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Teaching insight?


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I haven't been posting much for quite a few months. Had some major life changes, including starting a new relationship.

 

Now, I am very familiar with the Crazy, and have found ways to manage my own. My partner is also familiar with the Crazy, but doesn't have very good skills sometimes. His history with docs/meds has been so negative, he is currently not seeing anyone or taking meds (though he does take fish oil, vit. B & usually watches his sleep and eating patterns). His Dx has changed around over the years, from SZ to bipolar to SZA-- to me SZA seems about right. He was also an alcoholic for many years-- he stopped drinking over nine months ago, and only slipped up once badly (and had a drink or two on two other occasions). He is pretty solid about not drinking, and does not use any other drugs besides caffeine and nicotine.

 

When things are good for both of us, they are very good. We get along wonderfully and communicate well. However, he has been cycling into a darker persona more frequently in the last couple of months. Whereas he used to have a few days here or there when he would be paranoid and kind of a dick, he is now in it most of the time. Very paranoid and has auditory hallucinations almost constantly on some days. His paranoia used to be directed more towards the government/people he works with, but it is increasingly directed at me.

 

I am getting very worn down by the anger and suspicion (esp. because initially I was so happy to have found such a sweet, loving, supportive man). Though I know it is his illness, some of what he says to me is very hurtful.

 

So I know I need to convince him to seek help to get his brain back in order, but he is so paranoid, that is not an option right now. I am in contact with his family, and they said that they have never been able to get him into treatment when he is like this. I *know* CB is for first person help-- but to get myself help, I need to figure out how to help him.

 

Any ideas about how to get him out of this episode? As fucked up as my brain has been, I have almost always held on to a tiny thread of insight that maybe what I was going through wasn't all right. He has like, ZERO insight (he even told me that he has a very good grasp on reality the other day-- a "reality" in which he thinks I am out to get him and treating him badly, even though I am doing my best to be supportive and good to him, while battling fucking suicide demons myself).

 

It makes me sad to see him living in such a scary, dark world. I lived in it for so many years, I know how horrible it is, and how real it feels.

 

Anyway, any insight or support would be very much appreciated.

 

If you know me through real life or have my regular email or phone number PLEASE DO NOT EMAIL ME OR CALL. He is so paranoid right now, it would probably cause a really terrible situation for me. I will check back in here for responses/emails. PLEASE. We share a phone and computer- he WILL see anything you send outside of here. Part of how I have dealt with my own paranoia is to be totally open with what I do. Hiding this post makes me feel gross... :(

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i realize you're looking for answers and maybe someone else's experience will be very different from mine and they can give you some tip to break through. as someone who spent well over a decade lacking all insight into my illness...and even now that when stable i can see the sick...i still lack insight once it takes hold and when i go, there's no "teaching insight".my overall suggestion is that you create for yourself an exit strategy if things go from bad to worse.  the thing that haunts me most about episodes i've had is that once lucid i see the damage i've done to all of those who went above and beyond with their efforts to reach me. the more they tried ...the worse it was for them when it didn't work. the people who've made it through--the very few people who've managed to stay in my life--are those who established boundaries for themselves and when *I* went too far...they didn't continue to go down with me. they did what they could to be supportive....they called 911, etc,they checked in when appropriate, and later, when i was rational again, they got back in touch.  

 

i don't know the contents of his mind and what propensities he has, so i'll just speak for myself.  when i am off medication and start slipping...the further i slip the less likely anyone who makes clear obvious efforts is to be spared from becoming an object of my delusions. it's happened in countless ways, but the bottom line is that, for me, and i am also paranoid schizophrenic, my head will work stronger and faster than any efforts people can make. questioning me, telling me i'm delusional, telling me i'm psychotic, asking questions about voices, encouraging treatments when i've discontinued...all of that --whether said straightly, aggressively, or crying and begging me-- just gives me reason to add them to the growing list of people out to discredit me....among other things. it establishes them as "not on my side/not believing me". it doesn't matter how deftly, how subtle the approach, how soundly their position is made. every reason a person can give ... my head can twist.  the second i don't "trust" someone....it's gone. 

 

it sucks to admit, but the fact is, if i'm psychotic, the only thing someone else can do about it is keep an open line of communication until i cross a boundary and then, for their sake, and mine, keeping around to whatever extent is realistic...calling 911 if i am clearly a danger to self or others...that's about it.  as i said, i cna only speak for myself, but i've had .at this point probably hundreds of people over the years who've seen what i simply was unable to...and to them it's like (i've had several say) i'm standing on the tracks and a train is bearing down on me and they can shout and reason and plead and even try to yank me off the tracks. and, not only do i stand there resolutely...i have gotten offensive, verbally abusive, arrogant, and for years of my life, even after the train would take me out and i'd be in the hospital, etc... filled with remorse and regret and grateful to those who accepted my apologies.  the second i discontinued...maybe there's a narrow window now....but not then. unmedicated i would climb right back up on the tracks and it'd all play out again. some people tried more than once. a few tried several times before they let me go.  

