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Delusional Disorder

The Don said:


*That* was my point, delusion is in the eye of the beholder

My friend was hardly shopping for a diagnosis, each time he got "sectioned" (detained under the mental health act) they just diagnosed him differently and pumped him full of a different set of psychotropic drugs.

I woudl argue that the reason main reason he was differently diagnosed each time had to do with the subjective nature of the diagnosis criteria and the scope that leaves for the psychiatrist to diagnose one of thir "pet" conditions.

Of course none of this helped particularly in treating his condition :(
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My son had to spend 6 months in a hospital (come home on weekends) before they would diagnose him with anything. This is because you have to present the symptoms for that long, and it's hard to fake or misdiagnose anything after you've been there six months.

It was a good thing, because all the guesses added up to one thing finally.

I'll be trying to read further up, but what was with your friend? I'll tell ya, that would never happen here. My mom is clearly schizophrenic and she can't be made to go to a hospital and she doesn't have to take any medication. If she hurts or kills somebody, well, then they might make her take meds.

Your friend, was he observed for a while before they tried meds? Then the meds can aid in diagnosis after that-to see if symptoms are helped or aggravated. Meds for kids with ADHD (ritalin) make my son psycho (thus ruling out that diagnosis on its own). Anti-psychotics turned him into a kid that could relate/reason, and stop smelling things that weren't there.

What I'm trying to say is, getting an accurate diagnosis takes time. If everyone is freaking out about whatever treatment they are trying out at the time, then it only makes it harder.

Believe it or not, most psychiatrists actually know what they are doing. They are also assisted by neurologists, and use whatever tools at their disposal (EEG, CAT scans, etc.)

I'm not sure if you just listened to your friend's version of the story, or actually know what the doctors were doing?

My mom would sure would tell you wild stories. I managed to get her in a hospital (they let her out after only a month, and now she's hating my guts) and she told me how horrible they were, how they were doing this and that to her. I of course was talking with the doctors and therapists, and got quite a completely different picture. I had to prove she was still a danger to herself and others after she was there for a month. Hmph, the panel listened to her lawyer instead, who argued her side (that she's perfectly normal and just wants to get back to her life). I'm still scratching my head on that one. I guess they just believed that she was a meek harmless person because she didn't talk in the room that time, her lawyer did all the talking. If they heard her talk though...

But that's how they handle things here. Everyone has the right to a lawyer and have the lawyer argue your point of view. It's only fair, right. Hmph. I'll tell you the drawbacks to this system.

So we have two extremes here. Your friend obviously got meds. My mom doesn't have to, no matter what, until she threatens to kill her dad again, and I can get that on tape somehow.

What's worse? One system of handling things over another. Well, I don't know the whole story on your end, so I can't judge it at all.
 
Wow, EofE, you sure state the case for family memebrs very well,
it is very hard as a mental health professional to know how to deal with family memebrs, first and foremost they are there to deal with the 'identified client'. And that can make things really difficult for family members.

It is quite horrible to watch a family member decompensate and shoot out into the abyss. I did it as a paid 'helping professiona' for twelve years and it was tough on me as a professional. especialy when my clients would include me in thier delusions and threaten me.

In the US in our county of Illinois it is very difficult to hopitalize people. from a civil liberties POV that is a good thing, but as a family member , it is horrible. To see a loved one loose thier friends, thier money and thier home is terrible. And even then, in our county, being homeless is not a reason to commit someone.

The only thing I can think of is to see if there isn't some mellow mental health professional who could check in on your family member on a regular basis, I used to take my client's to the store, make sure they payed thier bills and the other things that a person needs to get done in thier life. The main goal is to establish trust with the person and hopefully engage them in treatment. When someone is off thier meds, it is always very exciting, but a useful process. It also takes alot of pressuer off the family.

Best wishes.
 
Dancing David said:
Wow, EofE, you sure state the case for family memebrs very well,
it is very hard as a mental health professional to know how to deal with family memebrs, first and foremost they are there to deal with the 'identified client'. And that can make things really difficult for family members.

It is quite horrible to watch a family member decompensate and shoot out into the abyss. I did it as a paid 'helping professiona' for twelve years and it was tough on me as a professional. especialy when my clients would include me in thier delusions and threaten me.

In the US in our county of Illinois it is very difficult to hopitalize people. from a civil liberties POV that is a good thing, but as a family member , it is horrible. To see a loved one loose thier friends, thier money and thier home is terrible. And even then, in our county, being homeless is not a reason to commit someone.

