Delusional Disorder: Managing Symptoms and Family Dynamics

Q: Delusional Disorder: Managing Symptoms and Family Dynamics

Hello, Ban： The drops have a sedative and hypnotic effect, so they should be used at night and not during the day. <br>Are you using "Risperdal" drops? This medication has a low incidence of side effects and is less likely to cause adverse reactions. <br>If the dosage is sufficie

Delusional disorder

Hello Dr.
Chen: I am the person who asked a question previously.
After my mother’s consultation, it was confirmed that she has a delusional disorder.
Previously, my mother suspected that my brother wanted to take her to see a doctor under the pretext of getting out of the car.
My brother noticed something was wrong and followed her to bring her back.
After walking for a long distance, he was tricked by my father to return to the car.
Now, she is suspicious of everything (things cannot be placed randomly, hospital items cannot be taken home, etc.).
After her visit, the doctor did not prescribe her any infusions, but my brother, who works in a pharmaceutical company, secretly administered an infusion to her in the morning (not exceeding the dosage recommended in the instructions).
When I returned home, I noticed that she seemed weak during the day.
Could this be a side effect of the medication? I want to discuss her condition with her, but will this provoke her? She still believes that the neighbors across the street want to harm her.
Is moving necessary to completely resolve this issue? I would appreciate your guidance.

Ban, 20~29 year old female. Ask Date: 2005/10/11

Dr. Chen Wenyu reply Psychiatry

Hello, Ban: The drops have a sedative and hypnotic effect, so they should be used at night and not during the day.
Are you using "Risperdal" drops? This medication has a low incidence of side effects and is less likely to cause adverse reactions.
If the dosage is sufficient (based on experience, your mother may need more than 3 mg/day of Risperdal, but this should be assessed by a physician), it typically takes at least two weeks to start seeing antipsychotic effects (with a gradual reduction in delusions).
Therefore, I suggest that you do not rush and avoid actively discussing her delusions with her, as delusions cannot be explained.
Once the medication starts to take effect, these delusions will naturally begin to diminish.
At that point, she may be willing to seek psychiatric care.
Experience shows us that patients who are more severely ill often believe they are not sick and do not need treatment; however, after receiving treatment, they may come to realize that they have issues and need medication, which reflects insight into their condition.
You may postpone moving for now; if she continues to take the medication, you should see results in three to six months.
Thank you for your letter!

Reply Date: 2005/10/11

More Info

Understanding delusional disorder, particularly in the context of family dynamics, can be quite challenging for both the individual experiencing the disorder and their loved ones. Delusional disorder is characterized by the presence of one or more delusions that persist for at least one month. These delusions can significantly affect a person's perception of reality, leading to misunderstandings and strained relationships within the family.

From your description, it seems that your mother is experiencing significant paranoia and delusions, which are common symptoms of this disorder. Her belief that others are trying to harm her, including her suspicion about your brother's intentions, indicates a profound mistrust that can be distressing for both her and your family. It’s important to approach this situation with empathy and understanding, as confronting her delusions directly may lead to increased agitation or defensiveness.

Managing symptoms of delusional disorder often requires a multifaceted approach, including medical treatment, psychological support, and family involvement. Here are some strategies that may help:
1. Medical Treatment: It’s crucial for your mother to be under the care of a mental health professional who can evaluate her condition and prescribe appropriate medication. Antipsychotic medications are commonly used to treat delusional disorder, and they can help reduce the intensity of the delusions. However, it’s essential to monitor her response to medication, as side effects can occur, including fatigue or other changes in mood and behavior.

2. Open Communication: When discussing her condition, it’s vital to approach the conversation delicately. Instead of confronting her delusions directly, focus on expressing concern for her well-being. You might say something like, “I’ve noticed you seem more anxious lately, and I want to make sure you’re feeling okay.” This approach can help her feel supported rather than attacked.

3. Family Support: Family members should educate themselves about delusional disorder to better understand what your mother is experiencing. This knowledge can foster compassion and patience, which are essential when dealing with someone who has a delusional disorder. Encourage open discussions among family members about how to best support her without reinforcing her delusions.

4. Coping Strategies: Encourage your mother to engage in activities that promote relaxation and reduce anxiety, such as mindfulness, meditation, or gentle exercise. These practices can help her manage stress and may reduce the intensity of her delusions.

5. Safety and Environment: If your mother feels threatened by neighbors or others, it’s essential to assess whether her fears are based on reality or are part of her delusional thinking. If moving to a new environment can help alleviate her fears and improve her mental health, it may be worth considering. However, it’s crucial to ensure that such a decision is made collaboratively and with her input to avoid further feelings of loss of control.

6. Professional Guidance: If your mother is resistant to treatment, consider seeking guidance from a mental health professional who specializes in family therapy. They can provide strategies for engaging her in treatment and help the family navigate the complexities of her disorder.

In conclusion, managing delusional disorder within a family context requires patience, understanding, and professional support. It’s essential to prioritize your mother’s safety and well-being while also taking care of your emotional health. Engaging with mental health professionals can provide the necessary tools and strategies to navigate this challenging situation effectively.

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