What to do when someone is hearing voices/having paranoid delusions?
September 19, 2014 9:08 AM   Subscribe

My fiance is hearing voices or random strangers talking about him/us. Really intimate details that no one could know. I am 99% sure this same type of thing cost him his job recently. This has happened maybe 4 times in the last 2 years that I've known him. On two of those occasions over been in the same place he has and I've not heard any of this. He tries to confront people and of course no one knows what he's talking about when he does this.

Today he called me in a panic after hearing people on the street taking about or relationship and other intimate details and I had to come home early from work. He's not a danger to himself or anyone else, but he's very upset and absolutely doesn't listen to me that this isn't real. He's hurt that I won't believe him.

He doesn't have insurance and I dont know who to call to get him some help (if I can even get him to go, and I'll be able to go with him). This is in the Atlanta area. I assume this is the kind of thing we cant schedule an appointment for in two weeks or whatever, since who knows what will happen in the mean time. What should I do? We don't have a lot of money now what I'm the only source of income, and I am not able to pay rent even by myself, but I'll pay out of pocket. I just don't know who to call or what do to to get him help.
posted by anonymous to Health & Fitness (52 answers total) 19 users marked this as a favorite
I would start with the Georgia Crisis and Access Line. They can be reached at 800-715-4225. Your boyfriend is ill and needs to be seen by a psychiatrist as soon as possible.
posted by shoesietart at 9:14 AM on September 19, 2014 [5 favorites]

What to do when someone is hearing voices/having paranoid delusions?

You call 911 (or a cab) and get him to an emergency room for a psychiatric and neurology workup ASAP. This is his brain, and it is not something to delay about.
posted by rtha at 9:14 AM on September 19, 2014 [48 favorites]

I am sorry that sounds really unsettling. You can start by calling the information helpline at NAMI and they can give you referral services and information on what sorts of options are available to you. They are very compassionate and this is exactly what they do. They have an FAQ which may answer some of your intermediate questions. Here are links for your local NAMI organizations who may have information on support groups for you or your fiance as you work through this.
posted by jessamyn at 9:14 AM on September 19, 2014 [13 favorites]

Side-remark: when you interact with him, try as hard as you can to remain calm and reasonable-sounding. Listen to what he's saying, whether it's nonsense or not. Don't interrupt him with an immediate dismissal; at least appear to consider what he's saying.

You need him to know that he can trust you.
posted by aramaic at 9:24 AM on September 19, 2014 [6 favorites]

The ER offers the advantage that they have to treat you regardless of your ability to pay, and they often have income-based forgiveness funds you can apply for after the fact. It's probably the scariest way to get help, but it is essentially free and they'll see you within hours.
posted by teremala at 9:30 AM on September 19, 2014

It's also worth knowing that police in your area have some officers that are trained in Crisis Evaluation which means that they have had some training in dealing with people who are having mental health issues. Your local NAMI chapter has a web site that explains more about this including how to assess who you might need to call and how to talk to them when and if you do call.
posted by jessamyn at 9:36 AM on September 19, 2014 [4 favorites]

You are right that you should take this very seriously.

How are things with his family ? You might consider reaching out to them for some support and guidance.
posted by Pogo_Fuzzybutt at 9:43 AM on September 19, 2014

I don't have suggestions for how to access help but agree that you shouldn't challenge his beliefs.

When a friend has similar beliefs it upset them more and made them trust people less when they were told it wasn't happening or it was just in their head.

I know it is scary and hard to hear but if you can manage to listen calmly and neutrally and express how you care about him and how you understand this is very distressing to him. Acknowledging his views goes a long way to keep him seeing the world as safe and that any helpful suggestions you have are to be trusted.

Sometimes I found doing this made it easier to get my friend to accept help from professionals. Framing it less as "you are crazy for hearing things!" and more as "this is a really upsetting thing happening to you and lets work together to get you less upset over this obviously upsetting thing".
posted by kanata at 9:45 AM on September 19, 2014 [10 favorites]

This is going to scare/upset the shit out of you, but he needs to be temporarily confined to a treatment ward. Medication for the kinds of illnesses that come with auditory hallucination is really heavy-duty and it's dangerous to get started without 24/7 supervision, especially during an active stage.

