and Managing Paranoia and Delusions in Family Members

Schizophrenia

My mother used to tell our family that my grandmother had cast a spell on her, claiming that she wanted to harm her.
She would go around saying that my mother was inappropriate and liked to be with other men.
My aunt also claimed that they were colluding to harm her.
My mother said she learned about spells from watching television.
After we moved back to Pingtung, she started to imagine a person, saying he was a big businessman who wanted to harm us, and also claimed that my father was involved in casting spells against her.
She would often ask us if we were being set up or if anything else was happening outside.
Previously, she even suspected my brother of using drugs, and when they were together, she would interpret my brother's actions or expressions as if he were seeing an enemy, questioning him about any incidents outside.
Now, she also suspects my father of having an affair.
She mentioned that when we lived in Yilan, my grandmother would say that my mother was shameless and that she was meant for my father.
Since my father rarely initiated intimacy, after returning to Pingtung, whenever he went out, she would accuse him of going to find women, leading to loud arguments.
There were times when she would run out of the house without clothes during these fights, and we had to stop her.
Sometimes, she would write down her thoughts and stick them in our mailbox, claiming she wanted everyone to see.
What she wrote was either completely fabricated or related to her delusions of being persecuted.
Once, I tore one of the papers down, and she threatened me, saying 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 that paper and confronted my mother, directly telling her that she had a delusional disorder.
Of course, my mother was unwilling to admit it.
Later, I took the papers she wrote to a clinic and a major hospital, where the doctors told me she showed signs of schizophrenia and delusional disorder, but they didn't provide detailed guidance on how to handle my mother.
At the Pingtung hospital, there were many people, and since I was the last to register, the doctor seemed uninterested in explaining how to deal with the situation, which left me very disappointed.
I also photocopied the information I gave him; she had written it in a notebook and attached it to the documents.
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 I couldn't find such a hospital in Pingtung.
I want to ask what to do if she writes something and posts it for others to see, or if she has an episode when there are no outpatient services available, or if it happens late at night and I can't take her to see a doctor, but she hasn't reached a point where she could harm someone.
Calling 119 might not be effective either.
What should I do? I also thought about asking at the local health center, but I'm not familiar with the process.
Can you explain what the regulations or rules are at the health center and how I should communicate with them? I plan to check with other clinics as well.
Do you know of any psychiatric hospitals or clinics in Pingtung where I can inquire?

Xiao Yu Tian, 20~29 year old female. Ask Date: 2006/09/08

Dr. Huang Weiqin reply Psychiatry

Dear Inquirer,
Hello! It seems that your mother may be suffering from schizophrenia.
It would be advisable for your family to encourage her to seek medical attention for further evaluation and treatment.
In Pingtung, you can seek professional assistance at the Pingtung Hospital's Psychiatry Department.
Wishing you all the best!
Sincerely,
Dr.
Huang Wei-Chin

Reply Date: 2006/09/08

More Info

Dealing with paranoia and delusions in family members can be a challenging and distressing experience. It sounds like your mother is exhibiting symptoms that may be consistent with a psychiatric disorder, such as delusional disorder or schizophrenia. These conditions can lead to significant distress not only for the individual experiencing them but also for their family members. Here are some steps you can take to manage the situation effectively.

Understanding the Symptoms
Your mother's beliefs about being harmed or conspired against, as well as her accusations towards family members, are indicative of paranoia. This can manifest in various ways, including:
1. Delusions of Persecution: Believing that others are out to harm her.

2. Paranoid Ideation: Suspicion of others' motives, leading to accusations without evidence.

3. Hallucinations: Although you did not mention auditory or visual hallucinations, these can sometimes accompany delusions.

Understanding that these symptoms are part of a mental health condition can help you approach the situation with empathy rather than frustration.

Seeking Professional Help
It is crucial to involve mental health professionals in this situation. Since you mentioned that doctors have indicated the possibility of schizophrenia or delusional disorder, seeking a psychiatric evaluation is essential. Here are some steps to consider:
1. Find a Psychiatrist: Look for a psychiatrist who specializes in treating psychotic disorders. If there are no specialized facilities in your area, consider reaching out to general hospitals that may have a psychiatric department.

2. Emergency Services: If your mother becomes a danger to herself or others, do not hesitate to call emergency services (119). They are trained to handle psychiatric emergencies, even if it feels daunting.

3. Community Resources: Contact local health departments or community mental health services. They can provide guidance on available resources, including outpatient services, support groups, and crisis intervention.

Managing Day-to-Day Situations
In the meantime, here are some strategies to manage daily interactions with your mother:
1. Stay Calm: When she expresses her delusions, try to remain calm and avoid arguing with her about her beliefs. Acknowledge her feelings without validating the delusions.

2. Set Boundaries: If her behavior becomes disruptive or threatening, it’s important to set clear boundaries. Let her know that certain behaviors (like posting notes) are not acceptable.

3. Document Everything: Keep a record of her behaviors, statements, and any incidents that occur. This documentation can be helpful for healthcare providers when assessing her condition.

4. Support Network: Involve other family members in the conversation about her care. Having a support system can help you manage the stress of the situation.

Visiting Health Services
When you visit health services, be prepared to explain your mother's symptoms clearly. Here are some tips:
1. Be Specific: Describe her behaviors, thoughts, and any incidents that have occurred. Mention any family history of mental illness, if applicable.

2. Ask Questions: Inquire about treatment options, including therapy and medication. Ask about support services available for families dealing with similar issues.

3. Follow-Up: Ensure that you have a plan for follow-up appointments and that you understand the next steps in her care.

Conclusion
Navigating the complexities of mental health issues in a family member can be overwhelming. It’s essential to approach the situation with compassion while also seeking the necessary professional help. By documenting her behaviors, setting boundaries, and involving mental health professionals, you can create a supportive environment for your mother while also taking care of your own well-being. Remember, you are not alone in this, and there are resources available to help both you and your mother.

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