Delusional Disorder with extreme anger and hate toward family members

JRo1

I live with my mother who seems to have delusional personality disorder.  Cannot get diagnosis because she will not go to a doctor, lawyer or any professional that can help.  I have provided for her and cared for her as an only child for decades.  She has always been suspicious of others, judgmental, distrustful and jealous.  Now she has turned all of this on me and accuses me of every think one can imagine and uses the most vile language I have ever heard with threats to ruin my life.  Has been especially bad last two years.  I am told I have no recourse to force her into any evaluation or help unless she does something harmful other than just words.  She functions well other than the delusions and is 95 years old.  I have no idea who can help as every professional I know says there is nothing unless she is some kind of therapy or care.

Marta

Jro. You are in a tough spot. I hope over the decades of caring for your mother that you have developed a few extra layers of skin.

Pure delusional disorder, also known as paranoid disorder, is relatively rare, although you certainly describe long-term symptoms of this phenomenon. What may be happening with your mom is that she has dementia with delusions.  You say she functions pretty well, other than the delusions. But, ask yourself, without the scaffolding you have provided for decades, could your mom make it on her own?  If not, the likelihood that she has dementia shoots up.

In any case, what I would recommend is that you seek out an on-line psych provider, e.g. a psych nurse practitioner- there are thousands of us across the country.  Foment a plan with the provider and establish a relationship. With you providing the history and the symptoms, the NP may be able to prescribe an anti-psychotic after just a brief on-line encounter - you could say you are face-timing with a friend, and just engage mom in the conversation, structured by the provider, as a matter of course.  No leaving home, no forcing her to “go to the doctor.”

At this point, a diagnosis is not needed.  The treatment would be the same:  anti-psychotics.  The NP and/or members of this board can advise you on how you might get mom to take the medication. Example:  you are starting a new vitamin to help with ———.  Does mom  want to try it with you?  Use your imagination to think outside the box, so to speak, to come up with a scenario that is likely to fly with your mom. Hiding it in her favorite food would not be unethical, as her quality of life, and YOURS, are at stake.