I think my brother is about to have another episodic relapse

Family
1

Hey,

It’s been two weeks since my schizophrenic brother’s had an episodic relapse, and after being relatively OK for these past two weeks and despite taking his meds - I saw him take them last night - I think he’s about to have another relapse.

How do I know this will likely happen?

From past relapses…

  1. He has a certain wide eyed look in his eyes
  2. He hasn’t slept as much
  3. He’s been pacing a bit more, specifically last night
  4. (THE BIG ONE) About a hour ago I glanced at him as I passed by his room, and he got all paranoid and pissed as he asked me why I was doing such; I played it off and said that I wanted to make sure he was okay; I don’t exactly remember how he responded but it wasn’t exactly “okay, my bad”.

I’ve also thought that those factors wouldn’t lead to relapses in the past, but they always have, and as much as I hope and pray that it will be otherwise, I don’t believe this time will be any different.

TBH, I’m afraid of what the next couple of days may well bring, because it’s been the case for the past year-plus.

I know and appreciate all the suggestions and support that were made on my last post, but I honestly feel that my brother is going to have another relapse that will cause hell for me, and there’s realistically nothing I can do about it besides go into my complex’s clubhouse to get away from him and call my area’s mental health crisis team to go talk to him if it - God forbid - gets bad,

Which while it works in the short term is unfortunately not a permanent solution.

Like I said before, I (also) honestly feel that the only real solution to all this for my mental health and well being is to cut my brother out of my life,

Or to better put it, to cut myself out of my brother’s life,

Because sometimes, no matter how hard one tries whether through LEAP or any other method, due to anosognosia (more or less) and, in my brother’s case, his refusal to do more to curtail his episodes, i.e., up his med dosage, see his doctors, join groups, get therapy,

Much like stage 4 inoperable cancer, nothing one does will be effective.

Come to think of it, stage 4 inoperable cancer is a pretty decent analogy for what my brother is going through, at least IMO.

I’m not looking for suggestions this time, I’m just here to vent;

This SZ that my brother will always have is, to me, a life sentence in hell on earth without parole;

At least that’s how I feel too much of the time.

And that’s depressing, which is not good for my chronic depression nor my mental health.

BTW: Yes, I’m seeing a psychiatrist for it, I have an appointment next week.

I can’t think of anything more to say about this. Thanks for reading…

2 Likes
2

Thanks for sharing here , I’m glad you have your plan in place for now even if it’s temporary do you keep a little ( safety bag ) or backpack packed with things you might want with you while your at the club house in case you need to leave quickly?
I did this for years when my Partners BPD borderline personality disorder was out of control I kept it in my trunk just in case it brought me peace of mind to I had my things ready .

I understand about the look I know it well with my sibling also , my sibling in the past has done counting, and starts to talk in radio like 10:4 or over and out , he also usually gets on the roof at some point or the attic when there was one, moves around more manically and moves furniture.

I haven’t lived with him in years but this is what I have witnessed over the years and even in my long distance relationship with him through video calls .

One thing I realized now is he has pretty severe PTSD and what I’ve thought were going to turn into episodes recently he has been able to settle from so he becomes very heightened I don’t start responding to it at all and eventually a few hours later he’s fine again.

Mind you he lives alone right now and I truly don’t believe he could live with anyone at this point he can rally for short periods to be around certain people but I believe that’s pretty much it for right now.

I received hundreds of messages a day from him at some points he seems well enough to care for himself and in the same day he seems like he needs to have a guardianship placed.

This disease is absolutely heartbreaking I understand the analogy of the stage 4 cancer diagnosis, I often think of it as like a Tasmanian devil like the old cartoon just whipping through and leaving chaos behind.

I’m wishing you peace and strength and I hope your sibling does not have a psychosis episode this time.

3

Sounds like you weren’t thinking rationally in the past and now you are. That’s a good step.

Yet, the black and white thinking that follows isn’t rational. And contradicts your narrative that you expect an episodic relapse. If it’s episodic then it isn’t permanent and isn’t necessarily (to use your metaphor) terminal.

I’ve been in the caregiving game for my brother for over 45 years, and as a diagnosed person I also had an episode similar to his and spoke with my brother hours before being hospitalized. It didn’t help much, and I recognize there wasn’t anything he could have done or said that would have prevented my hospitalization. I’ve had at least 3 or 4 similar direct interactions with him in a similar state in lead ups to hospitalization and/or prolonged incarceration. (And more that I wasn’t directly involved with) All I could do once things became inevitable is try to mitigate potential fallout and try to muster support from the rest of my family, friends and professionals. In the end, however, his mental health is his responsibility, just the same as mine.

LEAP isn’t meant for acute care. It doesn’t come with a time machine. I recognize also that your ASD diagnosis can make you prone to black and white thinking, just as my ADHD diagnosis can make me impulsive from time to time. Caregivers do the best they can, but to borrow an Al Anon mantra, sometimes you have to “let go and let God” for your own protection. There’s nothing wrong with disengaging, but it doesn’t have to be permanent and it doesn’t mean there isn’t hope.

For the first time in 45 years, my brother’s actually consistently taking his medication and avoiding alcohol and as a result his life’s improving and so is our relationship. And much of this is a result of what some ADHD coaches say: “sometimes to do more, you have to do less.” Meaning: it’s okay to disengage from things that aren’t productive, and focus on things with more potential— in this case your own mental health. There’s nothing wrong with that. But using this as an excuse to do nothing, try nothing and give up hope on future achievements and goals— that’s just as debilitating.

Finding a balance, helping just enough and not too much, and recognizing when others can help better than you or when those under their care need to take responsibility for their own lives and suffer some consequences if they don’t— that’s the lesson I feel is the silver lining to the suffering you’re experiencing. And I’m sorry you’re having to go through this, but perhaps next time or the one after that with some help from LEAP will be the time your brother gets it right, and you won’t have to wait 45 years like I did.

3 Likes
4

My experience exactly.

5

The key is that they are episodes - not a permanent state. There’s hope in that. Do whatever you need to do to take care of yourself. Just allow for the possibility that he can build on his strengths and create a life worth living. This is a cruel illness and the suffering isn’t confined to the diagnosed person. But I don’t see it as a death sentence - especially if the illness intensifies in episodes.

I feel for you and I hope you can find a way to take care of yourself.