I Think My Husband Has a Delusional Disorder

Reader’s Question

I believe that my husband is suffering from a delusional disorder — in particular, delusional or morbid jealousy. He is fixated on the idea that I self-pleasure in my sleep and call out the names of other men (neighbors, co-workers, etc.) almost every night. We have only been married two months, although we have lived together for two years, and in that time I have never been unfaithful to him in any way. A few weeks after the wedding, I found hidden cameras he had placed in the house, and when I confronted him on the issue, he went ballistic, then made up some story about how a police officer came to our door a week or so earlier “by mistake” saying that someone had been reported coming into the house and that he was trying to “protect” me by placing the cameras.

I didn’t buy his story, and within a few weeks, he packed up his things and moved 800 miles away to his parents’ home. Since then, he has accused me repeatedly of having an “obsession” to expose myself to the neighbors and then fantasize about them. He has also repeatedly accused me of self-pleasuring in my sleep and calling out men’s names as I mentioned above. I have learned from my neighbors and co-workers, that he actually told two of them that I was doing this and calling out their husbands’ names. I also learned that two of the neighbors (different ones) have actually observed him pleasuring himself in the front room of our house with the shades open while I was at work. Confronting him with any of this has only led to anger and hateful e-mails (as e-mail is the only way he will communicate with me at all), and he is now demanding a divorce.

I believe the stress of the wedding along with some financial stresses we have been facing and being confronted about the cameras has caused him to “snap” and go into some state of mental breakdown or even full-on psychosis.

My question is how to get him to realize that he has a delusional disorder and get some help? Do you think there is any chance he will calm down enough to see any form of reality? How does one go about getting help for someone who doesn’t know they need it? I would love to save my marriage (I don’t believe there is an exception to “in sickness and in health” for mental illness), but more importantly I would love to save my husband…

Psychologist’s Reply

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This type of behavior is often encountered in a Delusional Disorder. In a Delusional Disorder (DD), the individual develops nonbizarre false beliefs (delusions) — nonbizarre in that the situations are often encountered in real life such as being followed, jealousy, having a disease, or being infected — that are extremely exaggerated to the point of being an overwhelming obsession and preoccupation. In Delusional Disorder, the person exhibits severe “ideas of reference” — the assumption that routine things or experiences in the environment are directly connected to the delusions — as people talking on a cellphone are felt to be reporting your location, planes overhead are photographing you, or a noise or moan by a partner during sleep is a sexual behavior.

The confrontation about the cameras didn’t make him “snap” into a psychosis. The fact that he installed cameras tells us he was delusional before the confrontation. Most people install cameras to monitor people “outside” the home — not inside. It is possible that recent stressors have triggered an underlying delusional disorder but in truth, that’s still unlikely. I suspect the DD has been present for many months and the stress of marriage/finances only increased his bizarre behavior.

As we consider what happened, Delusional Disorder usually surfaces in middle or late adult life (DSM-IV). If this has surfaced under the age of 25, we might suspect the influence of drugs or even prescription medications. Delusional Disorders have been linked to excessive Dopamine in the brain and for that reason, the use of crack, cocaine, meth, speed, crank, etc. can produce similar symptoms. If he had no paranoid symptoms for two years, then experienced a prescription medication change and became delusional, then medication reaction is a possibility.

Delusional Disorder is self-justifying and self-reinforcing. From his delusional standpoint, the evidence that supports his delusion is everywhere (ideas of reference). Delusional Disorder is very difficult to treat, as when the paranoia increases, everyone becomes part of the delusions, including the treatment professionals. It is unlikely that you will be able to convince him to seek evaluation or treatment. It is also likely that his behavior will become more bizarre and more aggressive if you pressure him. He could actually become dangerous to you due to his delusions. What do you do:

  • Keep in contact with him through email. Email provides an open channel of communication that is controllable and less threatening than phone or face-to-face contact. Email can at least keep a channel of communication open.
  • In the emails, try not to react to his multiple accusations. Take a position of “No matter what you think about our marriage, I’m concerned about you and your health”. Try to keep communications “grounded” in reality rather than chasing delusional comments or beliefs.
  • A Delusional Disorder is very difficult to hide/mask and for that reason, his nearby relatives will be aware that something is wrong. While he will have initially blamed you and described your bad behavior, it will quickly become obvious that he remains delusional even when you are out of the picture. When contacted by relatives and friends about him, express your mental health concerns rather than defend yourself regarding his delusions.
  • Excessive brain dopamine (a neurotransmitter) is very uncomfortable and produces many more symptoms other than paranoia and delusions. He will have problems with sleep, concentration, agitation, tremors, and a sense of being “wired”. When these are mentioned, suggest that he seek consultation with a physician. Most physicians can recognize a Delusional Disorder and despite the normal view of “paranoia” as being secretive, people with a Delusional Disorder often want to talk about their delusions.

In truth, this is a very serious psychiatric condition. You may not be able to repair this and save your marriage. On the other hand, financial stressors and marriage — and you — didn’t cause this. Delusional Disorder is a rare neurotransmitter-based severe psychiatric disorder that is typically not associated with a stress reaction.

While you may believe in the “in sickness and in health” aspect of your marriage vows, attempting to maintain this relationship will likely subject you to mental and physical abuse, humiliation, and verbal abuse. I would recommend consulting with a mental health professional to help you through this very difficult time. If your husband does return to reality, marital counseling will be needed as in Delusional Disorder, even when no active delusions are being created, the previously-believed delusions are still retained. Under medication, for example, he will realize that you are not currently engaging in those behaviors but he will still remember that, in his mind, you once did. Those old delusions make marital reunification difficult.

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