Q: My girlfriend of 4 years, whom I have a child with was recently hospitalized and diagnosed with schizo-affective disorder. She has come out of the hospital and does not want a relationship anymore. She now states that she wants to play and be single, without responsibility. Why has she come out of the hospital with this attitude? She says she hopes that we can be together in the future but right now she wants to explore her sexual self since she never had a chance. I am only her second sexual partner. what’s going on? I thought medication bring would calm someone down.

A: Schizoaffective disorder is a very difficult diagnosis for both the patient and the people who care about her. This mental illness is characterized by symptoms of a thought disorder or other psychotic symptoms such as hallucinations or delusions (schizophrenia component) and those of a mood disorder (depressive or manic component). My guess is that the hospitalization settled your girlfriend down by providing a time out from the responsibilities of life and by prescribing some medications to manage the psychosis, to help calm the anxiety, and begin to lift the depression. While a person is hospitalized, most hospitals will encourage patients to participate in groups to talk about how they are feeling and how they can manage their illness. But there is no where near enough time during most hospital stays to help a patient re-examine her/or his life and make necessary changes.

You’ve been together 4 years and have a child but aren’t married. I don’t know whether your girlfriend’s desire to “explore her sexual self” is a symptom of mania or whether she is expressing legitimate reservations about her relationship with you. Contrary to what the entertainment industry shows us, many, many people happily go through life with one sexual partner so I see her complaint as more metaphor than fact. She’s trying to tell you that something is still very wrong. Either her illness isn’t being adequately treated or there is something amiss in your relationship that needs to be addressed. You need to become part of her treatment team. Ask her to let you go with her to the next psychiatrist visit. If the doctor thinks she is psychiatrically stable, then it’s time for the two of you to see a couples therapist to talk about how to be a couple and how you both can best manage her illness. You have a young child. I hope you will both make every effort to keep his/her mom stable and keep your family together.
I wish you well.
Dr. Marie