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How Not to Talk to a Psychotic (long)

post #1 of 40
Thread Starter 
I feel sort of strange writing about this. Also, it's going to have to be long. DH is having an episode of mental illness. This is the third. Two years ago, he had for the first time a, well, "psychotic break with reality," an episode of such extreme paranoia that he felt that televisions were giving him messages. After the night when I found him in the bathroom unscrewing lightbulbs to look for bugs, he checked himself into the hospital for awhile and then took medicines. Then last summer, he had another bout. It's obviously brought on by specific, work-related stresses, and it begins with him worrying about things that are reasonable, about his position in terms of work. We are academics, and before you have a job, you can feel very vulnerable in terms of having your ideas accepted by those in the "establishment." He's also very worried about internet security. Anyway, when he's having episodes it escalates, and he loses the ability to distinguish legitimate fears from illegitimate ones. He's suspicious of our friends, of me, of everything.

So anyway. It's happening again. This time we have some of the anti-psychotic meds in the cabinet, and he's set up an appointment with his old therapist (he stopped going to therapy, of course) for Monday, and there's already a check-up with the psychiatrist that's been scheduled for mid-April for a long time. So we have some of the system in place. But I still feel alone. Alone in the house with a crazy person who -- this is the kicker -- does not accept that he has in any way lost perspective on things in the world. Graffiti contains secret messages to him. His students mention things in class that are meant as messages to him because they have looked him up on the internet. He yells at me for having "loose lips" (to him, this post would be another example), for things I said four months ago to someone at a party that has somehow compromised our security.

Unlike the last two times, I lack patience with him. I'm angry at him for not taking more steps after last time to prevent this relapse. His therapist recommended yoga, for example, which he never took up. He never takes his vitamins. He doesn't want to stay on an anti-depressant, which I'm sympathetic to, but doesn't take the extra care with nutrition and relaxation that would obviate the need. I know that mental illness is NOT HIS FAULT, but that doesn't prevent me from being angry that he hasn't been more proactive about managing it, as I've been proactive about managing my own anxiety issues. I'm angry that I saw the signs coming two weeks ago but when I asked about them he shrugged them off. I'm angry that he doesn't accept there is a problem, and as a result, I have to FIGHT with him to get him to take medicine, and I piss him off by "monitoring" what he's doing because I don't want him to say something to someone that he'll regret later. (For example, he was going to send an e-mail to our midwife's 15 year old daughter -- a local graffiti artist -- to ask about the messages to him in the graffiti. NO NO NO, honey, if you don't want our midwife to think you are weird and creepy, I think this is NOT the way to go!) So I have to FIGHT him to do all this stuff that I just do to try to help him and protect him. He yells at me and resists me. So it takes energy to worry about him, and energy to fight with him, and energy to not take personally the insults that he casts as a result of my attempts at intervention. (This is in addition to the energy that I need for my own job, and energy for being pregnant and tired.) He says he thinks he is FINE. But then he'll say, "I just don't understand what's going on right now." Um, nothing? Your brain is having a little trouble and needs a little medicine, that's all? But no. When he walks outside, he can feel the "convergences" in the air. This is preferable, though, to the mornings when he can't get out of bed, can't eat, when I have to insist I'm not leaving until you take two more bites. No, you have to eat another bite. I'm not leaving until you eat another bite!

Last time I had infinite patience. This time I do not. I'm pregnant and don't feel like being strong in that way. I have a REAL child to think about now, so I feel angry when I have to treat the other ADULT as a child. I'm finding it hard to bite my tongue, to not argue back. So when he hasn't taken his medication and is being crazy, we have fights. Where I should just recognize that he's not himself and be the "big person" and step away, I yell. For example, he'll tell me to close the windows (paranoia), and I'll set out to say, they'll be fine for a few minutes, but what comes out is "I'M SICK OF LIVING BY YOUR RULES!" followed by bursting into tears and yelling about how not only does he has to recognize he has a problem, but that yes we DO have to reorganize the study before the baby comes, he's not the boss of me! Uhm, mama, overwrought much? :redface

Anyway. I suspect arguing with him isn't the BEST strategy, but I don't know a better one, and I resent that right now I'd have to bottle up all my feelings, and plus when I get really upset, it usually shocks him into taking his medicine, which then seems to make him more reasonable. But really, I'm alone. His family and mine know that he's had these episodes, but what can they do? Nothing meaningful, unfortunately. It's all just me. Talking about it with family doesn't help.

