Schizophrenia

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Susan Cody HERWriter Guide

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ask: Advice and help needed for woman whose relative is paranoid schizophrenic and not taking her medicine

By Michelle King Robson Expert HERWriter

I recently received this question in the ASK Michelle section from a woman named Suzanne. As you'll see from her post below, a relative who she loves dearly has paranoid schizophrenia but is not taking her medication and is really having a hard time. As a result, Suzanne is clearly having a hard time too and is really suffering watching her loved one go through this. Please read her words below and then please post any words of wisdom you have for Suzanne. I'd be very interested to hear from people who have dealt with this issue--what did you do to help the person? what resources and options does she have? Thank you so much!

Please tell me all you can about helping someone survive and thrive through the mental disorder paranoia schizophernia. I have someone very dear to me who is suffering, not taking meds and is thoroughly confused with the disease that has such a grip on her life. I cry myself to sleep at night not knowing where she is and who is helping her. I want her to be OK again.

Add a Comment5 Comments

EmpowHER Guest
Anonymous

My husband has Schizophrenia. He was diagnosed finally this week. He attacked my father and tried to strangle him because of the voices in his head. I took him over to the hospital within an hour after the incident. I am at a loss to tell you what to do. My only suggestion is that she needs help. Help that only a professional can handle. My husband thought of suicide, as well as trying to kill others by the time he finally cracked and went after my dad. Don't allow her to hurt herself or others, get her in now while there is still time to keep her safe.

July 8, 2009 - 10:24am
EmpowHER Guest
Anonymous

Thanks, Tina. This is such helpful information. I'm sure a lot of women will find this to be very useful. Especially, since mental health is such an under-served condition in my opinion.

Please thank Addam Gross for his helpful and thoughtful insight.

Best in health,
M

February 2, 2009 - 10:21am
Tina Tran

Hi there Michelle, We asked mental health expert Addam Gross to share his recommendations and here's what he had to say.

"Schizophrenia can be a very devastating mental illness especially going untreated by professionals. With schizophrenia there are some common characteristics or symptoms that last at least 1 month in duration, often without treatment symptoms can present on and off for a lifetime for many. These symptoms are: Delusions (the belief in an idea that is founded on reality), hallucinations (auditory, visual, olfactory, tactile), disorganized speech (incoherent speech or derailment of dialogue), grossly disorganized or catatonic behavior (motoric immobility or peculiar movements), and other negative symptoms or parts of the person that are loss (loss of emotion). These symptoms will most likely cause major social and occupational functioning which can exacerbate the symptoms due to increased stress levels and or threats to safety and security for the person. Schizophrenia has a few subtypes: The paranoid type, disorganized type, catatonic type, undifferentiated type, and the residual type.

Early in my career I was able to work on an outreach team to engage people with serious mental illnesses (many had schizophrenia) into seeking help. This sounds like an easy sell, but the reality is that many people are not well enough to recognize their need for help or have symptoms of paranoia or delusions that inhibit them from seeking help. In addition, there is a lack of knowledge on where to start, especially if the person does not have the financial means to pay for treatment. Here is what I learned in my experiences:

1. You have to have a relationship with the person and a certain level of trust needs to be present. You have to remember that this person may be scared or out of touch with reality and may not feel they can trust anyone at that moment in time.

2. You can’t make someone get help if they don’t want it. Unless there are serious risk issues with the person’s safety or the safety of others, there are usually some sort of state laws that prohibit people being detained against their wills because someone is just concerned about them. This was incredibly frustrating for me because it was obvious the people needed help but they were not severe enough for the “system” to address these people’s needs. Civil commitments are possible where a person can get picked up through a court order (once again, there has to be evidence that the person is in some sort of danger or is a danger to others) and will be evaluated for up 72 hours in many cases. At that point treatment can be court ordered in the client’s best interest which may be against their wishes at the time.

3. “Hold the Hope.” What I mean is that you or someone close to the person should keep trying and don’t give up. Learn to accept any declines in treatment as a choice and not personal rejection. As I mentioned earlier, a person’s symptoms will come and go often and sometimes the best time to engage a person is when their symptomology is not at its worst. A wise mentor once told me, “Wait for that window to open with the person and when it does be ready.” Meaning, keep working on developing your rapport and when the timing is right have a plan in place to seek help fast. Those windows can close rather fast from my experience. You may want to explore options for treatment in the public and private sector and how to access these services. Which hospitals could the person go to for medication stabilization? Is there a public mental health center or community mental health center that a person could get low cost or free help at? If the person is needing to be hospitalized, who will take care of there home/pets? Try to think of as many possible pitfalls for not seeking treatment and have a plan to address these issues to put the person at ease. To seek more information, you can contact NAMI (National Alliance for Mentally Ill). They have support groups for friends and family and truckloads of educational materials usually for free."

