u/jakeywow

My sister (30s) has been in what looks like a first manic or psychotic episode for about 10 weeks. The picture: grandiose beliefs, paranoia that people are conspiring against her, and almost no sleep for days at a time.

The one opening we have: she is convinced her brain is "expanding" and is actually asking for a brain scan. But she refuses anything framed as psychiatry or mental health, and she will not go to an ER. I am abroad; family is local and coordinating. She is uninsured (self-pay).

Two questions:

1. Is "let's get your brain scanned" a legitimate medical way to get her in front of a doctor who could recognize and treat this? And what kind of physician both orders brain imaging and can prescribe (neuropsychiatry, integrative psychiatry, or a neurologist who will co-manage)? At 37, is a brain MRI plus labs genuinely warranted for new-onset psychosis, or am I just chasing her framing?
2. For anyone who has gotten a loved one with no insight (anosognosia) into care: what actually worked? We are trying to keep her trust and not argue the delusion.

Thank you.

My sister (30s) has been in what looks like a first manic or psychotic episode for about 10 weeks. The picture: grandiose beliefs, paranoia that people are conspiring against her, and almost no sleep for days at a time.

The one opening we have: she is convinced her brain is "expanding" and is actually asking for a brain scan. But she refuses anything framed as psychiatry or mental health, and she will not go to an ER. I am abroad; family is local and coordinating. She is uninsured (self-pay).

Two questions:

1. Is "let's get your brain scanned" a legitimate medical way to get her in front of a doctor who could recognize and treat this? And what kind of physician both orders brain imaging and can prescribe (neuropsychiatry, integrative psychiatry, or a neurologist who will co-manage)? At 37, is a brain MRI plus labs genuinely warranted for new-onset psychosis, or am I just chasing her framing?

2. For anyone who has gotten a loved one with no insight (anosognosia) into care: what actually worked? We are trying to keep her trust and not argue the delusion.

Thank you.