My Sister got divorced about 2 years ago from a very angry man who she was married to for about 40 years. She lived in fear for a couple of years. She has since the divorced been to a few doctors about this bug thing and feels that no one believes her. She did have a mold problem in the place she moved to. I am totally confused as to how to deal with this. She has now added sleep walking to it and is doing things while sleep walking. She even let herself out of the house recently. What do I do? Any advice?

A. I don’t have enough information to know what might be wrong with your sister. For example, you mentioned that she thinks she’s infected with bugs. Does that mean she feels them on or in her body or does she think they’re in her home? What kind of bugs? Bedbugs? Parasites? Perhaps most importantly, what type of evidence does she have for her claim?

If she has no evidence to support her claim, one possible explanation is that she’s experiencing the signs of psychosis possibly triggered by her having lived in fear of an angry man. It is common for episodes of psychosis to be triggered by traumatic or stressful events. Sometimes people have episodes of psychosis and never have another. The stress of certain life events can occasionally be too much to bear.

Psychosis is a break with reality. Symptoms include delusions and hallucinations. Delusions involve believing that something is true despite convincing evidence to the contrary. Hallucinations involve the five senses. The sensation of bugs could be considered a hallucination. Other symptoms include paranoia and disorganized thinking.

Ideally, she should be evaluated by a mental health professional, preferably a psychiatrist. A psychiatrist is a medical doctor with specialized training in mental health and neurological disorders. They would be in the best position to determine what might be wrong.

Try to convince your sister to consult a mental health professional. Go with her if she will allow you to do so. At the appointment, you can provide support, ask questions and learn the diagnosis. Your going with her will eliminate any confusion about what happened during the appointment. The mental health professional will also make recommendations for treatment.

If your sister is unwilling to seek treatment and if her symptoms continue to worsen then she may need to be hospitalized. If she is experiencing psychosis, it usually does not get better on its own; intervention is generally required. Supervise her if you can and call emergency services if necessary. If she needs treatment, the emergency personnel will ensure that she gets it.

In the meantime, you might try googling “mental health or psychiatric emergency services” and your ZIP Code. It will help you to determine what services are available in your community.

I hope this information helps you to know how to proceed. Please remember that I do not have enough information to know what is wrong with your sister, so my recommendations are general. However, the information you have provided suggests that you are right to be concerned. Do what you can to help her. Try to convince her to seek help from a mental health professional and call for emergency services if needed. That’s the best you can do.

If you would like to write again with additional questions, please don’t hesitate. I will do my best to help you. Thank you for your question.

Dr. Kristina Randle