what fresh hell is this?

Last week my sister asked S to bring her to the Wellstone Recovery Center. My parents and I were cautiously hopeful.

She began calling Dad on the 2nd day, demanding that he come get her. Dad spoke with the staff at the Wellstone Center but since she is an adult they could not give him much information as that would be a violation of her privacy - the usual bullshit we run into. We can provide details about her illness that would be helpful in treating her. She relies upon us to help her financially and emotionally. They did reveal that she would not attend group therapy sessions. The Wellstone Recovery Center is a facility for the mentally ill and for addicts. Could her reluctance to attend group therapy stem from the fact that drug addicts will not understand or believe she hears voices? Is it beneficial for people with schizophrenia to participate in group? In the Quiet Room Lori Schiller writes that the voices told her they would force her to hurt herself and anyone else she told about them. It's like  Fight Club - the first rule about the voices is that you don't talk about the voices, the 2nd rule about the voices... The voices have swallowed my sister's mind. They are more real to her than anything else. The voices are her only reality.

I don't intend to criticize the Wellstone Center. It was a nice 5-day break for me. She didn't bring her phone with her so she didn't call or text me for 5 blessed days! They were the best days of my life, I felt like I was on vacation! I didn't have to worry about her because she was being taken care of.

Dad picked her up on Monday. As soon as she arrived home she began calling me. She asked in a dead voice if I was happy that she had brain damage and was paralyzed and couldn't turn her neck or move her body. Apparently they gave her a medication that doesn't mix with the ones she already takes and was experiencing side effects.

The Wellstone Center created a care plan to give to the ACT Team. My Dad intended to spend the night at her apartment but she became psychotic and kicked him out. He stayed in a hotel while she made shrieking, threatening, abusive phone calls to my mom and I all night long.

On Tuesday Dad convinced my sister to go see the ACT Team but they were in a meeting and asked them to come back later. The ACT Team has to buzz you in and when they returned no one answered, no one let them in! What kind of care is this? If the ACT Team is not going to do their jobs they should remove my sister's name from their books and stop being paid for her care! They have not provided proper care since she relapsed and now they are scrambling to figure out how to cover their asses.

it must be winter in my heart

I do not want the snow to melt. I agree with my colleagues and customers at work when they complain about the amount of snow we have and the chilly weather. But, secretly, I never want spring to come. My sister does not drive long distances at night or in the winter. The snow is the only thing that has been keeping us safe. When it melts 140 miles will not seem like a very long distance to drive at all.

how to talk to the delusional

The title implies that I know how to talk to someone who is delusional. I don't. I wish I did.

This is a typical conversation with my sister who calls my parents and I several times a day:

sister: Hi, you fat ugly cunt, I hope you like babysitting R! You are the grossest person I know! How can you be my sister?!!?

me: Hi, I don't know what you are talking about.

sister: Yeah, right! How did you get to be such a fucking ugly disgusting blimp of a bitch?

me: I don't have to listen to you talk to me like this.

sister: Don't you fucking hang up on me! You can turn me off but I can't turn you off, you bitch! Do you think that's fair? How is that fair? Why do I deserve this?

me: It's not fair. I am so sorry you are going through this.

sister: You are not sorry! You did this! You ruined my life! I don't know how anyone can stand you, inbred bitch! You ruined my career! I am pregnant with R's baby and you fuck him!

me: I don't know R! I don't want to know him! I haven't done anything to you!

sister: But you will, you gross fucking cunt! You will! You do it to me every day and then you laugh about it! You're going to get what you deserve, you ugly disgusting pig bitch!

me: This is not real! Please go to the hospital! This is not real!

sister: You go to the hospital, you fat fucking inbred! You are doing this! You have been psychically abusing me for months! Leave me the fuck alone!

me: I want to but you keep calling me! I'm not psychically abusing you - that is not a real thing!

sister: Yes, you fucking are! You don't stop even though I beg you! What kind of cunt does what you have done? What kind of auntie are you going to be, you inbred pig? Or are my kids going to call you stepmom?

me: I guess I'll be an imaginary aunt to your imaginary children.

