The Night the Neighbour Stopped Sleeping

Mrs Dsouza, 45, in Bengaluru, had been unwell for years and stopped her medicine last month. For four days she has not slept, believes the neighbours are poisoning her water, and has covered the windows. Tonight she is s…

Mrs Dsouza, 45, in Bengaluru, had been unwell for years and stopped her medicine last month. For four days she has not slept, believes the neighbours are poisoning her water, and has covered the windows. Tonight she is shouting at the door and has a kitchen knife in hand, saying she must protect herself.

Her son Peter, 20, is frightened. He keeps his distance, speaks softly, does not challenge her belief and asks his aunt to call the local emergency service. He keeps the door open so she can leave the kitchen, and removes small children from the room.

When the team arrives, Peter explains what has happened, that she stopped her medicine and has not slept. They speak calmly, and take her to hospital. She is frightened, but after some days of treatment and sleep she is calmer.

Afterwards the family and doctor build a plan: regular medicine, follow-up visits, and early warning signs, such as sleeplessness and suspicion, that mean they call the doctor sooner. Peter says, "I learned that safety comes first, and that I did not cause this." The neighbours, who had been frightened too, later bring food and ask how they can help, which makes the family feel less ashamed. Peter learns that calling for help early was a loving act.

How to recognise it

• Several nights of no sleep and strong fear or suspicion.

• Strange beliefs, hearing voices, or confusion.

• Threatening behaviour or holding a weapon.

• Recent stopping of regular treatment.

• Risk to self or others.

What this story explains

Severe psychosis or mania, and risk of harm to others, are emergencies. The priority is safety, calm behaviour and urgent professional help.

Probable root causes

• Relapse of a severe mental illness.

• Stopping treatment.

• Sleep loss.

• Stress or substance use.

What to do

1. Keep yourself and others safe and keep distance.

2. Do not argue with the beliefs.

3. Speak softly and give her space.

4. Call the local emergency service if there is danger.

5. Tell the team clearly what happened and what treatment she had.

6. Arrange follow-up and an early-warning plan afterwards.

Whom to consult

• Emergency service or nearest hospital immediately when there is a weapon, threat or risk to anyone.

• Psychiatrist for treatment and relapse prevention.

• Family doctor for support and guidance afterwards.

Do and don’t

How to behave and communicate

• Speak low and slow: "I am here. No one will hurt you."

• Do not shout or threaten.

• Use short sentences.

• Acknowledge her fear without agreeing to the belief.