The Dos and Don’ts of Helping a Family Member in Psychosis 

Man Helping a Family Member in Psychosis


Have you noticed a family member beginning to act strangely? Does he seem to think that someone is trying to hurt him when there was no apparent danger? Or maybe he has started following a complex belief system that you can’t quite understand? It could be that your loved one is experiencing psychosis. Psychosis and the disorders that cause it are complicated to understand. Thankfully, I came across a resource that helped me comprehend how to help someone in psychosis. Schizophrenia: A Blueprint for Recovery by Milt Greek, a person living with schizophrenia, helped demystify psychosis and gave me further understanding of its impact on individuals and their families.

milt greekThis book makes it clear how confusing and even terrifying psychosis can be for the individual and his family. It isn’t an easy situation to navigate and a lot of people can get it wrong. First, take a look at what psychosis means. Mental Health First Aid USA defines psychosis as “a mental health problem in which a person has lost some contact with reality, resulting in severe disturbances in thinking, emotion, and behavior.” Psychosis can show itself in a variety of symptoms such as delusions, visual and audio hallucinations, disorganized thinking and paranoia. Schizophrenia may be the disorder that is most commonly associated with psychosis but other disorders including bipolar disorder, schizoaffective disorder, depression, or substance use can have psychotic symptoms. If you have a family member or loved one who is experiencing psychotic symptoms, you want to make sure you don’t escalate the situation and are able to assist him in getting the help he needs. Here are the do’s and don’ts of helping a family member in psychosis based on what I learned from Schizophrenia: A Blueprint for Recovery.

The Do’s and Don’ts of Helping a Family Member in Psychosis

Don’t panic or overreact

When your loved one is experiencing psychosis he might say or do some strange or even alarming things. The important thing to do is to learn more about what your loved one is experiencing while remaining calm. Milt Greek writes “people with schizophrenia are emotional sponges” meaning your family member who is experiencing psychosis can easily be affected by the emotions other people are displaying.

You may think being in a psychotic state will prevent him from picking up on how you are feeling and acting but that may not be the case. He may be even more tuned-in to negative emotions around him than you are, which is why it is important to monitor your behavior, too. Also, don’t take any thing offensive he says personally or try to confront him about it. It is best to calm yourself before engaging with him.

Do listen non-judgmentally

Hear what your loved one is saying and don’t dismiss it or laugh it off. Empathize with the emotions he is experiencing. If your loved one is paranoid and acting afraid, understand that he is legitimately feeling fear. Often times people in psychosis don’t readily tell everyone what they are experiencing and why. Ask questions like “what can I do to help?” or “can you tell me more?” Keeping a calm tone and making it clear you understand the emotions he is experiencing might allow him to feel comfortable enough to open up.

Don’t make medication, treatment, or diagnosis the focus

Depending on where you and family member are in the cycle of discovery, this may not be the first time you have seen your family member in psychosis. You may know the disorder that is causing this behavior and that he is prescribed medication to manage that condition. While that may be the case, informing your family member that he is just experiencing the symptoms of a disorder and that he needs to take more of his medication may only aggravate the situation.

The psychosis your loved one is experiencing seems just as real to him as reality seems to you right now. Telling him what he is perceiving isn’t actually reality will only drive a wedge between you and him. It’s perfectly fine to calmly ask a few questions about medication to gain better understanding of the situation, but insisting or forcing medication while your family member is still in a psychotic state will only lead to him believing you are working against him. You want to make sure your family member thinks of you as being on his team, not an enemy.

Do speak slowly and simply

People in psychosis or who have just come out of a psychotic state might struggle to understand complex language like double-entendres, metaphors, exaggeration, or sarcasm. During this time, it’s best to speak in short clear sentences as you don’t want to further confuse or upset your loved one.

Ask one question at a time and give him enough time to respond. Try to remain at the same eye level as him: if he is sitting, don’t stand and hover over him. Also, if others are in the room with you, don’t speak about him as if he is not there. You want to communicate to your loved one that everyone is working with him to help him get better.

Don’t threaten

Especially if you are a parent, it may be second nature for you to threaten a consequence for your child’s behavior. When it comes to psychosis, it’s not a good idea to issue some form of negative repercussion for his behavior. The motivations for his behavior come from his mental health disorder, not from a lack of discipline. Furthermore, when your family member is in psychosis, trying to rationalize him out of his behavior is probably not going to work.

Do stay positive and encourage help

As mentioned earlier, the emotional turmoil that psychosis brings is very real and often very scary to your family member. It’s important to keep your side of the dialogue comforting and positive. Psychosis may make life seem overly dangerous, dark and threatening. Your loved one may think there is no escape. Try not to add to this negativity.

Ask him “how would you like to be helped?” or if this has happened before, “what has helped you when you felt like this before?” He may give you an idea of who he prefers to turn to during this time, (e.g. he may find his therapist more comforting than his psychiatrist or vice versa). Knowing who your family member trusts is an important part of finding the right intervention.

Don’t hesitate to contact a mental health professional

Your family member may not be willing to get help. This can be very frustrating and confusing for most families. If you are concerned that you or someone you care about is experiencing psychosis, it is important to seek help from a qualified mental health professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

Contact a Resource Specialist


Want the Book? Check out the link below.
Your purchases will help support the costs of running, a free service of Laurel House, Inc., 501 (C)(3), non-profit organization.

Schizophrenia: A Blueprint for Recovery
Schizophrenia Diagnosis & Treatment Options


Mental Health First Aid USA (1st ed.). (2013). Lutherville, MD: Mental Health Associates of Maryland.

M.G. (2012) Schizophrenia: A Blueprint for Recovery. Athens, OH: Milt Greek.


