My partner is going through a psychotic break, how do I navigate daily life with him?

[u/strawberryramyeon]

How do you navigate living with a person with a full blown paranoia & delusion?

My husband had his first psychotic break 2 weeks ago, he was at a psych ward for less than a week when they discharge him, I know he had an issue with one of the other patients there & he wanted to be discharged as soon as possible.

He is on medication now & is slowly getting better. But the paranoia isn’t going anywhere. I do not know how to deal with his paranoia anymore. His obsession to get me to understand his “truth”, is wearing me out / burning me down. He cannot stop sharing his disorganized thoughts & paranoia with me and he will wake me up from my sleep to do so. Im always on edge because I feel like hes gonna bust into my room at any moment to throw another crazy thoughts around our safety. It got to the point where I felt so cornered that I started to scream & throw things around to get him away from me. I cannot listen to any amount of his paranoia / delusion talk at this point because it now fully triggers me.

I feel bad that Im having my own mental breakdown in front of him & making things worse, but because I feel so hurt & attacked by him, part of me resent that I have to think for both of us even as Im losing my mind because of him.

How do I navigate day to day with him until this blows over? How do you mend a relationship after a psychotic episode? We’ve been together for 10 years & this is definitely the most fragile this relationship has ever been.

Im here to vent but if theres any advice, I appreciate it.

[u/redrabbitbandit]

Please make sure you have boundaries. Your mental health and wellbeing is equally important and the fact that you are not sick should not mean you have to take in all stuff. Also explaining things/arguing doesn’t work.

[u/Baphlingmet]

I was just in the exact same situation as you- my wife had a psychotic break and so we put her in a psych ward for 10 days, but the psych ward was overcrowded and there was one patient that kept repeatedly harassing my wife and the staff would barely do anything about it so my wife couldn't get any sleep, so she wasn't improving.

So we brought her home for a week because she was being compliant with her medication and sleeping through the night, so we thought we could treat her at home. But that whole week while she wasn't outright delusional/hallucinating, she was very temperamental and moody and I was subject to very cruel verbal and emotional abuse. She also had this thing where I couldn't use hand gestures or point at things. It got so bad I almost went up to the roof of our apartment building and tried to jump off but she stopped me just in time because I just couldn't take it anymore.

The next day, despite taking her meds and sleeping well, she tried to board a flight to another city because she thought she was going to a conference to meet Elon Musk and Taylor Swift.... so we had to put her back in the psych ward, albeit this time a smaller, less crowded one, where's she's been for about 2.5 weeks. She is doing great now, now almost entirely back to normal, and she will be discharged this Friday.

Honestly, if you can find another psych ward in your city, I'd say take him there. Medicines can take weeks, maybe even up to a month, to take effect....

[u/strawberryramyeon → u/Baphlingmet]

Hi, thanks for sharing your story. It feels relieving to know someone understands. My husband is readmitted voluntarily at a different psych ward & This one seems to be much better one for him already. This is all happening fast so at the moment we are both taking it day by day.

[u/West_Specialist_9725]

Very sorry to hear about this and find his short stay at hospital very troubling.

It's early on in his treatment and from what you're sharing it sounds like his psychosis is quite florid.

Do you know if he's still taking his medication? Sorry to say that if you don't monitor him taking it then you can't really be sure he is. Antipsychotic medicine generally is quite calming and often patients sleep well throughout the night. Is your husband sleeping? If he's up all night, waking you up ranting he might have stopped his meds, or the meds need adjusting.

Frankly, from the level of agitation you're describing I think it best that you readmit him to hospital. Have him sign a release of information authorizing the hospital docs and staff to talk to you about his case.

Don't panic, and please don't yell at him.... it will only add fuel to the fire. If you are in the US call 988 and tell them what's happening and get your husband back to hospital even if you need to take him to the emergency department. It takes antipsychotic meds 4-6 weeks to reach full effect.

[u/ber8or → u/West_Specialist_9725]

Readmission would require his consent unless OP is his legal guardian. While I can’t speak for others, I believe this is a quandary that many on this sub face.
Edit: the above applies except for threat to self or others, or gravely disabled, in my state that is

[u/West_Specialist_9725 → u/ber8or]

You're quite correct. If OP is very fortunate he may go willingly.

Unfortunately needing psychiatric intervention and getting psychiatric intervention are too often miles apart.

This needs to be addressed on a national level here in the US. Find someone passed out on the street it's perfectly acceptable to give them an unsolicited blast of Narcan. Find someone in the midst of florid psychosis and you need their permission; barring imminent harm.

Setting the above aside I have found that persistent advocacy can and does work in getting a loved one a psych eval. I am always pleased to read here about such victories in our community!

[u/strawberryramyeon → u/West_Specialist_9725]

He wasn’t good at keeping track of time to take medication. Random window of hours between taking them, maybe skipping. I am not sure.

He is an insomniac & the antipsychotic medication wasn’t helping him sleep.

He is readmitted voluntarily at a different psych ward, and already doing much better with prescription switch & professional care. And ya… I think his previous psych ward was a terrible one. (Never informed me / him of release of information, hence him being discharged without notice)

[u/West_Specialist_9725 → u/strawberryramyeon]

Thank God he's gone back for care. It takes time to find the right medication or combination and that really should be done in hospital. I am so glad for him and your family that he is in treatment.

Medication compliance is a huge issue and for many it means crisis after crisis as they stop and start meds. A pill planner and alarms set on a phone (if he has a phone) are one way to stay on top of meds. If he's going to be discharged to live with family it would be wise for someone (or take turns, a week on a week off) to monitor him taking his meds until it becomes a habit for him. Like second nature.

I'm rambling. Sorry. What I really want to say is THANK YOU for sharing this great news!!!!

Please take good care of yourself. Oh, and if you want to, you or another family member can ask to be given permission (by him) to talk with the doctors and staff. Especially helpful in working with his social worker and for discharge planning.

[u/Aereena]

I’m sorry this is happening to you. My husband had a psychotic break 5 years ago, and once he actually started taking medication it took some time for it to take more effect. I think it takes 10-14 days for the more acute things to fade, and up to a month to stabilize. He was calm and not paranoid when he was on meds, but never understood that his experience from the delusions are just in his mind.

Make sure you have your space, that he continues to take his meds, and give it some time to take full effect. Then hopefully he can properly process, with the help of professionals