Hi, my 22 year old stepson has recently moved in with us, and literally has every symptom of schizophrenia, but no formal diagnosis. He has anosognosia, so will not agree to see any type of doctor or therapist, and has never been medicated. He had his first full-on psychotic break in our home a few nights ago, was ranting about people wanting to ruin his life, the potential that any of us could get shot in the head (there are no guns in the house), he broke things, smashed a hole in the bathroom wall, and tried to choke his best friend. Too much happened to say it all here, but needless to say, it was terrifying to see him completely out of control of his thoughts and actions. His episode lasted for 4 hours before he passed out. The next day, he cried to me and apologized for everything he did and said, but tried to normalize his behavior, and adamantly refuses to get help. Where do we go from here? What is the first step to getting him diagnosed and then possibly the help he needs? His paranoia extends to medicine and the government, and I’m afraid that he will refuse any type of meds. He won’t take anything for physical illness, not even vitamins.
@Stepmom39 Welcome - sorry for what brought you here. Before you or your husband force your son into therapy read this book. It’s for someone in your situation and mine too, however, I did not learn to use this method before my son isolated himself from me. Many folks on this site recommend this book: I’m not sick I don’t need help. Here is the link to it.
My son has not been violent - well he slammed a few doors and I pretty much said if you do that again I will call the cops and if he gets violet I would not let him stay with us. He has years ago, before I knew what any of this was, smashed his cell but I wasn’t around and so didn’t feel threatened.
Another thing I did at the beginning made things required. If you are staying with us, you have to go to this counselor. That’s when he got diagnosed. But since I did not follow the Leap program - Listen, emphasize, Agree and Partner, I am back at the beginning trying to regain his trust.
Many folks will chime in. Hang in there.
I have read most of that book already, I’m very proactive, but he says there are things he will never tell anyone, and he wants to keep it that way. We’re trying to avoid involuntary commitment, because he actually does feel safe here, and trusts us to a degree in spite of his illness. I feel like we’ve reached a standstill in our progress. He can’t recognize his illness, and we don’t want to push him away by trying to talk to him too much before he’s ready. Like every parent here, we’re just scared for his safety and future if he has an episode outside of our house, where people won’t know his illness and/or have his best interests in mind.
@Stepmom39 Glad that you have that book. My son is unmedicated and has anosognosia as well. I understand your concern for sure. I stopped forcing him to go out due to some stories I’ve heard and seeing him standing oddly on the street corner. Last year I was able to get him to see a Chinese herb doctor who formulated a tea just for him under the guize that it was for his overall health and psoriasis. When taking that it seemed to help. He won’t take supplements either but for reason this tea is ok. Another neighbor’s son is bi-polar and hears voices and the herbs have helped him as well. You’ll get a lot of support from this forum. Others recommend attending Nami support groups, which I have not done.
Thank you for the advice. I may see if there is a naturalist or holistic person in town who could maybe give him something he would actually take. He is strictly vegan, won’t use a microwave, only drinks highly filtered water, doesn’t shower regularly “because the government puts things in the water to control people’s minds”, etc. Only wears one outfit all day every day, even the rare occasions when he actually sleeps. I’m prepared to buckle in for the long haul… I know this is a lifelong process… Just trying to find some hope for his quality of life in the future.
@Stepmom39 That is great that he is into a healthy lifestyle. You may be able to get him to a nutritionist which can help as well. I am in Boulder CO so I only know the local people here for herbs etc. Other people (on this site) have said a gluten-free diet can help and a sarcosine (Sarcosine - Wikipedia) which I have but have not been able to get my son to take - although I’ve put it in his smoothies - which he won’t drink. I really commend you for staying on for the long haul and my BF I have lived with for 7 years has said no more living with my son for him - which I understand and it may be better for it just to be my son and myself for a bit to regain his trust. Here is another article I just came across for maintaining a health relationship.
Some times…and then there may be others where he does open up more. Don’t be surprised if he doesn’t remember though. Roll with it.
You may not feel that you have succeeded in any way, but you have. He feels safe talking to you. That’s awesome…give yourself a hug. Good job!
And…welcome!
Thank you! Finding this site has been wonderful… Learning about what others are going through and reading tips and advice has really helped.
I’m “new” too…
I’ve been reading the older posts and have learned so much! Husband is now reading, albeit over my shoulder! The information and support (even in past posts…just reading the personal accounts really) has been quite validating for our entire family.
Additionally, the realization that there are people who understand.
We “get” it …(sometimes!!)
Son is actually moving around today…it’s strange. He asked to make quesadillas, and is doing so for both of us. He hasn’t done this in months…probably, mmmm, over 13 months now? Looks like things are shifting a bit. He just said that “sting rays are the tortilla’s of the sea”. Huh…sometimes I honestly don’t know what to respond.
BUT, he’s cooking his own meal.
and mine…
“Thank you!” works.
