A daughter looking for advice on approach for mother's relapse in Schizophrenia

[Mippy]

Hi there,

My mother suffers from Schizophrenia and it has been nearly 20 years since her last episode. She is currently showing signs of relapse and stopped taking her medication over a year ago and our family are looking for ways to get ahead of it but it is challenging given it is nothing something we have ever spoken about at home or with one another. 

She was seeing a psychiatrist but has since slipped off the books. To get back in she needs a GP referral, however we can't get a GP referral on her behalf and we don't want to approach it with her in fear that she will not think anything is wrong with her and regress further / lose trust with us.  

All the signs are there including paranoia: thinking people are coming into the house/backyard at night and installing surveillance cameras + other sensory hallucinations (sound and smell) and generally confused thoughts and delusions and pulling back on social interaction.

How can we approach this in the most sensitive way without breaking her trust? What other voluntary methods have people used? Or if we do have the conversation with and that is the only way her what are some suggestions to approach this given she is experiencing a episodes more frequently (often continuously) now.

Appreciate your guidance and support here. 

[tyme]

Thank you for sharing. It's a hard place to be in @Mippy . I hear countless stories of family members trying to support their loved ones to get the care they need. 

I wonder if you can go to the GP and let them know what is happening and perhaps they can provide some suggestions?

I'll also tag @RiverSeal who may be able to provide more insight.

[Mippy]

Thank you. 

My Dad has spoken to the GP and she is seeing her next week for other reasons but due to patient confidentiality she can't really say much and mum hasn't disclosed her condition to her. She is going to do her best but we are not hopeful. 

[tyme]

Absolutely in regards to confidentiality. But i can see that they may have suggestions about how a 'like' patient can be supported I guess.

All the best with everything. Please let us know how it goes.

I hope you find a way to practice some self care and I recognise it can be a very stressful time for you.

It's good you want to help her early on before it gets really difficult.

@Mippy 

[ccau_82]

I can hear how much you care for your mother and how challenging this situation must be for your entire family. Navigating a potential relapse when someone has been well for so long requires tremendous sensitivity and patience.

Creating Safety and Connection First ~ Before any conversations about medication or treatment, focus on maintaining and strengthening your relationship with your mother. When someone is experiencing paranoia and delusions, trust becomes incredibly fragile. Your presence needs to feel safe, not threatening.

Practical approaches to consider ~ Build on existing connection points ♡ Notice what still feels good and safe for her. Does she enjoy certain activities, foods, or conversations? Lean into those moments to maintain your bond.

Validate her emotional experience ~ You don't need to agree with her perceptions, but you can acknowledge how frightening or concerning they must feel for her. "That sounds really unsettling, Mum" shows you're listening without challenging her reality.

Gentle curiosity rather than confrontation - Instead of directly challenging her experiences, try asking open questions: "How are you sleeping?" or "What's been on your mind lately?" This opens dialogue without judgment.

Consider involving trusted people ~ Sometimes a family friend, former therapist, or someone she's previously trusted can approach conversations differently than immediate family members.

Regarding professional help ~ Some community mental health services have outreach programs or crisis teams that can provide guidance on engagement strategies. They may also be able to suggest alternative pathways to care that don't require her initial agreement.

Your mother's nervous system is likely in a heightened state of alert right now. The more you can help her feel genuinely safe and understood, the more likely she'll be to eventually consider support. This is a marathon, not a sprint Xxxx 

How does this feel as a starting point for you?

[Mippy]

Thank you for the response.

Sounds good and yes that's where we're at right now. Just maintaining trust but her condition is deteriorating more quickly than we anticipated (over a week or two) so we will need to broach the topic soon before its too late.

If anyone knows a health line for this specific type of help please let me know and ill contact them today.

Hopefully she goes to the doctor next week and she can offer some time of help without us intervening as youre right, the conversation re. Medication will be better coming from a health professional.

Im just so frustrated the system let her slip off the radar and now it requires so many unnecessary hurdles to get back in. 

Appreciate the support 🙏🏼 

[RiverSeal]

Hey @Mippy, thank you for sharing your experiences about your mother with the community!

I sounds like you and your family are going through a tough time with your mother and her episodes. It's heartwarming to hear that you and your family are supporting her and that you are reaching out for support with your peers. It can be really hard and you are being brave and courageous being vulnerable here on the Forums.

