'My Uncle Is Delusional After Election, Should I Tell My Aunt?'

Reader Concerned Niece writes,

I recently got a call from my uncle asking me to have lunch.  This in and of itself is very unusual. While I love him as part of my family, we are not particularly close.  He would not tell me why he wanted to have lunch.  A little background, my uncle has always been a bit odd.  For example, for the past 15 years he has been working on a mathematical formula to beat the lottery.  No winnings to show for it yet, but its a relatively harmless eccentricity, so the family has mostly humored him.

However, at lunch I learned that this eccentricity has developed into full blown mental illness.  Apparently, the presidential election results caused him to go into a delusional state.  At lunch, he told me that based on his review of the Book of Revelation, Nostradamus's predictions, and an almanac from the 1970's, within in 5-10 years we will be drawn into World War III which will be a nuclear war.  This delusion is very specific, and he spent an hour spinning a web of religion, history, and conspiracy theory worthy of a Dan Brown novel.  The delusion itself is very concerning, but even worse are his plans to act upon it.  He wants to cash out his pension and move to Argentina - according to his predictions, the nuclear fall out will be much less pronounced at the southern tip of South America.

I doubt there is much he can actually do to get himself to South America - he's never been to Argentina, doesn't speak the language, isn't particularly wealthy, and doesn't have a job or any connections in the country.  But, I am concerned he will try to take steps based on his delusions that would have a negative impact on his life or his family - like prematurely cashing out his pension...

I know at some point I will need to tell my aunt, my question is when?  I don't want to cause too much of a stir if it turns out to be nothing.  Right now, his "plans" are not immediate, and while I didn't try to dissuade him from his delusions, I did stress to him the legal implications of putting his plans into action (I'm a lawyer) as well as the emotional and financial stress he will put on his wife and two kids.  He seemed to hear me on that point and promised to talk to his therapist about his predictions and plans both before taking any action.

So, at this point, as a good niece, what should I do?  Tell my aunt?  Or, stay silent for the present until I have further cause to worry?  Thank you for any input you may have.

Dear CN,

This reminds me of this situation, except that in this case, your aunt is very involved with the outcome of this delusion.  In theory, he could take all their joint retirement savings and use them on this move.  I believe that you have an ethical duty to tell your aunt what he is saying to you.  It does sound like his "eccentricity" was triggered and is now full blown paranoia.  Most likely he has always had schizotypal personality disorder and a stressor triggered this progression into a (hopefully) brief psychotic episode.

You may be surprised to learn that your aunt is in fact aware of his delusions and has taken steps to mitigate the fallout, or that these delusions were always worse than you thought, but he kept them more to himself, possibly involving only her.  One silver lining here is the fact that your uncle already has a therapist. If he is sharing these ideas with the therapist, the therapist is likely doing everything in their power to bring him back to reality.

In general, people with personality disorders, like narcissistic personality disorder, borderline personality disorder (BPD), schizoptypal personality disorder, and others, generally appear a lot less disturbed until a major stressor hits.  For many narcissists, a key stressor is often being mocked or dismissed, and this leads to narcissistic rage. For those with BPD, a key stressor is often abandonment, and this leads to rage, suicide threats, and general decompensation. For your uncle and others with schizotypal PD or even schizophrenia, it's the idea of being put in danger that really sparks paranoia.  In your uncle's case, I believe you're correct that this increase in his symptomatology was provoked by his perception of the results of the election.  Without it, he may have remained more "eccentric" than actively paranoid and delusional.

If your aunt welcomes your input, you can suggest that she contacts your uncle's therapist to tell him the extent of the paranoia. Hopefully your uncle has signed a release saying that his therapist can talk to your aunt; if not, she can try to convince him to join a session or even just leave the therapist a voicemail.  While the therapist cannot return this call without a release, the therapist will listen to the voicemail, absorb that information, and potentially use it to direct what is discussed in session.  Best of luck to your aunt, uncle, and you, and keep me updated.  Till we meet again, I remain, The Blogapist Who Says, This Election Worsened Many Clients' Feelings Of Paranoia, But This Is Extreme.

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