Paranoid Symptoms: How to Help a Loved One

Q: Paranoid Symptoms: How to Help a Loved One

Hello, netizen： It is recommended to contact the local health bureau's community mental health center or health station regarding suspected individuals with mental illness in the community. <br>They will arrange for a public health nurse to conduct a phone or home visit, or sched

Could these symptoms be indicative of persecutory delusions?

Dear Dr.
Wu,
Hello.
My mother has been increasingly suspicious of our neighbor across the street since the beginning of this year, believing that they have ill intentions towards our family.
As a result, she often walks or runs with an umbrella to the neighbor's door, regardless of whether it is raining (I couldn't find any meaning for this action online, but I personally speculate it might be to ward off evil).
Because of this behavior, my father often scolds her, calling her "crazy," which leads to occasional conflicts between them.
In addition to carrying an umbrella, my mother has also put talismans on the front door, taped red strings to the air conditioning pipes in the living room, purchased specific potted plants, and placed a 100 NT dollar bill in the pots as a way to "ward off bad luck." Since I do not live with my mother (mainly because she runs a business and stays at the shop, while my father and I return to our home a few streets away to rest at night), we only gather for dinner in the evenings.
However, my mother is very particular about the colors I wear, insisting that I should wear green, blue, white, or brown every day because of my zodiac sign.
A few days ago, when I went to the shop, my mother insisted that I wear green, but I, as usual, did not pay special attention and said, "You tell me to wear different colors every day; I might as well wear rainbow-colored clothes." She then took a green shirt and insisted that I change into it, her tone becoming displeased.
Shocked by her unusual behavior (she usually just makes suggestions without such strong insistence), I immediately changed into the shirt, but she continued to mutter, "If I tell you to change, just change.
Why say all this?" repeating it multiple times.
On several occasions on the way home after dinner, my father often says, "She (referring to my mother) is really crazy." While I wish my father would stop saying such things about my mother, I also feel conflicted: I believe my mother may indeed have a related illness.
Although I understand that the treatment of mental or psychological disorders requires both the patient and family to have insight into the illness and seek professional help, the current situation clearly makes it impossible to directly persuade my mother to seek treatment.
In addition to my father's biases against mental illness and its patients, my mother also does not recognize the pathological nature of her behavior.
My mother’s daily life and interactions with customers appear normal, yet her frequent unusual behaviors cause me significant anxiety: I fear that my parents will continue to have conflicts over this, leading to a rigid family atmosphere, and I am even more afraid that my mother’s behaviors or symptoms may worsen.
I have always wondered why my mother has the delusion that our neighbors are conspiring against us: our family members are all healthy, and our employment or academic situations are relatively smooth, yet my mother still holds onto this belief.
In a moment, I will be leaving home to study in the north, but my mother’s condition truly worries me.
Therefore, I would like to ask you, Dr.
Wu: at this stage, aside from directly suggesting that my mother visit a medical institution, how can I help her improve this situation? I sincerely thank you for taking the time out of your busy schedule to provide your valuable advice!

Wei, 20~29 year old female. Ask Date: 2019/08/25

Dr. Wu Enliang reply Psychiatry

Hello, netizen: It is recommended to contact the local health bureau's community mental health center or health station regarding suspected individuals with mental illness in the community.
They will arrange for a public health nurse to conduct a phone or home visit, or schedule a psychiatrist for a home assessment.
After that, they will determine if medication or further examinations are necessary and will discuss the feasibility with you.
Dr.
Wu En-Liang

Reply Date: 2019/08/25

More Info

Dealing with a loved one who exhibits paranoid symptoms can be incredibly challenging and emotionally taxing. Your concerns about your mother's behavior and mental health are valid, especially given the changes you've observed in her over the past few months. It’s important to approach this situation with empathy, understanding, and a willingness to seek professional help when necessary.

Understanding Paranoid Symptoms
Paranoia can manifest in various ways, including unfounded suspicions about others, obsessive behaviors, and rituals aimed at warding off perceived threats. In your mother's case, her actions—such as carrying an umbrella to the neighbor's house regardless of the weather, placing charms around the home, and insisting on specific clothing colors—suggest that she may be experiencing heightened anxiety and a distorted perception of reality. These behaviors could be indicative of a mental health condition, such as paranoid personality disorder or another anxiety-related disorder.

How to Help Your Mother
1. Open Communication: Start by having a calm and non-confrontational conversation with your mother. Express your concerns without labeling her behavior as "crazy" or "sick." Use "I" statements to convey how her actions affect you, such as, "I feel worried when I see you so anxious about the neighbors."
2. Empathy and Validation: Acknowledge her feelings and fears. While her beliefs may seem irrational to you, they are very real to her. Validating her feelings can help her feel understood and may reduce her defensiveness.

3. Encourage Professional Help: Gently suggest that she speak with a mental health professional. You might frame it as a way to help her manage her anxiety rather than labeling her as having a mental illness. You could say something like, "Talking to someone who understands these feelings might help you feel more at ease."
4. Educate Yourself and Family: Understanding mental health issues can help you and your family approach the situation with more compassion. Research paranoid symptoms and potential treatments to better understand what your mother might be experiencing.

5. Set Boundaries: While it’s important to be supportive, it’s equally crucial to set boundaries for your own mental health. If her behavior becomes overwhelming or affects your well-being, it’s okay to take a step back and prioritize your own needs.

6. Involve Other Family Members: If possible, involve other family members in the conversation. A united front can sometimes help in encouraging a loved one to seek help. However, be cautious about how you approach this, as it could lead to defensiveness.

7. Monitor Changes: Keep an eye on her behavior and any changes in her mental state. If her paranoia escalates or if she begins to exhibit signs of severe distress, it may be necessary to seek immediate professional intervention.

8. Crisis Plan: Develop a plan for what to do if her behavior becomes dangerous or if she expresses thoughts of self-harm or harm to others. Knowing how to respond in a crisis can help alleviate some of your anxiety.

Conclusion
Your concern for your mother's well-being is commendable, and navigating her paranoid symptoms will require patience and understanding. While you may not be able to change her beliefs or behaviors directly, your support can be instrumental in encouraging her to seek help. Remember that mental health issues are complex, and it may take time for her to recognize the need for professional assistance. In the meantime, focus on maintaining open lines of communication, providing emotional support, and taking care of your own mental health as well.

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