Deeply concerned about my wife's mental health

February 22, 2020 9:51 AM

My wife had an emotional affair last year. Recently the other man was kicked out of home by his partner. Since this time, my wife has been convinced he is angry at her, despite no direct evidence for it. I am seriously concerned about her mental health and do not know what to do

I am in the UK. My wife had confessed her feelings for the other man before Christmas, and we had other issues ongoing we had been working through.

However, my wife has taken to following his social media and interpreting posts on general subjects as being about her. He has had almost no direct contact with her, his texts have been innoucous and denied having feelings for her.

Too try to indicate the level, while having a coffee late at night, she saw that he posted on Facebook at the same time "long day, time for a drink!" And took it to be about her.

At a cafe she likes, they hired a new chef recently, and after they put a post on social media about craft beer, she decided it was in the same style as he writes in, and that he must now be working there, and had written the post targeting Her.

When I suggested she shoot the ex wife of the man (who he is still living with and co parenting with) a text asking if he had got employment, she didn't want to because she doesn't trust the wife.

I have asked her to seek mental health via out private insurers, and she is already on anti depressants, but thus far does not have a councellor to talk to.

I don't know what to do. She gets extremely upset when I cast doubt on her account, I try to acknowledge her feelings but dont think lying and saying that her suspicions are founded would be helpful.

posted by anonymous to Human Relations (27 answers total)

From what you’ve told, I’d also be really concerned. She needs a neurological consult if she thinks that someone is talking to her in a coded way through social media. Can you call your doctor and ask for advice? What’s your relationship with this other couple? If he has indicated that he does not have feelings for her then it’s important that you protect them from her while she gets a consult. It really does sound in the realm of something has become unbalanced. I wouldn’t think of this as an “emotional affair” given the particulars you have outlined. If she is on anti-depressants, she must be under the care of someone. Reach out to them. I think you are right to feel that something else is going on here and it’s not infidelity.
posted by amanda at 10:33 AM on February 22, 2020 [17 favorites]

I think you’re pretty unlikely to get a neurological consult for this type of behaviour. It’s true that believing people are sending you coded messages can be a *symptom* of psychosis, but one symptom doesn’t make you floridly psychotic and even floridly psychotic people don’t all need or receive neurological workups. Referrals to neuropsych are pretty rare on the psych ward where I work. Lots of people live otherwise normal and functional lives while holding some odd beliefs. A belief in coded messages may not necessitate a diagnosis. Usually the order of operations is that someone has a mental health assessment and then the psychiatrist makes a decision about whether there are any neurological features to a persons illness. Your wife may not have an illness. It depends on other aspects of her functioning.

You can’t force her to get assessed, obviously, but you can set limits about what behavior you will or won’t tolerate. I would be upset if my partner were obsessed with a former affair partner, and I would probably ask them to stop following that person on social media. You would be within your rights to do this.

If your wife is not up for having her mental health treated, do things to manage your own levels of stress. Consider couples’ counseling to help establish boundaries about this behavior.

She sounds lonely and like she’s looking for meaning and connection. You can validate her efforts to seek out meaning and connection, and ask how to help her be less lonely.
posted by unstrungharp at 11:12 AM on February 22, 2020 [20 favorites]

What if the guy is angry at your wife? What can she do about it at this juncture? Maybe your wife is irrational or paranoid or overly worried or obsessed. Only you can know since you live with your wife and can notice changes. Your wife is married to you and if too much time is being spent on guessing or assuming the motivations of emotional affair guy it isn't fair to you or the marriage. That's for her to figure out and only she can decide what her priorities are.

If I had an emotional affair my husband might be understanding. We might decide together to move on once the emotional affair was over. I pretty much know for a fact that my husband would not be open to discussing emotional affair guy, his wife, his job, his Facebook posts, or his anger or lack of. My husband would not entertain the topic because it's not productive. He wouldn't engage in pointless worries or concerns about why my emotional affair guy left his wife and if he's mad at me. He wouldn't entertain my neurotic guilt, drama, or inflated ego, or whatever my ramblings might be over a guy I had an affair with. So, if you want to stop discussing this guy maybe you could refuse to discuss this topic with your wife. You could be enabling drama.