I know people who have to do this every so often for medication adjustment, and before you do it for the first time you think it is the awful-est thing ever and then actually it's really not.

You may need to be creative with your truth-telling while trying to get him to a hospital or place of assessment. Don't argue with him. Call NAMI and they can walk you through best practices for your area.

You need to treat this as urgent and serious. Most of us are assuming he has a mental illness, but he might also have an aneurism or brain tumor or be having strokes, he needs to be seen by professionals to make this determination. And while he may not be a danger right this minute, the tide could turn very quickly, or he could run into an unsympathetic cop or he could have a stroke and die. You do not know that this will be okay if you let it go again. Please get him help.
posted by Lyn Never at 9:46 AM on September 19, 2014 [43 favorites]

Auditory hallucinations + low insight into mental state = might be best to have him sectioned although this will be fucking terrifying for him. Unfortunately people with low insight into their own mental illness have poor rates of treatment compliance so he will need a lotta support.
posted by Sternmeyer at 9:48 AM on September 19, 2014 [2 favorites]

This is, as others have said, an urgent and serious situation, and you are right to be concerned. I think the idea to call NAMI is probably the best one; police who aren't specifically trained in managing mental health crises often take inappropriate actions that can badly escalate the situation, and calling 911 for an ambulance doesn't always mean that only an ambulance shows up. (Obviously the calculus changes on that if he becomes violent or if you feel he might be a danger.) NAMI will be familiar with the resources in your area and the best way to access them.
posted by KathrynT at 10:16 AM on September 19, 2014 [2 favorites]

Yes, do not challenge his beliefs. Don't affirm them either. Just say, "that must be really hard to feel." Or "if I thought that, I'd be really scared too." A delusion is a symptom of organic mental illness and does not need to be challenged.

My dearest friend succumbed to schizophrenia that was never diagnosed until it was too late. It began with benign fantasies and hallucinations that people excused because of his artistic temperament at around 18 (honestly, these people failed him), escalated to crazed manifesto writing and public suicide attempts, and finally ended up with us being estranged because he attacked an animal while hallucinating (heart crushing, awful, unforgivable). He is nearing 40 and has no insight. His brain has been mowed down by unchecked schizophrenia. There is no coming back.

Get this person help now. This helped me cope with my loss more than anything. You don't have to have a full loss if there is still time to get treatment.
posted by sweltering at 10:19 AM on September 19, 2014 [2 favorites]

Also, do not underestimate the power of paranoid delusions to bring about violent behavior, even in people who have not been violent before. Think about it this way: if you thought somebody was whispering plots to kill you, might you not (for the first time in your life) brandish a knife at them? My friend was the gentlest person I know until the paranoia took hold. Then he was the scariest. Being around an untreated schizophrenia or somebody suffering from those kind of delusions is dangerous, full stop.
posted by sweltering at 10:21 AM on September 19, 2014 [5 favorites]

I've dealt with family members who heard voices before. He needs medical treatment now. If he has no job and no insurance and no assets he should be eligible for Medicaid, and that will work retroactively. In other words, you don't need to apply for it now, if he's treated at a hospital they will help him to get ti.

The big issue is how to get him to agree to go to a hospital. If you can talk him into it, great. If you can get help from his family and friends do it. You are not married to him, do not, repeat, do not, sign anything at the hospital. The bills he incurs may become huge, you should not have to pay.

If he refuses to go you will probably learn from any of the various resources people have given you that he can not be forced to go unless he has threatened violence- either against himself or against someone else. Violence is a bit subjective. I was trying to commit my mother once and she broke some glass with no intention of hurting anyone, but all I had to do was show it to the police who came to take her.

My mother and other family members had serious mental illness. It's possible that your fiance does not, that he is just having an extreme reaction to medication or food. If it is mental illness treatments have improved dramatically. In other words, hope for the best. Good luck.
posted by mareli at 10:21 AM on September 19, 2014 [1 favorite]

And please let us know the outcome, we are all worried about both of you now.
posted by mareli at 10:23 AM on September 19, 2014 [7 favorites]

Go to the emergency room. There are a ton of reasons why he might be hallucinating, and virtually all of them are serious.

