The following is a discussion that took place on the web discussion area here at this web site on the topic of getting help for a delusional brother. All the names have been changed for privacy purposes.

I am looking for help/feedback for what my be the onset of schizophric behavior
in my brother. First, let me thank you for any and all help you might give. I will
give you a sketch of my brother and the problems he is having. I may be in the
wrong place, let me know.

Please forgive my typing and spelling errors

Age: 42 Moderate to heavy drinker for 20+ years Admitted heavy cocaine user
for axp 18 months ($30,000 worth) Stopped cocaine use apx 8 weeks ago,
drinking moderate?

He is very bright, well read and untill recently a hardworking partner in a growing
construction company. His circle of friends is large and he is well liked by all that
know him. He is a life long golfer, and skier. He has been married for 15 years
and is the doting father of a 10 year old daughter with Down Syndrom.

Before Thanksgiving, (1996) we (his wife, mother aunt, uncle, cousins, sister and
brother) met him in masse to tell him of our concerns for him, that we loved him,
and to offer our support to him in getting his life back on track. At the time we
assumed his problems were rooted in drinking and drug use and hoped he would
enter a rehab or detox for help. He freely addmitted that he had done many
strange and irresponsible things, but did not want or need a rehab and he would
"resolve this mess himself". During this time we felt if he would just get clean and
sober he could look at his situation with a clear head and get on with life. We
now wonder if there is some other problem behind his strange behavior.

When I mention strange behavior I am refering to the following:
 

• During the hieght of his cocaine use he became convinced that there were "people" living in the attic space in his home"
• On several occasions he "caught" the people in closets or bathrooms of his home. At times calling the police for "back up" only to find the rooms empty when opened.
• He cut holes in the ceilings and walls throught the house looking for the secret hiding place of the "people" (He built the house and knew the design well)
• He said he was being watched by the "people" and was afraid they were going to kidnap his wife and daughter.
• When you talk about this with him he sometimes admits that it might all be in his imagination and there is nothing really going on and in the same breath say " But there"s one more place I need to look, or one more trap I need to set before I can be sure.
• He became so obsesessed with this that his wife had to get a court order to keep him out of the house.
• He is currently living in a construction trailor near his home at a housing subdivision that is under construction. There he has uncovered an illegal imagrant smuggling ring that operates in the houses under construction. He says when he has enough evidence he will turn it over to the FBI and will be vidicated.(Note that the original "people" living in the attic were illegal imigrants but left after he got too close to catching them)
• He told my sister on Sunday that "They know that I know what they are doing and I know they know, because when I look out of the trailor at night with my night vision binoculars I can see them watching me. He now hooks up a car battery to the door knob of the trailor to shock them if they try to get him.

We have tried waiting, talking, reasoning, listening and arguing in order to get him
to go somewhere to be evaluated. But he wants no part untill he proves he is
right. We don't know what is wrong or what to do, the professionals we have
talked to have said that they can't help him untill he wants to be helped. What do
you think is wrong. What can we do.

Concerned Brother

 From: Bojangles
 Date: Tuesday, January 21, 1997 07:34 PM

Dear Concerned Brother, Depending upon the laws of the state you live in, there may be a
lot or nothing that you can do to help your brother. Some states have laws that
dictate that a person must be harmful to himself or others, or be unable to care
for himself...and the definitions of these dictates vary widely. Some states have
mobile units that will come to your home and do an evaluation and assessment.
You need to find out what the laws in your state are. Dr. E.Fuller Torrey's book
"Surviving Schizophrenia", is a very good resource. It describes all the symptoms
of the illness,and the treatments and gives sound advice for family members. It
also has a listing of all the states' statutes and laws. This website is also an
excellent resource. You will get a lot of support and guidance here. I've found
that the more information I can gather about this disease, the more I can help my
family member who suffers from it (son). Good luck and keep us all posted on
your progress. Barbara

Yes, I do believe you will get help here. Barbara has some good
recommendations and if you read through these discussion areas, I think you will
find lots of information that you will be able to relate to.