What am I supposed to say to her? I can't humor her. I can't say I've done things I have not done. I have tried apologizing but that doesn't appease her. Her insane, vicious, vindictive, hate-filled voice terrifies me and breaks my heart. No one should have to endure the torture she is going through. No one should have to listen to the horrible things she screeches at us. My parents always say, "I love you. You will always be my daughter." That just makes her angrier. She gets so upset we are afraid she will have a heart attack.

How do you break a delusion? Yelling, "None of this is real! Go to the hospital! You are really sick!" does not help. How can we wake her up and get her back. None of us can go on like this much longer. My sister has a life to get back to!

We have learned from NAMI and from our own experience over the years that you cannot reason someone with schizophrenia out of a delusion. It does not work. If you argue with them you become enmeshed in their delusion. But we cannot just agree with her, either. We cannot support her madness. So how do you talk to someone stuck in a delusion? 

please help

I wish I had started to write this blog months ago when my sister's relapse began. I had more energy and hope then. I am exhausted, pessimistic, angry and bone-weary of my sister's schizophrenia. It is killing my parents. My sister and her illness occupy all their time and use up what little money they have. My father has aged 20 years in the past few months and the constant worry about my sister has caused his alcoholism to become worse. My mother is heartsick and desperate to help her daughter, she repeats "our lives are ruined." I have lost my best friend, partner in crime, confidant and sister. My sister is going through more mental, emotional and spiritual torment than anyone should have to endure in a lifetime. Schizophrenia has gutted all of our lives.

My sister has suffered from schizophrenia for nearly 18 years. This is well-documented in her medical records. A few years ago before she was prescribed Clozapine, a medication that gave her back her life, she had an episode at a friend's house. He called the police on her and they peppersprayed, handcuffed and dragged her to jail. She eventually ended up in the Behavioral Unit at Miller-Dwan. We did not know where she was for 3 days. We called all of her friends, the police and every hospital in Duluth. The police and hospitals said they had no information. We were worried someone had hurt her. The police and the hospital knew where she was all along but did not tell us to protect her privacy!  We are her family and her caretakers! Because she was an adult we had no rights or say in her care. We are her advocates, we are the only ones who know her and what her normal is. The result of this experience is that my sister signed papers to give my parents the right to have access to her medical care. They go to her doctor appointments with her. My parents are my sister's greatest source of strength, support and encouragement. Without them she would not be as highly functioning as she has been. She revoked those rights when she had a psychotic break in December. This is the time when she needs us to advocate for her and make certain she receives proper care. She is too sick to ask for help on her own. We are powerless. The doctors and the ACT (Assertive Community Treatment) team will not talk to us because it would violate my sister's privacy. They do not realize how sick she is. They do not understand that my sister's shutting her family out is an indication that her illness is getting worse.

We contacted the ACT team in December when we realized that my sister was extremely sick and needed to be hospitalized. They said there was nothing they could do right now but when she tries to commit suicide, hurts someone, gets evicted, has her car repossessed, drops out of school, in short when her life has completely fallen apart they would "be happy to help her and she will need a lot of help then." Why would we wait until everything she has worked so hard to obtain is gone? Who benefits from that? Not my sister! Maybe the ACT team because they will have a lot to do.

Schizophrenia is a no-fault medical illness. My sister did not cause this disease. She needs medical attention but it is denied her because the mental health system in this country is broken. Previously, when my sister's symptoms began to overwhelm her she would go to the Bridge House for a few days or a week. She felt safe there and could get help right away if she needed it. The Bridge House was permanently closed this summer. If it was open her plummet into insanity could have been prevented.

My parents and I have spent countless hours begging people to help my sister. Here is a partial list:
-the ACT team including her psychiatrist - useless
-the police - useless
-+NAMI - sympathetic but nothing they can do
-+NARSAD - useless
-Miller-Dwan - useless
-St. Luke's - nothing they can do
-Al Franken - his representative who responded quickly suggested the United Way
-the United Way - useless
-Amy Klobuchar - no response
-WCCO - no response
-the Mobile Crisis Unit - they have checked on her several times and will transport her to the hospital upon her request but she is too sick to ask for help
-the +Wellstone Center - she must go there voluntarily


The problem is that when someone is having a mental health crisis they are unable to seek help. They are lost in a nightmare, they cannot tell what is real and what is not. They are denied medical care if they do not demand it and even then they may be turned away, they may not be considered "sick enough." Imagine if you had cancer and were not allowed medical treatment until your case was terminal. My sister's case has been terminal for months and we are not able to get her the medical care she needs and deserves!

the delusion

Well, she's still alive. She is calling and texting me all the time. Here are a few texts:
When he breaks my arm im gonna break your fucking face.
When he gets me pregnant I will fist fuck you.
When he fucks you I will burn your face off.