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62 thoughts on “The Dos and Don’ts of Helping a Family Member in Psychosis 

  1. Avatar
    KrisBee says:

    This explains almost everything about my mom’s behavior for years and years and years and years. Wow. Thank you very much.

  2. Veronique Hoebeke, Associate Editor
    Veronique Hoebeke, Associate Editor says:

    Thanks for commenting. Glad you found this article helpful! Best of Luck–Veronique

  3. Avatar
    Liz says:

    So from what I have just read, we are just suppose to go along with whatever they say or act? That is the best way for a family to deal with this? What about when they don’t want to bathe or clean up after themselves? Personal hygiene is part of this disorder too. Is it possible for them to live a productive life with society?

  4. Avatar
    Jay Boll, Editor in Chief says:


    This is a great question. Thanks for bringing it up.

    The short answer is that yes, people with schizophrenia and other psychotic disorders can live productive lives in society. To tell you how, I need to explain a little about how a disorder such as schizophrenia affects a person.

    When someone with psychosis hears voices or expresses strange beliefs (delusions), those are considered positive symptoms of the illness. They are “positive” because they involve changes in thoughts and feelings that alter or “add to” the person’s experience. Poor personal hygiene, low motivation, and apathy are considered negative symptoms because something is “taken away” from the person’s experience.

    Anti-psychotic medications can eliminate or reduce those positive symptoms of the illness. However, they have no effect on negative symptoms such as poor hygiene. One theory is that these negative symptoms are caused by cognitive impairment that often accompanies disorders such as schizophrenia. This impairment can lead to reduced short and long-term memory, lower attention, slower processing speed and decreased planning and problem solving skills.

    A form of treatment known as cognitive remediation can help reduce and even reverse some of the impairment. Combined with psychotherapy, life skills training, peer support, and psychosocial rehabilitation, cognitive remediation can make a positive impact on the negative symptoms, resulting in better hygiene and self-care, increased motivation, and greater overall satisfaction with life.

    Putting together the right combination of treatment, services, and supports to help a person recover from psychosis can be very difficult – especially for families who may not be aware of all the options. Our Resource Specialists are available to offer free assistance in this area to anyone who would like to Contact Us for Help.

  5. Avatar
    Dana says:

    Thank you for the “Do’s and Don’ts”. Eighteen years trying to help my son has left me despondent. He has medication resistant Schizoaffective Bipolar II disease. He goes into Psychosis even when he takes his prescriptions. I believe I have found one of the best doctors in Dallas Texas and he has not given up searching for some medication that might help. My son has very little quality of life and the psychosis lasts for months sometimes. If there are resources in Dallas that might help my son please let me know.

  6. Avatar
    Jay Boll, Editor in Chief says:


    Finding the right medication to treat a psychotic disorder can be challenging, as no two cases are the same. You mention two different disorders for your son: Schizoaffective Disorder and Bipolar II Disorder. While a person can have one or the other of these disorders, it is not possible to have both. If you’re not sure about the diagnosis, that is a good place to start by getting a second opinion and a comprehensive psychiatric evaluation.

    I can have one of our Resource Specialists contact you by private message on Monday to offer some suggestions for providers in your area. This is a free service to users of our website.

    Thanks for reading the blog and reaching out. – Jay

  7. Avatar
    kpt says:

    Hello, the article and feedback are very helpful. Right now my husband of 9 years is experiencing a major depression with what I believe to be, psychotic episodes. He is on the Tourette’s Spectrum and we have had a major crisis with our house. As a engineer, he is suddenly having trouble resolving the issues and keeping everything in perspective. He has completely shut down as a result of the depression and is now trying to end our relationship. I do not believe he is acting the way he would want to, if he was not in the negative spin of the depression. It is very difficult to step back and give him space, especially as he is isolating himself. In his isolation the depression gets worse. Any suggestions would be appreciated.

  8. Avatar
    Helena says:

    Hello, thank you for this article as it has provided me with a little hope that things can be managed and ultimately made better. My brother (who is studying as an international student) hasn’t been back home in over a year and suddenly, while talking to him on calls we (his family) started noticing something weird about his behaviour. One day he called us and started acting really paranoid and turned off his cellphone so it was hard to reach him. A few days out of contact with him we found out that he had been agressive and was taken to a hospital for an emergency treatment to calm him. My parents have gone to visit him and see to his situation but now he has started getting paranoid towards them too. He thinks they’re out to harm him. He is being taken to a psychiatrist but it’ll take a few days meanwhile I wanted to know how we can talk to him so that he feels calm and does not consider his family an enemy. This is a really hard time for us considering we’re in different countries and it’s hard to stay in contact and be with him 24/7. Please help me out. Can he get better? Can he start living his life normally again? He’s so young and full of potential and seeing him like this breaks our heart. Can he continue with his university alongside his treatment? Any suggestions will be very much appreciated. Thank you.

  9. Avatar
    Nohemi says:

    My bf has a schizoaffective disorder, bipolar type from what we were told at his psychiatrist’s place. He had a psychosis episode last week, and without knowing I seem to have done most of these things right, Idk… maybe I am in tune with him and that helped -thankfully. He is currently being stabilized at a clinic, but my concern is; what is the proper way to encourage him to take his meds?

    Because as of late (this past month), he has been reluctant to take them.
    He had expressed concerns about some side effects he didn’t like, so they’re testing out new medication to see what helps him best..
    But he has shared with me, he truly has no intention to follow on his treatment regarding meds because he feels they have no effect on him… =\
    I want him to be able to have the best quality in experiencing life that we can have, and I know the potential for more psychosis episodes by not taking his pills are not* going to help him live life to the fullest.. so how can I help him see that?

  10. Avatar
    Jay Boll, Editor in Chief says:


    Thank you for your comment expressing your concerns about your brother.

