My father has had paranoid schizophrenia for about ten years now, but it was hidden from me until recently. It isn’t severe enough that he is suicidal or has hallucinations, from what I’ve seen. He has been taking Abilify. Around the summer of last year, his psychiatrist decreased his dosage. (I think his psychiatrist at the hospital also changed around this time.) Afterwards, his symptoms were exhibited more strongly again; he was very anxious, and began to call certain types of food poison.

His psychiatrist prescribed him a higher dosage of Abilify again. However, once he got this prescription, he refused to take the medicine. He called it poison and read through the entire side effects list, claiming that it would kill him. He refused to eat food that was cooked more than a day ago. We basically had to force him to take his medicine though he did it before.

When I went back to school 2 months ago, he was taking his medicine regularly again. Before I went back home again at the end of March, he started to refuse his medication again. A random doctor friend of his referred him to a psychiatric specialist that came to his office. This specialist is of the same ethnicity as us and, according to my dad, did a bunch of tests. He then deemed that my dad didn’t have to take Abilify anymore. Since he received confirmation from a professional, he completely rejected any suggestions to take his medicine.

I’m really worried about a relapse. Although his symptoms are not very severe right now, he still is very picky with his food and seems to have slight depression because of work. His original psychiatrist continues to call to get him to go to an appointment (he has skipped the last two), or else they will have to send a mobile team to check up on him at home. This may lead to him being admitted to the hospital but he will then possibly lose his job. I have explained to him multiple times that he needs to tell his original psychiatrist what the new psychiatrist said. He just deviates from the topic every time or just doesn’t respond or shrugs it off. Please help me with this confusing situation.

A. You are dealing with one of the main challenges of caring for a loved one with schizophrenia: not wanting to take medication. It is very common among people with schizophrenia.

There’s a variety of reasons why people with schizophrenia might not want to take their medication including: they don’t like the way it makes them feel and they don’t believe they need it.

About 50 percent of individuals with schizophrenia don’t recognize that they are ill. This neurological condition is called anosognosia. Because they do not believe they are ill, they conclude that treatment is unnecessary and often subsequently refuse all treatments.

You should continue trying to convince your father to take his medication but as you recognize, this is difficult. You cannot force him to take his medication even though you know that it can stabilize his symptoms. This is one of the most difficult emotional aspects of caring for a loved one with schizophrenia. You know the medication helps because you’ve seen it work, yet your loved one won’t take it and becomes sicker and sicker. It’s the tragic reality that characterizes so many cases of schizophrenia.

Ultimately, the mobile team may have to come to the home and admit him to the hospital. Obviously, that is not the ideal outcome, but at least you will know he’s safe in the hospital. The hospital staff will constantly monitor and treat his symptoms and keep him safe.

If he loses his job, then you may want to contact an attorney to assist your father in applying for Social Security Disability Insurance (SSDI). SSDI is a federal program that, if approved, will provide your father with health insurance and a monthly stipend.

For additional assistance, I would recommend contacting your local National Alliance On Mental Illness (NAMI) support group. NAMI is a free support group for people who are caring for a loved one with a severe mental illness. Virtually every community has a NAMI presence. I would also recommend the book I’m Not Sick I Don’t Need Help: How To Help Someone With Mental Illness Accept Treatment by Dr. Xavier Amador. The book provides practical assistance to family members dealing with the challenge of caring for a loved one, with mental illness, who does not want to take their medication.

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

Dr. Kristina Randle

Photo

 

 

Last reviewed: By John M. Grohol, Psy.D. on 11 May 2014

APA Reference
Randle, K. (2014). Paranoid Schizophrenic Father Told Conflicting Diagnoses. Psych Central. Retrieved on October 20, 2014, from http://psychcentral.com/ask-the-therapist/2014/05/11/paranoid-schizophrenic-father-told-conflicting-diagnoses/