New Here- Lost. Scared

Hello, this is my second time posting (I deleted my first post because this is so difficult to talk about). In short, my sister is experiencing psychosis, and has been for years, apparently.
I didn’t know how bad it was until her daughter finally told me two years ago. My niece did not understand how to articulate to me what was happening to my sister at first because she(niece) was so young when it started.
My sister’s husband works a lot, and goes back and forth about forcing her to get help. He has mentally checked out of the situation, and fluctuates between severe depression, and denial.

I flew out to see her over the summer when I heard how bad it had gotten. It was devastating to see her that way. She is in constant psychosis (auditory, tactile and visual hallucinations). But she is functioning when she isn’t triggered.
Her daughter (now 19) wants to have her committed, but is so scared of what that entails.

My sister doesn’t think she’s sick. She believes that what she is experiencing is from God. We were raised in a very religiously abusive house, and experienced a lot of trauma as children— so I understand why it is hard for her to separate the horror of what she is experiencing from the religion that we grew up in.
I guess what I am asking is this: Is it cruel to have her committed involuntarily? I’m scared that she will hate us. She doesn’t speak to me anymore because she believes that God removed my soul and left only the bad parts of me.

I’m wondering if medication will help. I’m wondering if she could get some semblance of normalcy back. I’m wondering if the damage that has been done to her children (she also has a teenage son whom she thinks has been replaced by a robot) can ever be repaired.
I understand that these are questions that are relative to her specific situation, and that nobody can truly answer them… I suppose the real reason that I am here is because I feel alone, and I am asking for support. Thank you in advance for your replies.

Je n’ai pas osé regarder la douce jeune pluie,
Et entre mes côtes, il y avait une douleur étincelante.

I’m sorry for being so long winded. And apologize if this is posted incorrectly.

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Going from being at home and unmedicated with no prior treatment to residential care seems very extreme. My son has a history of psychosis. My heart goes out to you. I understand the absolute heartbreak. We have had moments where he did not recognize me. After his first episode, we had him admitted to an inpatient psychiatric unit of a hospital. He was evaluated and put on antipsychotic medication, his symptoms got better. He became more stable and could function daily. People like my son and your sister need so much support and compassion. I am taking a NAMI family to family class. Its for caregivers and family members of people with serious mental illness. It has been wonderful. They offer resources and really explain mental illness in good detail. I think there is hope for your sister. I tell myself the goal for my son should be the minimal amount of medication needed so that he can function daily. Also a therapist is so important in creating goals for managing symptoms. I truly wish you all the best and hope your sister finds the supportive team she needs. Oh, and also my other kids go to support groups for family members of those with serious mental illness. They learn about mental illness. I think this is a step in the direction of reducing the stigma around psychosis.

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Thank you for replying to me. And thank you for your compassion.
Yes, going from no treatment to sudden care seems extreme. But so is constant psychosis over many years, living in turmoil and fear. The voices have suggested taking her own life as well. So one might say that continuing to live this way is extreme.
I am so relieved to hear that you were able to get help for your son, I have two sons and I couldn’t imagine the pain of seeing my babies hurting like that.
Where we are with my sister is that she refuses to accept the concept of illness or treatment. We have read many books, and my niece has been in contact with a family friend who was diagnosed many years ago, and has been through the same thing my sister is going through now. She said that what saved her is when her husband had her hospitalized against her will.
We have tried every scenario imaginable that we were told to try in order to push her to accept help. Any suggestion that hints at medical intervention or of illness triggers her into an episode of screaming, followed by fleeing the house, driving dangerously fast. She can also be very abusive to her son who is still living at home. We have tried every angle imaginable with no success. It has been two years of trying everything but ivc.
She has cut us all off, one by one. I can no longer directly contact her, and she has banned her daughter from entering the house. We are scared for her and for my nephew at this point.
Our goal is not long term residential care— more like forcing her to recognize that she is suffering from an illness, and needs treatment. Realizing that the people around her love her and want to help.
The outcome we desire is the possibility that a medication will be Introduce that will bring her out of psychosis and back to reality long enough to acknowledge that medical help is needed.

Thank you for bringing up NAAMI. That is something that I’ve been considering for a while, but had forgotten about. I live in a relatively small town so finding a group here may be difficult. I’ll still try.

Again thank you for your time and your kindness. I apologize again for the length of my posts.

