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My little brother and I are 14 months apart. When we were children we were best friends. Over the past few years he has isolated himself from everyone. He slowly started to lose friends and now i fear he has none.

Just recently my family found out that he has paranoid personality disorder. He constantly is talking about how everyone is out to get him. Us, his therapist, and his old friends. 

He refused to take his medication, said that its going to 'ruin his brain". But would stock up on medication just to take a HUGE dose so he could get high. 

A few months ago he started verbally abusing my parents. Calling them awful names and physically abusing my father. It became impossible for me to live there so i left just last week. Just a few days afterwards my mother couldnt take it anymore so she told him either she will call the cops or he had to go to our local mental hospital. His living situation was awful because they roomed him with a man with schizophrenia. He was in there for a week and it seemed he was starting to be grateful for his life and told my parents he was gonna be better. He was desperate to come home and my mother and father took this as a good sign so they told him he could come home.

He came home yesterday and it was like he never left. He was abusive and refused to take his medication. So my mother called the police and they had him committed again. 

This is completely unreal. My mother is traumatized and scared that he will never be the same funny, loving man. I miss my brother. My family and I feel trapped. I am worried about my family. And i dont know what else to do. It seems like there isnt much to do.

I just graduated from college and I want to start my life. I keep on thinking about him...I feel so bad. I want him to get better but have no idea how to get through this. 

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What you describe is not an uncommon problem with psychotic disorders. He starts to feel better on his medication and decides he is no long needs his meds. The thing he needs in psychotherapy along with his medications. There are many people with profound psychosis, who can be quite functional provided they understand through psychotherapy that there disease is life long and is based on chemical imbalances in the brain. Much as a type I diabetic understand they have to be on insulin (may diabetics stop their medication because they feel better and decide they no longer need it... the list is endless). Your brother can be told this for years and it will not do much if any good. He has to come to this realization himself through therapy with a good psychiatrist and it will take time and he may never come to terms with his disease. Many people with psychotic disorders are aware of their actions and like the alcoholic they use it as an excuse to avoid life's responsibilities. I tell you this because you may have to come to terms with the fact your brother need to do somethings too, and hard as it may be, you are entitled to your life too...  I am not saying to turn your back on him, but to realize as much as you may want to help there is very little you can do beyond offering support while avoiding being consumed by something you are powerless to fix. Good luck to you, your brother and family  

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