How likely that asecond schizophrenic episode will happen?

For issues specific to caring for someone with mental ill health.
Can a woman, my sister, who had only one schizophrenic episode due to marijuana abuse (early 20s) accompanied by a suicide attempt and diagnose of bipolar when discharged from a psychiatric hospital, lead a normal life without any treatment AT ALL since? She suffered childhood traumas, today 35 years old has always been difficult to relate emotionally unstable and accumulated several conflicted personal relationships in all aspects of her life. How likely is that a second episode will happen? She does not accept psychological help and distance herself when the family tries to help. Any advice for family members?
Hi Helena and welcome.
Have you looked at the Mind website, it offers guidance both for those with mental health and also those trying to support them.

Melly1
Are you fearful she will make another attempt on her own life?

If not, then, in a way, her life is her own to choose (one might even argue it is hers to take, if that is her profound wish, however dreadful that is to contemplate - it's a tricky moral area after all).

Do you think she could be happier 'if only' she accepted treatment? Why do you think she resists it? Does she not think she has a problem?

My mother had some form of severe mental illness (never fully diagnosed for her generation of women), but refused treatment as she did not think there was anything wrong with her!

Refusal of treatment is extremely frustrating, and sometimes it takes a crisis that precipitates sectioning, and that, finally, can break the impasse, and 'force' treatment upon them. Then, when they see how 'less horrible' life is when 'under treatment' they cn finally see the reason for it, and accept it voluntarily.

You say she distances herself from her family, but if her traumas go back to childhood, then that might be a very understandable reason for her not to want to expose herself to such associations and memories.

Do YOU have any counselling? Because if you did, you could put all this to a trained counsellor, and see what they say about her. To be honest, I can't think any psychiatrist in the world could promise that a breakdown could NEVER happen again.

Do you think, overall, she is getting worse?
Thank you! But that is the issue... Yes, I do if she falls into another episode.

She does not accept help, neither from therapists. Many years ago, when she saw a therapist she stopped as soon as the professional mentioned that some of her behaviours were not "good for her" - she blames everyone around her, does not take ANY blame or constructive criticism (does not matter how careful you put it). When she finds herself completely alone, feeling down, she seeks my company and is the most adorable person to be around - until she decides to accuse me of unbelievable things - betrail, lying to her, the smallest thing is a massive issue - basically gets really paranoid when she is into any kind of relationship, even work.
Is this a sign that she may, depending on the trigger, fall into another episode?

There is nothing at all I can do until she gets to the bottom?
Sadly, probably not. If you read these threads here, you will see that it can take a real crisis to trigger sectioning and hospitalisation. But that is not easy to achieve.

If she refused to accept constructive help, or take responsibility, do you think she is fearing she will be blamed for what was done to her?

I would suggest YOU get counselling, as I said, to see if you can understand what is driving her behaviour, and hopefully how best to get her into counselling herself.

Do you think she understands WHY she is like this? ie, what was done to her?

Does she blame you for being the sister who 'escaped'?? While she took the brunt of the abuse?

Fially, if she is 'delightful' with you, but then 'turns on you', I would simply say at that point she has to leave. You don't have to put up with such accusations etc. If she won't control her behaviour, then you have to take steps to not let it adversely affect you, and parting company is probably it.
Thank you, again.

A while ago, I mentioned some of her behaviours to a friend who is a therapist - the answer was exactly like yours, and that I have no control or responsibility for her actions.

When my mother and father split up, she was 4/5 years old. my mother had to move to another town to provide financially for us. I went with my mother because I was older and could look after myself, etc and she was left with our grandmother - we would visit once/twice a year, bring them money and many gifts. When my mother got married again, therefore could provide fully for us, she went to live with us (she was around 10/11) - it was when her anger, jealousy, rage, etc started, went to drugs fairly young, at that time her behaviour was mostly against me and our stepfather.

So yes, she does not rationalise her anger against me, neither is willing to understand WHY she is like that - she has a real stigma against "mental health" and several unresolved traumas inside herself.

I feel really really sorry for her, as I educated myself a little lately and feel for her instead of feeling sorry for "me". I hope you understand? It would be easier if I could see her as "a bad person" but I see her as a "sick" sister.
Helena_1808 wrote:
Mon Aug 27, 2018 11:26 am
Can a woman, my sister, who had only one schizophrenic episode due to marijuana abuse (early 20s) accompanied by a suicide attempt and diagnose of bipolar when discharged from a psychiatric hospital, lead a normal life without any treatment AT ALL since? She suffered childhood traumas, today 35 years old has always been difficult to relate emotionally unstable and accumulated several conflicted personal relationships in all aspects of her life. How likely is that a second episode will happen? She does not accept psychological help and distance herself when the family tries to help. Any advice for family members?
Everyone differs - but the prognosis for those struggling with bi-polar or schizophrenia is that any stress can trigger a relapse - and that medication can help manage the condition.