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Schizophrenia

Question:

My son is 18 years old. He was diagnosed with disorganized schizophrenia when he was 16. He has been on many medications but none have really helped. Recentely he was hospitalized and the doctors there said he didn’t show signs of schizophrenia, but was more behavioral. I am very confused and scared that I have made many wrong decisions in his care. He stopped taking his meds and has been very angry and aggressive. I have tried to talk to him about getting help, but he won’t make the calls. I very worried about him.

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Answer:

The situation that your son presents is certainly a dilemma and it is very understandable that you are confused and scared.

I can only presume that the doctors in the hospital rejected the diagnosis of schizophrenia because your son is not hallucinating or having delusional thoughts. Hallucinations are sensory experiences in the absence of any stimulation such as hearing voices without anyone being there. Delusions are false thoughts that are far removed from reality. These and other symptoms distort reality and make it impossible to function. If he did not demonstrate these symptoms the doctors would change diagnosis.

The problem is that your son was hospitalized for a reason. Therefore, the question becomes, if he does not have schizophrenia what does he have? What did the doctors mean when they told you he has behavioral problems and what did they recommend?

So, what are you to do?

Your son is now 18 years old and is an adult. There is not much you can do to get him to call a psychiatrist or take medication. However, you can insist on his following house rules. I assume he and others have rules they must follow at home, such as controlling anger, behaving in civilized ways, respecting you, not being violent, getting a job, etc. If he cannot follow these rules it becomes necessary for you to insist that he move out.

I am guessing that he was recently hospitalized because he was violent or socially disruptive in ways that go him arrested and treated on a psychiatric unit. The fact is that, if he becomes threatening or violent to you, to others, or to himself, you have every right to call 911 have him returned to the hospital. His safety, your safety and the safety of the public are crucial. However, until he behaves in those ways your hands are tied as to what you can do…except to have him move out.

I want to stress the point that I understand how painful this must be for you. No parent likes to think of having these things done to their child. It is also painful to have a child with a mental illness. It is also painful but necessary for a parent to take the necessary steps to protect self and the adult child. In other words, you may not want to take these measures but you have to for your sake and for his. Most certainly, if he displays threatening behavior towards you or acts in ways that are bizarre, you will have to call for help. Then, your son will get the help he needs.

In situations like yours, it often takes multiple hospitalizations before a patient settles into medication with psychiatric help.

The next time he is hospitalized, assuming that happens, it will be important you be give clear information about his diagnosis and medication regimen. You can also insist that he not be sent home to you but to a half way house for those with his type of psychiatric illness. After all, you deserve to have a life of your own.

Best of Luck

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