I don't respond to these texts. They have nothing to do with me. They are part of her delusion. I am not offended by them. They are a way to gauge the progression of her illness.

In the summer of 2012 my sister's behavior began to change. I was worried. I told my parents about it and they could see a difference in her and were subjected to some outbursts. She would text our brother terrible things from time to time. Things were the same between her and I for the most part. She's my best friend. We spoke on the phone at least twice a day and I would often visit her for the weekend. In the fall she stopped answering my calls. When she did she was hostile and said things that were out of character. My sister has been doing so well for the past few years! My parents and I could not face her disease overwhelming her (and us) again and we ignored the early warning signs and let her illness get out of control.

On Dec 15, she texted me, "So sister are you going to have a pig with R??? You are disgusting." I had no idea what she meant. I thought she was joking. What did she mean by asking if i was going to have a pig with her boyfriend? I could not fathom what that could possibly mean. It took me days to realize by pig she meant baby.

When she called me a few minutes later screaming with so much rage her voice was barely recognizable and nearly incomprehensible I began to realize how extremely sick she was. I was shocked. We hadn't been talking much. That hurt me but I was trying to do whatever was best for her. Lately, it seemed like talking to me upset her. She was taking difficult nursing classes and I was giving her space. I want her to do well in school. I knew she was having problems. I didn't know how to help her and when I told my parents my fears of her having a relapse they didn't want to contemplate that possibility.

The main symptom of schizophrenia is hearing voices. While medication helps to lessen the voices and allows my sister to control her reaction to them the voices have never gone away. Sometimes they attack her and she screams at them. I've learned from years of experience that if I try to intervene or calm her down, the episode will last longer and I will become part of her delusion. When I visit her and she has an episode I let her cry and scream. When she's done we go on with our day. I have been waiting since Dec 15, 2012 11:54am to go on with my day.

My sister has been utterly lost in a sad and terrifying world where everyone hurts and betrays her since then. In her delusion she is pregnant with R's baby and I am also pregnant by him. Sometimes she believes she is pregnant with 3 babies by 3 different men and that I am too. She is enraged that I would have sex with her boyfriend(s). The voices say cruel things to her. Sometimes they say that they are me or mom or dad. They are more real to her than we are. The voices are her reality now. She is trapped in a nightmare. My parents and I trapped in it with her.

Whenever I tell anyone this, they inevitably ask, "did you have sex with her boyfriend?" The answer is NO! I would never do that.

Another aspect of her delusion is that the she believes that our parents have chosen to support me instead of her. She feels deeply betrayed and abandoned by them. If any of this had happened in real life she would at some point get over it. But she can't get over something that is not real and has not happened. For her it is always happening, it is happening over and over and over. She keeps feeling the same torment and pain over and over. If your sister became pregnant by your boyfriend while you were pregnant, you would be understandably pissed off. You would probably call her up and bitch her out. If your parents took her side you would probably call them up and bitch them out. What if you were caught in a loop where this happened to you every day? What if when you called your sister to talk it over she doesn't apologize she says, "this isn't real! This hasn't happened! This will not happen! I am not pregnant! You are not pregnant! I don't even know R!" but you know for sure that it will happen? Wouldn't that enrage and frustrate you?

When I point out that I do not know R or want to know him sister says, "you will, you fat fucking cunt! You are going to fuck him in the future, you stupid ugly fake feminist! I KNOW THE FUTURE!!!!!" Sometimes when she hisses this at me I laugh a little. It's not funny. It's tragic. But it is a really bizarre experience to have my beloved sister insult me and berate me and yell at me for something that has not happened and could never happen but that she believes will happen because she can see into the future! It is so ridiculous I have to laugh to keep from screaming.

What would you do if your sister called you out of the blue and accused you of having an affair with her boyfriend/husband and told you that the next time she saw you she was going to fuck up your face, bitch? What would you do if she kept accusing you of this for months and said she was going to kill you for ruining her life and taking away her family?

death and the devil

This is a blog about my sister's struggle with schizophrenia. I will warn you at the outset that it is not going to be uplifting. It is not going to be hopeful. It is going to be desperate and tragic and full of rage.