    At Laurel House, Inc., our sponsoring organization, we have worked with many university students with serious mental health conditions, including psychosis. Many of them are doing well in school, but for them to succeed in such an environment it is usually necessary for them to be in treatment for the mental health issues and have their symptoms under control.

    You mention that your brother was taken to a hospital. If he was given medication for his paranoia, it could take a few days for his symptoms to subside. If he was released from hospital and is no longer taking medication, the paranoia could return or even get worse. In any case, it is best to be non-confrontational with him while he’s showing any signs of paranoia.

    I will ask one of our Resource Specialists to contact you privately to offer further assistance with your brother.

    – Jay

  11. Avatar
    Jay Boll, Editor in Chief says:


    It sounds like you used good instincts for handling the situation with your boyfriend last week.

    Unfortunately, many people in psychosis do not recognize that they have a problem and are often reluctant to take medication.

    It usually doesn’t work to be confrontational or coercive in a situation like this. Empathic listening to try to understand the other person’s concerns about medication can be a positive alternative that builds trust and helps reduce paranoia.

    I will ask one of our Resource Specialists to contact you in private to offer assistance with your boyfriend’s situation.

    – Jay

  12. Avatar
    Christina says:

    My step son has psychosis. He was in the hospital for a week. He took his meds for about a week an a half. Then he dumped them. He says there is nothing wrong w him an doesn’t want meds. How can I get him to go to the doc an get more meds an take it. He is 20 years old. He moved back to his moms because he thought I was poisoning him. He thinks everyone is the fbi following him. I just don’t know what to do

  13. Avatar
    Jay Boll, Editor in Chief says:


    It is not uncommon for people with psychotic disorders to believe there is nothing wrong with them. Dr. Xavier Amador of the LEAP Institute has developed a communication approach that family members can use to encourage a loved on with mental illness to get the help he or she needs. LEAP stands for Listen, Empathize, Agree, Partner.

    Dr. Amador has written a book on his approach titled I Am Not Sick, I Don’t Need Help! LEAP is a good approach for family members to use when someone doesn’t recognize he has an illness and is resistant to seeking help.

    I will ask one of our Resource Specialists to contact you privately to offer you assistance with your stepson.

    – Jay

  14. Avatar
    Rick says:

    My brother, 54 yrs. old, is showing behavioral swings, paranoia, conspiracy against him and suicidal thoughts. He is in CA, living alone, just lost his job and I am going over to be with him in the hopes of helping out. I don’t know how to deal with this situation, so guidance on this matter would be greatly appreciated. Thanks.

  15. Avatar
    Agatha says:

    I have a 16 year old son who have been give 4 different medication with in two years and none of them works please help me.

  16. Avatar
    Debra says:

    My son who’s now 35 suffers what they go between schizophrenia and schitzo-effective disorder. I’ve heard both diagnosis from different psychiatrists. I didnt understand how to help him. He had become violent towards his father and was court ordered to take medication. Well that didnt work, I notified the court psychiatrist that by his actions I felt he wasnt taking his meds. It fell on deaf ears. A short time later because his paranoia was so bad he purchased a gun for protection and when approached on the street at night thought a police officer was part of a group chasing him and shot him. Luckily a minor wound. He now sits in a secure psychiatric unit of a prison. Now my daughter who’s 31 with 2 small children has developed a psychosis . Her husband didnt understand it, they are now separated, shes lost her children and has been arrested for trying to go to her children. We’ve been trying to get her to seek help. Shes been hospitalized a few times but refuses medication because in her mind nothing is wrong with her. Her delusions get so bad people are not comfortable around her. I as her mother am trying everything to get treatment for her. I’ve been not understanding her mind until reading this article. I’m gonna try a new approach. I had been setting demands on her. I’m now gonna just try listening. I don’t want to see her in jail like my son because of mental illness. Both these kids had a huge loving heart towards people until the illness took over. There needs to be more awareness and go to places for family members who want to help their loved ones. I live in NH. Mental health services here stink!! Thank you for opening my eyes a little with how to understand the dos and donts with a psychotic mind

  17. Avatar
    Jay Boll, Editor in Chief says:


    Thank you for commenting and sharing your story about your son and daughter. It is very hard for a parent to watch an adult child succumb to a serious mental illness, let alone two children.

    In situations like this, the parents could also use some support. Our Resource Specialists our available to offer you or any other parent assistance and support if you’d like to Contact us.

    One of our Resource Specialists will be able to guide you through the process of helping your daughter and assist you to identify resources for help in your community.

    I wish you the best in dealing with this difficult situation. I know it isn’t easy.


  18. Avatar
    Ryan says:

    My brother-in-law, who is in his mid 30s, has been showing some signs of what appear to by psychotic depression. There is no family history of metal disease or schizophrenia that I am aware of. Prior to this he had his stuff together, he had a good career, owns 2 vehicles and owns his own house. About a year ago he came to me and told me that he could project his thoughts into peoples minds and that sometimes people could hear his thoughts. He has always been so level headed and down to earth, and he was so convincing I almost started to believe him. Now that more time has passed, recently he has been saying that he is possessed by a 2500 year old demon who wont let him sleep and pokes him awake and sometimes Satan stands at his door and wont let him leave. He is afraid to come by and see my daughters (his nieces) because he is afraid the demon will jump from him and into them. He has never been a religious person so it is interesting/strange that his psychosis took him in this direction. He stopped going to work, showing up to family functions and is quick to rush you out if you stop over if he even opens the door. We are having trouble getting him to see a doctor of any kind and are not sure what to do. Any advice?

  19. Avatar
    Jay Boll, Editor in Chief says:


    This sounds like a complicated situation. I have asked our Resource Specialist Denise to contact you directly to offer assistance.

    Hopefully, she will be able to help you with some ides for how to handle this.