I'm sure the stress of the pregnancy (because it makes our money situation more acute) contributes, but I want to say I don't think this is primarily about the pregnancy. He is excited about and very kind about the baby. I should also say that it's not bad all day everyday. It's kind of funny, sometimes, and we probably do both air grievances with each other that it usually isn't safe to air. And I am pretty patient and we cope well. But the absolute worst thing is that he insists that there is nothing wrong. He cannot admit that he is ill. And this is the thing that I find the most stressful. He doesn't understand, or can't, why this is stressful for me, because to his mind there is nothing wrong with him. And of course, I'm terrified about his happening again next year, when we have the baby.

So that's my deal. It's a weird situation. And I'm doing pretty well, but sometimes it's really hard because I am in no way an expert at this and I could use some kind thoughts, a pat on the back, some extra strength to help me remain cheery and calm and to remind me to feed the baby well because stress is kinda making me lose my appetite. Thanks mamas.
post #2 of 40
Big s for you.

I don't know what to say, I just wanted to tell you that it's good for you to get it all out, because you've really got a big serving of stress. Lay it on us! How's the weather where you are, can you get outside & do some yoga yourself?

I know it's got to be so hard to deal with, and I've noticed that the anger comes a little easier w/pregnancy hormones surging... I would just try to do your best to cope until he can get past this & when he's back in touch with reality, work together & w/the therapist on a plan to prevent another episode.
I'm so sorry that family isn't able to help carry the burden.

Know there are people out here sending out lots of positive vibes for you & your growing family.
Take care, Kelly
post #3 of 40
Minnow, I do not have personal experience with this but I wanted to send hugs. It is so much for you to have to handle right now. I suppose the positive side is that he and you are taking steps to get things back to a better place.

Perhaps some prenatal yoga for you and maybe his therapist could help you with how to talk to and be around him when things aren't so good?

Feel free to vent here, perhaps someone will have some good suggestions for you.

ETA just saw beemama's post. She has good ideas.
post #4 of 40
I couldn't read and not post. I have no advice...I just wanted to say I'm thinking about you and your DH. What a load on you!! Maybe when he goes to the Dr. on Monday something will come of it. With him taking the meds (he is -right?), going to the therapist on Monday - he's kinda admitting he's doing it again, right? Many HUGS to you! I really can't imagine having to deal with that and being pregnant. Try to hang in there!! Stay strong and calm! Feel free to come vent/talk anytime! I will be thinking of you!!! Sending you some extra strength and calmness!
post #5 of 40
Thread Starter 
Thanks so much for the replies. It feels weird to make such a huge post but I guess it does help to "get it all out there." The prenatal yoga is def. a good idea! Now that I am feeling physically better (yay second tri!) I think I need to get my butt over to the birth services place and do yoga with some other pregnant ladies.

Now I'm going to take a walk. Thanks again. It's somehow just helpful to tell your story to other people and have them respond.

Oh. I've been saying to him that I want to talk to his therapist for exactly the reasons you guys are saying -- she can give perspective, advice for how to deal with him, etc. He is ABSOLUTELY AGAINST the idea (which is the reason I've never done it before). His therapist is "private." I tell him of course, he can have a private session, I just want to touch base with her and get some advice. He doesn't like the idea of me and her talking about him. I know I'm going to have to insist, but it's yet another fight we'll have to have.

Or maybe I can just call her myself, but if/when he finds out he'll be angry that I'm "keeping things" from him; that will prove his suspicions that I'm in collusion against him! Sigh.

Edited to add: I called and left a (slightly incoherent) message for the therapist, so hopefully she can encourage him to let me speak to her too on Monday. Here's hoping she can help us!
post #6 of 40
Perhaps you could to talk to a therapist independent of him? You could get the help you might want to live/talk/parent with him now and in the future and he could maintain his privacy.

What a tough time, keep talking to us, we'll be here.
post #7 of 40
I have no advice to offer, just wanted to say thank you for trusting us with this part of your life. I so hope that the coming weeks will bring a positive turn for him . . . in the meantime, please do all you can to take care of yourself and your baby.

