and Managing Suspected Schizophrenia in Family Members

My mother is suspected of having schizophrenia?

Hello, doctor: My mother has previously told our family that she was cursed by my grandmother, claiming that my grandmother wanted to harm her.
She has been spreading rumors that my mother is inappropriate and enjoys being with other men.
My aunt also claims that they are colluding to harm her.
My mother says she learned about curses from watching television.
After we moved back to Pingtung, she inexplicably imagined a person, claiming he is a big businessman who wants to harm us, and also mentioned curses, alleging that my father is involved in this plot against her.
She frequently asks us if we are being set up or if anything else is happening outside.
She previously suspected my brother of using drugs, and when they went out together, she would react to my brother's actions or expressions as if he were an enemy, questioning him about any incidents.
Now, she also suspects my father of having an affair.
She mentioned that when we lived in Yilan, my grandmother would say derogatory things about my mother and suggested that my father should engage with other women.
Since returning to Pingtung, whenever my father goes out, she accuses him of seeking other women, leading to loud arguments.
On several occasions, during these fights, she has run out of the house without clothes, and we have had to stop her.
Sometimes, she writes down her thoughts and posts them in our mailbox for everyone to see, which are often baseless or related to her delusions of being persecuted.
Once, I tore one of these papers down, and she threatened me, saying that if I dared to tear it again, she would go crazy and kill someone.
I called my brother, and when he returned, he tore down the paper and confronted my mother, directly telling her that she has a delusional disorder.
Of course, my mother refused to admit it.
Later, I took her writings to a clinic and a large hospital, where the doctors indicated that she might have schizophrenia or a delusional disorder, but they did not provide detailed guidance on how to manage my mother’s condition.
At the Pingtung hospital, it was crowded, and since I was the last to register, the doctor seemed uninterested in explaining how to handle the situation or what to do in case of emergencies, which left me very disappointed.
I also noticed that she had copied my information and wrote it down in a notebook, which she kept inside.
Do you know what she is trying to do with that? I read online that I could inquire at a regional psychiatric specialty hospital, but it seems there are none in Pingtung.
I want to ask what to do if she posts her writings publicly or has an episode when there are no outpatient services available, or if she has an episode at night and we cannot take her to see a doctor, but she has not reached a point where she could harm someone.
Calling 119 might not lead to appropriate action.
What should I do? I also considered asking at the local health center, but I am not familiar with the procedures.
Can you explain what regulations or rules exist at the health center and how I should communicate with them? I plan to visit other clinics to ask for help.
Do you know of any good hospitals or clinics in Pingtung?

Qing Tian, 20~29 year old female. Ask Date: 2006/09/07

Dr. Zhang Zhehong reply Psychiatry

Hello, first, a diagnosis should be confirmed by a physician.
If it is not possible to take her to an outpatient clinic, a home visit may be a good option.
If organic factors are ruled out and schizophrenia is confirmed, it is advisable to arrange for treatment in an acute care unit.
Once symptoms improve, the patient usually develops insight into their condition and is willing to cooperate with further treatment.
If she is resistant to seeking medical care, explain the symptoms you have described to a nurse at the health center, and the nurse will assist you in arranging for her to be taken to the emergency department of a designated hospital for evaluation and treatment.
Subsequently, the physician will develop a treatment plan.
This is the best way to help her receive prompt treatment and recover quickly, so you need to make a decisive move! Wishing you all the best!

Reply Date: 2006/09/07

More Info

Dealing with a family member who may be suffering from schizophrenia or a related psychotic disorder can be incredibly challenging, especially when they lack insight into their condition. Based on your description, it seems that your mother is exhibiting signs of paranoia, delusions, and possibly hallucinations, which are common symptoms of schizophrenia. Here’s a comprehensive approach to understanding and managing this situation.

Understanding the Condition
Schizophrenia is a chronic mental health disorder that affects how a person thinks, feels, and behaves. Symptoms can include delusions (false beliefs), hallucinations (seeing or hearing things that aren’t there), disorganized thinking, and negative symptoms (such as lack of motivation or emotional flatness). Importantly, individuals with schizophrenia often lack insight into their condition, meaning they may not recognize that their thoughts and perceptions are distorted.

Steps to Manage the Situation
1. Seek Professional Help: It’s crucial to involve mental health professionals. Since you mentioned that doctors have indicated possible schizophrenia, it’s important to pursue a formal diagnosis and treatment plan. If local hospitals or clinics are overwhelmed, consider looking for private practitioners or mental health organizations that may offer more personalized care.

2. Emergency Situations: If your mother becomes a danger to herself or others, or if her behavior escalates (such as threatening violence), it’s essential to call emergency services (119) or take her to the nearest hospital. In many places, mental health professionals can assess her condition and determine if hospitalization is necessary.

3. Communicate with Compassion: When discussing her condition, approach her with empathy. Avoid confrontational language. Instead of saying, “You have a problem,” you might say, “I’m worried about you and want to help.” This can help reduce defensiveness and open the door for dialogue.

4. Document Symptoms: Keep a detailed record of her behaviors, thoughts, and any incidents that occur. This documentation can be invaluable when discussing her condition with healthcare providers. It can help them understand the severity and frequency of her symptoms.

5. Involve Other Family Members: If possible, engage other family members in the conversation about seeking help. A united front can sometimes encourage the individual to consider treatment more seriously.

6. Explore Community Resources: You mentioned considering local health centers. These facilities often have mental health services and can provide guidance on how to approach the situation. When you visit, explain your mother’s symptoms clearly and express your concerns about her well-being.

7. Educate Yourself: Understanding schizophrenia and its treatment options can empower you to advocate for your mother effectively. Resources from reputable mental health organizations can provide insights into managing symptoms and navigating the healthcare system.

8. Support for Yourself: Caring for someone with a mental illness can take a toll on your own mental health. Consider seeking support for yourself, whether through counseling, support groups, or online forums where you can share experiences and coping strategies.

Local Resources
While I cannot provide specific names of hospitals or clinics in Pingtung, I recommend checking with the local health department or searching online for mental health services in your area. Many regions have community mental health centers that can offer assessments and treatment options.

Conclusion
Navigating a family member’s mental health crisis is undoubtedly difficult, but with the right approach and resources, it is possible to provide support and encourage treatment. Remember to prioritize safety, seek professional help, and take care of your own mental health throughout this process. Your compassion and persistence can make a significant difference in your mother’s journey toward recovery.

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