My sister was diagnosed with schizophrenia 17 years ago. She has had many ups and downs but in recent years she has been doing well. She had a good job and went back to school. But last year was difficult as her best friend passed away and she had a series of personal setbacks. She suffered a total relapse a few months ago. She has been trapped in a terrifying delusional world ever since.

That is enough history for now. I'm just going to jump into the events of the past few days.

Her disease has progressed to the point that my parents and I have very little hope that she will survive much longer. She seemed to have a brief period remission in recent weeks but for the past 2 days she has been in a full-blown psychotic episode. She calls and texts my parents and I constantly.  She threatens, bullies, and abuses us. Today she told my mother that she is going, "to rape that fucking ugly cunt {me} with a knife and a gun," and, "I am going to stab her to death," and, "I fantasize about drowning you in the lake." We are pretty immune to the things she says. She constantly swears at us and calls us names (this is behaviour she would never engage in when she is well) and tells me to kill myself all the time. But these new violent threats signify a serious progression of her illness. I have been the major focus of her delusions but my mother and brother are also targets of her wrath. Our father has been her main support and contact person. Yesterday she began calling dad "a fucking bitch," and "a fucking disgusting cunt."  Now she is truly alone and has no one she trusts or can talk to. She has no link to the real world.

We are terrified that these changes in her illness signify that she is going to commit suicide or worse. My parents called the ACT team (more about the "people who get paid anyway" in future posts) whom Sis has worked with for the past 10 years and begged them to do something, to get her to the hospital and they said call the police. They have washed their hands of her and us. We did call the police a few months ago and Sis was hospitalized for 72 hours. In that time which in reality was 4 days as it was a weekend, she saw a pychaitrist and a psychologist for a total of 20 minutes. That was it. When she was released there was no plan, no after care, nothing. She was sicker when she got out than when she went in. Those with the best days in our lives in recent memory because we did not have to fear that she was dead.

Today my parents called our local police officer and set up a meeting with him to discuss options.  She cannot be allowed to go on this. It is inhumane to allow a sick person to live for months untreated, without medical care. Schizophrenia is a no-fault medical disease. The police officer called the Duluth police. They went over to her apartment. S, the mother of my sister's friend who passed was at her house as my father had called her and informed her that sis was having an extremely difficult time. We do not want to involve the police because we do not believe all of them are trained to deal with the mentally ill.  We are afraid the police will shoot her. We are afraid the situation will escalate because she is completely fucking insane and self-destructive right now. My father called S in the hopes that she could diffuse the situation if it became dangerous. She did, alright! She told the police there was nothing the matter. They believed her and left. Then S left. Now my sister is in a pychotic rage and all alone.

Meanwhile, my parents were subjected to a sermon by the police officer who seemed so nice and helpful.  A sermon! Complete with a bible! He said, "It's the devil! I can prove it! It says blah blah blah right here! If you would only go to church and not on Sunday, on Saturday!" For real! He said that! He's not even the regular kind of crazy Christian, he's the weird go to church on Saturday kind of crazy Christian! When my parents told me this and the tears of frustration and hopelessness had passed mom said, "He seemed so nice, I was shocked when he turned out to be crazy!" I said, " Ha! You're one to talk - you are a life-long member of the church of crazy!" She said through peals of laughter, "Well, you're the pope of the church of crazy!" Gallows humor is the only kind we have left. All of my smiles died in December.

Now Sis is in a life or death crisis and there is NO ONE to call. We have already called everyone imaginable weeks and months ago. We were met with brick walls, silence, excuses. No help. No hope. No medical attention for a person with a long-term medical condition. We have not heard from her for over an hour. We needed a break. We needed a rest.  We think we should call her. But we can't bear to hear her insane, accusatory voice - full of vitriol, pure hate and psychosis. We fear her silence means her illness has become terminal. Her doctor told us a few months ago we should be grateful that her illness is not terminal. But he was wrong. It is terminal. It has killed my family. It has killed every good thing in my sister's life. It has killed my parents. Will it finally kill my sister tonight?  Does silence equal death?