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Schizophrenic denies illness

This has been going on for 3-4 years now. My brother went through some stress while living alone abroad and developed schizophrenia. I think he was bullied there a lot. He thinks everyone is in conspiracy against him, including family members. He thinks he is being chased and followed all the time. He was much worse before, but now he "seems to be fine", he even got a job and outside for a stranger, he seems alright, just too serious, too introvert. But he still thinks we, family are on in too, that we betrayed him and asks us to admit the truth occasionally. He thinks he is supposed to achieve grandeur, become someone highly important and save the homeland or something. Of course, he refuses to get any treatment. He becomes violent when we mention medication. He says we want to declare him schizophrenic to get rid of him. Mom thinks he is getting better on his own, since he learnt to "play normal" outside, also at home he is ok most of the time. I am desperate for any help/advice. I think it is highly unlikely that he will get cured on its own, without any medication. But he knows to play healthy. What should we do? Is it okay to slip some medication in food/beverages?
7 Responses
Avatar universal
I know this is a very frustrating and distressing situation for the family, because my late brother had schizophrenia, and he was in denial of his illness for the first several years that he was sick.  IMO, the affected person has to come to an acceptance of the illness on his own.  Most people who have a severe mental illness do eventually come to understand that they need help.  Your brother might have to experience some unpleasant real-life consequences of his illness, in order for him to really "get it," and that is upsetting for the family to observe, but sometimes that is the only way for the patient to be convinced.

I would never put medication in someone's food or drink, because not only is it an affront to his dignity, it also could be dangerous.  You cannot precisely control, nor can you even know for sure, how much of the medication he will actually ingest.  Unless he knows what he is taking, he will not be able to recognize any side effects, and he will not be able to work with his doctor in any meaningful way.  So I don't think you can "make" him take psychotropic medication, unfortunately.

There may be some type of family support group in your area.  Check with the National Alliance on Mental Illness (NAMI), to see if they have a local chapter.  If they don't, their website might be of help.  You could also ask your brother's psychiatrist or the local mental health center about resources for family support.  Good luck.
675718 tn?1530033033
he has to be stabilized with the meds his choice :)
Avatar universal
Thank you for your advice. I know slipping medication is a horrible solution, I was just being desperate. Also, I only meant light, over-the-counter medication to calm him down, we cannot get potent drugs without prescription anyways. So, your advice is to wait for him to accept his illness, right? What approach is best - Should we confront him, try to logically counter-argue his conspiracy ideas to help him realize that we are not conspirators, or shall we avoid argument and try to be nice to him without arguing back? He is very adamant and persuaded that we definitely "are on it" too.
Avatar universal
That's a really, really difficult situation you are in:  loving a paranoid person who thinks you are out to get him.  There isn't any one "right" approach to this.  I think you are going to have to more or less feel your way with him and simply do what seems right, day by day, as you go along.  

I would NOT try to use logical arguments against his delusions, as his likely response to such arguments is to become even more firmly convinced that you are against him.  All you have to do to realize this is to put yourself in his place.  When you are firmly convinced that you know the truth, and someone argues against what you know, you will generally stick to your guns and marshal your own arguments.  That type of natural human response does not change in the presence of a mental illness, especially not in the presence of paranoia.  Paranoid people think that everyone is against them, and so if you are argumentative with them, it reinforces that belief.      

I also would not necessarily roll over and act like I believed his delusions, either.  I would try, if I could, to find some middle ground of maintaining my own view of reality in his presence, without being confrontational or offensive about it.  There may come a day when the sane core of his being needs to reach out to someone that he knows can help him, and it will be important for you not to have burned your bridges.  

I would be as empathetic with him as possible.  His life is very difficult right now  You can say things like "you're up against a lot of powerful forces"  or "I know it's hard to trust anyone right now," without joining in his delusions.  Those statements are actually true.  I would try to find things that are true, that the two of you can agree on, and I would politely avoid talking about his untrue beliefs.  If he wants to talk about his delusions, I would deflect that and avoid giving attention to it.  Your unwillingness to spend time and energy exploring his delusions is enough of a message for him as to what you think.

I would never lie to him, even if I had to tell the truth somewhat selectively.  Lying to him will severely damage any chance that he will ever trust you.  If you have already lied to him, even if it was in his best interest, I would bring it up to him and admit that was a mistake, and apologize.  Get that behind you, so that the two of you can move on.

As I mentioned in my first post, oftentimes people in your brother's situation will have to experience some real-life consequences of their illness, before they will agree to treatment.  It might be the loss of a job, the complete loss of any ability to work, one or more involuntary admission(s) to a mental hospital, or contact with the legal system.  During a time of crisis, you might be more able to have some influence than at times when he thinks everything is going okay.  Even in a crisis, I would try very hard not to be confrontational, but I might say things like, "maybe some medication could help with the stress," or "we need to get you to a safe place right now."    

Unfortunately, the reality is that you have very little power to help your brother, except by continuing to love him.  You can certainly do that, and if you believe in prayer, I would keep that up.  You may also have the ability to help keep him from being homeless.  I have not looked at your profile, but if you live in the US, be aware that a family member can file for Social Security Disability or SSI on behalf of a mentally disabled individual.  If your brother is without income, he might be willing to get a mental evaluation as part of a disability claim.  

Finally, it is extremely important for you and the other family members to conserve your own energy and try to avoid burnout.  You can't fix this problem of your brother's mental illness, so don't try.  The journey is a marathon and not a sprint.  Keep yourself in good shape, physically, mentally, and emotionally, so that, if and when you do have a chance to make a difference, you still have something to give.  You will always need to keep energy in reserve.  As I suggested above, look for local resources for family support, and if you want to post back here or PM me, you are always welcome.  Drifter0213, who posted above, is also a great resource.  Good luck.
Avatar universal
I cannot thank you enough for your advice and support. I will try my best to support him in any way I can, avoid confrontation and show him love. I will never lose hope of getting my brother back.
18706566 tn?1467142236
He is still your brother, i know that with my experience with my illness, i was in denial for years, I didnt even get any meds until my mid to late 30s and two small kids of my own later. I just thought everyone was being mean and judging me. Just assure him all the time that you are there for him if he needs you. He WILL come to the realization because it never gets better on its own...just worse
675718 tn?1530033033
schizophrenia is a form of psychosis most patients hear voices and sometimes they bother you and tell you to harm others,negative symptoms include delusions of romance for example. unable to tell from truth and reality
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