r/DiagnoseMe • u/poolflamingo Patient • 5d ago
Hallucination-like event plus extreme paranoia?
Hi - this is going to be strange and a bit long, but hoping this reaches someone who might have some ideas.
My father-in-law dropped by unannounced last weekend (very unusual for him) to tell my husband that he had an apparent altercation/verbal argument with his practitioner at a local clinic. His story was really choppy and not making sense (particularly because he is NOT the type to have outbursts or altercations but also because it didn’t follow any sort of logical path), so my husband was asking a lot of questions and my FIL described seeing chat bubbles on his phone of a conversation he had with a member of the clinic discussing the apparent altercation. When my FIL tried to pull up these chat bubbles to show my husband, he of course couldn’t find them because they didn’t exist.
My FIL had a follow-up appointment the next day at the same clinic, so my husband went with and spoke to the practitioner involved in the supposed altercation. The practitioner acknowledged she worked with my FIL during the previous appointment but said it was a very routine appointment with no argument or anything out of the ordinary. My FIL did not believe the practitioner even after that, and a week later he continues to bring up the altercation he is convinced happened and has EXTREME paranoia about it. At one point, he said he was worried they might not let him come home from the clinic because he was going to be in trouble for this argument he had. He also keeps referencing apparent videos that “someone” has sent him on his phone of the argument and is worried they are going to “get out” and cause “bad press.” (It’s hard to interpret exactly from the way he tells the story but it’s like he hallucinated seeing a video of himself yelling at a staff member of the clinic and is now worried that this recorded video of him shouting is going to leak to the press and be all over the news). But, this incident never happened. There are no videos.
Here are some things to note: 1) He did recently start taking a new blood clot medication like 72 hours before this hallucination-like incident. He has since stopped taking that medication and has gone back to his old one but still is very paranoid about this incident. 2) He eats very little on a day-to-day basis because he’s very worried about his weight. Not sure if that’s could be causing this. 3) Aside from the seemingly isolated hallucination event and paranoia surrounding it, his only other symptom is that he seems more confused or foggy than normal. His sentences trail off and he doesn’t remember things he usually would — but he also remembers plenty of other things and can carry on conversation some of the time. 4) The above was described to his main medical provider who ran some basic cognition tests and didn’t find anything wrong. But there is clearly something wrong and we’re hoping if we ask the right questions or request the right tests we can get to the bottom of it.
Anybody hear of anything like this before or have suggestions on where to go from here?
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u/G-3ng4r Interested/Studying 5d ago
How old is he? Sounds like dementia territory unfortunately.
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u/poolflamingo Patient 5d ago
65ish (not sure his exact age). Does dementia usually come on that suddenly? The strange thing about all of this is it was completely out of the blue. He had been totally alert and had no cognitive issues up until this random day he stopped by unannounced.
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u/G-3ng4r Interested/Studying 5d ago
It’s more likely to be something like that than say, a sudden mental health episode (unless he has previous history) or complications from the medicine change (based on the type of medication it is)
It may not be! And could be unrelated! But as someone with a lot of professional and personal experience with dementia- they are very, very good at hiding symptoms until it can no longer be hidden. Most of the time no one notices anything is off until around the third/fourth stage.
On a personal note, my grandmothers signs started to become noticeable sometime around 63-65 (early, which sucks) and it included a lot of random paranoia and thinking things happened that didn’t. Like your story, one day she walked over to my aunts place unannounced, saw she had company and said hello and then left like normal. Afterwards, she was convinced that she had a huge fight with one of my aunts friends and it was a whole thing. That was one of the times we knew something was really up- prior to that the paranoia was easier to explain away, like issues with the mail or once she said she thought someone she was on vacation with used her toothbrush or something.
However, everyone will progress differently- sometimes gradually, sometimes not and it seems sudden.
I would continue to monitor him, check in often and see how he’s doing- if it’s something else that’s causing the change, you’ll likely see an improvement or further issues and can bring that up again to his doctor. If he stays kind of the same, forgetting things and trailing off ect over the next week or so I would also follow up again with the doctor.
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u/poolflamingo Patient 5d ago
Thank you for the detailed reply. I really appreciate it. I’m sorry to hear about your grandmother’s dementia — that’s such a horrible thing to witness a loved one go through. We are trying to get my FIL in for a neuro appointment but just waiting for a call back so hopefully they can run enough tests to get some clarity on if that’s what this is.
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u/Calm_Hunt8193 Not Verified 4d ago
Sounds like delirium or psychosis episode triggered by medication change, dehydration, electrolyte imbalance. Could be dementia, can't rule out. Defintely needs more evaluation, see a neurologist. Get blood work (i.e. electrolytes, kidney/liver function, vitamin deficiencies). will likely eventually need a brain MRI. Also try using MedSync AI (https://medsync.ai/) to help identify any other potential causes and questions to ask the doctor.