Many people with schizophrenia have difficulty recognizing that they are ill. It’s a symptom of the illness. It’s called anosognosia. Anosognosia is a neurological condition that prohibits some people with schizophrenia from recognizing their symptoms.
The major concern is that your boyfriend is becoming increasingly paranoid and aggressive. There are times when he directs his aggression toward you. He has accused you of saying abusive things to him. His symptoms make it difficult for him to think clearly. Without treatment, his symptoms will likely become worse. His behavior will likely become more erratic and less stable.
Do what you can to assist him in seeking treatment but also recognize it’s important to protect yourself. Most people with schizophrenia are not violent but they can be violent, on rare occasions. For instance, your boyfriend believes that his neighbors are trying to poison him. That is a delusion. It’s a symptom of his illness. He might become convinced that he has to protect himself from his neighbors and preemptively attack them. In his mind, he might see a preemptive attack as a form of self-defense. It’s unlikely that he will attack the neighbors or anyone else but that is one example of how untreated symptoms can lead to violence.
Are their family members of his you can contact? If so, they may be able to assist you in convincing him to seek treatment. They may have more influence over him than you do. It’s worth contacting them to ask whether they are willing to help.
You said that he hasn’t sought treatment yet, but has he in the past? If so, perhaps there is a mental health professional who knows his case and can assist you with this situation. They may not be able to legally discuss details of his case with you, but you can give them information about his symptoms.
You can also contact the local mental health crisis team in the event that a situation becomes out of control. They can come to the home, assess his behavior and determine the appropriate course of action.
Finally, you can also contact the National Alliance on Mental Illness (NAMI). NAMI is an advocacy group that provides free information, referrals and support to individuals with mental illnesses and to family members caring for individuals with mental illnesses.
Don’t hesitate to write again if you have additional questions. Please take care.
Dr. Kristina Randle