Many, many hugs your way!
post #8 of 40
even though i have no words of wisdom specifically for this situation... i do know from past situations how hard it is to deal with someone's health when you have no control over the reality of it. it pains your heart so.

here's to your strength, patience, and persistence... no matter how far away it may seem occasionally. you've still got it!
post #9 of 40
My dad is a psychiatrist who has run a Shizophrenia group for many years.(I have a psych degree)
His biggest frustration with his patients is that when they take their meds, they are fine. But then b/c they feel fine, they don't believe they needs the meds any longer so they quit and get sick again. It really is a viscious cycle.

I think it's understandable that you are feeling spent, resentful and generally pissed off. Yes, pregnancy does make our fuses shorter and small problems look/feel bigger.
But please do understand that it's not that he is being lazy. It is the disease and just the way it goes with the people that have it.

He needs to his his Psychiatrist and get back on his meds. He needs to resume his therepy. Did he ever join any groups?

And most important of all--Paranoid Schizophrenics can be very dangerous, so if you are ever feeling scared or threatened-get out of the house.
Take care of yourself first and foremost.
Hugs to you! This too shall pass.
post #10 of 40
Thread Starter 
Originally Posted by Maple Leaf Mama View Post
He needs to his his Psychiatrist and get back on his meds. He needs to resume his therepy. Did he ever join any groups?
Nope. He's anti-group. He's anti-therapist, because he "doesn't think they help." (Although he did want to call his old therapist, so maybe that's a good sign.) More of why I feel like I'm the one that has to do all the coping with this...

Actually, with his first therapist (useless, according to DH), he was assigned to a "dissertation support group." That did nothing to help. So he now doesn't really feel that anybody out there will be able to understand/help.

What you say about the cycle seems right on. It's sort of weird b/c his diagnosis isn't schizophrenia, even though he has these paranoid episodes. It's just "depression" of some type. I suppose one thing that worries me is that he hasn't gotten a proper diagnosis, but his trajectory is an anomalous one. It doesn't really fit any of the categories.

I realized that my first post sounded really angry. That's not my dominant feeling about it. Mostly I feel tired and kind of sad.

Thanks again everybody. You've helped a lot.
post #11 of 40
Well I'm another one that doesn't have any great words of wisdom. But I am sorry you are going thru this. And I'm sorry for your dh that he is sick. It sounds like Bi polar to me, except unless he has bouts of depression then it's prob. not. I do have experience with Bi polar illness and the highs are very similar to scizophrenia highs. And it's the same thing with Bi polar patients and not taking their meds. It's frustrating and so hard on the person that is well. The only thing I can really offer is that hopefully he will get on his meds again and then maybe when the baby is here he will stay on them as he will see how impt. it is to be well. I think it is honorable that you can continue to love someone that is sick at times just as long as you and the baby are always safe. Do not be upset with yourself for not having the patience this time. I don't have patience for my dh and he is just the same as always... (a dolt ) What I think is that you should focus on taking precious care of yourself as much as possible. Stress as I'm sure you know, will never be good for you or the baby.
I really hope things improve soon so that you can enjoy this blessing of being pregnant!
post #12 of 40
Mental illness sucks, period. It is something that no one should have to experience in themselves or anyone they love. My heart goes out to you.

It is likely he has a diagnosis of something like Major Depressive Disorder with Psychotic features or something similar. It can be frustrating to know that the psychosis itself doesn't warrant a more significant diagnosis. BUT, with 3 significant psychotic breaks, the psychiatrist may be able to make a more accurate diagnosis that will help with creating an appropriate treatment plan.

And please, vent away here, this is a safe space for you. We will listen.
post #13 of 40
Thread Starter 
Originally Posted by Brilliantmama View Post
Major Depressive Disorder with Psychotic features.
Yes. That's it, I think. It says to treat with depression/anti psych meds and therapy, and he insists on quitting both... (to be fair, the therapy isn't covered by insurance :P )
post #14 of 40
I realize that he may not have changed in the past few hours but I am checking in to see how you are doing minnow.

I wish I had more to say.

Do you have local friends in which you are able to confide? I hope you are not feeling to alone.
post #15 of 40
(to be fair, the therapy isn't covered by insurance :P )
: This is very upsetting to me! Why don't they cover that? It's an illness, for crying out loud! A life altering one, at that. Good grief.

