Is My Brother Really Schizophrenic?

By Kristina Randle, Ph.D., LCSW

i have a question about my brother. hes been on concerta since he was about 9 for adhd and for the past 5 years hes been on and off of it. recently he went back on it, 56mg once a day. he was taking it for 2 weeks and was having mood swings but the dr ignored them, the dr also told him to take it before bed so that it would help him get up easier. last week he took the concerta before bed, woke at 7 am and went to work around noon he felt as if it wasnt working so my dad gave him bad advise, and suggested he just take his medication again. an hour later he was acting odd and saying odd things then a few hours later he hallucinated that my dad was the devil and he was god and grabbed a knife and told him he was going to end this, him first (my dad) and then himself. he lunged at my dad but didnt strike him then slide the knife across his arm but didnt actually cut himself. later he told me he thought he had stabbed my dad and he thought he really did cut his arm. the cops came and took my brother to the physc ward in the hospital. while he was in there we noticed odd behavior even after the medication wore off. he was talking about unreal things, couldn’t understand the meaning of everything in this world, seemed confused a lot, and also was forgetting a lot of things hed say just hours after hed say them. once we started noticing them we realized he has been doing this for awhile. (forgetting things, going into weird states of mind) he has also had aggression problems in the past. he wont get mad at normal things that typical people would get upset about or even frustrated (at least not show it) but there would be episodes where he just completely would loose control and break things or yell ext-ream mean comments. hes also threatened his life a few times before but only during these episodes so my dad didnt think anything of it. more recently he has also changed his social behavior, he used to be very popular in school and had a lot of friends. in the past few months he has lost interest in going to school, and applies for jobs but doesnt follow up with them and seems uninterested in getting one. he only associates with his girlfriend and family now. rarely talks to any of his friends. the drs. suggested that he might be sycophantic, the only thing not adding up is that he has relationships with people, including a girlfriend that he loves. im trying to see if there is any other diagnosis that might be suggested? maybe multiple personality disorder, or bi polar. he also has had an extream change in his life recently, he went from being a guy who went to parties and drank and smoked to going to church and trying to be very christian. also when he talks about things and seems lost its almost always regarding religion. im hoping maybe he doesnt have a disorder at all and maybe the change is just to much for him? please help.

A. It is always difficult to provide a reliable diagnosis over the Internet. Knowing if your brother’s schizophrenia diagnosis is correct is especially difficult in this situation since he had been taking psychotropic medication on an irregular basis. It is unclear if that medication was contributing to his symptoms.

You also mentioned that he used alcohol and possibly drugs. The use of those substances can worsen the symptoms of any mental health disorder.

I’m not sure of your brother’s age.. Schizophrenia is rare before the age of 15. Generally, the age of onset for males is approximately 15 to 25. He may have had a negative reaction to a medication or to drug or alcohol use. There are some people who have one psychotic episode and never have another.

Alternatively, schizophrenia is a realistic possibility given his symptoms and the fact that he received his diagnosis during a recent hospital stay. Mental health professionals, who have had the opportunity to evaluate him, believe that he has schizophrenia. That lends credibility to the diagnosis.

The reality is that over time you will know if the diagnosis is correct. If he does have schizophrenia, there is hope. There are many effective treatments. It is not a “death sentence.” There are people with schizophrenia who live happy, productive lives. Following the treatment recommendations of his mental health clinicians will significantly increase the likelihood of recovery and stability.

As a family member it is important to support and love your brother. Love does not cure schizophrenia but those who have the disorder do best in stress-free, supportive living environments. Encourage him to follow his treatment recommendations. If you have additional questions, please do not hesitate to write again.

Dr. Kristina Randle

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Last reviewed: By John M. Grohol, Psy.D. on 10 May 2012

APA Reference
Randle, K. (2012). Is My Brother Really Schizophrenic?. Psych Central. Retrieved on December 20, 2014, from http://psychcentral.com/ask-the-therapist/2012/05/10/is-my-brother-really-schizophrenic/