Help for us and our son, sorry this is long

[blue heron]

On Monday evening I recieved a call from our 24 year old son, who was living in a city about 6 hours drive from us, asking that I come get him now, that people were after him and wanted to kill him. He had felt threatened last Nov and in fact went missing for a week, and we feared him dead at that time. He did call that time after a week, but was convinced of danger. I began to suspect then that we were dealing with a mental illness, but with him so far away and other serious stuff in our lives, was unable to do much but try to stay in touch. As he did not have a phone, that was a challenge. I saw him a couple of times this spring when I was in that city visiting my mom in law (who is fighting cancer), and our conversations did not relieve my fears. He seemed a little delusional and I was suspecting halucinations. I just finished my third year of nursing school and was doing my psych rotation from Jan - April, so I was getting an education in more ways than one.

Well Monday's phone call confirmed our fears. I made arrangements and a friend drove me up to get him. Long, all night drive. He was very frightened and agitated. Tuesday afternoon, he was really paranoid, thinking that a new neighbour near me was planted to watch me, that there was a guy at a bus stop that was one of the people from the other city (when I looked, I saw no one), that I got my new undergraduate nursing job (on psych, BTW) so 'they' could keep an eye on me, that the security gard on psych was after him, and that two nurses there were talking about him. All this in about 25min.

Thursday, he agreed to go see his doctor to have a check up for diabetes, and I requested a psych assesment. The Dr was awesome, and talked to our son very matter of factly, and clearly. Our son was unwilling to accept a prescription, but did agree to stop smoking pot. The doc also sent a referal to the psychiatrist of our choice, and bless him, he called us Fri, before noon, and we were in his office at three pm. (We being, DH, son and me). He did get our son's agreement to try a medication (risperidal), explained why pot was very bad for him, and is arranging a CT scan. The family doc had ordered blood tests, and those were drawn on Thurs.

There is so much I really cannot write here, but it has been an exauhsting week. I just started my job on psych and was in orientation Mon-Thurs (missed Tues and will make it up later), and part of our orientation was training videos on how to help and teach families who have a member dealing with a first psychotic episode. I did not want to be there. I wanted someone to help me, not learn to help someone else right then. and just being with our son is so tiring. This am for example, in less than four hours he went from hypo-manic to agitated to paranoid to delusional. and he had only had three hour of sleep. (Yes I know the relationship between sleep and psychosis, but he has yet to figure it out).

so, besides just needing to vent, I need some resources for families of schizophenics. My hubby and I talked with our pastor tonight (yesterday, now), and he recomended we look for some info on line, but I do not know what some good ones are, and am too tired to search. He works in mental health as well, so that is really an asset now.

One need is for my hubby to learn how to and how not to communicate with our son. DH is a very logical man and asks a lot of questions. This is not a logical illness, and he is at sea as to how to deal with it. I could explain it to him, but I think he would like it better from another source. and that would remove a burden from me, too.

also, some resources for our son would be great. maybe BB or chat rooms??

Any help you can give will be appreciated. This is so scary, and it has already been a really difficult couple of years with two deaths in the family, the death of a friend, mom's cancer, me being diagnosed with depression last fall, now this???

I want to work in psych, and I want to learn about it, but I'm not sure this is how I would have chosen to do it. In the opinion of those more experienced than I, what reading/researching should I do or not do right now? I was planning to really concentrate on my psych textbook this summer, and work as much as possible to refine my skills in this setting, but with my family situation I don't know if that is a good idea.

well, its late and I need sleep, so thanks for 'listening', and any help you can provide.

[BBFRN, BSN, PhD]

Hi-

Have you considered placing him involuntarily in an inpatient emergency psych facility? He may need this to get him started on the meds and support he needs right now. It's not a permanent placement, of course. And at least you'll know he'll be safe and cared for. Plus, he needs a thorough evaluation.

The initial onset of schizophrenia can be scary for the person and their loved ones- i have been there myself (as a loved one). You and your husband need support, too. Here is a link to help you find and contact the Nat'l Alliance for the Mentally Ill.

http://www.nami.org/

They can help you find local support for you and your son.

Good luck to you.

