Q: My boyfriend of 4 months has paranoid schizophrenia. I am not sure how to deal with this issue. At times, he seems normal and I can’t even believe that he suffers from mental illness, but sometimes he talks about nightmares that he has and how he does things out of the norm. I have to admit that the whole situation scares me, mainly because I don’t know what to do or how to handle it. Should I be concerned that he will harm me if he has one of his episodes? How can I help him feel reassured?

A: You are in the early stages of a relationship. It is absolutely appropriate for you to be thinking about these things. When chronic illness is a part of a relationship (no matter what that illness is), I think it is the business of both people in the couple. How the two of you decide to deal with the illness can effect everything. Your boyfriend must be very, very special to you for you to consider taking on a lifetime of supporting him in a serious chronic illness. I’m glad you have the good sense to be asking some difficult questions. That shows that you also care about yourself.

The answer to all your questions is “it depends”. If he is taking medicine, seeing his psychiatrist and perhaps a psychologist or counselor regularly, and if he doesn’t have a history of hurting himself or other people, it may be that he is managing his illness very well. Many people with schizophrenia do. On the other hand, if he is not in treatment, he may not be able to always stay in control of his symptoms. It may be a bit premature now, but if this relationship becomes more serious, your boyfriend needs to let you become part of his “support team”. I strongly suggest that you ask him to let you go with him to a psychiatric appointment so that you can ask his doctor your questions. Educate yourself as much as you can so you can go to that meeting prepared. (You will find the website for the National Alliance for the Mentally Ill: www.nami.org very helpful.) If your boyfriend wants to move forward with the relationship but can’t let you be on the team, I worry that he is not quite being honest with himself or you about how much his illness could impact your life together. This is understandable but not very helpful. If that becomes the situation, you have some thinking to do.

-Dr. Marie