 

but, as i said, the few who remain...even now... they set boundaries for themselves and what they'll put out and when i cross the line... a few will stand by...or check in intermittently... but once the turn is made in me (and as i noted, maybe now...if you catch me in that narrow window right after discontinuation...but even that ...the odds aren't good) they hope for the best.  

 

if he gets emotionally and verbally abusive ...he's off meds and from what you describe...i've been in comparable situations and if i could go back and tell the people who are trying so hard to break through anything it would be this: recognize your impotence to fix this situation...that how i am psychotic isn't a reflection on how much you mean to me when i'm not...and thinking that you will regain my trust or if you just love me enough or just this or that....the best thing you can do for me is not let me destroy whatever part of you will be damaged when all of your efforts fail because it crushes me once i am to know that i hurt you.

 

 

i know that's probably not what you were hoping to hear, and as i said...i don't know the contents of his head and maybe he does have some shred of insight. ut if he's anything like me, you can't love him enough or want him enough to convince him once it's taken hold.  you can ensure you have access to support, you can love him enough to set a boundary for when you will remove yourself, and you can be prepared to call 911.

 

i wish you well in navigating this. i'm sorry you have to go through it. but once things play out, maybe he'll be back on solid ground and if you set those boundaries and not let him do irreparable damage...then you can go forward. 

Edited by mellifluous
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When helping people we care about who are struggling, I think it is important to understand the limits of what we can do for them. 

 

If we could bring loved ones out of episodes or teach them to have insight, then there would be no need for professional treatment, meds, and tdocs/pdocs. 

 

I would try to take care of your own needs and to set healthy boundaries.  You can be supportive, but I don't think it is fair or reasonable to expect yourself to "get him out of this episode."

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How is he directing his paranoia at you, doing things, saying things? How hostile is he?

 

I don't think you are in a position to give ultimatums, unless you are prepared to receive an answer you don't like. But if he is in anyway threatening, you need to get out of there.

 

I drink, so I am not saying no one should be able to drink. But if he has slipped 3 times in the last 9 months, he has not actually been sober for 9 months. So he already isn't being honest with himself. Also, on the boards and elsewhere, I have heard it said again and again it is not a good idea to get involved with someone in the first year of sobriety anyway. There are always exceptions, I'm happy if you are happy. But what you are recounting doesn't line up with what you believe about the relationship.

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I've been there... where your boyfriend is.  I've been paranoid of my girlfriend while psychotic, and I know how difficult it has been for her.  My situation is a little different in that I eventually became med compliant and in that my psychoses have been sporadic and short in duration.  The more psychoses I have had, the more insight I have, so I am more willing to a accept treatment now than I was in the past.

 

I hate to suggest this, but as a last resort you could think about trying to take him inpatient.  Call 911.  The risk with that is that he may never forgive you for committing him.  But it could allow him to get on the path to treatment.  

 

I know that in the past I subscribed to the paradigm that psychopharmacology was crap and the drugs did more damage than good... I was also paranoid of the meds and doctors.  Thought it was a conspiracy.  But last time I went inpatient they put me on risperdal, a drug with fewer side effects than what I'd tried previously (abilify and zyprexa), and I changed my mind. Now the med combination I'm on of wellbutrin and latuda have so few side effects and make me feel so good that I'd never want to go off of them unless they stopped working.  

 

You could go to a support group like NAMI to get support for yourself, and talk to people there.

 

I don't know.  I'm sorry things are difficult for you right now.  Do you know how long your bf's psychoses tend to last?  It is especially difficult because he has no insight that anything is askew.  I hope he snaps out of it so you are not forced to make some difficult decisions.     

Edited by koakua
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Thanks for the responses, everyone. I will write more later when I have more time. He is not violent or threatening- it's suspicion directed at me about cheating and the like.

crtclms- I didn't say he had been sober for nine months, but that he had stopped drinking nine months ago, meaning he stopped daily heavy drinking. Of course those three incidents mean he hadn't totally stopped, but comparatively, he is doing very well not drinking (not drinking a fifth a day). And I know it's not a good idea to start relationships when someone is trying to get sober, but in many ways my family and I have helped him into sobriety, so I don't regret it.

He is a very good person, struggling with a crappy MI. Yesterday and today have been better, so maybe he will be in a place to talk about treatment soon.

More later.

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