  20. Avatar
    Roupina says:

    My 38 year old son has been abusing steroids and marijuana for 20 years and refused to get off. After a 7 month intervention, he finally decided to stop cold turkey without notifying us and now is in a psychotic, manic bipolar state. He was in mental hospital for a week after threatening several people who filed complaints about him. I’ve been trying to help him, and have been paying all his bills so he can concentrate on getting well. He’s been taking medicine but cut morning dose in half, says it makes him drowsy but really feels he’s normal and doesn’t need medicine. His business has suffered since he had threatened clients, his car was being provided by a client who now will not return car and he is only nice to me when I help with money. He doesn’t feel he has a problem and he is fixated on a delusion his wife cheated when it was him with all the indiscretions and emotional abuse to his wife and family. He still plays the victim. I told him I will continue to help if he takes his meds and goes to psychiatrist and therapist, but he is very vulgar and disrespectful to me and I finally told him I love you and will help you IF you treat me with respect and do what you’re supposed to do. He has a restraining order against him and misses his son, but he is a bad influence now and not well and court is in a week. I’m trying to help him do the right thing so judge and wife will grant supervised visits. How do I help? Do I continue to pay bills even though he doesn’t want to cooperate? I’m at a loss now. This has been going on for years even though bad psychosis event happened a couple of weeks ago. He wouldn’t stop steroids and marijuana and those were making him delusional and emotionally abusive and grandiose and narcissistic for many years. How do I help without enabling him by continuing to pay bills?

  21. Avatar
    Jennifer says:

    My 21 year old daughter abuses marijuana. She works at a job where she can pretty much show up high, I can’t remember the last time I have seen her not high. Last week she came over paranoid that the world was ending and making all kinds of spiritual connections between random things that involved her and she was scared about it. I suggested these thought were due to her excessive marijuana use which she wouldn’t accept. Today she is completely comfortable in her delusions and they no longer scare her. She talks of time travel in her brain and totally embraces it. She talks of “them” watching us through every technological avenue and poisoning our food and water. She thinks she sees things clearer than anyone else and has nothing wrong with her, like a previous commenter she is so adamant about her beliefs that she almost sucks me into her delusions. How can I help her? She thinks she is living an enlightened life

  22. Avatar
    RM says:

    My husband does all of the above to me. I just had my first real psychotic break and am trying to recover. It’s so difficult.

  23. Avatar
    Lisa Anderson says:

    My family member has been struggling with depression and has been diagnosed with “some psychosis” from major depressive disorder. He is an adult and has stopped taking his medication about a year ago and is now isolating himself from our family……stays in his room and we are concerned he is experiencing fear and paranoia. Is there a way to help him here at home as he refuses to get help and we are all afraid of saying or doing the wrong thing that can cause him to get worse. We love him so much and it’s killing us to see him in this much pain. Is there anything we can do to help him?

  24. Avatar
    Gerald says:

    My mother has been like this for as long as I can remember. Currently I am caring for her and an recently had an altercation. While preparing to leave the house I stumbled on a bag of trash she had left laying around which caused me to dislocate my ankle. She freaked out not from my cries for pain but because my fall had torn the bag open and left the trash fall out. She immediately placed the fault of the incident on me and when I mentioned the excruciating pain in my foot, she began raising her voice yelling “Watch where you’re going don’t blame your stupid mistake on me.”

    It may have been due to the pain in the moment but for the first time in years I yelled at her mentioning her outrageous claim and pointing out her selfishness. At this point she snapped and began grabbing anything in the area to through at me, shoes, hangers, trash, and a water bag I normally take to the Gym. I got livid and caught the bag and rose it up high but as soon as I saw the fear in her eyes from me holding that bag up, I just threw it to the ground. It was at this point she locked herself in her room and claimed to have disowned me.

    I care deeply for my mother and for the past two days she refuses to properly communicate with me or allow me to take her out to see a doctor. She still eats the meals I prepare for her but consistently states to my face that I am a worthless piece of trash. I’m not really sure what course of action I should take. I’m attempting to meet with her psych specialist tomorrow to discuss any possible avenues to take but would like to hear other opinions which is why I am here. Thank you for your time.

  25. Avatar
    Paula says:

    I would like to know how to help my brother. He was diagnosed as schizophrenic. He was discharged from the Navy before completing his tour. Since then, we as a family, have experienced numerous violent episodes from him, 2002 to present. The last occurrence was this past Tuesday, and before that was in 2016. He doesn’t take medication and lives at home with my parents. I would, very much, appreciate any information or resources for him.

  26. Avatar
    Kim O'Reilly says:

    Thank you for your comment expressing your concerns about your brother.

    Often, an individual like your brother who has been diagnosed with schizophrenia does not recognize the need for help or medication. There is a book written by Dr. Xavier Amador called “I am not sick, I don’t need help” that provides practical advice and hope to families. Dr. Amador developed a technique called LEAP (Listen, Empathize, Agree and Partner) which helps families learn how to better communicate, listen, and resolve impasses with their loved one.

    I will have one of our Resource Specialist contact you directly to help you with some ideas for how you and your family can help your brother.

  27. Avatar
    Taj says:

    I have bipolar 1 schizo affective. I never started experiencing psychosis until my 40’s (I am 53 now).
    I moved back in with my mother because due to my illness I lost everything and became homeless. I experience approximately 3 – 5 psychosis episodes a year now. My problem is, no matter how open and candid I am with my mother about my moods, or how I feel I am heading toward another psychosis episode, she gets defensive, takes every minute thing I say or do personal, and in her defensiveness starts becoming verbally abusive saying the most awful things. This ALWAYS sends me plummeting to the depths of hell, which I cannot describe. I have always wanted to die when she does this and have attempted suicide 5 times now. My question, how do I make her understand me?