[BBFRN, BSN, PhD]

I forgot to mention PACT (Programs for Assertive COmmunity Treatment), which helps severely mentally ill individuals live more independently, with less hospital admissions for exacerbation, etc. They do provide in-home support, 24 hr availability, make sure they're taking their meds, and more. Ask your local NAMI rep about this- they've had good results in my area.

[blue heron]

thanks for the info and suggestions. Both the GP and the psychiatrist discussed admission with our son, but chose not to do so at present. They did tell him and us, under what circumstances to go to ER. He would likely be certified if that happened, and be an involuntary patient. (we live in Alberta, Canada)

Today has been much better, had long talk about his need to stay off pot, comparing his reaction to pot to my reaction to phenobarb or codiene, helped him understand better. Also comparing his need for medication to the need of an asthmatic or diabetic also seemed to help. He is also struggling with his self image, and what he can and cannot do in future-ie work, school, dating, marriage. He is showing incredible insight at this point, and I hope this continues.

I will check out NAMI, you are right that this is scary for all of us, and we each need support.

[Thunderwolf, MSN, RN]

Find a NAMI group in your area. You will receive much support thru them.

You and son are in my prayers.

[UM Review RN, ASN, RN]

Would it be possible for you and your husband to go to family counseling together for support/advice?

Other than that, I have no advice, just moral support.:icon_hug:

[Curious1alwys, BSN, RN]

I am sorry about your son and your mother in law. These two conditions are situations I am currently battling in my family too! And I am in nursing school!

Just wanted to add....if your son smokes pot, are you 100% sure he doesn't do other drugs, specifically, methamphetamine?? My brother has exhibited much of the same behavior in the last three weeks or so. He has a drug using hx, but recently has been using meth and we are yet unsure whether what he is experiencing is meth psychosis or onset schizophrenia. My family has a hx of Schizo. Brother says he has quit using meth. I think he is really, really scared. He maybe had hallucinations before when he did drugs but they always went away when he dc'd his use. He is now staying in a hotel and has abondoned his house, dogs, job....He calls us telling us bugs are leaving his body and he is dying......My family has been going thru extreme stress due to my fathers illness so I wonder if the stress could have caused him to have a psych breakdown or something.

Just wanted you to know that drugs can be responsible for symptoms like this too..FYI. I know meth can also induce an underlying psych condition. For my brother, right now, it is hard to figure out what is going on. He has gone to two different ER's and left without tx due to the waiting times here. It is like he wants help, but doesn't. How did you get your son to even agree he needed help? That alone is a big step in the right direction!

I would like resources too. Thanks for starting this thread! Also...do you psych nurses have any experience with meth psychosis, pt's who have stopped using drugs but were never the same? Thanks!

[blue heron]

Thanks every one. Just coming here and seeing your posts is a help right now.

Wolfie, its good to hear from you, and thanks for your prayers. You always have sound suggestions, and a compassionate heart. This is a road that is not going to be easy, but will be doable.

Angie, yes counselling is in the works, I had been seeing one over the winter due to severe depression last fall, so I will be re-starting that and DH is willing, too. He's having a hard time with all this as his brother died suddenly less than two years ago (DVT) and had been diagnosed w/ bipolar shortly before his death. Its been a lousy couple of years.

Thrashej, there is some hx of mushrooms and he also says he tried Ectacy three times. As you never know what is in E, who knows what he had injested. The pot is definatly a trigger for him, and the psychiatrist said that pot can trigger psychosis in 10% of the population.

As to how did I get him to the dr? I really took a chance and used some subturage (sp?). Our son mentioned he thought he may have developed diabetes, and I made an appointment for that, but when we arrived, I requested a psych assesment, and a refferal. (tests were run for the diabetes too) My son was not really happy with me, but when we left the drs office I brought it up. I told him that if I were in his shoes, I would be feeling betrayed and also relieved. He agreed, and we had a long talk. I told him that from now on I would be up front, but that I had been advised not to address the issue of a mental illness in a one on one situation. This was a very real risk, as his primary symptom is paranoia. But it has worked out.

