My son's delusions are worse. Will he get better, or is this permanent?

Family
1

My son started out diagnosed as bipolar 4 years ago, but recently his “20-minutes-a-session psychiatrist” diagnosed him with sz, and prescribed the very same 400-600mg of Seroquil at night.

My son largely seems to deny his diagnosis, and then only takes 300mg. He was on lamictal and lexapro but his last hospital doctor stopped those 2 meds (bad combination for the heart).

We started adding in Charlotte’s Web Hemp Oil because studies show the cannabidiol (CBD) reduces psychosis in sz. It works really well, but he started smoking THC-street pot :disappointed: and proceeded to get more angry.

I think he’s stopped the pot now, eats decently and he goes to the gym. But 50% of the time he talks about stuff that’s more strange/unreal/unattainable than ever before. He seems really stressed about the family money problems, and stressed about his inability to get his mind together so he can get a job. Will he ever have fewer delusions? Any suggestions? :worried:

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2

Sounds like your son needs more meds. I don’t think he will get better until he comes to term with having to take more meds. Maybe a med change will help though. He should be honest with his pdoc about how much he is actually taking.

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Schizophrenia is an unpredictable disease. It could get better or worse at anytime with no warning. The best someone with it can do is take meds and go through therapy which greatly increases the chances of it getting better.

4

Moved to Family.

Pixel.
(Wearing moderator hat)

5

Everyone’s different, as treebeard and schizofriendia write above.

Without effective treatment, the “typical” course of the illness is that delusions build up and become worse over the first years until eventually becoming somewhat “fixed” and stable in their own way.

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  1. Get a copy of this book and read it and have their families read it, as well. (Torrey can be a bit totalistic and unwilling to see exceptions to his “rules” at times, but most of the book is really worth the effort to plough through.)
    http://www.amazon.com/Surviving-Schizophrenia-6th-Edition-Family/dp/0062268856
    .
  2. Get properly diagnosed by a board-certified psychopharmacologist who specializes in the psychotic disorders. One can find them at…
    Find Top Psychiatrists by State. and Find Psychiatrists, Psychiatric Nurses - Psychology Today
    .
  3. Work with that “psychiatrist” (or “p-doc”) to develop a medication formula that stabilizes their symptoms sufficiently so that they can tackle the psychotherapy that will disentangle their thinking.
    .
  4. The best of the psychotherapies for that currently include…
    DBT – What is Dialectical Behavior Therapy (DBT)? – Behavioral Tech
    MBSR – http://www.mindfullivingprograms.com/whatMBSR.php
    MBCT - Mindfulness-based cognitive therapy: theory and practice - PubMed
    ACT – ACT | Association for Contextual Behavioral Science
    10 StEP – Pair A Docks: The 10 StEPs of Emotion Processing
    .
  5. the even newer somatic psychotherapies like…
    MBBT – An Introduction to Mind-Body Bridging & the I-System – New Harbinger Publications, Inc
    SEPT – Somatic experiencing - Wikipedia
    SMPT – Sensorimotor psychotherapy - Wikipedia
    .
  6. or standard CBTs, like…
    REBT – Rational emotive behavior therapy - Wikipedia
    Schematherapy – Schema therapy - Wikipedia
    Learned Optimism – Learned optimism - Wikipedia
    Standard CBT – http://www.beckinstitute.org/what-is-cognitive-behavioral-therapy/About-CBT/252/
    .
  7. If you/she/he needs a professional intervention to get through treatment resistance, tell me where you live, and I will get back to you with leads to those services.
    .
  8. Look into the RAISE Project at Google.
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7

Thank you, @Treebeard @schizofriendia @Hereandhere and @notmoses I appreciate your help. I will get a copy of that book. My son needs to break though his stubbornness and become willing to seek a better life experience.

I also want to examine any possibilities that the family (including me) may be enabling him to stay disabled. He had a therapist for a while who complimented my general handing of the situation, but I don’t want to rely on only one person’s eval.

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While I admit they can cause a parent to feel pretty squeamish at times, the following “ancient texts” on the families of sz patients offer a clarifying look into the often very subtle things that take place in those families without the parents realizing it. The parents are NOT to blame. (And they are NOT the cause. Sz can only take place when certain collections of predisposing genetics are there.) They were raised by people who were raised by people, etc., who transmitted these dynamics.