@Squid That is awesome news. I hope my son will make tortillas for me. You must be thrilled after over a year of not doing that. Thanks for sharing - gives me hope.
Hello and welcome.
I think it’s important to make a rule about interpersonal violence: if anyone who lives in this house tries to hurt someone or threatens to hurt someone or themselves, I will call for help. Either from CIT trained police or a mobile crisis team.
I didn’t have a rule about destruction of property (not that there wasn’t any), but that’s also one that could be put in place, not just for your stepson, for every person in the house.
You can’t do much except love him, keep him safe, and wait for a window when he might accept counseling or some other form of treatment.
Best to you.
Thankfully, my stepson can still cook for himself, albeit very messily, and still has 4 friends he hasn’t alienated himself from. We’ve explained to them about his illness, so they are more patient and understanding, and know how important their love and support is for him. He used to smoke tons of pot, which made his symptoms much worse, but he knows we don’t allow that here, and in his paranoia he is afraid to smoke here anymore. Only positive thing that has come from his illness, but hey, it’s something!
Yup and my son has stopped smoking cigarettes as I won’t get him any and he won’t go out! I’ll take it as a plus for sure.
Wow…as someone who practically chain smoked for over 5 years I’m impressed!
I’ve been off cigs for a year now, the holidays were certainly tempting!
Quesadilla was good, and he’s back to make more. I asked how he felt “taking care of himself”? Did he feel better about himself? He’s been so down lately, why the P-doc increased meds and further testing.
He says he feels like he can take care of me when I’m old and need it. 
(He can become obsessed with my eventual death. Pleeeeeeze, I’m healthy and only 46!!!)
Hey…he’s smiling (sort of…I know it’s a smile!) and is proud.
Edit: HE CLEANED UP AFTER HIMSELF!!! (Where’s the fainting emogi?)
I’m really curious about the progression of this illness. His symptoms started about 3 years ago, but we rarely saw him (maybe 2 or 3 times a year), so we attributed it to drug use because he was always high as a kite when we did see him. He first stopped bathing, shaving, and cleaning up after himself, but nothing else noticeable to us until the past year, when we noticed his speech pattern had changed, he was distancing himself from most of his friends, etc. Now, in the past 4 months he has been arrested for threatening to kill a security guard at his friend’s apartment complex, got kicked out of 2 places he was living with friends for lack of hygiene and combativeness when they tried to talk to him about it, which is why he is now living with us. He quit his job because his paranoia of what his coworkers thought about him got too bad, so now he has no income, although he is under the impression that he can easily get another job, even though his last 2 were arranged by family members. It just seems to be progressing faster as the weeks go by. Has anyone experienced something similar?
He is also highly intelligent, still has a good sense of humor, and is very well spoken, even if a lot of what he says is delusional or makes little sense, he can almost always express himself. Will that disappear at some point? I know every person is different, I’m just wondering what to expect in the coming months/years.
Hello Stepmom. Our son sounds very much like your stepson, but we’re about a year and three quarters ahead of you. Our son is 21.
Our son went through a period of 1.5 years refusing medication, saying he was not ill, and losing friends. His first psychotic break landed him in the hospital, due to the location it happened (in college). He then refused meds once released. His second hospitalization, due to me calling the police, led to forced medication (civil court hearing: “danger to self” due to inability to care for self). He then refused meds once released. His third hospitalization, due to our encouragement and his agreement, led to monthly med injections.
Over time, from the beginning of the illness to now, hygiene, ability to show empathy, motivation, aspirations have all diminished. These symptoms occurred whether on or off medications.
Our son’s ability to express himself verbally was at it’s all time low after about 10 months of continued psychosis (unmedicated). While on medication during these last 4 months, his verbal language skills continue to improve and are better than they have been in 2 years.
It sounds like your stepson’s illness is still in the developing stages. It’s likely that things will continue to deteriorate (“decompensation”) for many more months until you reach “baseline”.
I’m so sorry that this happened to you and your family.
This is something that seems to be common. It makes me wonder, as our son is only 13/14yo and has this belief structure going. It is rough to talk to him about his worries over what career he is going into, how he will get married, when he has children, etc. What? He has the belief he is going to do these things…but how?
Has anyone had to tell their son that this isn’t going to happen without some MAJOR changes? Changes that I don’t see will be able to happen?
So…to ask a few direct questions if you don’t mind. If you do, I understand.
Without meds…the negative symptoms seem to dramatically increase?
The self care abilities decrease?
Our son has been dx since 7/8, so he HAS to take his meds. I’m thinking of the future concerns.
We’ve been worried about his heavy sedation and quietness. There are moments of mania…and wow! that’s not fun for either of us. (He’s slightly manic today.) I’m starting to get a more accurate picture of young adulthood…I think. Perhaps it’s not so bad that he is sedated! Now that I’m talking to those of you who are going through the ages ahead of us, it appears that we are actually doing the right thing. Go figure…
I am very concerned for the safety of you and your family. you should discuss this situation with a professional.