My son in currently in jail. He is unmedicated. Functions ok with CBT most times, but had a crisis in late winter. However jail is the route to try to get him help. At the time of arrest they noticed something was off. He has been isolated even for visitation. So for the most part it has been not so bad for him. He says he eats well (food issues while a problem in the past aren’t right now) and is happy with his own company. The process however is painfully slow.
I agree as the consequences of not taking medicine is they are miserable. And isn’t that punishment enough?
A weekly pill box with reminder alarms has helped my son.
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My son gets a small daily allowance, which he knows is dependent on his behavior. Making it a daily thing means if he messes up, it can easily “try again” the next day. I don’t make it specifically tied to taking meds, but I think he has figured out that taking his meds makes it possible to stay stable, and thus get his allowance.
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Reading the posts on this thread so far reminds me of how each person’s manifestation of SMI can be so unique. If not taking meds is likely to cause your loved one or you or anyone else harm or significant trouble, yes, I think there should be consequences that are intended to help the person comply with meds and/or treatment for his/her own benefit, not as punishment. You have to get creative sometimes to do this in a way that works for your situation. It is not always successful so you also have to be prepared for that, or to try something else.
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@Moonwalker - thank you for your insight. My son has lived with schizoaffective disorder for 23 years now. He has been on Clozapine for about 19 yrs and in the past year got a new psychiatrist who started him on Invega injection as well. For the past 8 yrs or so he also has been taking a mood stabilizer. Since the Invega I have noticed he has a more happy mood and can spend more time having conversations about regular things. He has severe negative symptoms and many voices that he enjoys. Most of the time he is in his own world and does not communicate or his communication is very involved with his psychosis.
Since you said that you found it took two years for your symptoms to lift with I Vega, I have some hope that the Invega might improve things for him. My concern though is that he may not want the voices to be gone.
I think that’s why my son refuses meds. It makes his" girlfriend " go away.
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@Shallcro, not wanting the voices gone was one reason my son stopped his meds many times and as a result they no longer were effective. He was tried on many meds. Even the clozapine he stopped many times and we have our current results.
Even when there were times he wanted to take the meds he does not have the executive/cognitive functions to take them on his own. He relapses within just a couple of days without meds.
Without meds he cannot talk at all and is even too ill to eat or drink.
It’s all so heartbreaking for us.
This was a central theme of my recovery. A year of Psychotherapy without medication made me realize that my internal relationship with my delusions was keeping me from real-life relationships which were ultimately more compelling. However, a failed real-life relationship caused the delusions that I’d pushed in the background to snap-back and I ended up hospitalized. After processing what happened after I left the hospital, I realized I had a choice: take medication and have more real-life relationships, successful or otherwise, or live with compelling but ultimately unsatisfying internal relationships.
So I relented to giving medication a try and focused on improving my social life. The difficulty was getting me to see I was better off ‘breaking up’ with my internal ‘friends’ who seemed compelling, but ultimately always failed me.
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This is an interesting conversation. I’d like to suggest that this is where LEAP could be useful. It could help you find the one thing that your loved one would find meaningful as a reason to take the med(s). It may not be for the reason you know is the reality, but if it works for your loved one, then that would be a success.
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Hope people don’t mind me going all musical theatre on you, but I think it’s relevant to the discussion. There was a Pulitzer Prize winning show on Broadway years ago about a woman with Bipolar Disorder with psychotic features called Next To Normal. Caregivers may have missed it, because it was billed as the protagonist having Bipolar Disorder, when it was probably closer to SZA. Probably to make the show more accessible.
There’s a spoiler here if you think you might see it (good regional and community theatres sometimes run it, but it’s challenging and takes a talented cast to pull it off)
Anyway, here’s a clip of a song where there’s a character who manifests a delusion and sings about the relationship between the delusion and the person with the SMI. If you listen to the lyrics, the description of the relationship is pretty spot-on.
It does a good job of showing how it/he is compelling, intriguing, frightening, tormenting and seductively haunting all at the same time. He knows all about his host, because ultimately he’s part of her mind and knows all her emotional buttons and secrets.
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