Delusional disorder

[honeybuffe]

A member of my dp's family is currently an involuntary patient in a psychiatric unit. I am on file as his next of kin (long story) He is experiencing acute psycosis and they have said that at the moment they have "a working diagnosis" of delusional disorder. I have read a good bit of what I can find on the Internet about this condition. I was wondering if anyone here could offer any information or experiences of this or recommendations of things to read in relation to this. Thanks in advance for any info or suggestions.

I don't know about 'delusional disorder' but I do know that when I suffered from psychosis I was diagnosed with 'recurrent depressive disorder with psychosis'.

It is probably just a 'working diagnosis' at present because there are several conditions that can cause psychosis I think.

Hope he recovers soon.

Thanks. He has been there a number of weeks now and his meds are now at the max they are comfortable with and the delusions are still occurring. His are incredibly detailed and involve real people (some he doesn't know but that do exist). They originally thought that it was either going to be a purely drug induced psychosis or drug induced with a possible genetic vulnerability to having a psychotic episode. As his next of kin I just want to help and understand as much as I can. Also helps the more I know the easier it is explaining things to his mother, sister etc. I think purely drug induced has now been pretty much ruled out due to the amount of time that has passed.

Medications do take a while to work. When I started Aripiprazole (an anti-psychotic) I still believed that MI5 were watching me through a camera upstairs in my house - this belief lasted a few months. Part of me knew it was irrational but I still believed it. I improved quite slowly at first.
But then the med really started to work and I don't have any of those weird beliefs anymore.

Thanks, it's helpful to know other people's reactions to the meds and that they can take months to take effect. It's also great to hear you are doing so well and that they do work for people.

You might find it helpful to look at the MIND website honeybuffe or RE-THINK - there's a lot of info on those sites you might find helpful. Oh just seen you've read up on the internet so might have been on the sites. When you say "drug induced psychosis" do you mean that he takes recreational drugs - a lot of people with MH problems "self-medicate" with alcohol/drugs, which of course makes things worse.

There are some very good drugs for psychotic illness, but the trouble is there is a tendency for people to stop taking them once they are left to their own devices. The real dilemma is that when people are very deluded they don't believe there is anything wrong with them, and I think this could be one of the reasons they stop taking the meds, but that's pure conjecture on my part.

Hope your relative gets the help and support he needs. Mental illness is a torment for sure.

His drug use was recreational use of cannabis but he had been having some very hard to deal with rage/aggression mainly directed at his dm my mil. He had also experienced a massive personal trauma at the start of 2014.

You're absolutely right about him thinking there is nothing wrong with him. The problem is that his delusions involve real people. He was voluntary at first and ended up doing a runner after 3 days before ward was locked for the night which meant we had to make some difficult phone calls to people and police in case he turned up at their homes. In the end my dh found him and brought him home to us and he was admitted involuntarily the next day.

He was denied discharge or voluntary status at his tribunal and this has just made him more guarded about talking about his delusions. He does open up to me though and I then pass the info on, it's hard as I feel torn for betraying his confidence but they assured me its for his own good and he does always feel better when he's shared his thoughts but lately he's sharing less. Sorry if I'm rambling a bit here, just want to learn and understand as much as I can to do the best by him. I'm a great believer in reading and trying to learn as much as possible. If only so I know the right questions to ask his psych team. Just so hard at the moment as the poor fella is only 22.

Is this your relative's first experience of mental illness? It's just that psychotic illness does often show itself in the late teens/early twenties. Also excessive use of cannabis can be linked with psychosis, because I think this skunk is so much more dangerous than cannabis. I'm not being judgemental by the way - I think cannabis is better than alcohol in a way, but I think the problem now is that there is some very nasty stuff about (not like the "hash" that I smoked in the 1960's!!)

I'm wondering how you respond when he talks to you about his delusions - it's just some people try to deny them e.g. "No the meds aren't poisoning you" or "The TV isn't sending you messages" - he may also be hearing voices and these can be very compelling, often making people with psychosis believe that god is telling them to kill themselves. You might already know this, but it's best not to deny what is being said, although that seems the rational thing to do. It's probably best to say "I know that's what you believe and it must be very scary" or something similar.

Do you know what Section of the Mental Health Act he is on - there is one for 28 days, and one for 6 months I think. But he is in the right place and you sound lovely for supporting him. Many people are scared of mental illness and I think this is because the stigma (even in this day and age) is as bas as ever.

We're in Ireland so I'm not sure if the times for orders are the same. When we signed paperwork to have him brought in involuntarily it was 21 days and then he had a tribunal with a free legal aid solicitor and an independent assessment. He was not considered to be in a position to be anything other than involuntary. He has 14 days to appeal, which he is, although it's likely it won't change in which case the order was made for 3 months. Although, if they saw fit this could be revoked at anytime if he recovered enough.

Yes it was v strong cannabis, likely skunk(not like the stuff we smoked in the 90s either!) I gather at this point they think that this condition may have been underlying and the cannabis brought it forward. This is his first experience of a mental health issue on a professional setting, we have had a referral appt before for aggression/threats of violence but he refused to attend. This situation though is all new to him and us.

When he is talking about his delusions I tend to talk around them if that makes sense. So he might tell me something outlandish and I will agree I know the person but have no recollection of that happening. I also tend to encourage him to get his thoughts out as the agitation builds up in him over a couple of days as a new one seems to form. (That is not even remotely a medical opinion or fact just my own feelings on chatting and watching him, I could be way off) I speak to him briefly many times a day so can usually get a feel for a change in him. I do try to talk about things without ever agreeing as often he is looking for "evidence" and to agree would feel like feeding as the slightest thing can get taken, twisted and worked into the story to become evidence and upsets him more. The only time I have outwardly disagreed was within a family meeting with docs present and tried to do it gently, " I understand you think that but it's not true and since I and your family care about you we feel you deserve the truth" (this was a delusion about his family heritage so made sense) and it was what I had been advised to do as was part of diagnosis process.
Thanks for taking the time to respond, I really appreciate everyone's suggestions on how best to deal with this and help.