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Suzanne,

I'm so sorry that your family member is dealing with paranoid schizophrenia. You are a loving soul to feel her struggles so deeply.

I have a friend who is bipolar and schizophrenic and going off their medicine is a somewhat common problem. They take their medicine for a while, they feel better, and then want to go off it -- or just plain forget -- or believe it is controlling them and that they need to be without it. Also, anti-psychotic medicines can have side effects that are hard to live with.

Here's an excerpt from a story on MSNBC:

"Greg Coughlin, 53, a health department employee for DuPage County west of Chicago, said several years ago he repeatedly stopped taking drugs for a type of schizophrenia because he was “in denial” about suffering from mental illness.

"Coughlin said the last time he stopped, in the 1990s, he became extremely obnoxious and agitated, and ended up in a mental hospital.

"Now he’s on three mood stabilizers that zap his energy and cause weight gain, but make him feel “more solid, more relaxed, more satisfied in life.”

"Coughlin, a board member of the Illinois chapter of the National Alliance on Mental Illness, said he finally accepts that to function, he’ll need to be on drugs for life. "

I'm wondering if we could do some more research for you with the answers to a few more questions. Where in the country does she live? How old is she? Does she have a guardian or is she in charge of her own life? Do you know what the meds are that she is on, and/or whether her doctor is aware that she often doesn't take them? Does she, in your opinion, have the mental stability to care for herself if she does take her meds? Is her psychiatrist working with the family to help regarding these episodes?

Suzanne, here's a page on the treatment of paranoid schizophrenia from the Mayo Clinic. They mention that people often feel that they don't need treatment when in fact they do:

http://www.mayoclinic.com/health/paranoid-schizophrenia/DS00862/DSECTION=treatments-and-drugs

And here's a page on Understanding Schizophrenia from the University of Texas Psychiatric Center. If you scroll down, you'll see the parts of the page on treatment and, especially, "how family and friends can help." You say your friend is thoroughly confused; that's very empathetic of you, and is also consistent with her condition. One of the things this page emphasizes is structure:

http://hcpc.uth.tmc.edu/schizophrenia.htm#living

Schizophrenia.com has a page for families on how to help manage the five common symptoms of schizophrenia: paranoia, denial of illness, stigma, demoralization, and terror of being psychotic. From what you write, she has dealt with most of these. It mentions that "If they are denying that they are sick, they will also most probably deny treatment:"

http://www.schizophrenia.com/family/mansymptoms.htm

Here is a family perspective on living with schizophrenia from the online journal of Issues in Nursing:

http://www.medscape.com/viewarticle/499269

And the National Institute of Mental Health offers this article about Helpful Hints about Schizophrenia for Family Members and Others:

http://psychcentral.com/lib/2006/helpful-hints-about-schizophrenia-for-family-members-and-others/

Here is a page of chats/forums where many people are discussing various aspects of schizophrenia. Scroll down and you will see chats for caregivers/family members, siblings, spouses/significant others and children of schizophrenics:

http://www.schizophrenia.com:8080/jiveforums/index.jspa;categoryID=1

I hope there's something here that helps, just a little. One of the things that runs through all the schizophrenia sites I saw was this: That there are more successful treatments today for schizophrenia than ever before, and that many people are living better, more productive lives. Your relative doesn't have to give up hope, and neither do you. Take care, and write back with more information if it might help us get you more answers.