How Can I Communicate with Delusional Son?

By Kristina Randle, Ph.D., LCSW

He also doesn’t live near me. My adult son, who has a history of severe ADHD & rapid cycling bi-polar disorder, but who has never been psychotic until the past year (from meth use), is now at the point where his delusions are constant. He texts me often. Once I realized that he was not messing with my head/joking, that he was not experiencing temporary delusions, I was at a loss as to how to respond to his delusional statements. A few weeks ago his delusion became that I was (and have been since he was born) a member of a secret, powerful organization; that I held a large trust in his name and was keeping it from him. At that point he became threatening, texting statements such as “bitch give me the money/password, or I’ll send people to get it” and various versions of that with statements that “they” would take no prisoners, etc. I told him he was delusional and as long as he was threatening me I would not respond. Reasonable, right. As long as he is not being aggressive or threatening I don’t want to cut off contact completely. But, even when his delusions shift, I am at a loss as to how to respond. Yesterday he said that he was working for central intelligence, among other things. The delusions of grandeur seem to be an extension of his former episodes of manic grandiosity from childhood. He stopped taking all medications at 18. His meth use began in his late 20′s and accelerated over the past 3 years. He has had periods of sobriety off an on over the past year, but now seems to have descended into a full time delusional state. I am not certain if he is actively using daily at this time. He has been anti-psychiatry/anti-medication since early adulthood, so will not willingly accept help. He is functional enough to avoid a 72 hour hold. Any advice would be greatly appreciated, especially where communicating with him is concerned.

A. Your son is delusional most likely due to the fact that he is using methamphetamine. Obviously, he needs to be in treatment and should stop using drugs, but it sounds as if there is little chance of that happening without outside intervention.

Nothing that you could write in a text message would likely alter his behavior. If someone is delusional, they are psychotic. Psychosis means having a break with reality. An individual who is psychotic lacks the ability to be logical. Attempts at logic will almost certainly fail because of their inability to think clearly. Psychosis also makes it difficult to control one’s behavior.

Your son might need to be committed to a hospital. His threats against you may make him eligible for an involuntary commitment but that might be a difficult case to make given your distance.

Are there friends or family who live near your son who can assist in this situation? If so, contact them. Another idea is to call his local mental health crisis center and ask if they would go to his home and conduct an evaluation. You may also want to consider calling his local police department and request that they do a safety check. If the police believe that he is unstable or in danger, they can escort him to a psychiatric hospital where he can be evaluated and protected.

This is a difficult situation. There is no easy or convenient solution. Your son clearly needs help. My recommendation would be the call the local authorities or the mental health crisis team and see how they can help. I am afraid there may be little else that you can do.

If you have additional questions, please write again. Please take care.

Dr. Kristina Randle

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Last reviewed: By John M. Grohol, Psy.D. on 17 Mar 2012

APA Reference
Randle, K. (2012). How Can I Communicate with Delusional Son?. Psych Central. Retrieved on November 27, 2014, from http://psychcentral.com/ask-the-therapist/2012/03/17/how-can-i-communicate-with-delusional-son/