Schizophrenic amputee OR NOT?

[junglejane558]

My young friend has just lost his right leg in a traffic accident.  He was a keen footballer and very active before his amputation which happened about 6 weeks ago.
He s been angry and aggressive so the doctors put him on antipsychotic medication and diagnosed him paranoid schizophrenic, in fact that was the only information given about him on his discharge letter.  Nothing about how to manage his wound, a suitable exercise program or his physiotherapy requirements.
I d like to point out, at this point he lives in India, and has been recieving treatment in the government hospital .
He has not been examined by a psychiatrist.
There is no support,  advice or education after discharge, he came home today without even a crutch.
He is suffering lots of side effects from this risperidone tablets, i think maybe its better to stop them and allow him some time to adjust to the shock of his loss and let him express his anger without being doped up.
I m looking after him in my house so feels hugely responsible for his welfare.
My question is that could these "psychotic" symptoms just be temporary manifestation of the natural grieving process?
Do I give the pills or not??
He suffered slightly from depression occasionally  prior to the accident, but otherwise normal.

[BP2PROFESSIONAL]

Oh dear doesn't sound good, spiders might be anxiety and twitching, or simply that he feels like he has spiders in his head.  seeing the devil under his blanket is a good chance to be a hallucination, what has caused it is unknown, can be mania, could be shock from the accident, could be medication, could be body temperature could be all of the above, do you know if he had similar thoughts before the accident, what actually happened to cause his loss of limb.

Also check the infection that there isn't a smell there as my brother ended up getting gangrene which was the reason for him having to lose his leg.

I'll be perfectly honest I'm out of my depth here as I'm no doctor or psychologist you are doing the right thing though trying to get him help and a pyschiatric evaluation.

You truly are a wonderful person helping him like this, it must be difficult to see your friend this way, make sure you look after yourself as you need to be strong for both of you.  Invite your friends family to join this site if they need any help and support, as there will be an adjustment period for everyone and this is a great site for support.

Wish you well :0)

[junglejane558]

After observing my friends behavior since his discharge, there are definite periods of lucidity and co operation and other time when he feels "spiders in his head" and seeing the "devil under his blanket" also he seems to be distressed by a non existent smell which he says comes from a slightly infected wound he has in his groin.
He becomes agitated and tearful during these episodes and no rational conversation is possible.  He refused his medication tonight, and I m starting to feel out of my depth.  There is no community support or resources to help his family cope with what has happened.
I will take him for a psychiatric evaluation and proper diagnosis as soon as possible

[BP2PROFESSIONAL]

My brother lost his leg also at a young age.  There is definately a natural grieving process with the loss of a limb, my brother even considered suicide at one stage.  He is likely to have phantom pains in the early stages, i.e. his body feels like the limbs is still there and he even may try to use it, my brother use to get up and try to walk on his leg that wasn't there. That being said it does sound like the doctors over reacted and I would also check what the psychotic symptoms were.

Another thing to consider is what was he doing to cause the loss of leg as maybe he could have been in a period of mania or hypomania.  Loss of a limb is certainly a signal for possible risk taking.  My brother since losing his limb has all the characteristics of being bipolar just has yet to be diagnosed, he lost his leg in his teenage years and is now over 40.

That being said he has a wonderful life has recovered well and is working in a call centre and still out having fun every week.  It took a while for him to adjust but he has.  He rides motorbikes a lot and doesn't let the loss of limb hold him back at all.  He worked on getting himself really strong, I remember him walking up and down stairs doing a handstand on crutches with his strength.  Hasn't stopped him with getting any action with the ladies as well.

To a large part the possibility of bipolar doesn't need to be determined now though, more that he be safe and be able to grieve.  He's lucky to have a friend like you looking out for him.  I wish you all the best with love and support.

[Xila31]

Is there any possible way to get him to see another doctor or psychiatrist at this time? This sounds pretty serious in all ways. I agree that it could be possible he is just not adjusted to the fact he just lost a leg. And he needs someone to follow up on his healing for sure. I don't know anything about the Indian health care system, though. :(

[paranoid_cataclysm]

Well with the current information you gave, it sounds to me like they over reacted, maybe you should ask them what specifically made them think he has schizophrenia to warrant medication.  I would say it's definitely possible he's hostile right now due to the loss of a limb and hasn't come to terms with it yet.  Maybe someone should ask him why he's angry and aggressive?