Maybe you can remind your wife that nothing is personal and she shouldn't be so quick to assume anything is about her. Nothing anyone does is because of another person but a projection of their own mind.
posted by loveandhappiness at 11:21 AM on February 22, 2020 [6 favorites]

At a cafe she likes, they hired a new chef recently, and after they put a post on social media about craft beer, she decided it was in the same style as he writes in, and that he must now be working there, and had written the post targeting Her

I think you should disregard all advice that ignores or attempts to rationalize this incident.

I also think you should see a therapist on your own, in order to talk this through and perhaps get some advice (they couldn't responsibly diagnose or treat your wife secondhand, but they might suggest ways of talking to her or ways to understand her state of mind.) and if they can't offer any advice, they can at least be someone to support you who understands what it's like to try to maintain a relationship with someone unwell in this way.
posted by queenofbithynia at 11:29 AM on February 22, 2020 [59 favorites]

She needs to tell her psychiatrist about this delusion.

You need to get some mental health help yourself, and to set boundaries on what you will and won't deal with here and then not move the goal posts, like, she gets help by [date] or you move out kind of boundaries.
posted by bile and syntax at 11:33 AM on February 22, 2020 [2 favorites]

Consider that this could get worse. I witnessed a friend's development towards psychosis. It started with the news and believing government was targeting them (not entirely implausible bc of their line of work) to every person around them turning into a spy, one by one. Nobody did anything until the neighbours called authorities (after some very distressing, very public behaviours). Note: when I tried to talk them into getting help, I very quickly became a secret agent myself.

This friend lost their livelihood, their entire social circle, and their behaviour alienated most of their support network. Their life was ruined and they had to start from 0 in a different town. Now we're in regular contact: They seem to be doing ok after going through hell and back to a kind of purgatory of regret and waiting for life to start again.

Please protect your wife from this possibility and get her help ASAP. Please shield her from danger: from any bosses, police, the justice system, and the dehumanizing side of psychiatric institutions. Get her access to a compassionate doctor who has her best interests in mind.

You're going through some things right now and I totally respect that. I'd just ask you to focus on the present and suspend your need to know whether you're meant to be together forever, and be her unconditional ally until she is able to take care of herself.

Thank you on behalf of her (and on behalf of my own conscience, so full of regrets for not being a better friend back then).
posted by ipsative at 12:19 PM on February 22, 2020 [8 favorites]

i think this is a pretty classic delusion. she really needs a pdoc and a therapist, but as with anything else, she has to want treatment.
posted by megan_magnolia at 12:20 PM on February 22, 2020 [1 favorite]

In a previous AskMe, I highlighted a past comment from jessamyn, the linked resources from NAMI, including the TedX video "I’m Not Sick, I Don’t Need Help!" by Dr. Xavier Amador, and it may be relevant to consider here.

There is also the MeFi Wiki ThereIsHelp page, which includes a variety of resources, including links to UK support organizations.
posted by katra at 12:38 PM on February 22, 2020 [8 favorites]

You should contact whoever is prescribing the antidepressants and tell them about this and that you believe your wife is having delusions plus any other symptoms or changes. They can't discuss her care but they can listen to you or read an email. That is the first and main person who needs to know this in an urgent manner because there is a link between antidepressants, mood lifting and mania. It's far more likely she's sliding towards mania than she's got some other independant psychosis happening.

This happened to someone I know, he's fine now but if his prescribing doctor had been contacted sooner some unpleasantness would have been avoided for sure.
posted by fshgrl at 12:50 PM on February 22, 2020 [42 favorites]

Yes, I was attributing this to typical post-romantic obsession until I hit the part about the cafe. That is genuine delusion and it requires that you act to support your wife's mental health right away (even though you may not succeed). As for boundaries, it's one thing to assert emotional boundaries when your spouse is well but treating you in a way that makes you unhappy. In this kind of situation, you may eventually have to draw "treatment, or else" boundaries for your own self-preservation, but it's not the same as ordinary relationship negotiation, and you shouldn't treat it as such.
posted by praemunire at 12:52 PM on February 22, 2020 [4 favorites]

I witnessed a friend's development towards psychosis. It started with the news and believing government was targeting them (not entirely implausible bc of their line of work) to every person around them turning into a spy, one by one...Note: when I tried to talk them into getting help, I very quickly became a secret agent myself. This friend lost their livelihood, their entire social circle, and their behaviour alienated most of their support network.