The only thing I can think of is to see if there isn't some mellow mental health professional who could check in on your family member on a regular basis, I used to take my client's to the store, make sure they payed thier bills and the other things that a person needs to get done in thier life. The main goal is to establish trust with the person and hopefully engage them in treatment. When someone is off thier meds, it is always very exciting, but a useful process. It also takes alot of pressuer off the family.

Best wishes.
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The funny thing is, or the weird thing, my mom has not lost her house. My brothers are keeping a good eye on things there. My mom works, she gets fired a lot, or accuses her employer of trying to kill her, but she keeps getting more jobs. I've had people look at my last name before I was married, and asked me if I knew her. They would usually have a comment or two. Now I'm working in offices, and she never has.

Establishing trust is the hardest thing of all. My mom changes doctors all the time, especially if they don't agree with her "diagnosis" of a rash (she claims someone is giving her psychically) or something.

It's tough looking out for her when all she does in return is scare your kids and encourage them to yell at you. So I've given up for now to spare my children the horrors. I was unable to look after my own family and her anymore, and she refused to not talk about really gross delusions to my kids. "They have to hear it".

I can't believe someone who is living in the street is still not committed, um, actually I can, but why? I just don't understand it. Someone who is self medicating with drugs or alcohol are hurting themselves, and they still can't be committed.

It's ridiculous. I can't make her get help, she doesn't believe she is ill. She has never been on medication for more than a few days (she cheeked them when I had her in the hospital) and that is not long enough for her to even taste reality again.

So when someone is in the process of a diagnosis, it is important not to break that window of opportunity. My dad took her out of the hospital the first time she went voluntarily when I was 5. He listened to her tales of "abuse" in the hospital. I can't dwell on the "what ifs" ...she had stayed longer that time and was able to get somewhat well and let the doctors decide when she was ready to leave.

Her parents are still mad at my dad. He still doesn't understand the disease. She turned on him (delusions) and took us kids away for over ten years after that.

I won't get into more, but you can see where "listening to the patient" complain about their treatment may not be something you can take at face value.
 
I have to go to Ontario (the latest place my mom's run away to) in about a week and a half (unfortuanately, I can't go before that), to try and certify her. She needs to be an immediate threat to herself or others to qualify for involuntary medical treatment. She threatens suicide, which is an immediate threat, but apparently some judges won't really believe you.

However, quitting her jobs, and moving around, and cashing in her RRSP's and savings to run away from an international drug cartel, and disowning various members of her family, to the point where she has no friends, and will wind up a bag lady, isn't considered to be a threat to herself.

If she's not rational, then how can she make the decision to refuse meds?

Though I guess now they're giving injections which will last a week, and it takes about two weeks for the medication to take effect, if it does at all. So hopefully that will help.
 
Jas said:
I have to go to Ontario (the latest place my mom's run away to) in about a week and a half (unfortuanately, I can't go before that), to try and certify her. She needs to be an immediate threat to herself or others to qualify for involuntary medical treatment. She threatens suicide, which is an immediate threat, but apparently some judges won't really believe you.

However, quitting her jobs, and moving around, and cashing in her RRSP's and savings to run away from an international drug cartel, and disowning various members of her family, to the point where she has no friends, and will wind up a bag lady, isn't considered to be a threat to herself.

If she's not rational, then how can she make the decision to refuse meds?

Though I guess now they're giving injections which will last a week, and it takes about two weeks for the medication to take effect, if it does at all. So hopefully that will help.
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Hey, in Ontario-I hear things are different. Maybe she can get committed there? I'm not really sure though.

You make a great big huge point with your question:

If she's not rational, then how can she make the decision to refuse meds?
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Apparently the patient's "rights" to refuse is more important than them getting well. It protects people from being wrongfully committed, but aren't we able to better determine when someone is schizophrenic nowadays?

My heart goes out to you. I do hope things go better for you. It's horrendously frustrating to want to get a loved one the help they so desperately need, only to have the rest of the world tell you it's not up to you, it's up to the the ill person to suddenly become well enough to realize they need help...ugh.

And yes, judges require proof. You have to tape or use a camcorder to record your mom's threats of suicide. Even then, it has to be that she is aware of your doing either. I tried to give them my mom's diary, and when they started to refuse (because I took it from HER house) I simply turned to her and asked if I could give it to them. She wholeheartedly wanted them to have it to prove all the harrassment she gets from the world. I wanted them to have it so they could see how ill she was.