One thing that you have to your advantage and that is those close to your brother
are together with your concern for his welfare and are willing to be upfront with
him. You didn't mention whether or not there was a professional with your family
when you spoke with your brother at Thanksgiving. If not, that may be the next
step. Someone who is experienced in these situations may be able to facilitate
and "intervention" with your brother and help him to accept the evaluation. I
would recommend that you contact your local NAMI - National Alliance for the
Mentally Ill office. They would be able to recommend someone who may be able
to provide this service. In our area of western NY we have a Crisis Service s
Outreach Team which goes to your home to talk with you. Your community may
have a service like this. Family meetings sometimes are unsuccessful because
they end up as confrontations. Professionals can help convince the individual to
go for the evaluation. And IF there is legal cause to involuntarily place the person
for evaluation, they can do that too. Then the family does not have to get the
blame, as it was the professional's call, not theirs.

Hope this gives you a start on your search for help for your brother.

Sylvia

If your brother wants to prove the "people" really exist, then what better way
than to get evaluated, and take the prescribed drugs. Then, if they are still present
after a month or so, he can offer that as "proof!" This approach may not work,
but it might be worth a try.

Andrew

Hello again and thanks for the feedback,

There was a meeting last night between my brother and his wife. He told her, "go
ahead and divorce me, you can have everything, I,m not doing anything for here
on but try to get to the bottom of what these "people" are trying to do me." When
she offered to go out in the night and wait for the people with him he told here
that they would not come if they know we are watching for them, I'm the only
one that can see them. There was other talk of holograms, planted thoughts, and
being drugged. His behavior seems to be going further from reality each day.
Again, he wants no help and does not think he needs any.

I spoke to a Petition Team today on how to get someone evaluated if they do not
want to be and what happens during the process (his wife is a wreck and has her
hands full keeping her family and home together) should have something like this
done against thier will, on the other hand do I let him just drift off into his own
world and perhaps never see him again? Will he just get better someday on his
own. By then his life could be to far off track to go back to normal? I know he
will be very mad at me and anyone else involved in having him evaluated against
his will. He is still mad at me for taking part in the "intervention" back in
November. I don't know what to do. Is there anyone in this group who was
evaluated against thier will, how did you feel then, how do you feel now? Is the
risk of alienating my brother worth the possibility of helping out of a problem that
is much more than he can handle or even aware of.

Based on my first post and what I have said in this posting does he sound like a
person who is having a schizophrenic episode? Your thoughts are
appreciated.(please overlook the typos and spelling)

Thanks,

Concerned Brother

Concerned Brother,

Although it probably doesn't feel like it, you're doing all the right things. Your
brother is certainly having a psychotic episode. At this point, it isn't really
important if the diagnosis eventually becomes schizophrenia.

Regarding risking alienation, you yourself answered that in your message. If
nothing is done, your brother will probably drift farther and farther away, and
may harm himself or others in the process. The end result will be alienation, so
you really have nothing to lose and everything to gain.

Work with the Petition Team to learn exactly what the legal requirements are.
You sister-in-law must learn these also. That way, if there is even the slightest
hint that she or her family is in danger, she can call 911 and have the episode
documented. This may sound harsh, but this kind of action can bring results.

You may also want to have your sister-in-law get in touch with a local women's
shelter. They may have some experience with this problem. I'm not trying to
alarm you. My wife had paranoid delusions similar to those you describe and
although she destroyed a lot of her own property, she was never a danger to
herself or anyone else. I'm only suggesting that they may have ideas on exactly
what kinds of behavior could constitute a "danger" to her family.

I wish you luck. You are entering the darkest period of this illness. Be assured
that there can be light at the end of the tunnel. Your brother deserves a chance to
make his own decisions, but right now he cannot do that. You must do it for him.

Leonard

 I also have a brother who suffers similar
paranoid delusions. There is no amount of reasoning that gets through because
the nature of the illness is irrational thoughts overcoming rational reasoning. My
brother had/has similar thoughts of persecution and over time his feelings became
more and more intense until they would cause him to become so anxious and
nervous that he finally sought hospitalization on his own. This led to formal
diagnosis of paranoid schizophrenia and prescription of medication. That was
almost 15 years ago. Unfortunately for him, many of the meds have had only
marginal success, however to a large portion, new medications such as Clozapine
(clozaril) are giving many schizophrenics back "normal" lives. I sometimes
wondered if he had been diagnosed earlier, and if some of the modern drugs
were available 15 years ago, whether he would have been more functional now.
There is hope for your brother once he has been formally diagnosed and can get
on with a program to find the medications which will control his delusions. Good
Luck to you and to your brothers wife...I know first hand what you're going
through. John

The more you describe it the more it sounds like your brother has a classic case
of Schizophrenia - its very similar to what my own brother went through. We
largely had to take the course of non-action because my brother wasn't in the
shape where he was a "danger to himself or others" but he slowly got more ill
over the years. Finally after 10 years he got so sick (to the point it sounds your
brother might be) that we had to force the hospitalization on him - he was
destroying my parents house and they didn't want to make him into a street
person as so many end up.

