Brother Has Untreated Psychosis

By Kristina Randle, Ph.D., LCSW

I have a younger brother who’s 33. Several months ago, he called me to our mom’s house because he said he needed help. I had recently become aware that he had been acting strange, but I was not personally around him during that time. When I went to our mother’s home where he had been staying because his wife kicked him out of their home, I believed the “help” he wanted from me was to take him to the hospital for medical treatment. Our father died two years ago and I’m fairly certain he has not dealt with the loss in a healthy manner. Once I arrived at our mother’s home, he began talking about the “help” he needed was for me to take his computer because it was absorbing his thoughts and sending them to the government. He rambled on for 2 hours about things that made no sense. He said he had been to the pits of hell and shot up to heaven and talked to our father. He said he works for the Pentagon and needed me and my kids, and my husband to go down to a bunker because the world was coming to WW3, as well as claiming to have Messianic DNA, short of saying he was Jesus Christ. He has also been diving into witchcraft, and fasting, with the exception of coffee and water.

I was deeply concerned for my mother and my other brother who are also in that household. My other brother was diagnosed with schizophrenia 15 years ago and was under treatment. He is now not under treatment because my little brother has convinced him that he can “heal” him. My younger brother also has firearms in the home, which brought me greater concern. So I went to magistrate court to have him involuntarily evaluated, to which he claimed after 10 days that they released him because he was just being religiously persecuted. Obviously I didn’t believe him but I am not privy to his medical records. My mother has stood by his side and cut ties with me for having him hospitalized. She claims he’s “just having a rough time, and he’ll be ok”.

I have since told my brother that I no longer wish to have communications with him until he receives some medical help. I have four kids of my own and do not want them around his venomous words and actions. I love my brothers and my mom but I am obligated to have my children raised in a safe, healthy environment, family or not. He has repeatedly mentioned my children in random topics and has been in the past very adamant about spending time with them. This concerns me that he so passionately wants a connection with my children. I have gone several weeks without hearing from my little brother, but he has sent me an email saying he is filing charges against me for having him hospitalized and giving false statements against him…which is completely ridiculous. He is intelligent and very well versed, however he has obviously lost touch with reality.

With all the background information, my question is what is the progression of untreated psychosis and/or possible schizophrenia? Will this get progressively worse? He is adamant that he will not receive treatment because he does not believe anything is wrong. He claims he’s just more intelligent than everyone else. The problem is the people around him (our mom, brother, other sisters, etc) rally around him as if he will just “get over” this in time. I noticed these small somewhat insignificant changes in him over the last two years since our father’s passing, however in the most recent months, it has gotten significantly more obvious that something is “off”. Thanks for any help.

A. I’m sorry to learn about your brother’s condition. He is clearly not well. Unfortunately, you seem to be the only one who recognizes that he is seriously ill. Studies have shown that younger people with untreated schizophrenia have more psychotic episodes than older people with schizophrenia. Both can have a considerable number of episodes but it has been documented that patients experience a decrease in psychotic symptoms later in life.

Medication is typically required to treat psychosis. Medication has the power to reduce psychotic symptoms and prevent the occurrence of future episodes. Without medication, your brother is at risk for additional psychotic episodes, each one potentially worse than the one before it. Some research has shown that with each psychotic episode, the brain is damaged. It can also be difficult to return to one’s previous level of functioning. When it comes to psychosis, early intervention and treatment are of paramount importance. The earlier the treatment the better the prognosis.

You’re right not to allow your children to interact with him while he is actively psychotic. Individuals who are psychotic and not taking their medication have the potential to be dangerous. They are not thinking clearly. They are delusional and are not in touch with reality. They may do things that they wouldn’t normally do if they were not psychotic. Until your brother begins treatment and has been stable for at least six months, do not allow him to interact with your children.

I would highly recommend the book “I’m Not Sick I Don’t Need Help.” I consider it a “must-read” for family members who have a loved one with a serious mental illness and who refuses treatment. The book explains anosognosia, a neurological condition which prevents individuals with serious mental illnesses such as schizophrenia from understanding that they have a disorder. It also provides strategies for family members who are dealing with individuals who refuse treatment.

If you have additional questions, please don’t hesitate to write again. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice

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Last reviewed: By John M. Grohol, Psy.D. on 5 Jun 2013

APA Reference
Randle, K. (2013). Brother Has Untreated Psychosis. Psych Central. Retrieved on November 24, 2014, from http://psychcentral.com/ask-the-therapist/2013/06/05/brother-has-untreated-psychosis/