The voices he's hearing aren't real, but the distress and confusion he's feeling are real, so concentrate on that distress and confusion when you talk to him and kind of gloss over whether you actually believe in the voices he's hearing or not. You don't want to challenge him directly, because that's just going to distress him more, and he's already probably very scared.

The good thing about emergency rooms is that he's going to have to get seen and stabilized, and hospitals generally have financial aid programs (you basically just fill out a form after the fact, it's not a big deal). The bad thing about them is that they're pretty much about patching you up and sending you back out, they're not set up to actually *fix* anything, they're set up to get you out of immediate danger. So even though he needs to go to an ER now, they're not going to be able to solve the problem for once and all or even necessary diagnose the problem -- this might be somewhat of a health care ~journey~. The first step is definitely to go to the ER, though.

Re: Health Insurance Options

Is he officially a Georgia state resident? If he's a resident of a state that has Medicaid expansion, given that he has no income (?), he can enroll in Medicaid right now (it's *always* open enrollment for Medicaid). If he's a Georgia state resident, then he can still go to a community health center (here's a link to find one near you), where they probably can't treat him but they can at least refer him to where to go for treatment. When did he lose his job/income and become uninsured? If it's relatively recently, then he can probably enroll now in an insurance plan off of the federal exchange, which would at least get him some coverage, though it might be difficult for him to get a subsidy (because he has no income. But depending on what his income *has* been and what you expect it to be...well, memail me if you need help with this. It's not actually complicated, but it's all very new and being put into effect, so there's a lot for everyone to learn about all the ins-and-outs of this stuff). If he lost his income quite a while ago or never had access to health insurance through his job, then he can still enroll in a plan through the exchange when open enrollment begins again on Nov. 15, but I *think* he won't be on the new plan until Jan. 1. Even without subsidies, the individual plans are (hopefully) not all that expensive (compared to being uninsured and in need of medical care), especially because they don't take things like pre-existing conditions into account in terms of pricing or admittance -- I am in my late twenties and mine, which is a very good insurance plan, would be $230/mo without subsidies, for example.

Since you're already engaged, you might also want to think about having a courthouse marriage and getting him onto your insurance (because marriage is a "life event" that means you can enroll even outside of open enrollment periods). If you don't have access to insurance through your job or if your insurance premiums are very high (above 9.5% of your income for a plan that would just cover you), then you can both enroll in insurance through the federal exchange (again, because of the "life event" of marriage, you can enroll even though it's not open enrollment yet) and, depending on your income, can get subsidies for premiums (if your income is 400% of poverty level or less) and for cost-sharing (if your income is 250% of poverty or less).

Re: Hospital Financial Aid

However, when the ACA was being written/passed/put into effect, policymakers thought that the combined effects of the individual (health care) mandate and the expansion of Medicaid to cover everyone in the nation below (roughly) the poverty level would mean that hospitals weren't seeing any more uninsured people and wouldn't need as much financial aid money as previously. So the federal funding for that financial aid was reduced as of this year, when the ACA fully went into effect. Then some states, including Georgia, declined to expand Medicaid to cover all low-income people after all, leaving those people basically without access to health insurance (it sounds like your fiance is in this group of people, since he doesn't have an income?). So now hospitals generally don't have as much money for financial aid as they did previously, but they still have many uninsured people coming in needing financial help (because your fiance is *far* from the only person in this group! it's actually super common for younger men to not have health insurance, they were one of the groups that the Medicaid expansion and the ACA generally was supposed to target for insurance specifically). So the end result of all that is, there's just less money for hospitals' financial aid to go around. *However* he should still be able to get financial help and you shouldn't worry about this *right now.* This is more something to consider later on, once you're married and you guys have a "household" income that gets used for income calculations, etc etc etc.

Re: His Income

If you think that he lost his job because a medical condition made it impossible for him to work, he may qualify for disability. If it turns out that this is a chronic health condition that's going to interfere with his ability to work, long-term, that's something to see a lawyer about once he's diagnosed. It can be harder to get onto SSDI for psychological disabilities, but it's definitely possible. If he gets onto disability, that will also automatically get him onto Medicare. So it's also something to think about if/when you run into hurdles getting him insured.
posted by rue72 at 10:28 AM on September 19, 2014 [7 favorites]

He's not a danger to himself or anyone else

Truly, you don't know this, and neither does he.