  28. Avatar
    Jay Boll, Editor in Chief says:


    Thank you for reaching out to us with your concerns. One of our Resource Specialists has contacted you in private to offer support and guidance in this matter.

    For anyone else who may be reading this I will include the phone number for the National Suicide Prevention Lifeline, which is… 1-800-273-8255

    And here’s a link to their website…

    They have staff available 24/7 to talk with anyone who may be feeling suicidal.

    Jay Boll
    Editor in Chief

  29. Avatar
    Char says:

    Hi, my cousin is 29 years old and she has had 2 involuntary hospitalizations. She has been diagnosed with both schizophrenia and “manic depression” as she refers to it (by 2 different psychs). She has a mood stabilizer but I don’t know if she’s taking it. She is completely stuck in her delusion. There are no moments of lucidity or clarity. If I ask questions (how can I help?), she answers in terms of the delusion. She has actively been in this delusion since September 2019. She lives at her father’s house with him and her brother – they have very little interaction because both males work and they don’t know how to understand her experience or seek help without legal involvement. Her mother and sister have ostracized her. She doesn’t have her 5 year old kid anymore (he’s with his abusive dad). She was in the Navy and honorably discharged around 2013 after an injured foot / untreated infection. She drinks and smokes marijuana and has done some heavier drugs in the past (ecstacy, K2 spice, she said her boyfriend also drugged her). She began showing symptoms of auditory and olfactory hallucinations in June 2019. No one believed her. Since then, she has descended into this delusion (working as an underground FBI agent since age 9, involvement with gang warfare internationally, and has the highest title in the Navy – 1 of 19 men), and is completely unable to have a conversation about reality / anything in the present. I have to help her. Please give me advice on working with someone who is actively and constantly in the delusional state, subsequently, rendering her unable to answer questions or talk about ANYTHING normal or future-oriented.

  30. Avatar
    Kim O’Rielly, Young Adult Resource Manager says:

    Thank you for sharing about your cousin who is experiencing delusions and is exhibiting symptoms of psychosis. Often persons with delusions and psychosis do not recognize the need for help or want it. There is a book written by Dr. Xavier Amador called “I Am Not Sick, I Don’t Need Help” that you might read to gain some understanding. He is a psychologist but also a family member as his brother has mental illness. He developed a technique called “LEAP”, Listen, Empathize, Agree and Partner, to better communicate. I will email you privately to offer you some assistance and recommendations on helping your cousin.

  31. Avatar
    lita says:

    My nephew abuses marijuana for 8 years and experiencing hallucination and paranoia. We confined him to a rehabilitation center and clean for a year now, But last week he uses marijuana again and stop drinking his medicine and he experiencing a partial memory loss and hallucination again. I am helping him financially for his rehab because he lost his jobs and no source of income now. Can you help me understand what will i do ?

  32. Avatar
    Tim Ouellette says:

    What a wonderful resource for family members and friends of those of us afflicted with mental illness! I have been living with Schizoaffective Disorder/Bipolar Type since my late teens/early twenties and found the steps included in this article to be very helpful and pragmatic. Those of us who experience psychosis often feel scared and alone during an episode; it’s comforting to know that someone has made the effort to break down the family member or friend’s planned responses in a way that is both helpful and comforting to the one experiencing psychosis.

  33. Avatar
    Paula Feisthamel says:

    Hi my family member has been abusing street drugs like meth, cocaine, opiates you name it she has taken it. About 20 years ago she started with delusions about being watched and a group of men who were watching her. She was able to work jobs such as waitressing during this time but never was able to hold one job consistently. 13 years ago she had a child and stopped using street drugs, and got a job in a factory. Although she stilled believed the “people” were watching her she was able to live a pretty normal life. People and family always listened and included her because underneath the delusional thoughts she was such a kind hearted person. About 2 years ago though the mental illness has progressed, she started abusing drugs again, and now she believes the people are still watching her but she also has a religious higher purpose. She’s a prophet from God and has to tell everyone his will. She has lost her job, she’s living her elderly mother and daughter. In the past few months she’s projected these higher powers onto her daughter. She’s the savior of the world. Her daughter is confused and angry, they fight nonstop. Her mother and her fight nonstop. She refuses treatment because she truly believes her delusions and everyone who disagrees is sent by the devil to destroy her. When she talks it’s like no one has free will we are all just puppets being controlled in her life. The mental health professionals that she sees in order to try and get her own apartment gave her a mood stabilizer which she refuses to take. Obviously everyone cares and loves her but at what point is enough? When does her daughter become the priority? Do you have any advice? Can she be helped? We live in a small community with not a lot of resources. Can anyone force her to take meds or are there even meds that can help? At my wits end!

  34. Avatar
    Cheryl Endicott says:

    My mother in law had been hospitalized numerous times and 2 of them due suicidal attempts & mental wellness which I knew later on now that shes living with us. We took her in temporarily when she was released from the hospital because none of her family would including her stone who is my husband, which now makes sense.

    She has been living with us for more than 3 years now. She was diagnosed with mental disorders on top of her other chronic illnesses but I’m not exactly sure what.

    Last Nov 2019, she was notified that she needs to move out and that she should be out by end of Jan 2020 due to accumulation of financial, emotional, criminal, health & safety issues we had to deal with her being around. I’m more worried for my 12 yr old daughter who is mostly alone with her when my husband and I are at work.

    Living with her for 3 more years, I then learned & witness a lot of things & I can no longer just tolerate them. I’m very concerned aboutjher behavior lately, specially since after she was tokd she needed to move out.

    She is now playing the pitty me game & she tries to pull the sick & senior card. As much as Iwould like to help, with her conditions & her behavior nowadays, I’d rather have her out of my house immediately.

