Family and Caregiver Schizophrenia Discussion Forum

Sister with paranoid schizophrenia and anosognosia with escalating accusations

My sister was diagnosed with paranoid schizophrenia when she was 35. She has been on/off medication since. Her last med was Abilify which she stopped taking 6 years ago. Lately her symptoms are getting worse than usual. She has denied her illness and refuses to take any meds. Her paranoia has focused lately on her bedroom and car. She believes that when she is asleep that someone enters her locked bedroom rearranging items or going through her purse. This escalated today with accusations that someone touched or molested her while she slept. She and I live in separate bedrooms in my 3 bedroom, 3 level townhouse. She also thinks someone is driving her car when she’s asleep. I’ve always giving her “space” and tried to reassure her she is safe. She previously lived in New York and suffered abuse once when she had a psychotic break and was missing for some time. She was hospitalized multiple times after that. Since moving in with me she’s been very active in the community. Now her paranoia seems to run rampant every day. Any suggestions on how to persuade her to get treatment? She had threatened to hit me on two occasions for an accusation of going into her room and moving her stuff (which I don’t). The one time that she hit me I called the police and they provided information for a crisis team if it happened again. We are both in our mid-60s.

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Must have items for bedroom security:

Solid wood or steel door and 357 or 44 mag:

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I’m sorry for you and your sister, I also relate
My sister is also paranoid schizophrenic and late onset age 35, 7 years ago.
She lives with our mum

Being your sisters carer must be unbelievably tough
I can’t ever, I have schizophrenia too, as did our middle sister,
I’ve always had to keep a distance, because of my illness
I hear you that you are in a different situation.

I have no clue how to get help for my sister

Is your sister non compliant?
To what extent currently?
My sister is anti psychiatry and anti doctors friends, peers, us.
Is it possible to say to her gently at some point
“don’t you think maybe you could speak to a doctor because something isn’t right and maybe they can help”
That is what my friends said one time I went in to hospital
I have no idea if it is more difficult than gentle concern at the right time

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Hi. Thanks for your feedback. Despite her prior diagnosis and previously taking medication, she thinks today that she no longer has schizophrenia. I have tried talking with her before but will certainly try the approach you noted that worked for you. Wishing the best for you and your sisters as well. Thanks for sharing your experience.

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What we know is rational is not at all rational to someone who has anosognosia and is not being treated for the illness. So trying “to convince” someone of our rational ideas is probably pointless. It requires other kinds of communication. There are lots of posts on this site about it…NAMI has support groups and especially helpful is an 8-week free NAMI class called Family to Family. If there is not one in your area there are others all around the country who are meeting via Zoom right now. https://nami.org/Support-Education

And the book “I Am Not Sick; I Don’t Need Help” is a must-read. This is how I helped my son move from non-med compliance to getting the help he needed and being med-compliant. It is not easy but it can be done.

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@hope4us and @GSSP are giving good advice, although I don’t know about a gun (I won’t keep one in my home although I was an excellent shot in the Air Force decades ago), as security measures and education can help a lot. If your sister had a way to bar access to her room when she was inside, and kept her car keys and purse in the barred room, maybe that would help her (and you) feel safer. The Family-to-Family class by NAMI was great for me in many ways. A person with anosognosia is likely to never develop enough insight to feel they are ill, as in a high percentage of cases, the mentally ill can’t see their own delusions and hallucinations are not real. ONLY forced treatment ordered by a judge, and forced hospitalization saved my daughter, which saved me too. Do not be afraid to use the police, the courts, or a crisis team if needed. A threat from your sister is worth taking seriously with action on your part. Even if “she doesn’t mean it”, it can be the path to medication. I never, ever used to advocate for forced medicine before sz hit my daughter. Now, I totally see that it sometimes is the best or only solution.

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Thanks for all the information!

Thanks for the advice. She utilizes methods to bar access to her room but now believes it’s being accessed in a different method than through the door/windows. I did call the police when she hit me and they provided information and a card with a mental health crisis team. Unfortunately, I believe at this stage it may require forcing her into treatment. Gentle suggestions so far are not working. Thank you for sharing you’re experiences. This illness is so isolating for both the afflicted and supporting family member(s).

@Tamer343 I e come to learn I don’t think it matters about them accepting the illness. It’s better to focus on getting them on medicine no matter what it takes. Can you suggest she see the doctor about stress and get meds to help her sleep? Any other ideas to take meds but don’t mention mental illness. Or get a prescription and put it in her food.

Yes @Tamer343, this illness IS very isolating to both the ill person and their family. It is a tough road to navigate getting help.