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Oh! For some reason, I immediately thought of residential care. When my son started running from the house because he did not recognize us and truly thought we were trying to hurt him, we took him to the ER and asked for a psychiatric evaluation. From there, he was admitted to the inpatient psychiatric unit. He was put on medications, received intensive therapies, and was evaluated throughout. It was a long road, but he is now stable. Life is still difficult for him. We also dealt with talks of suicide for years. He started Prozac this past summer. Since then, we have not heard any talks of that nature.

In our NAMI class, we talked about police intervention if the person is threatening to harm themselves or others. They had the wonderful advice of asking for a “mental health trained officer” on the scene. They also advised that you be clear that you want your loved one taken to the nearest hospital and request a psychiatric evaluation. Your loved one should be able to ride in an ambulance. It sounds traumatic for our loved ones. I see it as, it is like they are stuck in a terrifying nightmare they can’t wake up from. We have to do everything we can to keep them safe while trying to wake them up.

In my experience, it is so helpful to keep a journal of these dates and details of episodes and events. That way when you speak with psychiatrists, you can review the notes so you can relay as much as possible for her sake.

Please do not apologize for the length of your posts. It shows how much you care about and love your sister and her family. She is lucky she has someone like you who wants to help. So many people give up just want to pass people with mental illness off to someone else to take care of.

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A book that may help you understand your current situation is “I’m not Sick, I Don’t Need Help” by Xavier Amador. Sounds like your sister is experiencing anosognosia - lack of insight. I would try to get treatment for your sister any way that you can. I know it can be difficult. I live in TX and the yardstick for commitment is danger to themselves or others. Simply saying they will hurt themselves or others isn’t necessarily enough - the police will probably want some evidence that they have access or intention - such as a weapon being available or show they are taking steps that are unsafe for them or others. Talk with your local police to find out what resources are available and how they will handle your situation. If sister flees when triggered, is it possible to keep her from accessing the car keys?

I would definitely get help/support for the teen still at home. This is not a healthy situation for him. You may want to consider other place for him to live so he can have some normalcy.

It’s a tough situation that affects all involved. Educate yourself, join Nami - most have virtual meetings now, join a support group for yourself, etc. I belong to 2 groups on facebook in addition to this forum. The people that live this know the most about SMI (serious mental illness).

Does your sister have a primary doctor? Could you suggest an appointment for an annual checkup? I would talk to the doctor office prior to the visit with your concerns. Unless they are authorized to speak with you due to HIPPA, they will not but you can talk to them. Wish you the best as you navigate this difficult situation and know that you are not alone.

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Everything will be ok - you just have to get from here to ok.
I wonder if it would be beneficial to have a clergy member speak to your sister? I’m so sorry for your niece, brother-in-law, you and your family to be in this situation because it feels hopeless. But it’s not.
Your sister needs an intervention, and a trusted clergy member or deacon can help you spearhead that.
If that’s not tenable, you might have to buck up. I had a very close friend in high school who started to experience suicidal ideation. When she had a plan, I freaked out and told her parents. She went for treatment for 9 months, and when she came back told me I was a horrible person for betraying her trust and she hated me.
20 years later, she sought me out to tell me she was a research psychologist, happily married, and so glad I said something to save her life.
Tl/dr: The right medication will help, but it may take some time. Please don’t worry about what she’ll think about you intervening - her thinking is not clear at all right now. An involuntary hold may highlight some needed insight for her, or at least start a log and give your niece a good night sleep knowing her mom is safe.

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Thank you for your kind reply. Yes, she is able to function for the most part in day to day life— so residential isn’t really what we are going for. The urgency now is getting her to realize she needs medical help and that she is loved.

I believe my niece has made the difficult decision to move forward with forced medical intervention very soon. We are very worried about her younger brother— and she has been having more and more angry episodes. It is time.

I am definitely looking into NAMI. I do need support. It is so incredibly hard to be so far away from my sister while this is happening. I will be flying out soon to see her. Hopefully things will
Look brighter by then. I’m hoping against hope.

Thanks again for your help.

Thank you so much for the book suggestion. I’ve ordered it, and look forward to reading and learning more.

I also live in Texas. My sister is in NC. Unfortunately, I am unable to be physically present for all of this. I did fly out over the summer. I will be going back sometime next year. It’s so hard to find the money and time to physically be there, but I’m doing all that I can from here.