He is frightened, and he knows you don't believe the same reality he believes. It's possible he hasn't told you every bit of what he's experienced/heard (don't ask him to.)

This is very serious and his family should be involved in decisions regarding his treatment, if they are willing. Will he resent you for contacting them? Probably no more than he'd resent you for getting any kind of help. I'm so sorry; that is a terrible position for you to be in, but please do the right thing: contact his family and help him get professional attention immediately.
posted by whoiam at 10:32 AM on September 19, 2014 [2 favorites]

Anon, I know this is scary and lonely. I have 3 family members with illness that includes persistent or occasional delusions & hallucinations. There is some great advice above.

He needs to be evaluated at the ER by a psychiatrist. But the problem is he believes his hallucinations, right? So he's not going to just go along and comply, necessarily.

You need immediate, in person help to get him to the ER so he can be evaluated. Can you slip away to call a member of his family that can help get him to the ER? We've had to do this in my family before. It's terrifying to KNOW your family member needs to be treated, but that person REFUSES to accept they are hallucinating and possibly headed down a terrible path. You shouldn't have to do this alone. His parents? His siblings? Your parents? A mutual friend of yours? Now is the time to enlist help. You shouldn't have to do this alone.

I couldn't say if this approach is right for you, but my family member has more than once had to be transported to the ER under false pretenses so he could be medicated to organize his thoughts enough so that his hallucinations would put him in immediately subsequent danger. e.g., "Hey, family member, let's you and me go to the ER to help Mary with her gall bladder pain."

Please update us if you can. I'll be thinking about you.
posted by ImproviseOrDie at 10:40 AM on September 19, 2014 [3 favorites]

A high school friend was stabbed to death by her husband, who'd already exhibited some signs of paranoid-schizophrenia, but not quite enough for people to believe he was a threat to himself or others.

For that reason and many others, its best to deal with this stuff as soon as possible.
posted by Good Brain at 11:06 AM on September 19, 2014 [4 favorites]

I am deeply sorry if this sounded insensitive:

Probably no more than he'd resent you for getting any kind of help.

I meant it when I said you're in a terrible position, because he trusted you and it's understandable that you don't want him to feel betrayed. Please know it is not a betrayal at all to put his health and safety ahead of your relationship; actually it is a sacrifice.

I know you don't feel he is a danger, but even if he is in danger (as others mentioned, a tumor, aneurysm, allergy causing swelling, etc.), he does not know it, because he has broken from reality.

This is very different than trying to help someone with anxiety or depression or other forms of mental illness. For example, when I suffer severe anxiety, I can't simply switch it off, but I do know that my fears are irrational. At this point he does not know that he has broken from reality, and that is why so many folks are saying that he could become a threat to himself or others. He could also get treatment and do very well in the long run, so be careful, but don't assume something permanent just yet.

I'll also echo others that have asked for updates. I am so very sorry this is happening.
posted by whoiam at 11:18 AM on September 19, 2014 [2 favorites]

Thanks everyone. OP here. After he calmed down last night and slept this started again this morning. So we are at the ER worth his dad and brother and he's being seen right now. He was really freaked out because he realized/it became obvious that no one else could hear this stuff and he really started panicking. He knows we're getting help now and seemed a lot calmer.
posted by polywomp at 11:28 AM on September 19, 2014 [110 favorites]

Well done, OP, and thanks for the update! Sounds like you did everything right, and I wish you both the very best.
posted by whoiam at 11:40 AM on September 19, 2014 [2 favorites]

A family member of mine suffered from paranoid episodes when their bipolarity suddenly went off, and I feel for you at this moment.

Psychiatric care is an option that will probably be quite unwelcome to them and you, but you must consider it seriously because no-one can see the future.

If they are committed, visit them a lot. Try to give them whatever agency you can. Weigh and respect their viewpoint carefully. Don't just pretend to, they'll see through that. Actually, really, truly do this.

Also think about how to protect your own raw feelings. They need you fit and healthy, so looking after yourself is a part of helping them.
posted by devious truculent and unreliable at 12:51 PM on September 19, 2014 [1 favorite]

Delighted to see your update.

