A year ago, Denise brought her mother Sue in to my office. A tiny Asian lady with immaculate dress, makeup and hair, Sue was very quiet and her daughter did all the talking. They had come to see whether cannabis might help Sue. Denise appeared to be a happy, articulate woman who cared deeply for her mother, but she expressed doubts about using cannabis. Given the level of desperation they both felt, she was open to trying it.
Denise was about five years old when she first knew her mother Sue was different than other mothers. She and her two sisters remember their mother storming out of the room, believing people were talking about or laughing at her, despite there being no one in the room. The girls learned their mother had a traumatic childhood with an abusive father, that she had left school to care for brothers and sisters, that one of her sisters died and that she herself nearly died from scarlet fever. Their father met Sue when he was in the Air Force. He and the children learned to tolerate Sue’s delusions.
It wasn’t until Denise turned 20 years old that she decided to do something to help her mother. She knew her father wasn’t capable of taking care of Sue’s increased paranoia, so she pursued a psychologist and eventually a psychiatrist, and her mother was placed on medications after the diagnosis of paranoid schizophrenia was made. The family agreed that the therapists assigned to their mother were great, but Sue always stopped going to appointments and stopped taking the medications only to have the delusions appear again. The drugs made her gain weight and she never felt comfortable taking them. She said that she didn’t feel like herself on them.
A devout Catholic, Sue prayed all the time and took care of herself by eating well, exercising and taking care of her body. Despite her struggles with delusions, she managed to cope on her own over the years, even working as an assembler of computer chips in an aerospace factory. The work helped her focus on something other than the delusions. Her employers loved Sue because she worked so hard, but despite their support, she continued to have challenges, sometimes believing that others were whispering about and plotting against her.
When she developed glaucoma, she refused to seek medical assistance, convinced that the voices were responsible for what was happening to her. She said that these voices were physically harming her, taking nutrients away from her body and causing her pain. She was forced to quit her job, still didn’t seek medical assistance and finally lost partial sight. She was heartbroken when she lost her job and tried to fill the hours with hobbies to stay busy, but her attempts to stay social were often stymied by the voices she experienced every day.
I started Sue on low dose CBD-rich oil, and slowly increased the dosage with the goal of finding the dose that would mitigate her symptoms. Although she continued to have some delusions, she reported feeling “more in control” and that for the first time in her life she wasn’t just passing time until she died, but, rather, really “living.” She felt calmer and able to handle the delusions that she continued to have during the day, reporting to me that they didn’t bother her as much.
During the night, delusions continued to aggravate her with symptoms that were both physical and painful. We added THC oil at night and experimented with the dosing until Sue began sleeping without waking up multiple times. The increased sleep made a huge difference for her in the day. Denise reported that her mother felt the positive effects of the THC within a week. Sue said “the voices” left her alone and that she was able to stay at home by herself, content. Although THC may cause increased anxiety and paranoia for some suffering with schizophrenia, starting at very low doses, restricting THC use to nighttime only and continuing CBD concurrently has worked well for Sue. Additionally we are experimenting with higher doses of CBD oil during the day to see if we can find a dose that completely eradicates the delusions. Sue reports that she has not experienced any negative side effects from either oil.
Denise and her sisters are feeling huge relief for the improvements in their mother. While their relationships with Sue are complicated because of Sue’s psychiatric history, they all notice the positive changes in her behavior and feel more at ease. Denise says, “I’ve always felt really responsible for my mother as far as being a caregiver, but we’ve kept a space between us because it’s always sort of dangerous to get too close to one another. With cannabis and this positive change, I feel like we’ve both entered that space and feel its safety. We can now get to know each other better. My mother is now living to live.”