My brother was very loving and seemed to be on the road to recovery when he
finally got on medication - he couldn't understand why he did or believed the
things he did. To my infinite regret he got very depressed shortly thereafter and
killed himself. Please don't let this happen to your brother! My 2 cents worth are
to think what you would want your brother to do for you if you were in his
condition. For myself, there would be no question - get me good medical help as
quickly as possible however you do it - this is a life and death situation!

Brian.

 From: Concerned Brother
  Date: Monday, February 03, 1997 06:31 PM
 

Thanks again to all for your input and encouragement. I start the process today
to have my brother evaluated by the people at Com Care, our local Behavioral
Health Services organization. I feel a degree of guilt about doing this but I can't
sit on my hands any longer. At our family meeting over the weekend it was
brought up that we should nolonger be worried about hurting his feelings or
jeopardizing his selfesteam because the person we are dealing with now in not
the same person we once knew. We have to get the brother we know back and
help that person. Someone in the group said that he is not thinking for himself and
we need to think for him, how true. Tomorrow I file the application. I hope this is
the first step on the road to his recovery. Thanks again for your support.

Concerned Brother

 From: Bojangles
  Date: Monday, February 03, 1997 07:52 PM

Dear Don, Good Luck with your brother....I've been away for a few days and
just read through all the replies to your requests for help. It's all very good advice
and I just wanted to add my two cents worth and reinforce the message that you
are doing the right thing. You cannot afford to wait for something terrible to
happen, and those of us who have been down this road before you can tell you
that something very definitely will happen sooner or later. It's the hardest thing to
do but you really have no choice. Keep us all posted, this is a wonderful place to
get support and feedback. We all care very much. Barbara
 

You mention ComCare. Arizona has Com Care. If you are in AZ, have
you been in contact with Arizona Alliance for the Mentally Ill. People there can
be a big help. Phone is 602-244-8166. Ann

I think my brother's disease is at the stage in between what's happening
with Don's brother, described above, - in between the family knowing that
he has this paranoid schizophrenia but not yet at the stage were he's not
himself. My brother appears to be in a stage where he's deliberately hiding
his paranoia, and is mostly like his nomal, loving, witty self. It's as if he's in
a "remission" now, in between openly paranoid episodes. If I were him I
would want him to confront me with what he believes to be the truth and
force me to a doctor. But, my parents don't want me to confront him (and I
admit the thought makes my legs weak) because they are so afraid that he'll
stick to his denial and that we'll totally alienate him, his only support
system. He seems very lucid. He, my parents, and I all avoid any discussion
of his two past episodes. He seems to care about us like normal. He can
read and watch television. I can see how hurt he will be if we confront him
while he's this lucid - and in his denial.

Has anyone on this list at all ever been able to successfully persuade
through verbal means only a paranoid schizophrenic to go to a doctor
voluntarily? Or has anyone suffering from this disease ever gotten their
diagnosis by going to a doctor willingly - not forced by cops, etc.?

Because my father has read that paranoid schizophrenics' delusions are so
strong, and unshakeable, he thinks my brother will never believe us and
that we'll only hurt him and he'll feel that he has nobody. Is it worth the
risk??? I know that all the experts and research now indicates that early
treatment leads to a better prognosis, but if there's no currently open &
obvious psychois going on, can you ever persuade them to go to a doctor? I
would really appreciate any comments at all. In Backlar's book ' The
Family Face of Schizophrenia' there is mention of one boy who was
persuaded by his minister to go to a doctor, but that's all. My brother seems
to be trying so hard to be normal, to be "well", it would feel like we're
kicking him in the teeth to confront him about this. It would be worth the
risk - if we had a fair chance of successfully getting him to agree to go to a
doctor so we could get that diagnosis and he could get the medicine to help
him. But everything I've read, with the exception of that one episode in
Backlar's book, indicates that there is no chance to persuade them to go
voluntarily. This is my family's cross-roads. We want to do whatever is best
but can't agree on what that is. Must we be forced to wait for him to get
worse to get treatment?? Just wait for the other shoe to drop??? Thank
you for sharing any thoughts or experiences. Angie
 