My final paragraph is still relevant.
posted by devious truculent and unreliable at 12:54 PM on September 19, 2014

I'm just so scared now. They said they had to keep him for 24-48 hours for an evaluation.I don't even know if hell be coming home after that. And I can't see him. I am so terrified. I'm just sitting here absolutely in the dark about what's happening.
posted by polywomp at 1:33 PM on September 19, 2014

I'm so sorry. I can't even imagine. All I can add is that even though you can't see him, he is in a safe place now, with people there to help. He is in the best place he can be. Also, him acknowledging his situation will go a long way towards getting better. Hang in there.
posted by Vaike at 1:49 PM on September 19, 2014 [1 favorite]

I'm so sorry. This must be terrifying and you must be terribly lonely and lost without your partner, without the person you'd usually turn to in difficult times.

It sounds like he's lucky to have you, but of course that doesn't make it easier for you to be separated and confused.

The resources jessamyn linked to above are a good start in terms of learning about what's going on. I wish this were easier for you or had a more definite end date.

You'll be in my thoughts.
posted by the young rope-rider at 1:56 PM on September 19, 2014 [3 favorites]

Thank you for the update, and I'm so sorry this is so scary. Please reach out to NAMI and other resources people have linked to.
posted by rtha at 2:12 PM on September 19, 2014

Glad you've got the doctors checking him over!

Just FYI, when my mother had auditory hallucinations, they were caused be transient ischemic attacks --- what used to be called 'mini strokes'. Hearing things can be caused by a PHYSICAL problem, it does NOT always mean you've got a mental problem!
posted by easily confused at 3:08 PM on September 19, 2014 [2 favorites]

I've recently started working at a mental health facility as a volunteer staff assistant. IANAPsychiatrist or any specially trained person. But just for reference here's what is written in my handbook for intervention guidelines:

Dealing with a psychotic client in crisis:
- remove to a quite, private area if not aggressive or hostile
- decrease stimulation
- listen carefully
- avoid premature interpretations
- orient to reality
- avoid reinforcing delusions or hallucinations, but don't challenge them either
- interrupt hallucinations by having the client attend to what is happening
- assess content of hallucinations; are they commanding in nature?
- make clear, concise statements
- limit choices as the client has difficulty making decisions.
posted by lizbunny at 3:09 PM on September 19, 2014 [2 favorites]

You did the right thing. It will be ok. We're all proud of you for getting him in to help!
posted by Jacen at 3:43 PM on September 19, 2014 [3 favorites]

Polywomp, I know how scared you are but I promise you that you have done the right thing. They are likely putting him on a psych hold in order to evaluate him. They are going to need to make some kind of preliminary diagnosis to begin to try to help him.

Call NAMI for support. Many, many families have been where you are. It will be less terrifying to talk to someone who knows.

Most hospitals have social workers or patient liaisons, too, if you need someone to sit down and walk you through the process.

You are very much in my thoughts and I am wishing you all the very best of luck.
posted by DarlingBri at 4:08 PM on September 19, 2014 [4 favorites]

You are doing the right thing. It is scary, you're right, but this is the best course of action you could have taken. 24-48 hours seems like a long time, but given what you described, it sounds like this has been intermittent behavior (though occurring more frequently now). Since it has been intermittent, observing him over this longer period of time is going to help the people who are treating him make sure that they get a true sense of what's going on.

You have done the truly loving thing in making sure your partner gets care.
posted by ocherdraco at 4:20 PM on September 19, 2014

Try not to let the fear take over - he is now in a safe place and getting help. Can you call the nurse's station and ask for an update on his condition? You can also find out about visiting hours - usually it is encouraged although there may be delay while they do their preliminary evaluation. If you can't get any information, talk to his father and see if he can find out more. Usually the patient gets to say who is allowed information about how they are doing, it might take a little finagling to make sure you are on that list but once you do, you should be able to check in regularly.

