Issue with 19 year old with Psychotic Disorder Nos

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My 19 year old insists he has been given super powers from God. He has been diagonsed with psychotic Disorder Not Otherwised Specified (NOS) but even with meds nothing seems to have changed. He becomes mean and even violent when told anything he does not want to hear. Any suggestions on how to deal with this would be helpful
Jeannie

He might need another medication or a higher dose if this one is ineffective.

Don't let him go anywhere alone, take time off work (if you work) if you do - you certainly have grounds to, get help for usual daily things like going shopping from reletives so that you can keep a close eye on him, avoid bringing him outside when he's like this. Don't argue with him about his delusions, it never works, read the book "schizophrenia for dummies" if possible, keep in constant contact with his doctor and always ask for advice aff your doc before asking the internet


Regards
Someone whose had psychosis.

If you believe you (or anyone else) is at risk due to his violent behaviour it may be more appropriate for him to be receiving inpatient treatment until his condition is stabilised. Without knowing more about your personal circumstances or what country you live in I cannot be more specific, but I would echo that you need to be keeping in very close contact with any professionals involved in his care and keeping them informed of any incidents and concerns that you have.

Or he might need a lower dose, drugs can have negative effects as well.....either way certainly something to look into to rule out if it's an issue with the meds.

I always wondered *why* shouldn't a professional try to disprove their patients' delusions. I'm not even talking about the environment, but someone trained.

I guess it is because the psychiatrist or family member might become part of a conspiracy in the mind of the schizophrenic person. People with schizophrenia often think in black and white terms. People are either on their side (but suspicious) or against them. If they think that the people in their life can't be trusted, they will withdraw from them, reject their advice and refuse treatment.

But I've also read that the prognosis is much better if the patient is well educated. Schizophrenics don't lose their reasoning capabilities and can learn to distinguish reality from delusion. John Forbes Nash (whose case inspired the movie "A Beautiful Mind") said that he managed to intellectually reject his hallucinations and delusional beliefs at some point. So perhaps mental health professionals should be more honest with their patients and try to reason with them more often.

In my opinion, the worst thing a psychiatrist or a relative can do is to treat a person with a disability or disorder like a child or an idiot (or, even worse, as potentially dangerous). Give people some credit. They need to feel accepted and respected as a human being, not patronized and coaxed.

I think that because people need to feel accepted, they will want to be talked to. I wonder if psychotherapy had ever been tried with patients who had schizophrenia, who weren't drugged up to their eyeballs.

Drug-free approaches have been tried with some success (although I believe this was mainly with people experiencing psychosis for the first time, not sure how it would work with people who have already been taking anti-psychotics for a long time). Try Googling Soteria as that is one of the more famous examples.

For the record, I am well aware that the vast majority of people experiencing psychosis are not a danger to anyone, but was reacting in my previous comment to the OP's statement that her son had previously become violent. Three of my four closest friends suffer from serious mental health conditions and I have had mental health problems myself. Although most of us have never been a danger to anyone, one of my friends is in the minority that becomes violent when he is unwell so I have first-hand experience of dealing with this. I care about him a great deal and have had to see him come to terms with hurting people he is close to when he has recovered and the pain it has caused all round. There is a difference between the reactionary "anyone with a mental health condition is an axe murderer" headlines we sometimes see in the press, and trying to manage a situation safely with someone you care about.

Thank you.

If he gets violent, I would second the idea of inpatient treatment to get his meds adjusted. They can watch him closely there and adjust the dose as needed until they find the dose or med that works for him.

Arguing with your son is pointless at the moment. Just agree and change the topic if you can, and get help to make sure he doesn't hurt himself. The management at this point is medication. When he is a little better you might talk to the treating team about how he can learn to manage delusions. But at the moment he is not in a state to learn anything.

I'm sure you'll be fine. Don't worry!

Do you have any evidence to validate your statements with?

very good point

Mmm good question. I doubt there has been a randomised controlled trial on the subject. I speak from my own experience with psychosis five years ago, and from an ongoing friendship with a very delusional person and what does and does not work with him. I actually went to visit my psychotic friend today and at first he was very delusional but I simply went along with it and changed the topic, after a while we began to have a conversation on normal things. As the delusions started to intrude into the conversation I tried a number of ways to demonstrate the difference between reality and the delusional world but none of them worked, and they have never worked. I find it helps to have a flexible mind and appreciate that everyone has a slightly different reality.

In addition to this I have studied neuroanatomy and physiology in my bachelor degree, also psychology and applied linguistics. Since I became diagnosed with bipolar disorder, I have done an awful lot of reading. This has included studies and papers on neuropsychology, and several which were on the cognitive deficits associated with psychosis, such as problems in learning, concentration and memory. I am sorry, but I cannot remember exactly when and where I read all of this, I read for my own interest with no intention of collecting references.

I went to psychology for twelve weeks to learn cognitive behaviour therapy but at that time I didn't want to take medication. I found it difficult to learn and apply the techniques I learned. Sometime later when I was being treated medically for the depression, I revisited the cognitive behaviour therapy (my psychologist gave me handouts) and I was able to then learn and apply the techniques more effectively, which has helped me ward off depression for the long term.

When I was psychotic, I suffered paranoid delusions about certain people from my past. All I wanted was for someone to believe me, and when they didn't, I felt betrayed and actually became more paranoid.

Upon this experience and knowledge I base my recommendation not to argue with the delusions for now and teach him the strategies for insight, if there are any, once he is feeling better. The brain needs to be healthy in order to learn optimally.