I am new here and new to mental illness in my family. I am by profession a social worker who works in education with children with behavioral/emotional disorders. Ironically enough, my own son, aged 21, has psychosis and will likely have a diagnosis of sz soon. He was a college student, in his 4th year, when he began developing motor tics, high anxiety, and paranoia. I found an early intervention program for him in my community which is based on the RAISE initiative. Problem is, he is completely unwilling to submit to any medical intervention. He will not see his PCP, undergo the requested MRI and CT, submit to blood work or has been adamantly opposed to taking medication. He will, however, meet with the psychiatrist and primary clinician. At what point do I attempt to force his hand by removing his car, etc…until he complies with the program recommendations? Should I give him some time to process all of this?
I’m sorry to hear your son is having problems.
I know in my case, I hid my symptoms and refused help for 20 years. Ultimately it really impacted my life in a negative way. But, I’m not sure if “forcing my hand” would have worked any better; especially at 21. My main concern would be pushing him away.
`The good thing is that you have identified the issues and he is willing to see professionals. As you said, I would give him some space and let him process the rest.
Earlier treatment yields better prognosis.
A lot of folks don’t want to comply with mental health treatment. Sincerely, a lot of folks don’t comply with their cardiologist or oncologist, but the percentage of noncompliance rises much when we’re talking about a psychmed prescriber.
My parents worked the good cop/bad cop routine on me pretty well. After I knew the difference between the State Hospital and the nice private hospital, one had bargaining power with me.
My Dad bluffed sometimes.
That sounds reasonable to give him some time. As a parent, that is exceedingly hard. However, I think a few more weeks should give him an opportunity to meet with the psychiatrist a few more times and some reflection time. He admits that there is an issue and that he is having trouble thinking. I guess I need to carefully plan my approach. As Jayster mentioned, earlier is better and I certainly am hoping for better:). Thanks for responding!
It is good that you are intervening at this stage in his life. I had a lot more autonomy in a one parent household and it took a major occurrence (a break from reality) to point out how sick I was. Had I had an earlier intervention, it would’ve saved me significant pain and anguish, but I don’t know how receptive I would have been to treatment and medication. I sometimes feel something ‘bad’ has to happen before any treatment can begin, such as an involuntary hospitalization, an arrest, a drug problem, etc.
My mom is a county worker for the working disabled and did a good job keeping a watchful eye on me throughout the first few years. Nowadays, she won’t remove privileges such as driving or going out, but if I am on drugs (I’m a marijuana addict), she will temporarily take away my keys and credit cards as I’ve been known to have manic episodes around my using. My advice would be to give him time to process, while gently pushing your treatment agenda. My mom has been able to guide me through the administrative aspect of the illness (securing and maintaining disability), your line of work (I assume) gives your son a better chance at treatment and recovery.
You have a leg up on the disease. I was hospitalized before I realized I had a problem. Even after it took about 18 months to get a sz diagnosis and it wasn’t until after my 4th trip to the hospital that I began to accept the diagnosis. It takes some time but I did take my medicine once I was diagnosed. Good luck and it’s a good sign that he is seeing someone. If they develope a repore he may listen to the doctors.
Hi, my son is 18 and was diagnosed about a year and a half ago with Schizoaffective disorder. One of the many symptoms he experiences is a lack of insight that he is sick and needs meds. His compliance with meds has been an issue and I have found the book, "I’m not sick I don’t need help by Xavier Amador very helpful. Basically, you try to help your loved one see how medication can help the things that they DO acknowledge they would like help with. For example my son wants to finish school and learned the hard way that he is unable to do so without medication. For him, Abilify has helped him the most with the negative symptoms and only with it can he concentrate enough to be successful in school. It’s currently the main reason he is reluctantly complying with taking it. I am also encouraging him to take it so that he can go to drivers Ed and get his license which he wants very badly. I’ve learned that reason and force don’t work. But if we can find a way to positively reinforce compliance with what their goals are, it helps improve compliance greatly. The longer he takes them, the more stable he gets and I’m praying the more insight he will have and want to continue to comply independently. Hang in there, it’s a long tricky road, but I hear many on this site talk of how well this illness can be managed and it keeps me hopeful! : )
You can talk with them about locating a professional interventionist in your area. Most Psy.D.'s and some of the more experienced and specially trained MA/MS psychotherapists are actually very good at not only direct work with the patient but counseling the family members how to smooth the path through the five stages of recovery (see http://pairadocks.blogspot.com/2015/12/the-five-stages-of-recovery.html).
There may also be useful information among the suggestions below:
Get a copy of these books, read them and have your family read them, as well. (Torrey can be a bit totalistic and unwilling to see exceptions to his “rules” at times, but most of his book is really worth the effort to plough through.)
Get properly diagnosed by a board-certified psychopharmacologist who specializes in the psychotic disorders. One can find them at…
http://doctor.webmd.com/find-a-doctor/specialty/psychiatry and https://psychiatrists.psychologytoday.com/rms/
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.
The best of the psychotherapies for that currently include…
DBT – http://behavioraltech.org/resources/whatisdbt.cfm
MBSR – http://www.mindfullivingprograms.com/whatMBSR.php
MBCT - http://www.ncbi.nlm.nih.gov/pubmed/22340145
ACT – https://contextualscience.org/act
10 StEP – http://pairadocks.blogspot.com/2015/04/the-10-steps-of-emotion-processing.html
the even newer somatic psychotherapies like…
MBBT – https://www.newharbinger.com/blog/introduction-mind-body-bridging-i-system
SEPT – https://en.wikipedia.org/wiki/Somatic_Experiencing
SMPT – https://en.wikipedia.org/wiki/Sensorimotor_psychotherapy
or standard CBTs, like…
REBT – https://en.wikipedia.org/wiki/Rational_emotive_behavior_therapy
Schematherapy – https://en.wikipedia.org/wiki/Schema_Therapy
Learned Optimism – https://en.wikipedia.org/wiki/Learned_optimism
Standard CBT – https://www.nami.org/Learn-More/Treatment/Psychotherapy & scroll down
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.
If you or your sz patient suddenly becomes manic: http://www.currentpsychiatry.com/specialty-focus/bipolar-disorders/article/what-to-do-when-your-depressed-patient-develops-mania/f3218a38f6603114ff2f9d9bfc21acfb.html?
Look into the RAISE Project at https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=raise%20program%20schizophrenia.
Look for mental illness clubhouses in your area (which can be hugely helpful… but may also pose risks). Dig through the many articles at https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=mental%20illness%20clubhouse%20model to locate and investigate them.
Thank you notmoses. I am currently reading Dr. Torrey’s book, although it is a bit harsh and somewhat depressing…I know his opinion is based upon years of treating people with this illness.
What a difference a year makes. My son is now 22 and has been in treatment for his sz for 10 months. While he hasn’t gone back to college, he works part time in an Insurance agency, goes to the gym, and goes out with cousin to movies, dinner, etc…He has been compliant with taking medication…thank goodness! I have come to terms with his illness and feel so fortunate that he has responded positively to treatment. Just wanted to update thus post.
I’m glad to hear your family is doing well. Thank you for updating:)