My sister’s son, 23 and diagnosed with schizophrenia, just got home after a two-month stay in psych hospital — his longest stay yet. He is convinced that his latest delusion is real somehow and that she is a threat to him — which she is most certainly not. But he needs to feel safe, of course. He has mentioned coming to live with me, which I am definitely open to, but I also don’t know how much we should cater to his delusion — and also whether it’s time to consider a group home or assisted living of some kind. I understand these are hard to get into as well, even if we could get past the idea of it. Looking for guidance.
more like Subservient, care, docs, meds and cash
yes, purchase him a home, apartment or trailer out back…
Even on meds, we are told it can take a long time for delusions to lessen, in the meantime, the delusions are real to your nephew.
This is an interesting question isn’t it? What I have learned from my son’s experiences with scz, is that I don’t have any power over his delusions. I can’t make him have delusions and I can’t make them go away. All of his delusions are created in his mind and are real to him.
I am curious, do you think there is a chance that your nephew is fearful of his mother because she is keeping him compliant on his psych meds? Many of our family members with scz will leave their homes and families and go leave on the streets rather than take their meds. My son often believes that he won’t have the same problem if he lives in a different location.
Welcome to the forum!
It’s important to make the distinction, whatever you decide, you’re considering catering to him and he has a delusion. Don’t confuse the delusion or his disease with his identity, nor give the delusion a life outside his illness. A common caregiving trap is believing you have no choice in the matter, and over time you may give-in to the situation non “choice” after non “choice” until you’re trapped. And in buying into this trap, you may in turn condemn your charge to being trapped by their illness.
Set rules and boundaries ahead of time and stick to them. I’m not saying these can’t be renegotiated, but avoid the trap of the proverbial (and archaically stigmatizing) “inmates running the asylum”.
Personally, were I considering taking on the care of my brother at a similar time of his diagnosis, I’d be very reluctant and would only take him for a limited time with the understanding that he’d either return to his parents when he felt safe again, or was able to manage independent living or life in a group home. I’d strongly advise requiring him to sign a lease with rules and restrictions, and have him pay room and board— even if it’s a token amount and sourced by his parents. This way you would have legal protections and model real world responsibilities and consequences to him for his future.
Disclaimer: While I am a part-time caregiver of my brother and father with SMI, I was diagnosed with SZA over thirty years ago. I’m an advocate of appropriate drug treatments for SMI, but I feel they are incomplete treatments and additional CBT, supportive talk and psychosocial therapies are helpful where feasible. Any drug advice is from personal experience or research and not a substitute for qualified Psychiatric care.
One thing I’ve learned is that it is useless to deny the illusions or argue that they are not real because to him they are very real . And never argue with a SZ - pointless that could lead and escalate to something regretful. Dr. Amador’s LEAP method is helpful.
Thank you. Yes, I’m being very respectful of his delusions. I understand that to him they are entirely real. And yes, he is angry at his mother for calling the police, for having him hospitalized, and for having him on meds. For sure — though it manifests in different ways. He had completely gone off his meds prior to his recent episode. Of course. He had been doing so well! But that is the nature of the illness. Thanks for the warm welcome.
I search Google and found some articles in Lancet before.
You can discuss with your MD. Good Luck!
“Evidence that schizophrenia may be a prostaglandin deficiency disease comes from three main sources: (1) all effective antischizophrenic drugs stimulate prolactin secretion and prolactin is a potent stimulator of prostaglandin synthesis; (2) schizophrenics are resistant to pain and inflammation and are free of rheumatoid arthritis and there is increasing evidence that prostaglandins play important roles in pain, inflammation, and rheumatoid arthritis; (3) high doses of drugs recently shown to be prostaglandin antagonists cause schizophrenia-like syndromes. The hypothesis is not necessarily inconsistent with current transmitter theories of schizophrenia since prostaglandins modify transmitter secretion and action. It does indicate radically new approaches to investigation, treatment, and drug design not suggested by the transmitter concepts.”
Prescription Medicine “Misoprostol”:
“Misoprostol is a synthetic analogue of natural prostaglandin E1. It produces a dose-related inhibition of gastric acid and pepsin secretion and enhances mucosal resistance to injury.”
" Prostaglandin E1 is in the vasodilator family of medications. It works by opening blood vessels by relaxing smooth muscle. Prostaglandin E1 was isolated in 1957 and approved for medical use in the United States in 1981."
Prescription medicine: “Ursodiol”:
Ursodiol can eliminate excess Bilirubin level. It may reduce or eliminate the symptoms of agitations, anger, auditory and hallucinations.
You have to check with your MD .
Ursodiol will reduce your bilirubin level for sure. You shall know higher bilirubin also reduced the dopamines. When your bilirubin back to normal ranges and your dopamines will rise too. This is big problem for SZ patients. You have to ask your MD either take prescription drugs or 5-htp supplements to keep dopamine lower.
I wanted to mention what one doctor told me when I was concerned about my son’s delusions. Unfortunately, she said that the delusions are often set as memories once the active delusions pass, so if that’s the case, it may be very difficult to get him to understand that the delusions were the reason for unfounded memories. If your sister is the target of any of his delusions, they can come back over and over again. I wish you all the best in trying to cope with this - been there, done that, and still living thru my son’s “memories”.