Boyfriend’s First Psychotic Break

By Kristina Randle, Ph.D., LCSW

Hello! For the past few months everything was going fine in my two year relationship with my boyfriend. He’s my best friend, boyfriend, and lover, and we’ve been very much in love. Everything was normal, he works, I go to school, we go on dates etc. He is the sweetest most loving, caring, responsible, logical and ‘together’ person any of us know.

Then one day he came home from a concert and started acting strange, talking rapidly, heart beat quickening, sweating profusely, rarely eating and sleeping.

Within the following days, he’s been becoming worse, and even started experiences signs of withdrawal, throwing up, shivers, sweating. A few days later he was starting to act manic and started talking even more rapidly about things that don’t make sense, stressing everyone out with his sudden change in behavior. A couple days ago he started his first psychotic break. This whole thing was sudden, out of the blue, and he was using marijuana heavily the past few months, and lying about taking any pills.

A couple nights ago, at the heat of his manic-ness, he smacked me across the face because he was angry I wasn’t listening to his rambling. He was talking about GOD and satan and saying he understood everything about life and was enlightened. Then when I tried to leave and locked myself in the car to get away from him, he ran in the house and started balling out stuff up saying he was taking me to this romantic spot. Then he starts talking to his grandfather and admits he is doing several drugs of which I had no clue about. His grandfather realizes he needs help. I then go to talk to my boyfriend and asked him if he was taking adderall. He admits yes, and I realize he’s been hiding taking adderall from me for months. and he tries to break up with me. Tells me he doesn’t want to engage in premarital sex although we’ve been having a healthy sex life for two years, and rambles on not making any sense when trying to explain why he doesn’t want to be with me anymore, says I need to move on to the next stage in my life, tells me about some girl at church he had love at first sight with when he was 15 and says he hasn’t seen her since but I will meet her one day, and then abruptly yells at me to get the f*ck out and just leave! Nobody saw the breakup coming, everyone thought we were so happy together. So I pack up all my belongings and left, confused, hurt, knowing this man that he turned into was not my boyfriend.

The next day he threatened to harm himself and is now in a psych ward undergoing treatment for likely to be psychosis. I know he is sick and needs help so I’ve been able to separate some of the breakup hurt because I know it was not him breaking up with me, but this new person who emerged from the drugs and psychotic break talking.

My question is: How do I deal with my boyfriend’s sudden psychotic episode, how can I accept he has a problem when it’s all so sudden, how can I be there for him during his recovery, and how long until he gets well enough to want to continue a relationship with me. What can I expect over the next few years if I stay with him? Why in the heat of his psychotic episode he decided to break up with me in the meanest way possible?

A. When people are psychotic, they are not thinking clearly. Psychosis is a break with reality. That means that an individual has difficulty distinguishing what is real from what is not real. Your boyfriend said and did things that he would not normally say or do because he was under the influence of drugs and in the midst of a psychotic episode. You witnessed first-hand how drugs and psychosis changes personality and behavior.

Hopefully, this was a one-time event, but it may not be. Some people have one psychotic episode and never have another. Others have repeated psychotic episodes. It is possible that your boyfriend will have difficultly recovering from this psychotic episode. Only time will tell.

The most concerning aspect of this incident is his physically harming you. You might say “well that was the drugs and his psychosis and not him.” We should always try to separate the symptoms from the person, however his aggression is evidence of his potential for violence. You shouldn’t ignore this “red flag.”

Consider the following scenario. He uses drugs again and becomes psychotic. He begins to believe that you are planning to harm him. He knows this because he says that God told him directly about your plans. He might, logically, preemptively strike first. In his mind, he is protecting himself, but in reality there was no threat.

It’s important to remain cautious and vigilant. Your boyfriend was using drugs without you knowing. He also has demonstrated a potential for violence. These things could happen again. You mustn’t be naïve to that possibility.

He might never again strike out against you but delusions and hallucinations feel very real to the person experiencing them. The psychotic brain is tricked into believing in things that are not real.

Try to be supportive and encourage him to participate in mental health treatment. If he adheres to his prescribed treatment, it could protect him from having future psychotic episodes.

If things do not improve, consider consulting a mental health professional who can help you know how to appropriately handle the situation. Therapy could also help you to maintain an objective view of your relationship. Please take care.

Dr. Kristina Randle

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Last reviewed: By John M. Grohol, Psy.D. on 16 Jul 2014

APA Reference
Randle, K. (2014). Boyfriend’s First Psychotic Break. Psych Central. Retrieved on December 22, 2014, from http://psychcentral.com/ask-the-therapist/2014/07/16/boyfriends-first-psychotic-break/