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56 years old started behaving abnormally. What cure should be done?

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Practicing since : 2004
Answered : 1835 Questions
my father is 56 year old, his abnormal behavior starts when he was expelled from his company 10 years back. He will not go any place and just sitting in home and sometimes he beats us. we have taken to one psychiatrist, but they told he doesn't have any problem. but the condition is going worst, he acts violently and speaks unrelated things and uses abuse words that too loudly. me and my sister is staying away from home, only my mother is staying with him. she alone is not able to handle things. he will not come again to any doctor and i can not present this topic to him. some days he acts normal but some days he will be worst. can you please give some suggestion. i am looking forward for your reply. please dont reveal my name
Posted Thu, 7 Mar 2013 in Mental Health
Answered by Dr. Ashish Mittal 23 minutes later
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     56 year old male
•     Duration of problem: 10 years
•     Complaints of: abusive-violent-abnormal behavior, confined to home and denial to visit doctor.

From the history it appear that your father is suffering from psychotic illness. It may be depression with psychotic symptoms or schizophrenia or Delusional disorder. In psychotic illness patient do not have insight and they do not consider them-self ill even after lots of confrontation and conversation. Due to lack of insight they do not accept going to doctor or taking medicine.

As he is violent and your mother is alone who can not manage him, it is an urgency to get him in treatment. For treatment anti psychotic medicines are given. But it is difficult to bring such cases in treatment.

Although there is no guideline regarding how to bring these patient in treatment, but following are usual methods in practice by family members to bring them in treatment:
-Call nearby Psychiatrist for home visit.
-Forceful consultation considering urgency.
-Meet doctor without patient and get prescription of medicine. Start treatment without knowledge of patient. When patient become well, bring him to the doctor.
-If patient refuse taking medicines: give medicine in food or drinks. Treatment with long acting injection is also available, which needed once in 2-4 weeks

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
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