Q. I have a coworker, whom I care about a lot, confide in me that he believes his skin moves and that it moves all the time. He also believes that a muscle that was in the front of his knee is now in the back of his knee and that he needs to find away to move it back, he?€?s even bought a machine that he thinks can do it, although he hasn?€?t tried yet. He thinks some kind of electric charge can move it back in place. He?€?s also said that if it wasn?€?t for his parent he probably kill himself. I believe he has family history of mental illness. He has told me is brother has tried to commit suicide. I think I believe even my coworker has tried it himself, but I don?€?t know. I think the world of this guy and would do anything for him. I am wondering what he has symptoms of and how can I approach him for getting help.

A. While I cannot know this for sure without personally interviewing your friend, I would say that the symptoms that he has described are indicative of someone who is delusional, and perhaps in the early stages of a psychotic break. The idea of his skin moving is delusional; believing in an electric charge as the solution for moving, that too is a delusional idea. Some people have mild psychotic symptoms that never develop any further. For others, these symptoms turn much worse, sometimes into full blown psychosis. It is hard for me to say what the case is for your friend.

It may be hard to approach him directly with the idea that he is delusional because if he is indeed delusional and heading towards a psychotic break, he likely is paranoid. He might outright reject what you are saying, be insulted and end your friendship. Often delusional people do not realize they are delusional. Without being confrontational or directly telling him that you think he is “delusional”, you should encourage him to seek help. You might tell him that he has not been looking well lately and that you are concerned about him. I would not argue or try to dispute any of his delusional ideas since it is a battle you would likely lose. Try to get him to agree to go to a doctor. Does he have a doctor he likes? What about his family? If your concerns continue, you can call one of his family members and report what you are seeing. If you cannot get him to seek help and family is not an option, perhaps you can monitor him and make sure that he is not hurting himself or a danger to others. If he does get to that point, and you feel he may be a danger to himself or others, you can call the police who will take him to a hospital for a psychiatric evaluation. I hope this helps. Please write again with any more questions. Take care.