    My husband no longer care to assist her in any way shape or form when she moves out. Id rather put her in a facility where her mental wellness & hygiene is going to be addressed than her living somewhere else when she can still continue to abuse the health cade system & her prescription drugs knowing she has mental issues.

    Is there any chance you can assist on what’s best for me to do or direct me to to can assist

  35. Avatar
    Anika says:

    My friend is experiencing psychotic episodes regularly. One being that she is convinced her hair is on fire and runs around feeling out, screaming in pain and tears her hair out in the process. It’s very scary to see!

    It usually happens after she parties/uses drugs and stays awake for long periods, so I’m prone to think it’s drug-induced or caused by sleep deprivation.

    I can’t decide how to handle it. Do I call 911 when it’s happening or tell her family? She lived with me so I think that I and her now ex-fiancé know what’s really going on.

    I just can’t decide how to handle the situation and I’m in no means equipped to handle it on my own….

  36. Avatar
    Jay Boll, Editor in Chief says:


    It can be frightening to see a friend in psychosis like you describe.

    You did the right thing by reaching out for help. One of our Resource Specialists will contact you privately to offer free personalized assistance in this matter.


  37. Avatar
    Robert says:

    My granddaughter has been prescribed prozak, buspirone (10 mg/day) & possibly one more med for depression & and anxiety. I do not know the actual diagnosis. I read that one should not take prozak & buspirone together. She informed the family that she was seeing orbs & dark cloud-like images. A scratch appeared from her shoulder to her elbow after her shower that she didn’t think was there before & then started an intense burning sensation. She feels like there is some presence around her most of the time. She feels her chest fill up with warm air & has uncontrollable euphoria & laughing. Yesterday, she told my wife that she was “with” my wife’s deceased father & that he was communicating with her. Today she had an episode at her mother’s house where she thought snakes were coming out of the ceiling, walls & floor, was hissing like a snake & was calling her mother, her father & her other grandfather devils & not recognizing them. I know she smokes pot & drinks a little, but I’m afraid she may be taking psilocybin mushrooms or ayahuasca drink. She told me she was reading a “wonderful” book by Rick Strassman, the psychedelics guru. Any suggestions would be very much appreciated.

  38. Avatar
    Jay Boll, Editor in Chief says:


    Thanks for commenting. Anti-depressants and psychedelic drugs are a dangerous mix, especially if your daughter has a predisposition to mental illness. I will ask one of our Resource Specialists to contact you in private to offer assistance and support.


  39. Avatar
    Lynne says:

    I know of a loving husband, father, pastor, friend…loved by all. All of a sudden he went “crazy’ and started having screaming conflicts with others. Serious threats ensued, and his family fled to a safe place. More “craziness” continued as he was arrested in various states and hospitalized twice, He’s just wandering around and having delusions and hearing voices also. He won’t take his meds and is drinking red bull and taking caffeine pills…and probably doing marijuana again. (It is now pretty certain that his “psychotic break” happened when he suddenly QUIT the marijuana several months ago that he apparently was secretly “self-medicating” with.) But now his wife realizes that he’s had some “manic episodes” in the past, especially during times of high stress. So…

    I’d like to know more about “cannabis induced psychosis”….and what is the cure? Is this what probably happened?

    What can be done for someone who will NOT believe that anything is wrong with him and who will NOT take his meds?

    I think he’s been diagnosed with Bipolar 1 with Psychosis.

    Please help! Thanks…

  40. Avatar
    Spencer Weaver says:

    Jay Boll, Editor in Chief, you made the remark that it is impossible to suffer from schizoaffective disorder and bipolar disorder, yet my exact diagnosis is, in fact, SCHIZOAFFECTIVE DISORDER BIPOLAR TYPE. Can you please elaborate on what it is you’re identifying as, “Impossible?” because I am a bit put off by what seems to be a very insulting statement towards the folks, like myself, who do suffer from mental ANGUISH, TORTURE, DETACHMENT, AND ISOLATION. Judging by your photograph, I’d assume you’re a very clean cut, mind healthy type whose never felt anything remotely relatable to what I personally go through on a random, unpredictable, and sudden basis, but I am forced into the curiosity of if you’re a mental health professional or not.

    Spencer Weaver
    (Schizoaffective Disorder, Bipolar Type.)

  41. Avatar
    Kayla says:

    I have a family member who is in their mid 40’s an has a child who is a minor. This person believes the FBI is following them everywhere. They have caused public scenes in the grocery store and in a public library yelling at strangers and recording them. They quit their job and will not leave the house. They are genuinely afraid to be alone in fear something will happen to them. They are trying to run away from the FBI and take their child out of state with them. I’m not sure this is wise. I don’t know what to do. My first concern is for the child because the parent is not in the right mental state. I am willing to take in the minor but not sure how to do so or if this is even an option.

  42. Avatar
    Jay Boll, Editor in Chief says:


    Thank you for the clarification. In my earlier comment, I made a distinction between Schizoaffective Disorder and Dipolar II Disorder, which are two separate diagnoses. But you are correct that there is a bipolar type for Schizoaffective Disorder.


  43. Avatar
    Myra Jane Slon says:

    My adult daughter is 38 years old and lives with my husband (her stepfather) and myself. I read above where you told someone a person could not be diagnosed as Schizoaffective Bipolar Disorder but that is what her first psychiatrist told me she had when she was hospitalized. She was hospitalized three other times and the doctors did not meet with me when she was dismissed and they would never confirm their diagnosis of her. Her first psychiatrist told me she had underlying bipolar tendencies and when she was prescribed Adderall, it was like throwing gasoline on a fire and it just went wild and out of control. It has been ten years since she exhibited paranoia and losing touch with reality. She is obsessed with the government and thinks she works for the FBI. She has held down two different jobs during this time, off and on and there are times when she does alright but I suspect the times she does not do well are because she is buying Adderall off of the street. It is hard to monitor her medication because she will go and stay at my mother’s (her grandmother’s house), a friend or here at home with me. She gets very upset and angry at times and raises her voice and it is very hard to calm her down. It just seems like we are in a vicious cycle where she goes to the hospital for approximately ten days and then comes home and does better then it starts all over again. I am desperate for any help you may offer.

