Reader’s Question

About 2 years ago my boyfriend and I started having a lot of problems. Many of my boyfriend’s actions and accusations were simply not “normal.” I couldn’t even look in the direction of another man without him accusing me of flirting. This even happened with females. And, if I even so much as stuttered when trying to answer his accusations, he took it as a sign of that I was lying or otherwise deceiving him.

This summer I took a general psychology class. When the class learned about mental disorders, I “diagnosed” him with schizophrenia. When I told my boyfriend what I thought, he said I was crazy. So, I urged him to see a doctor, and in fact he was diagnosed with paranoid schizophrenia.

Ever since my boyfriend was formally diagnosed, things have gotten worse. He accuses everyone around him of lying or somehow trying to hurt him. I do not know how to respond to that anymore. I sometimes get extremely irritated, but at other times I just have to laugh. I don’t think either of these are the way to handle things, but I don’t know what else to do. Do I go along with him when he makes crazy accusations? Do I confront him? When I don’t confront him he says I’m confirming his beliefs. But it seems a waste of time to fight him. His wild accusations are destroying our relationship, and I am very close to giving up on us. I’d appreciate any advice.

Our Clinical Psychologist’s Reply

Paranoid Schizophrenia is a serious and most often chronic mental disorder. It appears to be caused primarily by the excessive presence of the neurotransmitter dopamine. Individuals with the disorder are typically not thinking rationally, so it is hard to reason with them, especially with regard to any delusions (i.e., false beliefs) they might have.

These days there are fairly effective medications that can help control the symptoms of the disease. Intensive therapy services such as day treatment programs are also often available and provide a valuable adjunct to treatment with medication.

Sometimes, various combinations and dosages of medications have to be tried in order to find a therapeutic “formula” that works effectively. If your boyfriend is being treated with medication and/or is receiving other services and his symptoms are not improving, it’s best to provide that information to the physician providing the primary care.

Many schizophrenia sufferers are able to lead normal to near-normal lives after finding the optimum combination of therapies. But some are so averse to the side effects of their medications and so dislike the way they “feel” when their systems are functioning more normally, that they go off their medication or otherwise sabotage the therapeutic efforts. So, it’s important to work with treatment providers and to make it a team effort to keep the patient compliant with treatment.

Schizophrenia affects not only those with the disease, but all those (e.g., family, friends, partners) who love and have to deal with them. It’s natural to feel frustrated, but it’s important to remember that the sufferer has a disease that no one would rationally choose to have. So, when your boyfriend acts in his strange ways, remember that he has an illness that keeps him from thinking rationally. In the best of cases, the sufferers eventually come to realize this, too, and are much more receptive when you point out to them when they are thinking irrationally. That helps make things easier on everyone.