I was just checking back, too. You've got lots of people thinking positive thoughts for you!
post #16 of 40
Hi Minnow. No words of wisdom here. Just wanted to reiterate that we are here for you - if you need to vent, to be angry, be sad. It is ok to feel all those things and more and we don't mind "listening". This is certainly not a burden that you need to take on by yourself.

I hope that your DH can get the help that he needs. In the meantime take care of yourself and trust that things will get better.

Many hugs to you.
post #17 of 40
Thread Starter 
Originally Posted by beemama View Post
: This is very upsetting to me! Why don't they cover that? It's an illness, for crying out loud! A life altering one, at that. Good grief.
Oh, I should clarify. It's covered, but only if we use the student health center (DH did not like his therapist there). Otherwise it's "out of network," meaning they pay like 15 percent or something. Our cost is still pretty high, esp. if he's going weekly. If he starts going regularly, she might let us negotiate a slightly lower rate, I think.

I do have a few friends in town, went for a walk with one yesterday, gonna visit one today. A lot of our closest friends have graduated and moved but we still know some people.

Wow, you guys are awesome. Thanks for thinking of me/us. I slept well last night, after reading a Hypnobirthing manual a friend sent me and being reminded of how your mind manifests what you imagine, so I thought about the baby and imagined DH calm and well and whatnot. Can't hurt. Got him to take medicine after only about five minutes of refusal. He's sad and quiet today, but now he's out in the sun going for a bike ride, which I think will help. I'll let you guys know if anything happens with his appointment tomorrow.
post #18 of 40
Hey mama.

I am so sorry you have to deal with this right now. I understand how hard it can be dealing with someone with a mental illness. I grew up with a mother with severe bipolar disorder who would not believe anything was wrong with her. When she did take her meds, which was very rare, we could all make it by. Problem was that she didn't think she needed them. Every day was a battle for my siblings and I.

I don't have any sound advice here, just wanted to let you know I understand (at least a little) where you are coming from. I think it's great that you have a place like this to vent because I think talking about situations like this does make one better able to handle them.

Thinking of you and sending positive viibes your way.
post #19 of 40
minnow - I left a message for you in the preg w/ #1 in our 30s thread but I wanted to post here too (after reading your full post). You have every right to be angry with your DH. Yes, he is ill (and HAVING the illness isn't his fault) but he is also an intelligent functioning adult who MUST take responsibility for his own well being. I know you love him very much and that you hate seeing him this way, but you absolutely need to stop overfunctioning for him. I'd set some strict guidelines for him 1). You must be in therapy regularly (since he is currently experiencing symptoms this needs to be at least once a week visits if not more...too bad if he doesn't "like" the therapist...either figure out how to fit an out-of-network therapist into your budget or learn to live with student health) and 2). You must take your meds continuously, even after symptoms subside and you feel better. Discontinuation or reduction in meds will be a joint decision between you, DH, and his therapist(s). These guidelines are necessary for his health and for you two to continue as a functioning couple (soon to be parents). Failure to comply with these guidelines is (in my view) the very same thing as an alcoholic who refuses to stop drinking or a drug addict who refuses to stop using. If DH doesn't want his disease to be your business then he needs to take the steps himself that keep it from affecting you - the second it affects you or your child, it DOES become your business. Oh! And I fully second the suggestion that you get some therapy for yourself - not because you have a problem, but so that you can learn some strategies to deal more effectively with DH, so that you have a safe neutral place to vent, and so that you can get some objective feedback about your situation. Best of luck to you minnow. I will be thinking of you and hoping DHs meds kick in soon!
post #20 of 40
I'm so sorry about the therapy insurance mess. : I know from experience that often the student health care therapists are overworked, underpaid, and far better at dealing with homesick freshmen that real illness. And I've found it impossible to work with therapists that you neither like nor respect (psychiatrists are, of course, a different matter). When I finally - after much persuasion from my psychiatrist - tried a private practicing therapist, I was amazed at the difference. Of course, that could have been sheer luck, too; I'm sure there are good ones in student health and crappy ones in private practice. But the two student health care therapists I saw (one once, another twice) had as many - if not more - issues than I did. This is all anecdotal of course, and so not be helpful at all, especially since I have no advice for your insurance. The only thing I can think of is are there other therapists at the school he hasn't seen yet?

At any rate, I'm really sorry you're going through this. Especially right now, when you're entitled to more support, not less.
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