  44. Avatar
    Kim says:

    Hi. My mother in law moved in with us over a year ago. I knew there was a history of mental illness but due to the fact that it is taboo to discuss different issues in my husbands family, we never found out the information we needed to properly care for her. Now after a year of living with us we understand that my mother in law talks to herself daily, many times a day. She often repeats the same conversation over and over again. Her conversations do not make sense. She sounds like she is “on the phone” because she is constantly saying “Do you understand? Okay. Bye.” after each sentence. She talks about someone taking her house and because of that she blew up the World Trade Center. She constantly repeats “Your kids are dead.” over and over again. I find the conversation to be disturbing and my husband does not believe it will help to reach out to her so he does not address the issue. I worry all the time. I have two children an 11 year old and a 17 year old. I often wonder how our arrangement affects them because I know that I am affected by the living arrangement. My mother in law is very disorganized and unaware of what is going on around her. If I am cooking she will walk right in front of me and do her thing in the kitchen. She does not acknowledge how other people might feel with her words and actions. Overall she seems harmless but I am still very concerned. I feel like doing nothing will just make this living arrangement worse. My husband feels like saying something will not help and probably exacerbate the symptoms. I have read two different books now that concurs with the advice you are giving but I worry my husband knows his mother best and I don’t want to rock the boat. I am also confused about psychotic episodes. My mother in law has never been hospitalized (as far as I know) but she does have delusions multiple times a day. Is that possible? To have delusions multiple times a day, daily? Is it also common for a person with schizophrenia to appear to be self-centered? My final question is, is it also a characteristic of a person with schizophrenia to be able to pop in and out of the delusions when they see another person in the room. My mother in law will be in full blown conversation and when she sees me, she stops. Is that a common thing to experience?

  45. Avatar
    Jennifer says:

    My 16 yr old daughter who smokes mmj daily just had her first psychotic break & is hospitalized currently which is extremely scary as a mom cause of covid I can’t visit her. Idk what to do right now I’m very afraid and worried for her. She’s the sweetest little girl in the world. She was on track to graduate HS 2 yrs early w honors and college credits & now Idk what’s gonna happen to her. This is so devastating. I’m so confused & don’t know what to do or how to handle this.

  46. Avatar
    Kay says:

    My sister has been diagnoised with schizoaffective disorder bipolar type and I suspect she meets criteria for possibly up to 3 Cluster B personality disorders. She has been in a psychotic state for nearly a year and she is having delusions about her older child, my nephew, and become extremely abusive towards him. I live in CA and they live in TX, so there’s very little I can do to help without calling a crisis mobile team or the police. I am incredibly concerned–I don’t even have words to describe how terrified I feel. I would greatly appreciate any referrals you may have for psychiatric and psychological help that is close to Waxahachie; is experienced with schizoaffective disorder, personality disorders, and psychosis; and is not faith-based. Thank you in advance.

  47. Denise Vestuti LCSW, Resource Specialist
    Denise Vestuti LCSW, Resource Specialist says:

    Kay, we appreciate your comment and we are sorry to hear the family stressors and your sisters’ untreated mental health conditions. I attempted to email you for personalized help but your email came back. You can put in a request for help at
    There is a crisis line for Ellis County which is North Texas Behavioral Health Authority and the number is 866-260-8000. Certainly, you can contact them for guidance as you mentioned risks with your nephew and safety is always the first priority. Additionally, The Substance Abuse and Mental Health Administration (SAMHSA) site has a treatment locator link

  48. Avatar
    Rudy says:

    After reading this I learned I did everything wrong for the past 3 years I’ve been struggling with the loss of my girlfriend of the previous. 5 years and my best friend for the previous 20 years before that. She didn’t pass away but I say loss because she became so crazy from using meth about 9 months after her first symptoms showed up that we no longer spoke to each other and by this time It was like she had died and another person after the last time I spoke to her I started grieving because she was gone there was not one trace of her in that body I lost the woman I love and there was nothing I could do about it it started out with her saying there were people talking outside our bedroom window from there it went to people having cameras watching us to her father who had passed away years before was god and she would talk to him like he was standing right there then she said I was the devil and I was trying to kill her she would scream at me when I was asleep that there were other women in the bed with us I woke up one night and she wasn’t in bed I found her standing out in the woods by our house in a t shirt and underwear at three am in the middle of the winter staring up at the sky she was freezing cold eventually she would not let me in the house and I couldn’t go near her she had been struggling with addiction that started about a year before we started dating I’m a recovering addict my self I had already had a few years of sobriety when we started dating and I’m still sober today I was not concerned about starting a relationship with her because I believed I could help her and I had always loved her since we were kids so it didn’t matter to me she had always been sober growing up while I was getting high and drinking she didn’t start using drugs until she was in her thirties she was always such a great friend to me we spent all our time together from the day I met her till she went to college we both had a child with someone else I had a daughter she had a son she moved back to our home town when our children where about a year old the two became best of friends just like we were then my relationship ended with my daughters mother and I still continued to take my daughter to play with her son and we started dating and things were really great her addiction was not too severe at the time and I had never been happier in my life we had her son all the time and I had joint custody of my daughter we were very happy and things just started getting worse until she started messing up I was just so blinded by my love for her I kept telling myself it would be ok I enabled her she didn’t have to work anymore because I worked and was able to comfortably. Support our family as things got worse her son eventually started staying with his father and I rented a n apartment where I would stay with my daughter and her son on the weekends because I didn’t want them to be around it so we would go visit her and stay at the apartment eventually I started putting off things with work and downsized my business then shut it down things got worse and worse I was spending all my time dealing with the problems she was creating going to jail paying for lawyers and bail over and over after a year of me being kicked out of the house for a week at a time home for a day kicked out another week not working I was losing everything but I was only worried about her after we stopped talking she ended up in prison I tried to talk to the judge and the lawyers I told them what was going on with her they promised me they would get her the help she need but they just sent her to prison no treatment nothing I didn’t see her for a year or so I am still struggling with this it’s been so hard I’ve never stopped loving her it’s not gotten any easier I ran into her yesterday she looked so bad she didn’t act aggressive toward me she just seemed so lost she told me to stop by and see her but i have not gone as much as I want to I just don’t see what it would do it s bothering me a lot because she was more sane seeming than she had been before but she still is staring at the wall for hours she went under her desk for hours people I know from when I was an addict hang around her place and they tell me about these things I know if it was me that was like that and her sober she wouldn’t ever give up on me so even though I don’t see her I still think about. Her everyday and I love her it’s so sad I feel so bad for her and I wish I. Had done everything different how can she be helped if she will never get help herself she thinks nothings. Wrong with her can anything be done