I had a similar experience with an acquaintance. Lots of us were in denial about it because she was in her late 50s at the time and had never struggled with mental health issues before. It came on very quickly and got very bad.
posted by sallybrown at 1:18 PM on February 22, 2020 [2 favorites]

....Please shield her from danger: from any bosses, police, the justice system, and the dehumanizing side of psychiatric institutions. Get her access to a compassionate doctor who has her best interests in mind.

I know this sentiment is good hearted and the outcome we all hope for but it can be a paralyzing burden to place on a partner who might be feeling isolated and inexperienced with the medical system. Especially difficult to manage if the afflicted person is uncooperative, hostile or unpredictable. The fear of setting off a domino effect might keep them from calling for help in a genuine crisis.

I hope the OP can reach out to someone close to them to use as a sounding board, even if it feels like a betrayal of their wife's trust.
posted by bonobothegreat at 2:15 PM on February 22, 2020 [12 favorites]

Seconding fshgrl - you can and should tell her provider that she's experiencing delusions.

The MeFi Wiki page "There is help" has UK-specific mental health resources, including support for those who have family members who are having mental health issues. They may be able to make recommendations more specific to your area/situation.
posted by bunderful at 3:01 PM on February 22, 2020 [1 favorite]

I would not recommend telling her care providers she is having ‘delusions.’ If I were doing an assessment at the psych unit where I work, and came to find out the above information, I would probably not use the word delusions. I’d call them overvalued beliefs, possibly. Whether or not they’re delusions is really between her and her psychiatrist. The OP would be better off describing the events neutrally, as they have here. A layperson is NOT qualified to diagnose delusions.

Unless it were an emergency (imminent risk of harm to self or other) I frankly wouldn’t breach her trust or interfere with her therapeutic relationship with her doctor by telling them anything, without her explicit permission. She may have mental health problems, but she still has rights- including a right to privacy. Even if these were classic delusions, that doesn’t mean she’s at the kind of imminent risk that justifies overriding someone’s privacy rights.
posted by unstrungharp at 3:35 PM on February 22, 2020 [3 favorites]

It’s very hard when people we love don’t want to treat health problems, whether it’s diabetes, cancer, depression, or psychosis. People have a right to live at risk, though, and to less diligent in treating ailments or less communicative with their care providers than we want them to be. Mental health is not an exception. They basically do not lose their rights, in most jurisdictions, to consent to treatment or decide what information to share with whom, until they are in much, much more serious condition than the OP’s wife, unless some major information is missing.
posted by unstrungharp at 3:46 PM on February 22, 2020 [2 favorites]

Separate from the mental health question, why does your wife think that it's okay to talk to you about her obsessions with this guy? That seems really problematic to me. Is your relationship open? Presuming that it's not, why would you encourage her to contact the man's wife rather than saying that she needs to let this go for your own relationship to recover? I would argue it's fair for you to request that she stop following him on social media. Are you friends with this couple, or is there any reason why she shouldn't fully cut ties?

It's also not clear to me whether they were ever involved or if the feelings were entirely on her side; do you know? If it's the latter, it seems even more worrisome that she's convinced he's thinking about her.

The cafe situation is most concerning, though it's certainly *possible* that he does actually work there. I had a strange experience once: while living in a city of around 13 million people, I once walked into a bookstore and recognized the handwriting on a review posted next to a bookshelf as someone I'd gone to high school with years earlier thousands of miles away (there was no name on the review, but initials). I later learned that this former classmate had, in fact, moved to the city and was working at the store. I can imagine recognizing someone's phrasing on a website and imagining that it might be this person. The idea that these are messages to her is a different story, but I think it's plausible that she's obsessing and not fully delusional.
posted by pinochiette at 4:02 PM on February 22, 2020 [15 favorites]

Separate from the mental health question, why does your wife think that it's okay to talk to you about her obsessions with this guy? That seems really problematic to me. Is your relationship open?

this is a natural question but I think it is very naive. This woman is not making choices and following impulses separately from her mental health; her mental functioning is not a separable part of her brain that she can take off along with her glasses at night. These are things to ask her when and if she can discuss the situation without becoming very upset, and without the risk that she may come to believe the asker is her enemy. it might be possible to talk her into that kind of calm objectivity, or it might not be possible until she has started on some kind of treatment plan.

