Family and Caregiver Schizophrenia Discussion Forum

Schizophrenia or Malingering?


#1

New member here, with concerns about my 26-year old nephew Dan who has been diagnosed with schizophrenia within the last couple of years.

He presents as having a delusion that God has chosen him to fight demons and Satan and convert them to Christianity. He says he hears voices most of the time, sometimes in his head and sometimes to him they sound like they are in the room. A lot of voices. He lives at home with his Mom (my sister) and his Dad, who are in their 60’s. Most of the time Dan lies around the house sleeping or pacing while arguing with the voices. Occasionally he will clean up his room, do his laundry, clean the kitchen or vacuum, etc.

His childhood years were relatively unremarkable, he wasn’t a great student but did all right, he was a very good swimmer and did some school-related competitions. He has asthma, since he was a baby, so there were occasional trips to the hospital and it kept him from going in the military which he said he wanted to do. He is musically talented and not a bad artist. However, he has always been argumentative and oppositional, which got worse in high school when he began doing drugs. We know about the marijuana, we don’t know what else he may have ingested – he hung out on the street with his friends who seemed to be fairly decent kids except for the drug use. He refused to obey parental curfews and came home when he felt like it, left when he felt like it. He had/has strong objections to how his father treated him, and it is true that his Dad was not always the best parent – brushing him off when Dad was doing something else, being overbearing (shouting) when Dad did something unappreciated. Dan has an older brother (2 years older) who is basically fine except for some anxiety issues but who has completed a BA in Psychology and is thinking about going for his Masters at this time. The older brother just recently moved out of the family home.

Neither of these boys has had a normal social experience during high school in the sense that neither of them has had a girlfriend or done regular dating, although both have had friends of both sexes.

About 5 years ago, Dan went to a motorcycle mechanics school and did very well, but then could not find a job locally. Not sure how much he actually looked. He worked for a short time at a fast-food restaurant earlier this year until a customer complained that him talking to himself scared her.

From childhood, Dan has been an attention-seeker with his behavior in general ways and with things he said he wanted to do or was going to do.

Dan’s medical history with the current diagnosis began about 3 years ago when he called up my husband (his uncle by marriage to me) late one night and announced that his voices were telling him to pour gasoline in the house and set it on fire. This precipitated a flurry of calls to my sister to check and make sure everyone was in fact all right, which they were. But I put my foot down that he needed a psychological evaluation because a threat like that was not just attention-seeking or game-playing.

At first, Dan was diagnosed as bi-polar and schizoaffective, but more recently as schizophrenic and I’m not sure whether bi-polar figures into it anymore. He has a paternal uncle who is bi-polar but who manages his condition very well.

Dan has been in and out of a couple of local treatment centers, I think the longest stay has been about a week. He has generally been the one to say he wants to go. He has been on Geodon which needs to be taken WITH food in order to be properly effective, but he will go 2 or more days without eating, so it’s not known really how effective that medication is. When he first was put on it, it made him vomit, so I think the dose was changed because now it doesn’t bother him that way.

Besides lying around the house, Dan is very demanding that his parents provide him with cigarettes, marijuana and alcohol. He has a marijuana card, ostensibly for lower back pain, but beyond SAYING he has “excruciating pain” there is no actual evidence of anything wrong with his back. But due to his drug usage through high school and beyond, it seems he mostly wants the marijuana in order to get high. His parents can’t afford to keep him in as much marijuana and cigarettes as he wants to have. He badgers them all day long to give him one or the other.

Recently they have been rationing his cigarettes. One evening about a week ago, when my sister told him he’d need to wait another hour or so for his next cigarette, he got angry, claimed that she was not listening to God and God didn’t love her anymore, and he threatened to stab her and “make Satan happy”. The next morning, my sister went to the local treatment center where he has most often been, and filled out a form for Involuntary Commitment. The local police were supposed to come and get him, but several days went by and somehow her petition got missed until she asked about it a week ago Friday. The police came on Sunday and took Dan to the treatment center. He went calmly.

Once at the center, he began calling and being verbally abusive over the phone to her and his Dad because he wanted out and to come home. He was on a 72 hour hold. A few days later, my sister went back and re-petitioned to keep him another 72 hours which the center is doing.

Both my sisters (his Mom and our other sister) went to the treatment center a day or two ago to visit him. Apparently when he is at the center – on all occasions now and in the past – he does not pace around gesticulating and arguing with the voices but behaves in a fairly normal fashion. This time, when my sisters were there, he wrapped himself in a blanket so he was shrouded like someone from the Middle East, refused to sit down, stood over them demanding to be brought home and given all the marijuana, cigarettes and alcohol that he wanted. When his mother told him “That’s not going to happen”, he shouted that she is not his mother anymore, and that she is not doing what God wants, God doesn’t love her, that his name isn’t Daniel anymore but she must call him Eli, etc. He put a hand on the shoulder of our other sister and pushed down hard, then stabbed his finger into the middle of her palm, pinning her hand to the table.

At that point, the assistants in the room intervened and said my sisters needed to leave the room. Outside the room, the assistants told them that they have NEVER seen him behave like that, and that they will arrange for him to get a psychiatric evaluation. There will be a hearing in the local Mental Health Court and my sisters and his Dad will be subpoenaed to appear and testify to their observations and experiences.

We are all struggling to determine whether Dan is actually ill with schizophrenia, or is faking it. He became manipulative in high school, he lied a lot, etc. He says he has tried to ignore the voices or reduce them, but that he can’t.