  49. Avatar
    Josephine says:


    I am the sibling of a family member who has been diagnosed with schizoaffective and bipolar disorders. Experiencing life with her caused me to go into psychology studies, earning a BA in psych and I am currently attending grad school for I-O.

    I noticed in previous comments, you mentioned “it’s not possible to have both”? I have heard this before, but no one fully explains why. Does that mean that there is possibly a misdiagnosis? Or is it possible for those with dual disorders to be in a small, rare percentage that has not been fully studied yet?

  50. Avatar
    Jay Boll, Editor in Chief says:


    This is a confusing issue for many people.

    Schizoaffective disorder has many similarities with bipolar disorder and even clinicians can have a hard time telling them apart. Sometimes a person will be diagnosed with bipolar disorder and is later diagnosed with schizoaffective disorder by a different clinician. In this case, only one of the diagnoses is correct.

    To make it even more complicated, there is also a diagnosis known as “schizoaffective disorder, bipolar type.” This is a single diagnosis for someone who has schizoaffective disorder with bipolar features.

    Here’s a link to an article on the similarities and differences between the two… Schizoaffective vs. Bipolar Disorder: How to Get an Accurate Diagnosis

  51. Avatar
    Katherine says:

    Thank you Veronique for writing this very important article. What you included in this article helped me deal with my sister’s psychosis. It is very helpful and has positive results. I plan to buy and read the book. Grateful that you posted this article to help families.

  52. Avatar
    Katherine says:

    Thank you Veronique for writing this very important and valuable piece of article and posting it so many people can learn from it and making their lives better. I also plan to buy the book as well.

  53. Avatar
    Ashley says:

    I have been reading about all kinds of different mental illnesses. My fiance just turned 30 years old this past October. About 2 1/2 years ago, He and I were at his mother’s house visiting his sister and her boyfriend. We all had started to drink because we were celebrating his sister’s boyfriend’s birthday. Long story short, a few hours later, a fight broke out in between my fiance, his sister, and her boyfriend. My fiance was walking out of his sister’s bedroom door (which was the door leading outside) and her dog bolts out the door right along with him. That’s when his sister started yelling and cussing my fiance/her brother out and even shoved him on his shoulders. Her boyfriend then told the dog to attack or sic…(dog is a full-grown pitbull). So this pitbull is “eating” my fiance’s leg. His other little sister happens to walk outside and was able to save him. I was already passed out inside from being heavily intoxicated. My fiance ended up having stitches and staples in both his legs and had to learn to walk again. He also had to appear in court for his sister and her boyfriend filing charges on him. He won the case and a jury had found him NOT GUILTY. Since the attack, he has withdrawn himself from friends and family, he isolates himself in the bedroom, he has NO want for sex or intimacy, and NOW it’s worst. He is talking and yelling and cussing at a voice he hears in his head. He and I are and have been using meth since the dog attack. I’ve been doing my research on his symptoms, and I believe he is in the stage of early psychosis. I’m not a doctor by no means just going off what I have read. He says he knows he is going crazy but he doesn’t want help or doesn’t want to be put on medication. He is also trying to say that I did this to him. I don’t think he would hurt me but he has shown signs of anger problems. All the signs that he has shown in the past 2 1/2 years are all coming together for me. I was just unable to notice until he started having the voices in his head. I need help and so does he. I want my fiance back! We have a 5 year old little girl together that shouldnt have to go through this.

  54. Avatar
    Mike says:

    My spouse’s father had a stroke and almost died. Her mother caused significant additional issues, including talk of divorcing him and not wanting him to return to their home when this occurred. He has since recovered significantly and after a long series of moves from care facility to care facility, he is now at home.

    The reason that I’m writing this is that when he initially had the stroke and it was thought that he would die, my spouse went into a psychosis for three days. She was delusional, didn’t eat or drink water and did not sleep. I have no experience with this. She ended up walking down the street in the freezing cold and rain, neighbors called the police and the police brought her to the house. long story short, I had a service take her to the hospital where she was tested and then I convinced them to let me take her home. She did not want to stay. I then nailed all the doors and windows closed so that she wouldn’t leave the house in the middle of the night. At the last moment I was on a call with my mother discussing this and she recommended that I take her back to the hospital. I was extremely distraught and I don’t know exactly why, but she snapped out of the psychosis as if a light switch had been turned off.

    It has since been a year. She doesn’t like to speak about it and didn’t talk to any doctors about it any further.

    Is there something that I need to know or do to prevent this from ever happening?

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