I used to feel similarly in having no sympathy for people excused from full responsibility for their actions on the basis that they experienced command hallucinations. I wouldn't do X just because a real person outside my head told me to, I would think, so why would you do X just because an unreal person inside your head told you to, how is that a reason let alone an excuse.

but I have come to accept that it isn't like that. for hallucinations or for delusions, for any kind of mental state where what you know and perceive isn't in line with what other people know and perceive. It is possible to experience delusions of reference (I am not sure whether these fall into that category exactly & am not a doctor, this is just a for instance) and know them for what they are, and disbelieve in them while still perceiving them. but this woman does not seem to have such an awareness yet.

I remember talking to someone once about his experiences with this stuff and he said it was like a freeing epiphany when he realized (or decided) that he could just ignore these hidden truths about the universe -- he couldn't stop seeing secret signs and messages to and about him, but he could play a game where he pretended not to notice and enjoyed imagining the frustration that the message-senders must feel. But he was on antipsychotics at the time we talked about it, which (he said) helped.
posted by queenofbithynia at 5:15 PM on February 22, 2020 [11 favorites]

Mod note: Deleted several that were arguing back and forth. Other posters are allowed to offer advice you don't agree with.
posted by Eyebrows McGee (staff) at 5:18 PM on February 22, 2020 [6 favorites]

I recall your previous questions, OP. It appears your wife's behaviour and thought patterns are escalating. I can understand your concern, and wouldn't hesitate sharing your thoughts with your wife's GP or psychiatrist.

They have the existing relationship and will be able to put this information in context, and devise what next steps might be.

Best of luck.
posted by smoke at 5:33 PM on February 22, 2020 [4 favorites]

I'm no expert, but I have the impression that both an affair and delusions are consistent with some form of bipolar, based upon an experience I had with someone. (Relevant link?)

It's important to get bipolar treated promptly because, left untreated, it worsens over time. Getting the medication right for bipolar can be tricky. If she has been diagnosed with depression and actually has bipolar, antidepressants may not be the best medication for her.

This is all to agree with fshgrl and others advising you to get this information to her pdoc and to get her seen by them soon. You can contact a medical professional and share your observations with them. They cannot discuss the care with you in general, but if she brought you with her to the appointment and seemed in favor of having a group conversation, for example, then they could.
posted by slidell at 7:26 PM on February 22, 2020

It would not be appropriate to discuss the wife's diagnosis or treatment with the doctor without her consent, nor to attempt to dictate her treatment, but I am really not aware of any sort of ethical boundary that forbids a relative of a patient to report observed symptoms of the patient to the doctor.
posted by praemunire at 8:31 PM on February 22, 2020 [8 favorites]

Since my previous comment, I've updated the list of UK resources at the ThereIsHelp page, both for crisis-focused and more general mental health support resources.

The Mental Health Foundation offers guidance on How to support someone with a mental health problem, including:

You probably aren’t a medical expert and, while you may be happy to talk and offer support, you aren’t a trained counsellor. Try not to make assumptions about what is wrong or jump in too quickly with your own diagnosis or solutions.

Rethink offers suggestions for how to frame conversations related to Persuading someone to speak to their GP, with a list of examples. Rethink also has a page about Getting help in a crisis: "If your relative has a mental illness, you may find that there are times when their mental illness gets worse. This page gives you information on who to contact if you feel that the situation has reached crisis and they need urgent help," which includes:

Getting help can sometimes be difficult. It is important to keep trying if you had problems the first time. You may find that you need to try different services before getting the right support for your relative. This can especially be the case if they don’t want to get help.

You could put your concerns in writing, and send these to professionals as well as sharing them in person or over the phone. This can make it easier for professionals to understand your concerns. It also gives you a record of what you have said and when. You could send the concerns in a letter or email. Sometimes it can be helpful to send copies to other professionals too. For example, if you send a letter to the community mental health team, you could send a copy to your relative’s GP too.

Try to include clear and specific examples of the concerns you have. You could tell them about thoughts or behaviour that you are worried about. If there is any risk to the person themselves or to other people then make this clear. [...]

If you share concerns about your relative, professionals may tell your relative that you did this. This can affect relationships and trust. When sharing your concerns verbally or in writing, try asking for any information you share to be kept confidential and used as sensitively as possible. You could explain that this is necessary to protect your relationship.