We don’t understand why his behavior seems “normal” when he’s in the treatment center, but when he comes home, his behavior becomes “strange” again in terms of talking back to the voices, pacing and gesticulating, making demands of and threats to his parents, etc. He’s lost most of his friends who have been moving on with their lives.

Personally speaking, my husband and I wonder whether Dan is faking this stuff in order to control his parents, get a “free ride” in life living at home, doing what he wants or not as the mood suits him.

I apologize for this being so long, but don’t know any other way to set out what we see and know.

Would appreciate thoughts back!

BarbPI


#2

Hi BarbPI,

Welcome to the forum.

I will touch on just a couple of things you mentioned.

This behavior is not the least bit unusual for a person with schizophrenia. Many of our family members seem to snap out of an episode when they encounter police or a treatment center. I have often felt that my son’s schizophrenia has “jumped ship” on my son and left him to deal with the situation it has created.

Our family members can sometimes suppress the symptoms of the disorder, usually for short times, and its exhausting for them to do so.

Schizophrenia is cyclical, at times, some of our family members appear absolutely normal. Other times, when they are in a psychotic episode, a total loss of contact with reality - they can experience multiple voices and visual hallucinations as well. Even during an episode they may emerge at times. Much like my MIL with her vascular dementia - one sentence is rational, the next is totally irrational.

Religion and Satan are common delusions for some of our family members.

In addition to being cyclical in nature, schizophrenia is also a progressive brain disorder - usually it gets worse over time.

Your nephew seems to have a very involved family. Any chance all of you would consider attending a NAMI Family to Family class if there is an active NAMI nearby? Family to Family is a free several week course offered by NAMI. I am glad your nephew has so many supportive people in his life. He needs them very much.

I am concerned about everyone’s safety in regards to the statements your nephew has made and the recent physical handling of your other sister. Also, often our family members pretend to be taking their meds when they are actually not taking them. Keep it in mind.

(On another note, for some of us, relatives suggesting that our children are faking a severe brain disorder is a bit of a sore point. Looks like there is plenty of evidence to support otherwise and the things you mentioned are all pretty normal for someone with the brain disorder schizophrenia)

Take care, hope


#3

One more thing, probably the quietest the Family to Family classroom got the entire time was when the leaders told us we could “maybe” expect our family members to be able to do one thing a day. One thing.

Once a person gets however stable they will achieve on meds, the second part is working their way back towards doing more than one thing a day. Sometimes it takes several years, for some its faster. If you have time, read a lot of the threads on the forum here and Dr E Fuller Torrey’s book “Surviving Schizophrenia”.


#4

Thank you for your response! It’s very helpful to hear how the disease can by cyclical and how “normality” can rear its head. I’ve been reading for months online and this aspect is not brought out – but I wondered, and that’s why I came here to find out what others who actually deal with it might know.

In answer to your NAMI question, both of his parents as well as our other sister did attend a NAMI course the latter part of this past summer, and it helped a great deal. Also, at least one of his parents is present to ensure he takes his medication … the problem is that he usually refuses to eat when he takes it, and it’s supposed to be taken with food so we are not sure how effective it is under that consideration.

Lastly, my concern about whether or not he is “malingering” stems from his past history – largely from junior high through high school and beyond – of provoking his father into arguments anywhere and everywhere over small things, being manipulative to get what he wants, lying, disappearing for days and etc. Family counseling was not effective. Given this background, it’s not such a leap to wonder whether he might be faking some or all of his current behaviors in order to not have to work but live on at home while getting the things he seems to like the most: marijuana, cigarettes, and beer. Mind you, this concern has been mostly that of my husband and me – WE don’t live close enough to the family to have actually seen Dan sink under the weight of schizophrenia, and it has been easy for us to wonder if it is some other form of mental disorder (i.e., faking to such an extreme would be a different but no less important mental disorder), which if so would require perhaps different medication and treatment. We saw the whole family at Thanksgiving, and Dan seemed sleepy but was coherent.

We all love this kid beyond belief – he’s very intelligent, and at his best is witty and fun and a delight to converse with. But yes, in his illness he and his parents and brother have and will continue to have our full support in any way we can contribute.


#5

Thanks for your comments!

As a matter of fact, I just ordered and received a copy of “Surviving Schizophrenia” to take to my sister and her husband. I flipped through the book and now think I might want to order a copy also for myself.

Today I have time to read more on the Forum and I’m off to do so.


#6

I actually have schizoaffective bipolar type. My illness goes in cycles and I pass for normal most of the time.

However, I can be a very nasty, mean, manipulative person when the illness comes out. It manifests at first as anger. I’ll want to pick fights with everyone. I don’t know how my husband put up with it so long when I was unmedicated.

We can be great one minute and unable to do anything the next. I’m working my way back to being able to do regular life things again. To be honest, right now on my down days I’d prefer to sleep all day and vape. Can’t do that because I have kids to take care of. But if I had no kids…I’d be the same as your nephew and want to do nothing.

So, I doubt he is faking. There’s always the possibility. But the things you describe sound like classic schizoaffective. He sounds high functioning which doesn’t always mean someone can do thongs, just that they can talk and “pass” as normal.


#7

Because of the cycling, it was years before I realized something was seriously wrong with my son. I didn’t have any previous experience with scz. My son’s version is an insidious version - it worsened very slowly.

My friend always says that any personal traits they had before the disorder will still be there after the disorder makes it’s presence known.

What a nice supportive family you all are:)


#8

He isn’t malingering. Our son does the same thing. It seems as if they can control this behavior at times, especially when needed.