It is possible that it may take time to get this under control. The few times I had to deal with this for a loved one, the hospital stay was a week or two for them to make sure that the medication was working and voices were under control. Depending on how bad things are (and his willingness to get help) they can also offer an intensive outpatient program where he goes during the day to get help learning about his challenges and developing tools for dealing with things as well as letting them monitor how he is doing on a daily basis.
posted by metahawk at 5:23 PM on September 19, 2014

24 to 72-hour hold is completely normal, and I should have said so in my previous comment. This is okay, you've done great. The reason for the hold is to keep him from taking off if he gets worse, and to give time for any medication to reach therapeutic levels in his body (and make sure it's not going to make him sick or more delusional).

And it is actually a fantastic sign that he was frightened. Someone else mentioned the phrase "low insight", and that's when he refuses to believe you can't hear the voices either. That he "gets" that you guys don't and it scares him is higher insight into his own condition and that's encouraging.

You did a scary thing, but it was the right thing. Take care of yourself, get some rest. You've been through something very frightening and you're probably exhausted.
posted by Lyn Never at 6:27 PM on September 19, 2014 [1 favorite]

I am glad he is getting help; you should also be getting help for yourself in processing this and becoming informed.

you might also want to think about having a courthouse marriage

Do NOT get married to someone with no income who is in the beginning stages of treatment for major illness. He needs stability and does not need possible avenues of financial support cut off because he is married. Sometime, in the eyes of various services "married" = "everything is the healthy spouse's responsibility".
posted by saucysault at 4:24 AM on September 20, 2014 [7 favorites]

Last update so I don't mean to keep posting. They said he might be there between 3 days to a week. I've become basically nonfunctional. All I can do is I sit in bed and cry and wait for him to be home so we can have our lives back. I don't see how I'll be able to go to work even. I'm just broken emotionally and so scared. I wish I could just turn off for several days and not have to experience the passage of time until he's out.

Our wedding is in a month and there is still a lot to do. Absolutely won't let this interfere, since the wedding is the only thing I have to look forward to.
posted by polywomp at 6:25 AM on September 20, 2014

Oh polywomp, please listen to saucysault: hold off on marriage for now. The wedding is not "the only thing [you] have to look forward to", it's just one day in your lives.

Meanwhile, for you: hopefully you have sick leave at your work? Use it. Talk to your boss, tell them you really need to take off the next week or so. Use vacation leave if you don't have sick leave; use leave-without-pay if you have to and can afford it, but take a few days off. Call your best friends, your closest sibling or your parents in for the emotional support you need right now. They can also just plain help you with the day-to-day stuff like groceries and such. If you attend one, the pastor of your church can help too: heck, that's what they're there for, reaching out to help you and walking you through this.
posted by easily confused at 6:47 AM on September 20, 2014 [8 favorites]

I mean, sorry to be blunt, but I can't fathom why we'd want to postpone our wedding. His parents will help with bills. The only thing that could make me call it off is if my fiance said "I don't want to get married" which would utterly crush me, but is probably not going to happen unless he's somehow become someone else (which I have to admit is a possibility I dwell on in my depressive pessimistic thought hole).

I do believe I need some time off work. On the best of days I have such immense trouble focusing that I am constantly calling behind, so out would be practically impossible to do anything at this point which requires concentration.
posted by polywomp at 7:05 AM on September 20, 2014

My husband has suffered with psychosis for years, so I am speaking from my experience. One of the major triggers of psychosis seems to be stress. Any wedding, no matter how loving and well-planned is stressful. (If it isn't, I would wonder if marriage wasn't being taken seriously.) I don't think it is coincidental that the psychosis is manifesting itself right before such a momentous occasion. At the early stages of treatment you need to minimise his stress as much as possible. YOU are not in a condition to be married, and he will notice that, most likely feel both helpless to sooth you, AND guilty he has "caused" your stress. As he is seeking treatment (yay! good for him) he will be struggling with side-effects from the various medicines.

You also need to be realistic and investigate how your marriage will impact his access to services. For many men, accepting money from their parents to pay their bills is extraordinarily emasculating - especially if that money is then used to support the wife society has drilled in to them that they should be supporting. So again, a source of stress for him.

I don't think you are realising how serious and life-altering his diagnosis is; please speak with professionals (psychiatrists and social workers for a start) to re-calibrate your expectations for both him and yourself. From where I am sitting, it looks like your fiance just broke his leg but you are insisting he has to take you out to tango tonight like he promised.
posted by saucysault at 8:01 AM on September 20, 2014 [2 favorites]

I mean, sorry to be blunt, but I can't fathom why we'd want to postpone our wedding.

