices show up. For her, what has helped a little, is that she was told by a therapist in hospital to “talk back” to the voices. To say “I’m not a loser. YOU are the loser.” to talk to them as you would a bully. 75% of the time this helps her. also telling me that the voices are present has given me the chance to “stare down the bully” as well. But 25% of the time, the voices win. She doesn’t tell me about them and she hurts herself and lands in the hospital. I have come to realize that all the help in the world cannot completely erase my daughter’s illness. But it can hopefully reduce the frequency of episodes and give her tools for when the episodes occur. I know this is not much help to give. But maybe you can ask your son about the voices. Maybe if he will share this with you, the voices will become less powerful. Bless you. Keep hope.

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Thank you. I think it will help him to hear that someone has been able to talk back to the voices. He knows no one else with this disease and has no belief that it can get better.

Oh I hope that it helps him. The symptoms will persist but if our kids can learn to manage the symptoms when they occur, life might improve for them.

I have to say, @mmom5587 ,that if you can do a NAMI family-to-family course again, or even just some support group meetings, that the shared stories and ideas will help your own family. My resentment towards my daughter and the “tough-love” overbearing attitude I had towards her at the start of her illness, began to dissolve in the NAMI meetings. They were good to get rid of as they only harmed our situation at home, so NAMI was instrumental and priceless in handling MY OWN destructive attitudes (which up till then I didn’t know were destructive). After that, this site, and the “I’m not Sick” Dr. Amador book helped tremendously too.

Yes, Florida does have more resources than many places, I am lucky that there are several psych hospitals nearby, that the police are trained by NAMI, that the courts understand mental illness, and that the government facilities meant to help others are active with community organizations which exist to help others. We have shelters for homeless with medical teams, half-way houses, live in facilities and many food pantries, plus the nice weather most of the time. It was key to my daughter’s recovery that so much help was available.