My own personal crisis

My husband, who says he is an Iraqi War Veteran, was suicidal this morning while i was at work. He sent a text message he "claims" was only supposed to be recieved once the police found his body. Instead it was sent to me and of course i rushed home from work after calling 9-1-1 and found him sitting on our front porch with his gun in his mouth. This was very traumatic to me. Now alot of things are starting to surface like the fact that he never made it out of basic training, he was injured there, but never did any active duty. So a big part of who i thought he was has turned out to be a lie. He is being kept as a 72 hour hold, and hopefully he will be treated longer because he obviously needs it. He has also told me things like he was in special ops and that he talks with the President alot and that our car has a tracking system on it. I have informed the social worker of all these things to help the doctors treat him better. So now i'm left just unsure about everything. Nobody can tell me what the right thing to do is. The social worker and i have already talked about confronting him, but they want it to happen once he has actually been admitted to a unit that way he is safe. I am so confused and find myself with so much anxiety, on top of already having anxiety due to financial issues, which he has contributed to, but i know that it's not completely his fault, but also mine. How do i continue to support him emotionally?

Although divorce and seperation has crossed my mind, it seems silly to want to put a mentally unstable person through that. I guess i'm not sure what to do next.

Ben's Answer:

This may already be apparent to you, but it's important to distinguish between lies and delusions. Talking to the president, being in special ops, and having a tracking device on your car - these are all very typical of grandiose and paranoid delusions. Common in several types of disorders, including Bipolar Disorder (during a manic episode), schizophrenia, and other psychotic disorders that may be acute or chronic conditions.

I do hope he is able to stay more than just a few days in the hospital (if it's a decent hospital) and get the care he needs. There are medication that will suppress those psychotic symptoms fairly quickly for most people; others with very chronic conditions may respond much more slowly to medication.

Medication is not the only way to treat these issues, but is often the quickest and most practical way to stabilize. It's definitely the mainstream approach, but is not without it's host of problems. I prefer the recovery model of Daniel Fisher MD, as opposed to the medical model of chronic psychiatric illness that most doctors and institutions adhere to.

I believe in treating the whole person, which means other forms of therapy and emotional support to address the underlying issues, as well as supporting the physical body and brain to function properly.

For now, his suicide risk should be the number one priority and until he is relatively stable, I would advise against talking about leaving or divorce.

One last note, when a person is truly delusional, and paranoid, unless their delusional state is a mild one, it is usually NOT a good idea to confront the person and try to convince them that they are delusional. Because it doesn't work. It depends on how much of a grip he has on reality and how much he trusts you. But usually, if a person really believes that their paranoid thoughts are reality, then if you tell them it's not true, they will simply believe that you are part of the conspiracy against them and every time you oppose them, it is just further proof that you're the enemy.

It's better in those cases to remain neutral, empathize with his fears and feelings, listen attentively and be calm and reassuring, rather than challenging. No persons delusions have ever been stopped by challenging them with logic and reason.

Wishing you the best,
Ben Schwarcz, MFT
Santa Rosa Psychotherapist

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