I can understand what your mother is going through as I have a diagnosis of schizophrenia and had similar delusions in my psychotic episodes. It's interesting that your mother stopped her medication a year ago and she is now having her first episode in 20 years. Medications for schizophrenia can help people with their symptoms but not always and it is a choice an individual can make whether they wish to take them or not.

With delusions it's very challenging, near impossible to change soemone's beliefs in thier delusions. Medications may help and they may take time to work after stopping them for a year but I hear what you are saying about the GP and privacy. Having a conversation with you mother and you may have to repeat the same message if she doesn't want to hear it. May help guide her to accept treatment and support if she accpeted her diagnosis in the past and can see that symptoms have become present again.

I understand that you don't want to break her trust in supporting her and you are trying to balance this while seeking support for her. There are some options that you might like to consider but might make it challenging to break her trust in the short term. But knowing that long term treatment is what may support her and to hopefully prevent symptoms from becoming more severe or long lasting.

Crisis and Assessment Treatment Teams (CATT) are able to come to your home and make an assessment of you mother and access whether she needs urgent care in a hospital. This may or may not result in her being admitted to a mental health ward but is an option to get her the treatment she needs if that's what is accessed. I know this may not be what you want for your mother but consider the distress that she is experiencing with her delusions and in her episodes. Even though you may know that they are not reality, they are her reality and the feelings and emotions she experiences are real. I will pop some links below for you to take a look at:

• https://www.healthdirect.gov.au/mental-health-crisis-support
• https://www.health.nsw.gov.au/mentalhealth/Pages/mental-health-line.aspxhttps://www.healthdirect.gov... 
• https://www.aihw.gov.au/hospitals/my-local-area

If you or someone in you family were the legal guidian for you mother you may be able to support her more with her treatment team. This may be more of a long term process rather than help in this immediate situation. But could be something to consider if your mother is not willing to engage with doctors about her symptoms.

I have put this here as something to consider and you may already be aware of these options. From my experience though the love and support from families is the most supportive thing a person with schizophrenia can have. I probally don't need to encourage you to continue to support her and show her that you love her no matter what. I'm sure she really finds it helpful even if she doesn't seem to show it or at times due to her symptoms. It made such big difference to my recovery!

We also have the Hearing Voices and Psychosis thread here: https://saneforums.org/t5/Useful-resources/Hearing-voices-and-psychosis-%EF%B8%8F/td-p/1682014 and I encourage you to share your expereinces and connect with other Members there too. 

Please don't hesitate to continue to ask questions and the community and I can share our insights and support you!

Take care

RiverSeal 

[Mippy]

Wow. Thank you so much. All very helpful information and appreciate you taking the time.

We are going to have some conversations with her to see if she would like to talk more openly about it. I dont know if it will work but she seems to be asking questions about her previous admissions to mental ward so I do think she is conscious things are changing. 

Thank you again and I will post any progress that might be helpful to others.

Xx 

[Mippy]

@RiverSeal while I have you, may I ask a question?

Will she know she is in an 'episode'? Is it something youre actively conscious about or what is the experience? Im curious to know so I can approach the conversation knowing if she knows or need to be advised things are changing?

Thank you! So grateful for this platform 

[RiverSeal]

Great question @Mippy! When you lose your sense of reality and are experiencing an alternate reality and you don't realise it. In the sense that your alternate reality is now your reality. Usually you are aware of what is going on around you but can't differentiate the two. People, like family get intertwined with the alternate reality and can start playing roles that they are not aware off and the person (your mother) may or may not tell you about. 

Your mother will most probably still know you and who you are to her but but may distrust you and her delusions my make her believe that you are acting against her in some way. You can still funtion, like do normal daily tasks such as eating, drinking and using the bathroom. But in some cases even that can be restricted but the delusions. Doing things like house work or going to the shops may or may not be possible depending on what the delusions say about it or may cause more paranoia.

You could be guided by asking her discrete questions built into conversation to guage her level of paranoia and delusions. It's important to ackowledge how she is feeling and what emotions are showing up but buying into or fueling the delusions.

I hope this answers your question but please just reach out if you need to!

Take care

RiverSeal