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Summary
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A reader is concerned about a friend’s fixed beliefs involving children and a doctor’s family. The reader fears possible harm and feels responsible for obtaining help despite the family’s reluctance.
The response describes the reported beliefs as potentially delusional and discusses how psychotic symptoms can appear in several conditions.
It emphasizes sensitive communication with the family about professional treatment and medication access, while noting that an adult’s autonomy complicates efforts to intervene.
Question
Reader · Identity withheldI recently reconnected with an old best friend from grade school. After talking for a few days, she shared a harrowing story with my fiancé and me. She told us that she had four children with one doctor, but another doctor had taken them away from her at birth. She was so upset and crying that it made me want to believe her.
\nShe begged me to contact the media to tell her story. I asked her why the first doctor, and the father of her four children, had not helped her. She said he was under pressure at work and that the other doctor also worked there. I decided to call the doctor she said was the father. To my surprise, his wife answered the phone. I told her everything my friend had said. After we hung up, a police officer called me, telling me what I did was wrong. When I explained the story, he didn’t believe me.\nShow moreShow less
Then I called my friend’s house, and her mother answered. She apologized and told me my friend has severe bipolar disorder. I was shocked. I called the police officer back, shared this new information, and asked him to talk to her mother. Later, he called me again to apologize. Even now, my friend insists she has children and they were taken aware. She says she plans to drive there with a camcorder to record them and has even given them all names. She told me, “do you know how hard it will be for me not to grab them?” That scared me deeply.
\nNow I’m afraid, not just for myself because I feel like I disrupted her reality, but also for the doctor and his family. Her mother refuses to get her the mental health help she needs. How do you help someone in this situation before something terrible happens? I feel like I’m the only person who can do anything. Please, I need advice.
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Answer
Mark Vigil Dombeck, Ph.D.It would appear that your old friend is in the grips of a paranoid delusion, or unshakable belief without evidence to support it, generally involving themes that others are out to harm you. Delusions like this are one of the hallmarks of schizophrenic-type psychosis (hallucinations being the other). They can also occur in related conditions like schizoaffective disorder and bipolar disorder (although in these latter disorders there tend to be mood problems (e.g., depression or mania) associated with the presentation as well).
\nThere are well-established medical treatments for these sorts of conditions (which are biologically based), but they aren’t perfect and they can’t help if patients don’t have access to them or won’t comply with medication routines. Hallucinations respond best to medication treatments, and delusions are harder to dissolve – but generally having the medications on board will make them less compelling. If your friend’s mother knows her daughter’s diagnosis it is highly likely that they have been to the doctor and know about the medications. Locking your friend up is not a good option unless she is in acute danger of harming herself or someone else as such inpatient stays are very expensive and short-lived.
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Basically, what they do in the hospital these days is to put you on the right medications and enforce your taking them until you just barely start to get better and then they discharge you immediately. That is all most people can afford and insurance won’t pay for a cent of care more than is minimally medically necessary (e.g., won’t open them to a lawsuit). If you want to help, you can possibly inquire of the mother whether she knows about medications. If compliance is an issue, you might brainstorm with her about ways to get her daughter to comply – but keep in mind that your friend is an adult who cannot be forced without a court order to do anything in particular, and that the whole issue is embarrassing for many parents.
\nWhatever you do should be done with utmost sensitivity for the feelings of all concerned.
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