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Date of last update: 8/24/2017.

Forum Name: Psychiatric Topics

Question: My mom believes people are conspiring against her

 oblivia723 - Tue Apr 15, 2008 12:15 pm

It is a well known fact in my family that my maternal grandmother suffered from some sort of mental illness, although it was never diagnosed. Now my mother appears to be ill as well.

It seemed to have started to develop about 12 years ago. She became convinced people were conspiring against her, following her, and talking about her. She became vindictive and decietful. i believe this was phase one of her illness.

She no longer behaves like that all though she still believes that it was true at the time. Now her beahvior is completely unusual. She seems capable of having only one emotion, over the top happiness. She does not respond to negativity, it is as though she doesn't recognise it.

She is very giggly and obnoxious, and the responses she offers to questions, while coherent, rarely make sense. she has unusual mannerisms both facially and in her body language. her voice is very sing songy (which never used to be the case) and the people who meet her only need to be in contact with her for about 10 seconds before asking me whats wrong with her. children are put off by her behavior and are somewhat afraid of her even though she is not mean to them.

she seems to crave constant attention and believes anything you tell her. its like the lights are on but no one is home. It is getting to the point that she can't function in normal society. I just want some idea as to what is wrong with her. she will be turning 60 this year.

 Dr. E. Seigle - Tue Apr 15, 2008 3:53 pm

Hi oblivia723,

The onset of a mental illness at the age of 48 in your mother is somewhat unusual- later than is typical. You have said that she had at first a period of paranoid delusions, which remitted and now she displays many years of elevated mood, odd social behavior, poor interpersonal relatedness, and some unusual movements or mannerisms of her body.

In a later onset of mental illness as in your mother, one considers a diagnosable brain disease as a possible cause. Some possibilities would include Huntington's Disease, which is suggested by the family history and her abnormal movements, a dementia, such as one caused by small strokes, early onset Alzheimers, and other dementias (these appear less likely). There are certain metabolic and hormonal diseases that can cause mental illness as well.

I suggest that you have your Mom evaluated by both a neurologist and a psychiatrist. Your Mom's evaluation might include a brain MRI, blood work, a neurologic and general physical exam, and perhaps an EEG. Be sure that you are present during the evaluation to provide all the information you can. In your situation, you should have ample time to talk to the psychiatrist as well as the neurologist, either privately or with your Mom present if she can tolerate you speaking frankly about her. it can be helpful to also write up the "story" of how your Mom's illness has evolved over the twelve years, to give to the doctors.

Barring a diagnosable brain process causing your Mom's illness, it is possible that she has a bipolar disorder, with a relatively late onse; she may have had a depressive episode associated with the paranoia, followed by a chronic manic-like condition, which is unusual in its being chronic. A late onset of schizophrenia or schizoaffective disorder is also possible.

My suggestion involves two steps: Have your Mom evaluated by a neurologist to rule out the primary brain diseases I spoke of. At the same time, have a psychiatrist do an evaluation of her. Try to obtain as much information, including medical records as well as medications used and people's memories of your grandmother's mental illness. That will be useful in helping to diagnose your Mom's condition. In particular, it will be useful to know if your grandmother displayed odd movements (what is called the "chorea"- jerky movements) associated with Huntington's Disease). Also ask relatives about any mental illness in other relatives/prior generations.

Good luck- you are on the right track in helping your Mom.

-Eliot Seigle MD

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