Schizophrenia/Schizo-Affective Disorder?

By Kristina Randle, Ph.D., LCSW

Q. I have reason to believe my husband is either schizophrenic, or suffering from some kind of schizo-affective disorder. Although not a doctor, I was in pre-med, and have continued to increase my knowledge by keeping track of medical journals, and reading university textbooks. My husband was admitted into hospital last year, in the psychiatric ward, although i was never informed of his exact condition. There are literally hundreds of little incidents, but briefly – Despite the fact that I was halfway across the world, he claimed that I was there in the room with him talking to him. He thought he was Jesus, re-incarnated – and suddenly became really paranoid, convinced that the government was spying on him. He would go to do something, i.e. go to eat some food, and come back convinced he had eaten, without touching his plate. His eyes were constantly red, and he could not stand artificial light of any kind. Whilst in hospital, under forced treatment, he had some kind of hallucinations, where he saw himself die over and over and live several different lifetimes. I’m being really brief here. After treatment lasting around a month, he was suddenly “cured”. And was completely back to his own self overnight – i.e. the day before, his symptoms were stronger than ever, and then suddenly next day, he was perfectly fine. He felt like a “great weight” had been taken off his mind, and he could not recall the previous two months, which the rest of us filled in for him. He felt better than he had done in years, and freely discussed the details of what had been going on his head, laughing at how ridiculous some of the things were. On release from the hospital, he was prescribed pills, and was told he had to take them. My husband didn’t even bother taking the prescription to the pharmacist, as he felt fine. [Despite repeated requests to continue his treatment, as I was familiar with mental illnesses in general, and schizophrenia in particular] Over the course of the year, he had spells where he didn’t feel completely in control, but was otherwise fine. Now exactly a year later, the same thing has happened. Except this time he is clever enough to hide all signs from everyone except for me. He burns things, is against science and technology, and believes that he is the Saviour of mankind, the only one who can save the rest of us from the darkness, and that he alone has been blessed by God to be the light. He was sworn me to secrecy, and is scared of other people’s reactions, thinking that “they can’t understand him”. The issue of his burning things leaked somehow, and he was admitted into the psychiatric ward again, but he managed to convince everyone that it was a false alarm, that he was only overworked. He pretended to take his pills, whilst actually flushing them down the toilet. His senses are so heightened, and whilst already more intelligent than the average Joe, he is showing uncanny brilliance and cunning in the way he conceals everything, from everyone but me. I have no way of taking him for treatment, even his family doesn’t believe me, as he has them and everyone else completely fooled. My question is, how can I “cure” him or at least improve his case (which is a pretty severe one) through natural remedies, which he doesn’t have to know that I’m doing because he is schizophrenic – a fact that he does not and cannot accept, as he is now totally convinced that medicine and all science really, is a money-making farce, with no real foundation (all this, despite his masters in physics, and his occupation as an engineer?) this includes use of the car, telephone, computer etc.? He sold our car, broke his mobile, and burnt our computer, as well as all our books, and most of his clothes. He also threw away all of my cosmetics, creams, and shampoos. In short, I would like your professional opinion on the use of vitamins and supplements to help schizophrenia – is there any way that vitamins can be dissolved in food etc? What food helps schizophrenia? Do dietary and lifestyle changes affect the severity and degree of schizophrenic symptoms? Does the argument in favour of orthomolecular medicine have any solid medical basis? Should we place 100% trust in allopathic medicine alone? The argument in favour of alternative methods of treating schizophrenic can be found here:- http://4optimallife.com/Alternative-Medicines-Cures-For-Schizophrenia-Mental-Illness.html There is no way I can “force” my husband to hospital, as no one believes me. I love my husband very much, and cannot sit by and do nothing, especially against his and his family’s express wishes. I want to somehow lessen the severity of his case, so that he will somehow be reasonable enough to consider accepting that he has a problem, and that he needs to take measures to control that problem. Please advise me?

A. You are dealing with a difficult situation. While I cannot offer a formal diagnosis online, it does sound like your husband is suffering from a psychotic disorder, maybe schizophrenia or schizoaffective disorder. Only a psychiatrist can know his diagnosis for sure.

He has many of the characteristics of someone with schizophrenia. Not believing his is ill is very common among people with schizophrenia. Many individuals with schizophrenia lack insight into their illness. Approximately one hundred studies have been conducted on this phenomenon and consistently report forty to fifty percent of individuals with schizophrenia have impaired awareness. The lack of awareness is a biologically based deficit known as agnosognosia. This deficit, or loss of ability to recognize one’s illness, is similar to what those with neurological disorders sometimes experience. There are occasions when people who have had a stroke do not believe their legs do not work despite much evidence to the contrary. Similarly, half of all individuals diagnosed with schizophrenia or bipolar disorder do not recognize they are ill. In these cases, they refuse treatment and will even generate alternative reasons to explain away their condition. Convincing someone they are ill when they believe they are not is extremely difficult. He might never believe his is ill but from what you have written, it certainly sounds like he is.

