How to Help My Paranoid Sister?

By Kristina Randle, Ph.D., LCSW

My sister is a married 42 year old mother of 2 girls. All of her life is has been a bit paranoid. A few years ago, she began taking drugs and drinking. When she got a full time jib, things seemed to return to normal. For the last year or so she has been really stressed out with work and family issues. Her paranoia has gotten to the point that she hears voices and sees things that aren’t there. She sees messages written in the grass, swears that her phone is sending her messages that her husband is trying to destroy her, a neighbors house burned down and she thinks her husband caused it because he’s part of some mafia, she believes her husband is having an affair with women he has never met, she has even started accusing her 14 yr old of conspiring with her father. She thinks my mom is in on this plot to destroy here. She honestly believes all this and more “out there” things. I do know that she has been prescribed Suboxone. She has sent me pictures of scratches in her furniture that she believes are messages from people. I see nothing. She refuses the idea that she may be wrong. I know that I can’t force her to go to a dr, but I really don’t know how to approach her about going to see someone. She doesn’t trust her husband, so I feel like its a bad idea for him to say anything. What can I do? I am terribly scared for her! She has never been diagnosed with schizophrenia, but it’s the only thing I can think of. PLEASE HELP!

A. It’s not clear whether she has schizophrenia but she does have symptoms of a psychosis. It can be immensely difficult to convince someone who is psychotic to seek help. As you have noted, she is paranoid. She thinks people are attempting to harm her. She has difficulty trusting even the closest members of her family. Many people describe the experience of psychosis as being horrific and frightening.

You cannot force her to seek treatment but you should encourage her to do so. Utilize the help of your family. Perhaps if your family banded together and suggested that she seek help, she may be willing. It’s unlikely, but it’s worth a try.

If she will not comply, then you may have to involve mental health professionals or the local crisis team. In your community, there may be a local crisis team who can evaluate your sister in her home. If they feel that she is a danger to herself or others, or is in grave danger of decompensating to the point where she can’t care for herself, they may be able to force her into the hospital temporarily. The hospital can keep her safe, evaluate her condition and provide her with the appropriate treatment and medication.

In the meantime, I would encourage you to contact the local National Alliance On Mental Illness (NAMI) organization. Virtually every community has a NAMI organization. You can call their local offices, discuss her case and ask for advice or a referral.

I would also urge you to call the doctor who is prescribing your sister’s medication. He or she may not be able to provide you with information about her case, but there’s no law against you reporting her symptoms. Perhaps her doctor and her treatment team may be able to provide you with assistance in this situation.

Undoubtedly, you’re faced with a difficult situation. The situation you have described, where someone is actively psychotic but refuses to seek help, is one that many families face on a regular basis. Utilize the help and support of NAMI, the local mental health crisis team, her prescribing doctor and the local emergency room if necessary. I hope this situation can be resolved successfully. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Last reviewed: By John M. Grohol, Psy.D. on 24 Mar 2013

APA Reference
Randle, K. (2013). How to Help My Paranoid Sister?. Psych Central. Retrieved on November 26, 2014, from http://psychcentral.com/ask-the-therapist/2013/03/24/how-to-help-my-paranoid-sister/