Our brother in law has been away working in Syria and about 5 days ago he started communicating in a strange way, talking about demons and slaying devils. Since then he has become progressively worse, talking nonsensically and very violent / aggressive. He does not know where he is or what is going on other. His hallucinations have been getting progressively worse as has his violence / aggression. They don't have any proper facilities to treat or diagnose him so he was been kept under secured observation and restrained. He is due to fly back to the UK today on a private ambulance.
We suspect some sort of brain trauma but of course don't have any specifics until he has had scans and so on.
I just wanted to ask if anyone had any advice. When he lands, he will be taken to hospital by ambulance but as far as his employers are concerned, that's the end of their obligations to him and they will simply hand him over. We are aware that this will need addressing at a future date but right now we are concerned as to what we should do when he arrives in the UK.
Our intention is to go to the hospital with him and see what they say but I would appreciate any guidance or perhaps pertinent questions we should be asking when we get there.
thanks
John
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johnboy12
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Gosh what a worrying time for you especially as your brother in law was abroad when this has happened. Have you been told that he has had some kind of accident where he hit his head? Was there some kind of trigger event 5 days ago. Other possibility could be a mental illness as what is happening in Syria could have perhaps mentally traumatised him. Yes someone needs to be at the hospital with him and they will need info as to what has happened and how he has been eg symptoms. Initially the hospital will not probably be able to say what has happened until they have done some investigations e.g blood tests, scans etc as much to rule things out as well as look for causes. There are several different potential causes for his symptoms including if he has taken or unknowingly been given drugs or exposed to chemicals etc.
Hopefully the doctors will make it a priority to ascertain whether it's a neurological/psychiatric or chemical issue.
If it were my relative I'd be asking for an MRI to firstly eliminate certain neuro conditions which might be of a critical nature. A hasty assumption of psychotic disturbance could cancel out the need for physiological tests.
I hope your brother-in-law gets the help he needs. Please keep us updated on developmens. Cat x
I cant add much to the great advice from the other posters. And my knowledge is very limited and uncertain.
I would reiterate that I think it is important to ensure that they rule out physical/ neurological conditions and dont go straight to assuming that its a mental health problem. Once it is labelled "mental health", can be hard to get other tests done.
Seems to me that being in Syria there could be quite a few possible causes for what he's experiencing and like others say it might be importnat to try and determine what he was doing in the lead up to (including mnonths before) the problems emerged. In particular, was he in contact with chemicals? Some of these could cause neurological damage. Neurotoxins are I imagine pretty easy to bump into in Syria - including residues from chemical weapons and chemicals released if there has been damage to chemical works. Also did he get any hospital treatment where he was given medications?
In terms of posisble brain injury, was he near any explosions?
Does he have any prior-to-Syria experience of mental health problems and in particular pyschosis?
Like others say, brain scan sounds like a good idea. maybe also an idea to get blood tests to test for poisons and also an ANA test to check that an autoimmune conditions wasnt triggered.
I think hair samples are meant to be tested when looking for toxic exposure as it can indicate toxic exposure from time hair started growing (whereas any toxins may now be out of the blood).
Hope things go well and keep us posted if possible.
If you hadn't mentioned brain injury I would have immediately thought mental health problem.
I've worked with clients for over 20 years, the majority having a diagnosis of a mental health problem.
However I have NO medical training but I can say modern treatment has served my clients well, most of them making a full recovery, other needing to take medication to stabilise them.
johnboy12 firstly if they do not have proper facilities to diagnose the problem then it is morally wrong for him to be restrained
secondly you say hes been out there 5 days, is it possible he may have had an allergic reaction to his jabs or if he didnt have jabs then his behaviuor maybe the result of a viral infection hes picked up while hes been out there
Many thanks for all of your comments. I apologise, I got the country wrong, it was actually Somalia where he has been on contract work for 3 months previous and had returned just after New Year. It seems he was flown into the UK on a private flight without a paramedic so an ambulance had to called at the airport along with a police escort to ensure the crew were safe.
Some serious questions to be asked regards the company or contractor he worked for and their repatriation short falls which are nothing short of shocking and most likely actionable.
Nevertheless, he was taken to the A&E of a London hospital last night where they ran a series of tests to exclude biological / physical causes. They did a CT scan on his brain along with blood tests and heart tests. All of which have come back ok and he has been diagnosed as having a severe phsycotic episode & has since been sectioned which is probably a good thing given his hallucinations and aggression / violence.
Hopefully they can now start giving him the treatment he needs. Thank you again for all your help and answers.
Whatever the illness, he will need his family. Obviously you need to determine the actual problem if it is a head injury he will not act like the person you knew. He will not be able to accept he has changed. It has taken me many years to accept it. But it was very important to me my family were around so be as positive as you can be.
Best wishes I hope things go well he needs to see a neuroscicolgist.
I really hope the medics can get to the bottom of your brother-in-law's psychosis ; thank goodness he's back home and can be monitored for his particular type.
It can be a lengthy process, often delayed by temporarily tranquilising the patient to ease their agitation/confusion prior to psychoanalysis and diagnosis.
Of course if it's the brief, acute type he could be functioning again within a few weeks ; I hope that's the case John for his sake and all the family's.
I would hope that he would have blood tests, and CT scan of his head as a priority because a) he has been away in another country with unknown whatevers. B) he is acting out of character as has no previous history C) there could be an acute cerebral event
If the tests and CT are clear then this may be a stress response, an unrelated psychotic episode that needs treating, and the fact he has been away as he has has been the trigger or incidental.
His thought processes are very real and frightening and real. Then hear them but don't challenge them. Just be there. You will find a cause and he will improve.
In short rule out and sit it out. I wish you all the best and hope he has a speedy recovery xxxx
And he may need some medication in the form of major tranqillisers to help. They should take the heat out of the unpleasant thoughts and aid some relief and sleep. They need not be long term, just to help now. Please don't be alarmed by this. They will be carefully prescribed and used. However, he needs physical assessment xxxx
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