Additionally, those who do not believe they are ill can be very good at hiding that they are ill, especially when in the hospital. It sounds like your husband is good at convincing the hospital to let him go. Then soon enough, he is out, not taking his medication convinced that he does not need it, claiming he is fine. Soon enough, without medication he will slowly slip back into psychosis. It is unfortunately a common scenario for people with schizophrenia who do not believe they are ill and do not take their medication, one with a predicable pattern. Without proper treatment, it is likely this pattern will continue to occur.

I am not sure what the mental health system is like in the UK. I am not sure if you can “force” people into the hospital. In America, in some cases, people can be committed against their will when they are very ill and this can be effective in getting people to take their medication in some cases. You should try to get your husband help at the hospital or help him find a doctor or psychiatrist that can trust. This may be a difficult task since he is paranoid but it is not impossible.

I would not recommend attempting to treat him on your own, especially with alternative medications. There is no “cure” for schizophrenia only ways to manage the disorder, most of which include him taking antipsychotic medication. For psychotic disorders like schizophrenia or schizoaffective disorder, there are medications such as Zyprexa, Seroquel, Risperadal and others than have proven effectiveness in treating hallucinations, paranoia and the other symptoms that accompany psychotic disorders. Zyprexa makes a tab called Zyprexa-Zydis that melts in mouth within five seconds to combat those who spit out pills or try to cheek their pills. Many of the antipsychotic medications can be given in an injectable form, sometimes only requiring an individual to receive the shot once or twice per month. The antipsychotic medication can prevent his relapses.

I am familiar with a case of a woman who was so ill and she relapsed every other year (like clockwork) for twenty years. She staunchly defended her belief that she was not ill despite being hospitalized over 30 times for her illness and adamantly refused medication. Every time she left the hospital, she quit taking the medication. She was okay for some time usually, but she always relapsed eventually. Her family believed that no one could help her and even doctors gave up trying to treat her since she so strongly believed she was not ill. Everyone thought she was unhelpable.

Then the family decided they had enough. They were not going to let her keep relapsing. It was too hard to watch her to continue to become psychotic, watching her decompensate right before their eyes, to watch her stop eating and showering, becoming totally unresponsive, even catatonic at times. They engaged in a plan to stop her relapses that included them taking turns giving her the medication every night, using the Zyprexa-Zydis (that melts in the mouth) and using the threat of hospitalization or a group home as leverage. When they all banded together and consistently stuck with their plan, their plan did work. It truly is an amazing feat because she so strongly believed that she was not ill but the family was able to get her to take the medication. At first, she resisted taking the medication claiming she did not need it and she did not have schizophrenia. But soon enough, taking her antipsychotic medication became commonplace in the household and she came to accept the family giving her the medication every night. She has been taking the medication and has not had a relapse in close to two years. The antipsychotic medication was the only way to manage her illness. It was the only remedy that worked.

Learn from this example and do not wait 20 years to take charge with your husband. Work with the hospital workers and doctors to get him on a plan to take medication. He does not have to believe he is ill, the woman I wrote about above still does not believe she has schizophrenia, but takes the medication anyhow. It is important you find a way to get him to accept medication so that he can stop relapsing. There is some research evidence that suggests with each psychotic relapse, there is brain damage. I do not recommend trying alternative medications or vitamins, and I especially do not advise you to experiment on your own. I would suggest finding a psychiatrist you and he can both work with and trust.

To read more about agnosognosia (lack of insight) and the results of untreated psychosis, I recommend two resources. One is the psychlaws.org website. This website contains very good information about people with severe mental illnesses and how to help those who do not know they are ill. The founder, E.F. Fuller Torrey has a sister with schizophrenia who does not know she is ill and has written many books, articles, etc. on the subject. He is extremely knowledgeable. I would also highly recommend a book by Xavier Amador called “I am not sick I don’t need help”. It is a great book that also discusses people with schizophrenia that do not believe they are ill and provides great advice on how to best deal with the situation.

I wish you the best of luck and hope I have helped just a little bit. Please write again if you have any more questions/comments.

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Last reviewed: By John M. Grohol, Psy.D. on 30 May 2006

APA Reference
Randle, K. (2006). Schizophrenia/Schizo-Affective Disorder?. Psych Central. Retrieved on December 18, 2014, from http://psychcentral.com/ask-the-therapist/2006/05/30/schizophreniaschizo-affective-disorder/