Please help with paranoid family member

Specialties Psychiatric

Published

I need help. I was having alot of trouble with my daughter-in-law and just couldn't figure out what was going on. Our relationship had deteriorated over several years from warm, close to hostile and lots of control issues. Being at loose ends, I sought counseling, knowing the only person I could help in the situation was me. Half way through the session, the counselor, Linda, stopped me and said "you aren't the person here with a problem, you have a daughter-in-law with serious mental health problems." While I had recognized that she was paranoid, I didn't realize she was Paranoid. Linda let me know that her problems were going to be difficult to get help for and that, if left untreated, would get beyond the point that treatment would help.

I don't want to go into all of DIL's problems...the post would be too long, but I would like to hear your experiences dealing with paranoid patients and any helpful hints you can give me. I greatly fear for my son and their 7 month old little girl. Right now I have decided to back off from seeing DIL or the baby since that always causes a crisis in their life.

Thanks

finness

86 Posts

I am not a nurse yet, but I can certainly sympathize with this. My father is a Paranoid Schizophrenic, and dealing with him has been such an uphill battle. When you say that you "greatly fear" for your son and his child, do you sense that she may become "violent"? If you fear that she is a threat to others, you and your son may want to consider actions that prevent her from harming anyone, like commitment. I know it is not an easy thing, but if I had it to do over again, I would have gone for the second- commitment with my father. Anyway, I do not know if this applies in your case. I know it is hard though. Best of luck.

that baby needs you as an adult who loves them unconditionally and has stability. Try to be part of the baby's life. I have no advice but really feel for you. I am a grandmother with babies thousands of miles away and I know how it hurts not to be part of their life.

Nurse Ratched, RN

2,149 Posts

Specializes in Geriatrics/Oncology/Psych/College Health.

I'm so sorry for your situation. Since you use the word "paranoid" I'm going to answer assuming a clinical diagnosis of paranoia. I would question if she's paranoid *and* delusional (I suspect that's the case - delusions of some degree are part and parcel of paranoia, ranging from "MIL doesn't like me" all the way to "There's an international conspiracy to take down our gov't that only I can stop.") The next question is, does she have delusions that are dangerous to their infant son? If not, your son may just be willing to tolerate this situation and you may not be able to do anything about it. How open is your son to trying to get her treatment? Ultimately, she has to want to, but those with influence on her may be able to scoot her in the right direction. Apparently, that's not you as she appears to focus on you as a source of "trouble" (and this doesn't necessarily have anything to do with you personally, just the illness.)

It is important to know that in a clinical diagnosis of paranoia, untreated, the symptoms often do worsen over time.

These are just a few thoughts to bounce off you. Hoping this works out.

MandyInMS

652 Posts

It's really hard to say not knowing all the issues...so many times DIL's may be jealous of their MIL's relationship with son..but seeing how you mentioned you feared for the safety of your son and grandchild it needs attention asap...try talking to your son about your feelings/fears and put the ball in his court..any action YOU might take would probably cause even more paranoid actions, possibly escalating behavior. I'm sure you're worried sick, with good reason..especially with a baby involved..hopefully your son can handle the situation, but if I felt my child/grandchild were in danger I'd HAVE to jump in...hope everything works out for you all (((hugzzzzz)))

Katnip, RN

2,904 Posts

How much of this have you shared with your son? I know spouses can be blind to their loved one's problems, but this seems as though he really needs a wake up call.

BELLE0924

30 Posts

I have one name for you... Andrea Yates. While her situation is different, if she was to get help sooner, her 5 beautiful children may still be alive. Too many times in life people say, "I wish i would have done something, all the signs were there". Mental illness is something that shouldn't be ignored. I wish you and your family the best. I'm sure this won't be easy on any of you.

CliveUK

80 Posts

Hmm - well, my first thought is what qualifications does your counsellor have that make her able to decide your DIL is "paranoid", without having seen her or heard her side of the story?

I would be wary of proceeding to offer you advice on the untested word of a "counsellor" - here in the UK, anyone can set themselves up as a counsellor, regardless of qualifications or experience. I don't believe it is any different in the States.

As for the poster who mentioned Andrea Yates - seeing as we have no real evidence to suggest this woman does indeed have paranoid delusions, nor do we know the content of those delusions (if they exist) nor whether they present a risk to her son, your comment is highly inappropriate. It could well be that this woman is suspicious only of the original poster, in which case her decision to draw back from contact is a wise one. It could also equally be true that this so-called paranoia is nothing more than the kind of friction that stems from a long history of interpersonal conflict between the original poster and her DIL. We just do not know nearly enough about this situation to make any sort of judgement nor to offer any sort of advice.

finness

86 Posts

True, true. Sounds like she may need her OWN psychiatrist. Can you talk to her about this?

ernurse2244

56 Posts

Thanks for all the answers and questions. I have worked 24 of the last 36 hours so haven't gotten back to you before now.

I didn't give you alot of details about my DIL to keep my post short. As an ER nurse, I see mental health patients in crisis situations, but don't have much other psych experience. However, I did do alot of research on the 'net about Paranoid Personality Disorder after my counselor suggested that as a possible dx for my DIL. It certainly explained her reaction to many things I did that I did not understand caused such a problem. Just a couple of examples of her behavior...I wanted to put their picture in the paper with an engagement announcement before their wedding. I live in a rural town in Georgia, less than 600 folks...she said no because her ex-boyfriend, who lived in Texas, might see the announcement and "go postal". She won't take the baby to a mall if she can't wear her contact lens because if she has her glasses on she doesn't have good periphereal vision and someone might run up and kidnap the baby.

