How do I help a paranoid schizophrenic sister who went off meds?
I need practical ways I can help my sister who went off her medication and is now deep into her delusions. She is living on her own but very volitile with family and neighbors and generally anyone who mentions that she needs to get back on her meds. She believes she is the heiress of European wealth or royalty and that I have stolen her inheritance. She throws her personal items, like toilet paper away then demands that I give her money for more or bring her some more right away. She believes me to be a step-sister. Being at her beck and call has not helped and now I am trying to bring her back to reality by reminding her who her parents really were. However, I just read that I shouldn’t be arguing with her delusions. She causes a ruckess at her apartment complex with her screaming and stomping. Fortunately, the manager now keeps me aware of any new behavior that comes up. The police has been called on her several times but nothing can be done to get her into mental health until she harms herself or someone else. My next step is to see if her GP will have his office call her for an annual check up and maybe he can talk her into taking her meds or be able to some how get her into Mental Health. We are both now in our 50s and this in the 3rd or 4th time since the disease first manifested itself in her early 20s that she has gone off her medication and sunk into a delusional state. The last time she was on the streets for weeks before the police could clearly take her in as a harm to herself. It’s terrible to see this happening again and feeling like I have no control over helping her avoid what’s coming if she does not get back on her meds. She is very stubborn and belligerent with anyone who does not do as she says or asks her if she is taking her medication. She has told me that the only medication that she is on is for diabetes and anorexia nervosa (neither of which she has ever been diagnosed with.) She has never, even on her medication, admitted that she has a mental disease and generally tells people she suffers from depression. Any ideas on what I can do to help stablize her again?
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Unfortunately, not much. My former wife had the same problem. She refused and still refuses medication. In her world, she’s not sick, it’s all of those terrible people around her – the people who mistreat her – who are the sick ones.
The only thing you might be able to do is to find a very clever psychiatrist who can get her to admit thoughts of harming herself or others. Apart from doing that, you must protect your own mental health by either eliminating or at least limiting your contact with her. Contact with your sister will only get you her constant abuse, and will most likely fill you with both guilt and anxiety.
But saving yourself means you will need to mourn the loss of your sister as if she had died a physical death, for surely the healthy sister you once knew is truly gone and in a very real and concrete way that healthy sister is now dead.
Mourning the loss of your sister might best be done in a support group and/or with a therapist.
I sympathize very much; I also have a sister with the same disorder and I know how difficult the illness can be. I agree that your own health and safety must be your top priority and, since you’ve observed that giving into her imperious demands or threats does nothing to help, setting clear boundaries about what you will and won’t do is equally important. Look, you start off by describing all the ways you’ve tried to help that she refuses and then you ask, once again for some ideas, as if there’s some key to your sister’s illness that you simply haven’t found… There is no simple key, no easy answer. The problem is that you, yourself, can’t help your sister- that is, not until SHE decides to acknowledge that she has something she needs help with. Even then, only she can decide to go to the doctor, take medication despite side effects, decide that there’s more to life than what she’s got when she’s acutely delusional….. Your role right now may be to be clear to her that you love her and hate to see her suffer, but you also recognize that she will make her own decisions about her treatment. However, you won’t allow abusive phone calls, you won’t be rescuing her when she throws good things away, and if she threatens herself or you or anyone else, the threat alone is enough to get the police involved; she must not be allowed to frighten you to get her way… If the police come she may end up in a hospital where treatment can commence anyway… It’s a difficult thing to do with a sibling, believe me, I know, I’ve done it time after time. But that my sister is much better now is the hope I can offer you. There are many non profit organizations out there to help as well and many books on the subject of schizophrenia including memoirs from family members- I’d recommend reading some… Just remember, it isn’t your job to stabilize her- just be her sister and set limits reminding her that you do so because you love her. That’s my best advice as a sister.
What organizations would you recommend?
I would definitely get in touch with your closest NAMI affiliate and attend a NAMI Family to Family course. You can find information at NAMI.org.