The fact that your brother has gone to emerg is good, but I wonder ifthe wait is discouraging? that is one reason I wanted to avoid the ER with our son, I am pretty sure he won't wait well. Can you get your brother to go to a family doctor, and start treatment via that route? I'm not sure where you live and how your health system works in these cases, but a direct admitt might be the best choice.

I'm really sorry to hear of wht is happening in your family, and I'll be praying for you. Going to school while all this other is going on is both blessing and curse for me--how about for you? What year are you in and when do you graduate? I finish next April, so only one year to go.

Thanks every one, your support and prayers are greatly appreciated.

[lisabeth]

You, your son, and family will definitely be in my prayers.

[Daye]

It is exhausting to parent a child with a mental illness I know from experience.

NAMI is a wonderful support group, sometimes you have to look into several chapters before you find the right group, but be persistent and give it a chance before you give it up.

Medications are only effective if they are taken as prescribed as you well know, Hopefully your son is willing to be compliant.

Church leaders are are wonderful support system, i am glad you have that to go to.

I will keep your family in my prayers, God Bless

[BBFRN, BSN, PhD]

I would check out the hospital with an emergency psych unit close to him. if he expresses a danger to himself or others, he will not be allowed to leave once he is triaged. The hospital where I used to work that had an emergency psych, would get them back to a locked temporary unit attached to the ED, and then get them up on the unit once processed. The temp unit had their own security. The triage nurse in the main ED would attach a tracking bracelet to the pt once identified as a danger to self or others, so if they did try to leave before placed on the locked unit, security would know, and escort them back to the ED. Of course, these pts were processed much faster than the others.

[HM2VikingRN, RN]

On Monday evening I recieved a call from our 24 year old son, who was living in a city about 6 hours drive from us, asking that I come get him now, that people were after him and wanted to kill him. He had felt threatened last Nov and in fact went missing for a week, and we feared him dead at that time. He did call that time after a week, but was convinced of danger. I began to suspect then that we were dealing with a mental illness, but with him so far away and other serious stuff in our lives, was unable to do much but try to stay in touch. As he did not have a phone, that was a challenge. I saw him a couple of times this spring when I was in that city visiting my mom in law (who is fighting cancer), and our conversations did not relieve my fears. He seemed a little delusional and I was suspecting halucinations. I just finished my third year of nursing school and was doing my psych rotation from Jan - April, so I was getting an education in more ways than one.

Well Monday's phone call confirmed our fears. I made arrangements and a friend drove me up to get him. Long, all night drive. He was very frightened and agitated. Tuesday afternoon, he was really paranoid, thinking that a new neighbour near me was planted to watch me, that there was a guy at a bus stop that was one of the people from the other city (when I looked, I saw no one), that I got my new undergraduate nursing job (on psych, BTW) so 'they' could keep an eye on me, that the security gard on psych was after him, and that two nurses there were talking about him. All this in about 25min.

Thursday, he agreed to go see his doctor to have a check up for diabetes, and I requested a psych assesment. The Dr was awesome, and talked to our son very matter of factly, and clearly. Our son was unwilling to accept a prescription, but did agree to stop smoking pot. The doc also sent a referal to the psychiatrist of our choice, and bless him, he called us Fri, before noon, and we were in his office at three pm. (We being, DH, son and me). He did get our son's agreement to try a medication (risperidal), explained why pot was very bad for him, and is arranging a CT scan. The family doc had ordered blood tests, and those were drawn on Thurs.

I wish the very best for you and your family! I have worked inpatient psych for 24 years and it is always difficult to see patients decompensate.

Some thoughts I had....

MI/CD treatment? If the symptoms are triggered by drugs it is really important to help him find resources to live an abstinent lifestyle after stabilizing the MI symptoms.

I would ask the Doc why he chose risperidal? Risperidal has a linkage with developing diabetes. See http://www.depression-guide.com/risperidal.htm. Many patients have really good responses to the new generation anti-psychotics. I have seen several patients have absolutely great responses to Clozaril.

I would also try to get your son lined up with social services.

Its a tough row for everyone but I think you can do it!

(One bit of hopeful news in general the older patients are at onset of schizophrenic illness generally have a better prognosis and long term outcomes.)

I really hope that I have been helpful.