Because weddings are big and stressful even when both of you have nothing else scary going on.

Because postponing it means just that: put the date off for a couple of months while the dust settles and you both figure out what happens now.

Because you absolutely must investigate how his being married would impact any services he might be eligible for (e.g. disability), and this might take longer than a month to figure out.

Please, please call NAMI. You need information and support, and they can provide it and point you to local resources.
posted by rtha at 8:07 AM on September 20, 2014 [6 favorites]

Once we get married he can go on my insurance until he finds another job. He wants to get married more than anything, and I do as well. I mean, consequences be damned, there's no way I or him would call it off. It's inconceivable. We'll be ok, I just need to know when he's coming home and what we'll need to do to make sure he stays healthy. The hospital is just now informing us that there is apparently no visitation on weekends, so I'm not sure what to do exactly. I just need them to give me more info, which I understand they dont have yet.
posted by polywomp at 8:38 AM on September 20, 2014

All I can do is I sit in bed and cry and wait for him to be home so we can have our lives back... We'll be ok, I just need to know when he's coming home and what we'll need to do to make sure he stays healthy.

Oh polywomp :(

This could be what happens, but it might not. It is at least as likely that this is the day everything changed, and your partner will emerge with a diagnosis of a serious mental illness like psychosis, schizophrenia or bipolar disorder. In other words, he may not come out of the hospital healthy, but rather at the beginning of a very long road.

If that is the case, you need to listen to rtha. You will need to investigate how his being married would impact any services he might be eligible for. You cannot responsibly say "consequences be damned" if you are committed to caring for this person when they cannot care for themselves.

In general, I am curious as to why you have not mentioned calling NAMI as so many of us have suggested. Do you think you are refusing to accept the possibility that your partner may be serious, lifelong mentally ill? Do you think not calling will someone shield you from that possibility?

You need some help. Please model good mental health hygiene by reaching out for it.
posted by DarlingBri at 9:48 AM on September 20, 2014 [9 favorites]

Polywomp, I'm so sad and sorry for you. I know this is terrifying and it's tempting to put your head in the sand and your life on hold until he comes home good as new.

You were so right to reach out for help in getting him to the hospital. Do you think it would be a good idea to reach out for help in coping now too? Maybe his family, or your, and/or NAMI? Or finding yourself a therapist you can start to see solo ASAP? Having family members with psychiatric illness has meant I've seen therapists on and off for nearly 30 years. Learning coping strategies and having an objective, expert opinion can be key to navigating your way through what may seem like a whole new unfamiliar world.

I urge you to reach out to NAMI to learn, at the least, what you might expect when you visit your fiancé in the hospital.

Getting through this process takes a series of steps. You don't have to know what they all are right now. Just learn about the first one.
posted by ImproviseOrDie at 2:32 PM on September 20, 2014

Just because you and he get married does NOT mean that his medical expenses will be covered by your insurance: they're far more likely to claim this is a pre-existing condition (which it is: the condition exists before you're married and he can be covered), which means they'll refuse to pay any of the bills he is now or will in the future incur.
posted by easily confused at 3:35 PM on September 20, 2014

While there are other reasons it would be good to assess the situation before taking any drastic action, it is highly unlikely that there will be a pre-existing condition issue since the new healthcare laws have taken effect. Call NAMI. Go to a support group meeting. Take your time. Talk to your fiance's family. You don't have to, and shouldn't, decide anything now.
posted by jessamyn at 4:28 PM on September 20, 2014 [10 favorites]

Polywamp, I was engaged to the person I talked about upthread, over a decade ago. He was showing some signs of psychosis then, but I was sure he was harmless and artistic. We broke up largely because of his paranoia and distrust of me, as they were already expressing themselves in the relationship. We almost stayed together, though. I thought I could save him and keep him healthy. He did not have insight or believe anything was wrong with him. We remained very close friends.