I agree with you that it is a toxic situation for my nephew to live in. I’ve been talking to his grandmother (she lives in NC) so that she will be ready to take him when the time comes. I’ve helped my niece gather information needed to go before a judge to ask for medical intervention for her mom. Hopefully things will work out. She will
Be angry… we all know this. But she can’t go on like this. None of us can.

I’ve also been looking into NAMI for support for myself. I can’t thank you all enough for helping me
Navigate this.

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Thank you for your thoughtful reply. We have tried the clergy angle as well. To no avail. One of the strongest psychological beliefs that has taken hold of my sister right now is the belief that other people aren’t real. She see’s glitches, neurological visual hallucinations that make it seem like the people around her are cgi, or robotic. So she doesn’t trust anyone. This illness has progressed to the point of any intervention being involuntary. That’s unfortunate, but it is where we are now. She needs help, and we are moving forward to get her the help she needs. She can hate me for the rest of her life, I don’t care as long as she has some semblance of her life back for herself and her children.

I am so happy to hear that you helped to save your friend’s life. I have experienced losing someone to suicide- and that is nothing that I would ever want my worst enemy to go through. You did the right thing despite the pressure you felt to keep quiet.

Thank you again for your reply. I truly appreciate you.

I want to thank you ALL for taking time out of your day/night to support me with this situation. That is kindness, that is empathy.
We are all united in this heartbreak, and for that I am sorry, but also grateful to have access to your kindness.

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I have the (mis) fortune of having a dual diagnosis son- I have had great luck with very good results with convincing him to go into a 30 day in patient rehab with focus on mental health and meds.

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Thank you for your reply. I am so happy to hear that your son is getting the help that he needs. He is lucky to have you in his life.

Unfortunately, my sister is hostile at any mention of treatment— even the idea of going to see her general practitioner makes her suspicious. She is also good at masking her symptoms in public. We will keep trying different things to get her to the point of accepting care.

In the meantime, I am going to take the advice of so many in this community & see if I can find a NAMI group in my area. I appreciate your input so much.

Jeannette, How did you find a 30 day rehab with focus on mental health and medication?

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I am late to this post but after reading it I had to respond to the part about your fears of “being hated” --I have been there and experienced that with my adult son who is schizophrenic. I made many decisions early on in his diagnosis that made him seem to loathe me and he made me know countless times how much he hated me and how wrong I was in everything I did for him and on his behalf.

I once heard one thing from another mom going through what I was and she said, between my son and I only one of us is thinking with a clear and rational mind. Being that “one” you have to do the right thing for them because they/he/she simply cannot and will not because of their illness and the misperceptions that creates for them. Included in that, is the “hate” that can follow. However, that presents. What I learned is that once my adult son regained his sanity through consistent proper medication and getting him stable in his living situation. He had no memory whatsoever of saying he hated me or that he was angry with me about everything I did. Sanity brought rational thought back. He loved me before he got ill, and he loved me after he began recovering. My humble advice is don’t give a second thought to what your loved one’s opinion is of you when you are doing the right thing to help them try to get better.

Since you stated she already isn’t talking to you because of her delusions, it seems that your positive intervention can only improve things from here on out. She may need you or someone to advocate with her at her appointments or at assessments because I had to do that with my son, I ended up getting legal guardianship to do it. He was not able to accurately explain his own symptoms or experiences to a doctor because his delusions were very severe and interfered with his communication ability.

He eventually came to live with me so with my 24/7 observations and I kept notes I shared all this with his doctors and that lead the doctors (eventually) to the best treatment. It was not a fast fix, it a took a couple of years. Looking back, I call it a labor of love. Today my son still lives me and likely always will, but he is lucid, communicative, funny and interactive and stays busy with manageable hobbies and activities and we get along great together. I am beyond grateful I did what I did and stuck it out. I hope my story helps. I wish you the best.

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I can’t thank you enough for your reply. It helps a lot with the guilt.

The main issue that we (my niece and I) are struggling with right now is how my brother-in-law is not helping at all. He disengages from the situation— when involuntary medical intervention is brought up, he says that he would “rather not go that route”. He has been living with her going through this psychosis for seven years. I was horrified when I heard that. Seven years of watching her go through this torment. Seven years of going along with her desires, and her decisions in regards to her poor mental health. Her children are the ones suffering the most here. And her daughter is the one who is struggling to get access to help for her mom. She’s only 19. Without her father’s help or support. It’s gross. I live thousands of miles away. 25 hour drive (with these gas prices), and I can’t afford more than one round trip flight every several months (and that’s still killing me financially). It is so hard to do this with just the two of us over the phone. I did not know she was suffering for this long. She is very good at masking it over the phone. In person, not so much.