They only took it after she agreed.

If you want to tape her, you have to play into the delusions a bit. "I'm going to tape you so that you can tell your side of the story just in case you need proof some day". Don't tape that part of you "misleading the person".

It's freaking ridiculous what you have to go through, only to have them let the relative go after just a month.

To quote Dancing David, Best Wishes

Eos
 
This is a very difficult area, especialy since mental illness effects the basis of how we define ourselves as people.

And yes, is the US being homeless is not a reason to commit someone, in my home town we have gentleman who chosses to live on the street, he does well because he is polite and som many bussinesses tolerate him.

Also in the US deinstitutionalization is the preffered method of treatment, if you can get people to learn to take thier treatment in the community, well, it saves a lot of money for building highways and other "useful' stuuf. it is very hard for me to not be sarcastic about this. I feel that moving people out of institutions was a very good thing, I worked with individuals who were empowered to care for themselves. But there are those who can not care for themselves very well.

In the Us we also allow people to not treat thier heart disease and diabetes or to refuse cancer tyreatment. And so with the civil liberty issue, there is a real conflict in menatl illness.

Our courts basicaly ignoer the law about 'informed consent', there was a case in Florida ten years agao where a woman sued a hospital for discharging her because she was so sick she couldn't give informed consent. Ergo, how could she voultarily un-admit herself because she was not compis mentis.

There is a document that some families are trying, it is basicaly a limited power of attorney that allows a family memebr to make medical treatment choices for a faimily memebr if thier mental illnes get really bad. the problem is that the courts don't like it, because there is not a standard defintion of when the document takes effect.

There are newer medicines that are much less nasty than the older ones, haldol or prolixon has a really nasty side effect profile. I really enjoyed the work when I did it, but it was really hard to help familes.

Especialy since the main income entitlement in the US is only $570/month.

I hope well for you all.
 
EofE....I'm just scared that my mom will hate me. I don't know if I could deal with that.

Did your mom respond at all to meds when she was in the hospital?
 
Jas said:
EofE....I'm just scared that my mom will hate me. I don't know if I could deal with that.

Did your mom respond at all to meds when she was in the hospital?
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Nah, she cheeked them, and could refuse needles.

Tough love. Do you love her enough to let her hate you until she is well? If you are able to help her, then she will understand and be grateful when she is lucid. My mom has never been lucid since she got sick.

I did rent "a beautiful mind", and I was jealous that the main character got the help he needed.


Be strong if you can. Don't break yourself though. You can seek some help through the Schizophrenic Society. They can help counsel and encourage you. They are usually in the phone book.

It's a tough go, I know, but at least I can tell myself I did every darn thing I could.

Eos
 
So I'm trying to get as much info as possible before going to Ontario. I've talked to some of the RCMP officers whom she tried to get to investigate this conspiracy, and managed to track down her psychiatrist from when she was admitted to the hospital 17 years ago (when I was about five, I didn't realize that it was for the same thing until recently), and I'm getting everyone to write things down. Is there anything else you can think of?
 
This is where a mental health professional can be really helpful, they establish the relationship and break it so you don't have to, that way the family can carry on with trying to maintain the relationship. The issue comes down to the intervention being stressful and unproductive at times as well. If the intervention is likely to stress everyone out, it might not be worth it.

I don't know about Canadian laws, in the us people are often hospitalized just long enough to get better, then they are discharged and go right back to thier former life. It is one of the arguements for community intervention, when I worked with people living with a severe mentalk illness, the establishment of truest was crucial to the intervention, most people living with persistant mental illness are not very happy, once they trust you, that is usualy the the time they disclose thier unhappiness.
Of course there can be a lot of dancing to find a mutual language that people can agree upon. I worked with a yound man for two years who felt that his auditory hallucinations were ESP, in the end I was able to get him to try taking a trip to the doctor in the hope that the medication would stop his ESP. But that took a very long time of weekly visits and a lot of patience on my part.
With another client I talked to a client about how god was trying to minister to her through the doctor because he couldn't do it directly.
It is a real art because if you go too far then the person looses trust in you.
It really helps the family though to have a professional for the person to blame things on.
 
There is alos the really cool guy Fred Frese , who is the leader of the 'modern recovery' monement for people living with PSMI.
A browser search on Fred can give some great information on helping people withs chizophreia, although it takes a lot of time to understand his point of view.

Hre is a link to one of his more famous articles:
12 Coping Slills for People with Schizophrenia
 
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