Long hx of serious mental illness in family. Nephew is refusing to attend Thanksgiving because his dad and my brother who has always been unstable in his patterns of behavior has begun an RFK Jr style health kick that looks like OCD to my eyes. I am an immigration attorney so take that dx with a grain of salt.

My brother goes on a lot of kicks and they are usually triggered by a romantic relationship (that is always dysfunctional)

My nephew told me and my parents my brother told him the government puts poison in his food. The has began talking about thermal paper obsessively. They went to the store and he threw out all the tomatoes they bought because the clerk had put the reciept in the bag with the tomatoes.

Last summer I saw him pound a tequila drink at 10am on the highway driving me and his kids to the beach, so it's a sudden change.

When is it serious enough to intervene? He's lost almost everything to his two divorces and even lost money buying an expensive house with a third woman months after getting together with her. (He spends compulsively too. Income in high 6 figures since HIS TWENTIES. Net worth: $0.)