Advice needed on schizophrenic sister

In My Humble Opinion
1

I’m 19 years old. I have a sister who’s 42. My parents are 61 and 62.

The problem is my sister. I’m not that close to her at all, but from what I can gather, she’s always been fairly rebellious (if that’s even relevant here). At one point I believe she was diagnosed with schizophrenia, and there is also some evidence of manic-depression, which I think might run in the family. She’s been to mental hospitals before, but still she managed to keep a job working for the county for many years, and with some family financial support she’s been living in an apartment with her son and third husbandm (neither of whom are really in a capacity to be there for her, but that’s another story).

This all changed recently. For the past couple of years, she’s been convinced that she is contact with the spirit of some dead member of (I believe) Led Zeppelin (she’s always liked rock music), who tells her about her past lives and about the people around her. She even claims to be able to see his outline, which may be a visual hallucination (I think this is also complicated by an alcohol problem she has.) Whenever this spirit’s prophecy turns out to be wrong, she just claims a trickster figure impersonating him had deceived her. All the intricate details that she tells about her past lives are very consistent, so it’s clear she’s not making them up on the spot, and it’s also clear that she’s not trying to dupe anyone…she really believes all this. And she gets extremely offended and defensive if someone questions what she “knows.” When this caused trouble at her place of employment a few months ago, she ended up being declared mentally ill, and now she no longer works but receives disability payments (which she has no qualms about accepting, even though she “knows” she’s not ill). My mom (sometimes with the help of my input) has tried every conceivable way to reason with her, but now I’m convinced that it’s impossible…she’s mentally ill. She’s basically isolated herself from everyone around her and depends on her hallucinations for support.

A few days ago my mom went out to lunch with her. When my mom questioned her on something, my sister apparently went ballistic and claimed that Bearman (the name she gives to the spirit she channels) hates my mom and even wishes her dead. Then my sister said she never wants to speak to her again in this life, or in any other life. Although similar rifts between them have occurred before, I can tell that this is more severe than it ever has been. It’s obviously agonized my mom…it’s as though this disease has taken over and her real daughter isn’t there.

So this is where I need your advice. First, is there any conceivably appropriate way to treat someone who’s mentally ill but refuses to accept treatment, swears that nothing is wrong with her, and lashes out at anyone who doubts her? After putting up with her for all these years, my parents have basically given up trying to get her help.

Second, is there anything that I, as her brother, could do to help her? I’d like to help if I can, but then again I’m not really close to her. She doesn’t have the same hatred toward me; the last time I talked to her she said that Bearman told her I have my head on straight and I know what I’m doing. But I don’t know how to help without making things worse. I know I help by comforting my mom, but what can I do for my sister, for her own benefit and for the benefit of the family?

2

Sundog

My twin brother is schizophrenic. I am so sorry this is happening to your family, I really can’t imagine anything more difficult. I only have a couple of pieces of advice.

First, many states allow you to ask for a mental health check. This is where a crisis unit visits your sister to ascertain if she is a danger to herself or others. If she is a danger the state can usually mandate a brief period of treatment. This brief period can sometimes restore an equilibrium that is a step towards long term treatment.

Second, please don’t exhaust your or your family’s financial and emotional resources trying to deal with this. I know this sounds harsh, but getting a schizophrenic person to recognize the need for treatment can often be a process that spans years. Many families make the mistake of trying an intervention and expensive private treatment. If that fails they are devastated and unable to respond to the inevitable next time.

I would talk to her and try to develop a relationship. Her delusions are very real to her and posess an internal consistency that is beyond our understanding. You will not be able to convince her they are false. You can let her know you want her to get treatment and you are worried about her. At some point she may realize that she needs help. You just have to hope that point comes and be prepared to be there for her.

I hope this has a happy ending and the best of luck to you and your family.

3

fruitbat are you from newcastle by any chance?

4

Nope Washington DC. Just a little hop across the pond.

5

fruitbat, first of all, my sympathies to you and your family. This sort of disorder is Hellish to deal with.

Your sister (or her channeled persona) seems to trust you. If you really care about her, you’ll need to maintain this trust. This will probably be really hard to do. I’d recommend talking at length with your mother and making sure she has a grasp of this illness and how it manifests. Without that knowledge, your mum will probably keep making similar errors that antagonize your sister.

Since you have your sister’s trust, I’d do my best to try and reestablish the relationship between your mother and sister. Until your sister is willing to seek treatment, or harms herself (or others) sufficiently to warrant confinement or observation, she’ll need all the support she can get. If you are able to effect a reconciliation between her and your mother, that is at least one more back channel of help and caring.

That said, schizophrenics can be complete emotional black holes. Their illusions can so dominate their lives that an ordinary person cannot possibly combat the perceived demons and side effects. You may need to go so far as to surreptitiously video tape your sister during a flagrant episode. Have it reviewed by medical professionals if that is the route you want to go. Sadly, beyond being supportive and monitoring her behavior, there is little you can do for your sister. She may be unconsciously self-medicating, using alcohol as a depressant to suppress her more dire excursions.

While this will seem a bit off topic, please get yourself a copy of:

“The Origins of Consciousness in the Breakdown of the Bicameral Mind”

This book by Julian Jaynes was a preamble to his treatise on schizophrenia. The tome took on a life of its own and became a separate work. It details the evolution of human awareness. One of the more important models that Jaynes uses is modern day schizophrenics. For this reason, the book is a wealth of information on the illness and its mechanisms. It is also a supremely fascinating read, but that is another matter.

Finally, this may sound harsh, but you’ll want to avoid taking too much “ownership” of your sister’s condition. As mentioned, such sufferers can be complete sucking voids for all of your time and effort. Keep your own equilibrium and maintain perspective or you can expect to have your time consumed like snacks at a frat party. If you are unable to maintain sufficient distance to keep your own sanity, the help you might provide your sister may quickly become tainted by resentment, fatigue, frustration or all of the above.

6

Err … sorry. That was supposed to be addressed to sundog66.

Carry on.

7

The last part of Zenster’s excellent post is the most important

In practical terms there is little you can do personally for someone (even a sibling) who is going off the deep end due to an organic mental disease. The are no miracle drugs available to date and all have their tradeoffs. Medications are difficult to administer consistently and often have (to the afflicted person) very unpleasant side effects.

It’s like trying to help a drug addict or alcoholic, since the deranged state becomes the preferred default mental state and protects itself with paranoia. Keeping yourself healthy by keeping a loving but respectful distance from the growing whirlwind is the best you can hope for.

8

My sympathy goes out to you. Schizophrenia runs in my family. My father, aunt, and first cousin all were/are schizophrenic, as is one of my close friends from high school.

As others have said, there’s really not too much that can be done for someone who doesn’t realize they are ill and rejects treatmen unless they have been demonstrated to be a danger to themselves or others.

I would, however, mention that sometimes schizophrenics do improve somewhat as they become older. My father, who became severely ill in his late 20s, suddenly improved in his mid-50s. While some of this might have been due to improved medication, I believe that it was largely spontaneous. While he never really became normally socialized, his worst delusions and paranoia largely abated. So even without treatment, it is possible that your sister may eventually improve (though it may be a long haul0.