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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
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Experience:  Dr. Mark is a PhD in psychology in private practice
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My mother was diagnosed with paranoid schizophrenia 15 years

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My mother was diagnosed with paranoid schizophrenia 15 years ago after her first mental break, where she accused my entire family of being dopplegangers. Aside from the 2 times she's been committed (both for ~2 weeks), she's never taken her medication. For many years, she appeared to be "normal." But we were never been sure if it was because she was actually better, or if she was just better at hiding it. Over the last year, though, she's been saying things that make it clear that she's not well. She believes my father, her ex-husband, is behind an elaborate conspiracy that includes hiring hit people to kill her. She also believes he's involved the spouses of each of her children in his plan. She's never been violent, but yesterday, after a pleasant outing with my family for ice cream, she commented to my brother that she doesn't trust my husband and me, and that she wishes she could cut off my husband's toes. She's never made violent threats before this. My concern is that she could be a danger to my family. I have 2 young children who adore her. And when she's around them, she appears completely normal; by all appearances, a doting grandmother. My question is, given the escalation in paranoia and the recent violent comment, could she be a danger to my family? Should I no longer have her around my children? Or, if I do, should it only be in public settings?
Submitted: 9 months ago.
Category: Mental Health
Expert:  Dr. Mark replied 9 months ago.

Hi! I'll be glad to be of help with this issue.

I can imagine how distressing and even scary this situation must be for you. You are clearly a loving mom as well as a loving daughter and you have dual responsibilities. They seem to be at odds with each other here and that makes it very difficult. I'm sorry you're going through this. But I am really glad that you're taking this seriously and are trying to get help on the right way to proceed.

And this is actually the key to my answer to you that you need to consider and think about. This is very difficult because you do love your mom. But your first responsibility is indeed to your children's safety. You are right about that.

It is possible that your mom's schizophrenia went into remission on its own. That is not so rare. She may have had a psychotic episode that did recede. Once the delusional and hallucinatory symptoms eased up, her paranoid tendencies may have also become easier for her to control and to keep private. While we won't ever know what really happened most likely, that is a good guess as to what occurred.

That the symptoms, however, have now become active again seems to be clear. And that she has made statements about a desire to do physical harm to someone cannot be ignored. That she didn't in the past does not mean that this is not a new feature of her current illness. I need to also bring up the painful possibility that the recurrence of the delusional symptoms as well as the paranoid symptoms may be part of early onset of one of the dementia disorders.

This brings us to the difficult issue of getting her help. She was not willing to get help in the past. You are correctly concerned that this will be the case this time. Who should bring up the possibility of her getting help is something that the family needs to discuss. It will not be easy.

However, you have to protect your children. That does indeed mean that you have to have her contact with the children be supervised. That means by an adult who understands the reason for the need for him or her to be present at ALL times when she is with the kids. Because if the adult there with the kids and her doesn't realize the problem, then he/she may not be careful enough.

Your concern that your mom is going to notice the change is valid. But again, you can't accommodate everyone's needs here. Your kids needs come first.

That she might escalate in her suspicion of you and force you to limit contact with her even more is a painful possibility, I know. I've seen this happen before. This may not happen for a while. And her symptoms may recede again before it happens; that is possible. So there is room for hope. However, there is no way to avoid the step of having supervised visits.

Okay, I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Customer: replied 9 months ago.

Hi Dr. Mark,


 


Thank you for your response and for your kind words. I do have a follow up question. At the thought of forcing my mother to get help, my siblings and I are -- well, reluctant does not begin to describe it. Not only is it incredibly traumatic for my mother, but it has never actually helped in the past. So my question is, if she's not actually attempted to harm others and is not a danger to herself, is treatment necessary? Or is the threat of violence enough? Can schizophrenia and/or dementia turn a non-violent person violent?

Expert:  Dr. Mark replied 9 months ago.

This is so difficult. Because we don't know if these are symptoms of early onset of a dementia disorder or if it is an independent thought disorder. And certain dementias, like Alzheimer's disease, can indeed contain symptoms of violent behavior in people who never were violent before. This is usually a violence that comes from disorientation and great frustration as the cognitive decline confuses them.


Schizophrenia does not usually "turn" a person violent. However, if command hallucinations begin to form, then that can change. Command hallucinations are if she hears voices telling her to do things.


I know how scary all of this sounds and I'm sure you're feeling this is not your mom. And I hope very much it isn't your mom. I am only answering your question of what can occur. The problem is, let's agree that this isn't her situation. But you don't feel comfortable with her with your kids. And I believe you have good reason for that. Thought disorders are mental illness. They are not predictable. That is the source of your worry.


Getting her help is something the family needs to discuss. If you're not ready at this time, I can understand. But you all have to be watchful and you have to agree that there will be a threshold that if she crosses will require the family to act. This is important to be united because it is a mental illness even if it is not early onset symptoms.


I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX



Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5030
Experience: Dr. Mark is a PhD in psychology in private practice
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