For more about Addam Gross, please visit glpco.qwestoffice.net/

February 2, 2009 - 10:07am
Diane Porter

Suzanne,

I'm so sorry that your family member is dealing with paranoid schizophrenia. You are a loving soul to feel her struggles so deeply.

I have a friend who is bipolar and schizophrenic and going off their medicine is a somewhat common problem. They take their medicine for a while, they feel better, and then want to go off it -- or just plain forget -- or believe it is controlling them and that they need to be without it. Also, anti-psychotic medicines can have side effects that are hard to live with.

Here's an excerpt from a story on MSNBC:

"Greg Coughlin, 53, a health department employee for DuPage County west of Chicago, said several years ago he repeatedly stopped taking drugs for a type of schizophrenia because he was “in denial” about suffering from mental illness.

"Coughlin said the last time he stopped, in the 1990s, he became extremely obnoxious and agitated, and ended up in a mental hospital.

"Now he’s on three mood stabilizers that zap his energy and cause weight gain, but make him feel “more solid, more relaxed, more satisfied in life.”

"Coughlin, a board member of the Illinois chapter of the National Alliance on Mental Illness, said he finally accepts that to function, he’ll need to be on drugs for life. "

I'm wondering if we could do some more research for you with the answers to a few more questions. Where in the country does she live? How old is she? Does she have a guardian or is she in charge of her own life? Do you know what the meds are that she is on, and/or whether her doctor is aware that she often doesn't take them? Does she, in your opinion, have the mental stability to care for herself if she does take her meds? Is her psychiatrist working with the family to help regarding these episodes?

Suzanne, here's a page on the treatment of paranoid schizophrenia from the Mayo Clinic. They mention that people often feel that they don't need treatment when in fact they do:

http://www.mayoclinic.com/health/paranoid-schizophrenia/DS00862/DSECTION...

And here's a page on Understanding Schizophrenia from the University of Texas Psychiatric Center. If you scroll down, you'll see the parts of the page on treatment and, especially, "how family and friends can help." You say your friend is thoroughly confused; that's very empathetic of you, and is also consistent with her condition. One of the things this page emphasizes is structure:

http://hcpc.uth.tmc.edu/schizophrenia.htm#living

Schizophrenia.com has a page for families on how to help manage the five common symptoms of schizophrenia: paranoia, denial of illness, stigma, demoralization, and terror of being psychotic. From what you write, she has dealt with most of these. It mentions that "If they are denying that they are sick, they will also most probably deny treatment:"

http://www.schizophrenia.com/family/mansymptoms.htm

Here is a family perspective on living with schizophrenia from the online journal of Issues in Nursing:

http://www.medscape.com/viewarticle/499269

And the National Institute of Mental Health offers this article about Helpful Hints about Schizophrenia for Family Members and Others:

http://psychcentral.com/lib/2006/helpful-hints-about-schizophrenia-for-f...

Here is a page of chats/forums where many people are discussing various aspects of schizophrenia. Scroll down and you will see chats for caregivers/family members, siblings, spouses/significant others and children of schizophrenics:

http://www.schizophrenia.com:8080/jiveforums/index.jspa;categoryID=1

I hope there's something here that helps, just a little. One of the things that runs through all the schizophrenia sites I saw was this: That there are more successful treatments today for schizophrenia than ever before, and that many people are living better, more productive lives. Your relative doesn't have to give up hope, and neither do you. Take care, and write back with more information if it might help us get you more answers.

January 19, 2009 - 10:12am
misvives HERWriter Guide

I also have a friend whose Aunt has paranoid schizophrenia and also doesn't take her medication. It is certainly a very bad situation and cannot easily be resolved. I will share with you some approaches they have tried but I cannot say they have succeeded in their quest to save her from her mental disorder.

One approach my friend has tried was sending family members to her house to check on her and make sure she was taking her medication. Of course, this approach was short lived since family members are busy with their own lives.

A second approach was leaving her alone and seeing if she could care for herself. The answer to that: she was found wandering the streets in the middle of the night. This approach was not a good one.

The third approach was to hospitalize her in a mental institution. This may not be the perfect approach but this was certainly the best approach. She is well cared for and she is now taking her medication daily, has friends and even has a relationship.

From my experience with my friends Aunt, they are almost like children. They have to be cared for continuously since their minds are constantly in search mode.

The Mayo Clinic provides information about schizophrenia and treatment options that may be helpful in your search for an answer. That information can be found here http://www.mayoclinic.com/health/schizophrenia/DS00196.

Unfortunately, this is a life long disease that when treated is functional. When it is left untreated, it can certainly be problematic. I know this is a tough situation and I can certainly relate since I witnessed it firsthand. Please keep us updated.

January 17, 2009 - 9:39am
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