What would you say to him if you could talk to him about this? When he says, “oh, that’s just too difficult to think about” when we bring up medical intervention against her will, what would you reply to him? He’s infuriating me, and I don’t know how to talk to him. Im trying to be patient with him, because if I lose contact with him that is the ONLY contact I have with my sister at this point. She kicked her daughter out of the house, and my nephew avoids her at all costs. It’s a sad horrible situation. Rife with abuse and neglect all around.

Your son is so blessed to have you in his life. I’m so happy that he’s doing well and that he has you.

Thank you again for your reply and support.

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Your post is heart-wrenching, but the poetry excerpt is beautiful and fitting. Many others had insightful replies above, and I don’t have much to add other than there are a lot of us out here dealing with similar situations. This forum is useful and there are many others, such as “Families of Schizophrenia Support Group” on Facebook (and it is private too). I find solace & educating in reading/sharing experiences.

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Thank you for your thoughtful reply. Any support is appreciated. I’ll have to check out the Facebook group.

I don’t have too much to add to other’s great comments. You may want to check NAMI family support groups that are virtual. I am going to one since it is hard to go in person with a kid and my schedule to not cause any tension or create any sensitivity. Mine is called" Scissortail group" and am sure you are welcome there but you may find other options at your local NAMI. Just do not give up hope.

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Thank you for your input! I’m looking into the NAMI support groups. My area doesn’t seem to have any groups that meet in person. So your suggestion of virtual meetings is appreciated!

Wishing all the best to you. I’ll never give up hope!

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Thanks for your patience while I thought about my reply to you. Without knowing your brother-in-law, I don’t know how you could best get through to him that your sister needs care desperately. At least your niece is on board although she is very young, and this is quite a load for her to deal with. I was wondering if there is a NAMI chapter in her area and maybe in your area as well?

NAMI was such a help to me when I was floundering with my son, and not understanding as much as I needed to.They are usually a wealth of ideas and recommendations and if both you and your niece approach them from your different perspectives you may get some really good advice from them. In addition, I took their free class called “Family to Family” I highly recommend it because not only is it so educational and informative, but it can link you up with a network of people that understand what you and your niece are going through.

I was thinking about guardianship or conservatorship for your sister. If someone could obtain that legally through probate court, it would force the situation and your sister would have to be getting the regular help she needs as well as making sure she is living in the most effective and safe living situation. I know logistically you probably couldn’t do it and your niece may be too young to handle that but if it was brought to the court with the request that the court assign a guardian, that might work. That guardian would by law have to do what is best for your sister’s mental and physical health.

At least that is how it works in Ohio. You may want to do some further investigation for your area and your niece’s area to see what is what and maybe make some phone calls. It sounds like if you can get a psychiatrist involved and maybe a social worker as well, getting a guardian should not be too difficult given the seriousness of your sister’s illness and her behavior.

If they ask your brother and law to be guardian (which they probably would) and he accepts then legally he will have to do what is right because his actions will be monitored. If he refuses, then the court can assign someone else. As for the kindness or cruelty of intervention (your original concern) my own private thoughts are that leaving a seriously mentally person to fate with no intervention of any kind is far more cruel than any efforts made to help her. I think with any loved one who is mentally ill anyone that loves them has to try to do whatever they can, no matter how small the effort.

If you can, get in touch with NAMI if possible and learn what is needed for probate to get a guardian if possible and lastly but very importantly take care of yourself and your own mental health and try to strongly encourage your niece to do the same. If both of you don’t stay well mentally and physically throughout your efforts, then you won’t be able to help your sister. Even though I am in a good place now with my adult son, the stress and emotional wreckage my years of fighting for him placed on me took a toll, I got a therapist for myself whom I still to see regularly to this day. I don’t think I would have made it as well as I did without her help and guidance. PS: One last thought, maybe your niece could navigate what is needed to get your sister where she needs to be, she won’t know if she doesn’t try, with your help and guidance it may work but if it does not then trying to put the situation in the hands of 3rd party might be the best option ie: probate.

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