Sometimes, you may have information that professional services will not have. For example, if your relative will not share how they are feeling with mental health services. If this is the case, you could highlight that there is a risk that your relative would stop talking to you if your information is not used as sensitively as possible.

Mind also offers resources related to How can I help someone else seek help?, including What can I do if someone doesn't want my help?

You can't: [...] Force someone to get help (if they're over 18, and it's not an emergency situation). As adults, we are all ultimately responsible for making our own decisions. This includes when – or if – we choose to seek help when we feel unwell.

[...] If you're not in [an emergency situation] right now, but you're worried someone you care about may experience a mental health crisis in the future, it's a good idea to make a crisis plan with them to work out what steps you will take to help them in an emergency. (See our page on planning for a crisis for more information.)

As far as my own advice for you, I encourage you to get support from a therapist. You sound overwhelmed and understandably not well prepared to handle something like this on your own, but there are resources available that can offer a variety of supports, and I hope that you can find them.
posted by katra at 8:32 PM on February 22, 2020 [8 favorites]

If you want a terminology to discuss this with a doctor, the terms ideas of reference/delusions of reference might resonate, but your examples are great and all you need.

At least here in the US, HIPAA laws protect patient information in that medical providers cannot release patient information to family without signed consent but there is nothing barring family from providing info to medical providers. In fact, it’s often very useful! People don’t always remember all their symptoms or the timeline for medical and psych stuff and family members can be helpful! For the sake of your relationship with your wife it might be best to go to her next appointment with her and say what you want to say in front of her, but if she won’t consent to that you can call her doctor and provide info anyway. When depression is severe, people can develop psychotic features. Whoever is prescribing her antidepressant is in the best position to determine if these are psychotic symptoms, if so what disorder they are a part of, and whether a physical or neurological work up is indicated. Psychotic symptoms can also be a feature of dementia or a medication side effect or a number of other things. For whatever it’s worth, at the hospital I work at, someone presenting with psychotic symptoms for the first time always gets a full work up including blood work and CT scan of the brain.
posted by Waiting for Pierce Inverarity at 8:42 PM on February 22, 2020 [3 favorites]

Agree with Waiting ... the doc is unlikely to (and shouldn't) accept the diagnosis of a layperson - I'd just provide them with examples.
posted by bunderful at 4:45 AM on February 23, 2020 [1 favorite]

Another thought to add:

If your wife still has a crush on this person or still has strong feelings for him, it could be clouding her reality as crushes can do.

Crushes can cause a person to read into things as affirmation of mutual desire. A person can like someone so much that they believe when their crush looks their way it must be a “sign”. If she’s thinking of this person a lot it’s making her crazy in love so to speak. Her feelings are so strong that she thinks he might be thinking of her too. Longing or desire or crushes can make a person behave irrationally and looking for signs of reciprocal desire is not unusual. It’s not necessarily a reason to seek psychiatric care. People have crushes. If you think this might be the case it will probably pass.
posted by loveandhappiness at 1:30 PM on February 23, 2020

In the US here. I had one doctor say she could listen to my mom when mom was concerned about me but couldn't tell her anything.
But at the same time a different dr wouldn't even acknowledge to my mom that I was her patient.
I prefer the latter, but my point is that doctors tend to interpret confidentiality differently.

I understand that a doctor wouldn't take the diagnosis of a layperson, but wouldn't a doctor understand that you're a layperson looking for a way to describe your wife's behavior and not split hairs about whether you have the proper training to use a word like "delusion?"

This is a really hard situation with a lot going on. I hope you are able to find an outlet and set boundaries and get your own therapist.
posted by mermaidcafe at 1:49 PM on February 23, 2020

In the similar situation I know about in the US, the person’s spouse went with the patient to a long-time doctor, and had a discussion with the doctor in front of the patient about the delusions (not calling them that, more saying “Anna says the President is using her email to spy on her and is sending coded messages in grocery store coupon circulators”). The doctor then asked the spouse to leave, explained to the patient why this was concerning, and asked the patient to seek mental health treatment. The doctor then asked for permission to share this with the spouse and invited the spouse back into the room to tell them the same thing and outline options. The patient refused mental health treatment at that time, but later accepted it after a few more meetings with the doctor.
posted by sallybrown at 2:05 PM on February 23, 2020 [3 favorites]