Bateson, G., Jackson, D., Haley, J.; et al: Perceval’s Narrative: A Patient’s Account of his Psychosis, Palo Alto, CA: Stanford University Press, 1961.
Esterson, A.: The Leaves of Spring: Schizophrenia, Family and Sacrifice, London: Tavistock, 1972.
Henry, J.: Pathways to Madness, New York: Random House, 1965.
Jackson, D. (ed.): The Etiology of Schizophrenia: Genetics / Physiology / Psychology / Sociology, London: Basic Books, 1960.
Jackson, D.: Myths of Madness: New Facts for Old Fallacies, New York: Macmillan & Co., 1964.
Laing, R. D.; Esterson, A.: Sanity, Madness and the Family, London: Tavistock, 1964.
Lidz, T.: The Origin and Treatment of Schizophrenic Disorders, New York: Basic Books, 1973.
Lidz, T.; Fleck, S., Cornelison, A.: Schizophrenia and the Family, 2nd Ed.; New York: International Universities Press, 1985.
Scharff, J. S.: Foundations of Object Relations Therapy, London: Jason Aaronson, 1989.

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Disability is caused by illness, genetics, or accident, not family dynamics.

If everyone who grew up in a shitty family got severe mental illness, only fifteen percent of adults would be working and paying taxes.

Just an opinion.

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10

this illness is caused by uncountable things… or at least the illness is set loose by countless things… the potential for it is inborn… but stress alone can lead to psychotic breakdowns… and family dynamics can be a major stressor (I still get set up to relapse if I deal with my family for extended time frames)

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11

I completely agree with you.

Thank you for responding.

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12

he just need to find the right med…his life will improve…and things will improve for you as well…

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Thank you @notmoses @Hereandhere @OddJob @karl :sunny:

Today he was better, and when he had trouble with a task, he said, “I’m frustrated with…” and we asked, “Do you want help?” He said, “Yes but let me do it by myself.” all with a good attitude. I’m glad he’s speaking his frustration. We’re here for him and we appreciate YOU ALL writing here to help us. Many thanks! Day at a time! :sunny:

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Another book that may be VARY helpful, even though it was written for caregivers of elderly people with dementia. (The skills base it teaches is close to identical for caretakers of sz pts, at least with respect to managing the relationship between you and them when they are delusional.)

http://www.amazon.com/The-Validation-Breakthrough-Third-Edition/dp/1932529934

And once you have that skills base, you can add this one to get a very effective collection of skills for dealing with such people.

10 StEP – Pair A Docks: The 10 StEPs of Emotion Processing

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Wow, thank you again @notmoses !
Update: a few days ago I called the social worker/police team - he was talking in a heavy accent, staying awake for days, dillusional. They accessed that it wasn’t a “crisis” but call if it gets worse. This is the donut hole in the system. :frowning:

He was so said when he said he didn’t want to be hospitalized. :frowning: They got him to take his meds right there, but he had a bad reaction to the Seroquel. Extreme dizziness, nausea, incoherence, mumbling, rocking. Slept but woke up three times mumbling incoherently before sleeping all night.

Tell me what you think: I think he’s been not taking his meds for a while, thus the on-going never-improving psychosis. I thought he was taking 300mg/day but the 450mg dose sent him through the roof. I gave him some Charlotte’s Web to “take the edge off” and I think it helped, he slept then.

Sure seems like he’d stopped his p-meds for a while. Thanks to this forum I’m looking for a new p-doc to try a different med. Thank you again! :sunny:

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16

Sounds like a real good theory from here, but I cannot be certain, of course. Maybe you can talk to his doc about getting him on a depot injection every two weeks… though someone will have to take him there to get that, I expect.

It’ll mean a switch from 'Quel to something else, but with his possible compliance difficulties…

See http://pro.psychcentral.com/long-acting-injectable-antipsychotics-a-primer/004332.html#

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Thank you. I always wondered why people always say, “it’s good you caught it early.”

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Jimgym,

Your son is understandably struggling with this very difficult diagnosis. Anything that you can do to not enable and to support him if healthy. That’s great that he’s going to the gym. The resources everyone noted below are super important. I became much more empathetic and patient with our son’s sz diagnosis once I read quite a bit. Also it was important for us to stop enabling our son to get marijuana.

How can you lower his stress about the family money problems? Perhaps he can get approved for disability payments? I think that helped our son a little bit to feel that he was funded (although it’s not much it helps). The most difficult thing for us was to not be angry or impatient. The stubbornness and the willing to see a better life may take him time to work through. And, is it really stubbornness or is it just shock at the diagnosis? I try to think of it as bereavement of the life that our son had planned vs. having to figure out what’s possible. And, it takes years, in our case, but I hope it will move forward in a positive way for you and your precious son.

Prayers and hugs -

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