The petition team from ComCare interviewed my brother for 45 minutes today at
the storage yard where he now parks his van/lives. Their assesment was that the
problems were all based on his cocaine abuse and decline further action other
than to suggest outpatient treatment for drug abuse. They told me that the
hallucinations and bizarre behavior could go on for quite a while after he stopped
using and it could take as long as 6 months of being clean for him to truley start
thinking clearly. We are sort of back to square one on what to do because a
drug abuser cannot be helped untill they ask for help. We will continue to be
supportive to my brother and be there to help when the time is right.

Thanks for your help and support!

Don

Don,

If I were you I'd be asking exactly how they arrived at their assessment because
it seems reasonable that they may be wrong - and you want to be prepared if
they are. Can you get a report from them? What factors did they consider? I
don't know much about cocaine abuse but I've got a lot of experience with
Schizophrenia and your descriptions sure sounded like Schizophrenia.

How much experience did these people from Comcare have with Schizophrenia
- check the backgrounds of the people who have visited. I don't know anything
about ComCare - but check to make sure they didn't send some rookies out, or
some people who were only experienced with drug addition (and since they only
have a hammer see every problem as a nail). One thing familes dealing with this
type of problem absolutely must realize (I've learned very painfully) is that mental
health care workers make many mistakes just like the rest of us - but only your
persistance in getting to the bottom of things can save your loved one's life. Let
me give you a particularly painful example - My brother was identified as suicidal
at the hospital where he was initially treated. There was a slip-up in
communications at the hospital and that very critical information was never
conveyed to my brother's doctor/psychiatrist he saw on a regular basis nor to my
parents or any of our family. My brother would probably still be alive if we'd
received that warning - my parents would never have gone on their vacation
leaving him alone so soon after he returned home.

My recommendations for you and your brother's wife is not to give up - realize
that the problems are probably not "your brother" but rather the illness - or the
drugs if thats what they turn out to be. You might try the following: 1. Get as
much information about how ComCare assessed your brother, and who
assessed him, and the backgrounds of those doing the assessing.

2.If it truly looks drug induced and you have to wait six months to verify it, make
a contingency plan to constantly monitor him for the next six months. Maybe he
can move his van into the back yard of someone in the Family? Maybe everyone
in the family can take turns each day (or so) visiting him to see if he's OK.

3. Is there a process to get a second opinion from someone at ComCare, or
other agency? Have you written down summaries of all your brother's behaviour
and beliefs that have made you suspect it is paranoid schizophrenia - you should
type this up in the Computer and make sure that the people you deal with have a
full history of him so that more fully understand his condition even though he
might seem "OK" at the time.

Any other suggestions out there??

Hope that helps. Don't give up, your brother could be very sick through no fault
of his own.

Brian.

There's a book I read a couple of months ago called "Whispers". I can't
remember the author's name, but it was written by a psychiatrist who specialized
both in schizophrenia and in the effects of cocaine that I recommend that you
read. I had mixed feelings about the author when I read the book, because this
doctor actually in one of the final chapters discussed how he had actually
ingested cocaine himself to see if he could mimic the situation involved with one
of his cases. (This seemed to me a crazy risk that the doctor took himself with
that dangerous drug.) Anyway, each chapter involves him and a different patient
with paranoia. He was often hired as experts for the defense in criminal cases.
He was engaged in governmental studies of the effects of these drugs like
cocaine. Your initial post to this list indicated that your brother stopped using
cocaine 8 weeks ago I think, and I would contact the author of this book or try
to verify in the scientific literature just how long cocaine in a person's system
could cause the paranoid psychois without continually ingesting it. There's also
apparently a lot of stuff mentioned as to how people who suffer from this disease
turn to alcohol and drugs to "self-medicate" themselves. I am praying for you and
your family. Angie