Recent fire and my husband had a psychotic break

By Kristina Randle, Ph.D., LCSW

Q. I have been in a commonlaw relationship for 19 years, we have three children together. We also each have one from prior relationships. One month ago we endured a house fire, that although no one was hurt we lost everything but the clothes on our backs.

A few days after the fire my husband started saying he believed people were watching and following him, he believed that the radio and comics were relaying messages to him. At first I thought nothing of it, then he made a very disturbing comment to me that had me taking him to the hospital. He at this point was saying he needed help. They admitted him to a Psych Health Centre where he has been since. They have him on anti-depressants as well as Risperidone.

At first he was admitting there was something wrong, now he denies everything. He will not talk to the doctors. He says things to me like he believes either Elvis Presley is his biological father. That messages are being sent to him via radio, papers, billboards etc. He thinks a computer chip was placed in him when he was young so “they” could monitor him. He says everyone is in on it. The doctors, politicians, newspapers etc.

I am at a loss at to what may have happened to him. He went from the man I knew to someone I don’t. The doctors say they can’t diagnose anything until he starts talking to them. Being as I reside in Canada, they just relisted him as involuntary as he was at one point refusing his meds and threatening to leave. This is becoming very stressful on me and the children but also on him as I can only imagine how stressful it must be to have someone tell you that every thought you have is irrational.

My heart breaks when I hear him say he wants to come home, and that there is nothing wrong with him, when his words say differently. He will also spend hours pacing and laughing to himself. When you ask him what is so funny he says, “you know, think about it.”

Any advice you can give me on this would be greatly appreciated….

A. Thanks for writing. I cannot imagine what you are going through. I hope that things will improve for you and your family very soon. I will try to provide you with the best answer that I can.

Based on what you have told me, it sounds as if your husband has had a psychotic break most likely brought on by the recent tragic events. It could be that your husband had a predisposition to some kind of psychotic break and only needed an event, such as a fire, for the break to actually occur. There are many theories about why psychotic breaks occur and therefore it may difficult to accurately pin down the exact cause of his psychosis. But the fact remains that it appears that he has had some sort of a break from reality, and this break was likely brought on by recent events.

Some people have only one psychotic episode and never another. Please realize that my assessment of this situation is based on very limited information. You should always consult with his doctors, who have much greater access to him and to his history than do I, for the most complete assessment of his situation.

For someone who has had a psychotic break, it is not uncommon for that individual to deny that there is anything wrong and that they do not need medication. For people who have disorders such as schizophrenia or bipolar disorder (two disorders in which individuals commonly have psychotic breaks), at least 50 percent of them cannot recognize they are ill and subsequently refuse all treatments. I am not suggesting that he has either of these disorders since he would have need to have at least two psychotic breaks within a relatively short time span to be considered for these diagnoses. I mention this because there is a phenomenon that exists in which individuals who are clearly ill are not aware of their illness, and this phenomenon is commonly associated with schizophrenia and bipolar disorder.

I have written about this topic extensively on this website and hope that you will consider reading some of my previous answers to similar questions. To find those answers, please read through the “schizophrenia” category after hitting the “Ask” (referring to Ask the Therapist) button on this website. Even though there is no indication that your husband has schizophrenia, the answers to questions similar to yours can be found in that section of the website.

When you have a chance, please try to read through that section of the website. In the meantime, my advice is this: Do not try to force your husband to admit that he is ill but do try your best to get him to take the medication. This situation will try your patience but try not to be frustrated with him (easier written than done I know).

Monitor the medication closely and strongly consider administering his medication. His condition should improve with medication. He may not ever admit there was or is anything wrong with him but that is okay as long as he engages in treatment and there is an improvement.

Do not spend your time trying to convince him that his delusions are incorrect. Using logic to help an individual who is psychotic, and by definition, is not able to be logical, and who is unable to recognize their illness, is generally a waste of your time and energy.

There is a good chance that if he takes his medication regularly that he will improve and continue to stay stable. As I mentioned above, some people have one psychotic episode and never another but the key to this seems to be adhering to the medication and treatments.

Lastly, please try to find support from friends and family. During this extremely trying time in your life, you will need all of the help that you can get. You should not have to face all of this alone.

I hope this helps to answer your questions. Please write again if you have any more and need further clarification. I wish you the best of luck. Take care.

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Last reviewed: By John M. Grohol, Psy.D. on 5 Aug 2007

APA Reference
Randle, K. (2007). Recent fire and my husband had a psychotic break. Psych Central. Retrieved on September 23, 2014, from http://psychcentral.com/ask-the-therapist/2007/08/05/recent-fire-and-my-husband-had-a-psychotic-break/