He de-compensated over the years and, visiting me for just ten days last fall after not seeing each other for a few years, attacked my cat while a guest in my home. He was hallucinating. I do not think he meant to attack my cat or knew what he was doing. I had to call the police. It was the most horrible thing ever. I was terrified for him and for myself. I could not believe I would ever have to think that of him. I still cry every day about it. I am so glad I shied away.

This is a diagnosis and revelation as serious as cancer or a stroke. It's also kind of scattershot how treatable it is. If the paranoia or aggression is ever being directed at you (my friend would often hear me and others "whispering hateful things" about him), you may want to really think about your safety. I'm so sorry for what is happening to your fiance and to you. Your fiance probably needs SSI, community mental health support, all those things - legally marrying you would take that away from him when he's just beginning the diagnostic process. You don't have to deal with this yourself. I implore you not to. This is really rough.
posted by sweltering at 3:57 AM on September 21, 2014

There is a reason several of us are coming back in to check up on this- while you absolutely did the right first step, we are worried about the serious, long term consequences of his possible condition. Some are manageable by medications. Some may be less manageable. I can think of multiple reports of people, after a long period on medications deciding they are ok and stopping the meds, and the paranoia and abnormalities come back. I'm sure some of these cases end harmlessly, but unfortunately, they often end violently. You have no way of predicting what can happen! I'm not trying to scare you or upset you, but you have to face reality, because your fiance has already demonstrated significant problems with that. The hospital probably will not provide enough support.... this is why there are tons of resources out there. The more you can inform yourself, the more rational, adult plans you can make for yourself and your fiance. I know its scary and hard and the hospital isnt telling you much, but there may be other avenues of people who can while you wait. Fear and uncertainty is debilitating, knowledge is power and power is freeing.

Do try to take care of yourself- food, sleep,bathing, exercise- but the more you prep for the possible worst case scenarios, the better you are likely to handle the worst cases, the medium cases, and the really good news.
posted by Jacen at 9:33 AM on September 21, 2014

Update: Visited him yesterday, will again today. He is back to his old self, and realizes now he had been having these delusions, and is upset and shocked at that realization but accepted it (which is good), and relived that he's getting it addressed. He'll probably be home in one or a few days. Apparently going in on a Friday is bad timing as the Main Monday-Friday doctors, who actually diagnose and discharge and such, are not there.

Thanks to everyone! I was in a very emotional place the other day, and I'm sorry if I seemed combative. After seeing and seeing that he's OK. Along with his family and our close friends we're all giving each other a lot of support. Who know's what the future holds, but right now we are very optimistic that him, me, and his family can overcome any future obstacles.

PS: I will be seeing a therapist and my fiance and I will reach out for any other support together.
posted by polywomp at 1:13 PM on September 21, 2014 [4 favorites]

You were, and still are doing great. Thank you for updating us. It's okay to be scared or unsure and sometimes to curl in a ball and cry. All things considered, having a good long cry is pretty darn benign!

We'll be thinking about you.
posted by the young rope-rider at 2:28 PM on September 21, 2014 [1 favorite]

Thanks for the updates. Good to know.

One tiny piece of the puzzle you'll be piecing together: if I'm reading this explainer correctly, getting married would not affect your husband's eligibility for Medicaid, at least not directly. Medicaid eligibility is determined by household income. In the past, what counted as a household varied by state, and was based on things like marriage. However, the Affordable Care Act is nationalizing this definition and making it congruent with another program involving tax credits. Under the new rules kicking in this year, they're defining households as people who claim or are claimed by each other as a dependent on tax forms. I cannot emphasize enough that IANAL.

But do make an appointment ASAP with someone who can help you figure out all the legal and financial angles. The news won't all be bad, and it may have unexpected quirks you'll want to know now, before taking more steps (e.g. enrolling your future husband on your health insurance). Plus, making the appointment will let your brain feel like it has a bit of breathing space in the interim.

Best wishes. You both are being super-brave. Keep taking good care of yourself.
posted by feral_goldfish at 5:07 PM on September 21, 2014 [2 favorites]

polywomp, that is great news!! Future step: don't let the bills freak you out when they hit. Post another Ask if you need to; they can be dealt with without messing everything up.

I am wishing the very best for you two - you deserve it.
posted by DarlingBri at 10:14 PM on September 21, 2014 [1 favorite]

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