All I am asking is for you guys, the professionals, to give me advise on how you approach paranoid patients. I am convienced as I view many of her past behaviors with definitions of paranoia and realize that this explains her behaviors, that she is Paranoid, with a capital P. I can't help her, I doubt that I can get her to seek help. I doubt that I can convience my son to push for her to get help. I only want to know what I can do. I can only change my behavior...not her's and not my son's.

I feel that now I am a target for her paranoia...maybe I should let that keep happening so she won't change to my grand-daugher and/or my son. Just don't know. I have been carrying the burden of this for several years, blaming myself and trying to jump through the hoops that she has created, thinking I could change our relationship if only I did something different. Each hoop I jumped through created two more hoops.

Please...just some suggestions about how you approach and carry on with paranoid patients.

danu3

621 Posts

I am not a professional but I am interested someday to try psych nursing as I took care of one of my friend who has schizophrenia for close to a year.

Have you try your local NAMI (National Alliance for the Mentally ILL) office? They are at http://www.nami.org

You might get some down at the trenches kinds of advices from NAMI since most of them are parents with loved one who has a serious MI. If your local chapter has a Family to Family class, you might try to take it (it is a 12 week commitment, unfortunately) dealing with the mental health system, the police, communication with the ill family members, ... etc.

There is a classic book in which you might know already call "I am not sick - I don't need help!" by Dr Xavier Amador. It is a good book on how to communicate with an illed relative who is suffering from a serious mental illness. If you want to get really technical, there is a hard to get book call "Cognitive Therapy for Delusions, Voices, and Paranoia" by Paul Chadwick, Max Birchwood, and Peter Trower. Some of the principles and techniques you might be able to use. The Brits are a little bit ahead of the US in terms of CBT and serious mental illnesses.

Hope some of it helps.

-Dan

danu3

621 Posts

I only want to know what I can do. I can only change my behavior...not her's and not my son's.

I feel that now I am a target for her paranoia...maybe I should let that keep happening so she won't change to my grand-daugher and/or my son. Just don't know. I have been carrying the burden of this for several years, blaming myself and trying to jump through the hoops that she has created, thinking I could change our relationship if only I did something different. Each hoop I jumped through created two more hoops.

Please...just some suggestions about how you approach and carry on with paranoid patients.

Hello, again the following comments are not from a professional. But from someone who does have a love one with sz.

As for what you can do, here are a few suggestions for you to reflect on:

  • Keep a log of her behavior. That is your documentation which you might need sometimes in the future.
  • In the log, do not make any "diagnosis". Just keep purly description. Let the pdoc do the diagnosing as you are just giving him/her the data.
  • Want to create a short form of the log to hand out to the pdoc or psych nurse if the times comes. The summary should contain behaviors that say either it can be a danger to herself or to other, or that she is "gravly disable" (like won't eat for days). These are the behaviors that they can use legally to hold her and give her some treatments.
  • Do not argue or contradict her paranoia or delusion, which I am sure you know that already.
  • On the other hand, do not go along with it either. Just say your view and leave it. Don't get into a discussion over it.
  • If you are going to address the paranoia (or delusion for that matter), try to address the emotions behind it instead. Lots of time it is some form of fear. Do not address her reason for the paranoia because you will lose 100% of the time since you are not dealing with logic here (it is however perfectly logical to her).
  • One of the hardest thing for families who has someone with a serious MI is the helplessness that one feels. Lots of time, there is NOTHING anyone can do except to watch helplessly their love one slowly get worst and worst. Because the way the laws are set up, all they could hope for is that the illed relative will get bad enough that legally the mental health system will have to take them in, and one just hope it is not too late.
  • Take care of yourself right now. Learn to recognize when you can do something and when you cannot do anything. You are reserving the energy basically for when you can do something. With seriious MI, it affects everyone, not just the illed person. You try not to be part of the "body count" in this battle.
  • Expect your ill relative will say the most customized hurtful things you can imagaine to you. That is part of the illness but recognize that it still hurts like there is no tomorrow in your heart.
  • Create a crisis file. You should be able to do this with the help of your local NAMI chapter or some other organization.
  • Realize that her illness has control over her now and it is probably getting stronger each day until she gets the help she needs. What you can do is to refuse to have the illness control you also (indirectly through guilt or over-worrying... etc).
  • What else, safety for everyone is your number one priority.
  • Do not critisize as lots of people with serious MI have very very "thin skin". They would remember a complement for 5 minutes but they will remember a negative comment for 5 months.
  • Does she has any problem with the term "paranoia"? If so, use something else like "suspicious".
  • Does her paranoia bother her a lot? If so, there might be a small opening in that you can suggest that you know of potential ways to take care of it (going to get medical help). But it will be up to her. It is her choice (she will probably say no, but it is worth a shot). Bascially you are trying to gently push her in the direction where she see there is a price she pays for the paranoia and she does not have to pay the price if she is willing to get help.
  • Does she have a stigma going to a pdoc? If so, do you take any meds at all say for depression. If so, you can share with her that you yourself also go to a pdoc and there is no shame in it, you are doing it through your action.

Again, these points are not from a professional. It is just from someone who was down in the trenches for a while watching helplessly the one I care for get worst and worst until finally the mental health system is willing to takes over because it fits the legal requirement.

-Dan

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