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Sister-In-Law Is Delusional After a Stroke

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My brother’s wife had a stroke about a year ago. He is completely devoted to her. She has partial paralysis and slight trouble with speech. A few months after the stroke, she started accusing my brother of having an affair with a woman that lives 300 miles away. She’s now decided that the woman has moved a few houses away from them. She also thinks that he’s having affairs with every woman in the town and everyone they see while they’re together out of town. She will even say things like, “Who are you going to see on that plane?” When the plane she is talking about is flying over them. She is a registered nurse, and although she is doing these things at home, and making life totally miserable for him day and night, she evidently can put on a perfect act at every doctor’s visit. They all seem to think she’s doing fine, when we all know she’s not. She refuses to let anyone go to a doctor visit with her, to really tell how things are. What can he do? If he can’t legally force her to get help, what can he do to help her, or more importantly now, what can he do to help himself? He’s been dealing with this for months.

Sister-In-Law Is Delusional After a Stroke

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A.

Studies show that psychosis is a possible complication of a stroke but it’s rare, with an incident rate of about 1 percent. Her delusion seems to be very focused. She might have what is called delusional jealousy. A set of German researchers documented a rare case of a stroke victim who experienced delusional jealousy, a syndrome which they referred to as “organic Othello syndrome.”

In their 2012 case study, they describe a 49-year-old female with no history of psychiatric illness who had a stroke and subsequently developed the delusion that her husband was having an affair with one of her friends. The authors reported that she was unshakable in her beliefs despite there being no evidence to support her accusation. The alleged affair made her very upset to the point where she would angrily throw household items at her husband. She demonstrated no other psychiatric symptoms. The authors theorized that her symptoms might have been the result of brain damage suffered from the stroke. Typical treatments for post-stroke psychosis include psychotropic medications.

It’s important that your brother immediately report these symptoms to her doctor. Though she does allow him to go to the doctor with her, that doesn’t preclude him from contacting her doctor. He could either call or write a letter detailing her symptoms and his concerns. The doctor might not be able to respond, given health privacy laws, but there’s nothing that prevents your brother from contacting her doctor and reporting his concerns.

Your brother should also ask the doctor for advice about how to handle this situation. He or she might be in the best position to help your brother and his wife.

In the interim, there are some resources that may be of assistance to your brother in dealing with the accusations. Dr. Xavier Amador has written a good book that many people have found helpful called I Am Not Sick I Don’t Need Help: How To Help Someone With Mental Illness Accept Treatment. The book provides practical advice for families dealing with a loved one who is experiencing a break with reality.

Hopefully, once her doctor is made aware of the problem, he or she will be able to help. If not, your brother may want to consult other health care professionals who specialize in psychosis or organic brain disorders. Please take care.

Dr. Kristina Randle

Sister-In-Law Is Delusional After a Stroke

Kristina Randle, Ph.D., LCSW

Kristina Randle, Ph.D., LCSW is a licensed psychotherapist and Assistant Professor of Social Work and Forensics with extensive experience in the field of mental health. She works in private practice with adults, adolescents and families. Kristina has worked in a large array of settings including community mental health, college counseling and university research centers.

APA Reference
Randle, K. (2018). Sister-In-Law Is Delusional After a Stroke. Psych Central. Retrieved on September 16, 2019, from https://psychcentral.com/ask-the-therapist/2014/10/19/sister-in-law-is-delusional-after-a-stroke/
Scientifically Reviewed
Last updated: 8 May 2018
Last reviewed: By a member of our scientific advisory board on 8 May 2018
Published on Psych Central.com. All rights reserved.