Family and Caregiver Schizophrenia Discussion Forum

I Don’t Know What To Do

Needing insight, advice, help

I’m not sure if this is allowed or if this is even the right place, but I’m not sure what else to do. I’m 26F, and my dad is schizophrenic and also has major depressive episodes. My dad’s family is from a small town in the south, and very religious, and has always kept my dad’s illness “hush hush.” My mother is a first gen immigrant from Asia, and she and my dad have been married for almost 30 years. I think that it’s part of my mother’s culture to “hide” mental issues as well. My dad has always had “issues,” and my family tried to shelter me from them, but I always knew something was troubling my dad. As I got older, I was told a bit more here and there, how my dad was hospitalized twice, how he needed to take medication daily, that type of thing. Throughout my childhood, my dad was pretty fun-loving and goofy, and I loved spending time with him, but there were days, weeks, sometimes months where he would become someone else and I was afraid to do or say the wrong thing and make it worse. As I got older, I learned that my dad and his siblings were abused by their parents (my grandparents,) and that my dad, as the middle child, got it the worst. Verbal abuse, physical, mental, you name it. My grandfather has since apologized to his children for the abuse, but my grandmother refuses to acknowledge the extent of the abuse.

I don’t know if that’s a good summation or explanation, but I can answer any questions to clarify something. My dad has always had a hard time with transitions, or life changes, and they will usually send him into a depressive episode. Not eating, not sleeping, not taking his medications, sometimes auditory or visual delusions. My graduating college was very difficult for him. I recently got married to my best friend, and my dad honestly adores my husband, but I think this huge life event for me has totally overwhelmed my dad. A few months ago he decided he wanted to be Catholic, after being in a traditional church of Christ his whole life. This didn’t bother me at all, as I believe the church of Christ is more harmful than beneficial to most people. But as we got closer to the wedding, my dad dove head first in Catholicism. Daily mass, all the books, watching mass on TV at home, he stopped eating meat, the whole 9 yards. The day my husband and I got back from our honeymoon, my dad threw out or gave away a lot of my mom’s possessions, and she’s been staying with us for the last two weeks. I’ve been trying to be compassionate with my dad and know that he has an illness and isn’t thinking clearly right now. He has been telling me that he believes his grandfather is real dad (I think this is a coping mechanism from his abuse,) that god is speaking to him and making him make promises, that my real name is Anne after Saint Anne. I want to support him and not make him feel like he’s “crazy,” but I don’t want to feed into his delusions and make it worse.

This probably makes little to no sense, but I’m just kind of hopeless right now and I want to help him but I don’t know how.

Hi Mickey. Welcome, you seem to have found your way to the right spot. I’m sorry for the circumstance. I do have a couple of questions. Do you know what medications your dad is on, and does anybody in the family have open communication (as much as Hippa laws afford in most places) with his prescribing psychiatrist? My heart goes out to you and your mother. Let us know how you are doing.

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Welcome Mickey. The symptoms you describe point to a mood disorder component to your father’s illness. He may have schizoaffective disorder (my diagnosis, often abbreviated SZA here) or bipolar disorder (which my brother has), or schizophrenia (SZ) with depression comorbid (jargon for two diseases at the same time). While I feel distinctions between DXes is overemphasized by some laymen, it may be relevant if his current state is related to a manic state that’s untreated. Bipolar and Schizoaffective disorders can be accompanied with psychosis and symptoms can overlap. Knowing which prescriptions he takes (or fails to take) as @Wisdom suggests, can help us see how he’s being treated.

Many caregivers are troubled by religious obsessions by people under care. Religious beliefs can be especially difficult to separate from delusional beliefs, because prophetic experiences are similar, and impaired cognitive functioning can lead to novel misinterpretations of scripture. Often times in psychosis you feel a sense of “specialness” because others don’t seem to share your experiences and “knowledge”. Symptoms of “thought implantation”, “thought broadcasting” and delusions of reference can lead you believe you are communicating with or in tune with God as an explanation, reinforcement or confirmation of your experiences.

Even with the “sane”, religion can be a touchy subject that’s prone to argument. It’s often best not argue about delusional or religious content, but rather discuss feelings, behaviors and underlying motivations behind them without judgement. Dr. Amador’s LEAP method is often cited here to model improving better communication with people with serious mental illnesses (SMI) with poor insight or lapses of insight while delusional. The follow video of a TEDx lecture introduces the method which is further explained in his book 'I’m Not Sick, I Don’t Need Help!".

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Hi there, thank you so much for your response.

My dad has been on olanzapine for as long as I can remember, from 10-20 mg. He is a veteran and goes to the VA for mental health check ups and they are next to worthless. The appointment lasts all of 10 minutes and my dad says he is A-OK and the doctor refills his medication. Nothing more than that. He sometimes allows my mother to come with him, but rarely.

My parents both got Covid last year and they were in the process of making me power of attorney in case anything were to happen, but they didn’t follow through. I’m looking into court orders for mental health intervention (we’re in TX) but right now he isn’t presenting an immediate danger to himself or others, so I don’t know how much we could do there either.

Thank you so much for your insight… truly. I think these are thing I know, but having someone else put it into words is so affirming. It’s such a hard line, because I was raised in a very religious environment and religion really permeates our family. It’s difficult to separate “real beliefs” from the delusions, especially when the church puts such an emphasis on talking to God. I want to be respectful of his religious beliefs, but I don’t want to feed into his delusions.

I definitely think there are other disorders at hand, I lean heavily towards bipolar disorder with how intense his emotions can be. But my dad fights the schizophrenia diagnosis so hard, I think he is afraid of being diagnosed with something else and being “more crazy.”

My mom has been staying with us and my dad came over to our house yesterday, and we had a bit of a Come-To-Jesus moment, where my mom agreed to get counseling/therapy and that we would go as a family. I think a major issue in the past has been that my dad is the only one that needs help and everyone else is completely fine, which is not the case. I think it’s a promising sign that my mom is willing to seek help, because once the psychosis winds down he might be more receptive.

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