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My wife has paranoid schizophrenia, what should I do?

Q: My wife, son and myself live outside India. Last year, my wife, 35 years old, developed paranoid schizophrenia. She was suddenly suspicious of my activities, my whereabouts, etc. She complained of alien objects in her body and said that somebody was listening to her talk and was monitoring her every movement. She then assumed that she was the chief of police, the defence minister, etc. and became abusive and physically violent. She used to call me some 20 to 30 times when I was at work, and my boss told me to stay at home and try to get things under control. I requested her dad to come over by the first available flight, she was okay for the fist day she saw him, the very next day she was abusive - physically & verbally against her dad, accusing him of trying to kill her for the sake of insurance money (she has had an accident when she was in her late teens). Then when matters went out of hand, we managed to fly back to our country and I was forced to leave my 8 years old son and my wife in the care of my father-in-law, hoping that he would start treatment immediately. After some initial consultation with the local psychiatrists, she looked settled down, but soon was back to her violent nature. When things got completely out of hand and the police had to be called in for domestic disturbance, my wife was admitted to a hospital for 12 days and subsequently discharged. She is now on Pacitane. My worry is that my son, who is of an impressionable age, will suffer being in her company, seeing and listening to her ravings and ranting. Also, I wonder about the quality of life I will have in future, knowing that she may relapse any time. What are the options available for me? I cannot leave my job and look after my wife, as I have to think of my son’s and my future too. It has been a year I saw her.

A:I entirely agree with you that your son needs utmost care and protection. Also there is a potential risk of relapse. However, is she symptom free completely at this point? Since Pacitane is not known to treat psychosis, and I presume she must be on an anti-psychotic too. She needs to be adequately treated with an anti-psychotic under proper supervision of a psychiatrist with regular follow up and with a non-critical, empathic attitude of the family members. We need to look at the broader picture too. If somebody like our mum or dad develops hypertension/ diabetes, do we leave them to their own fate, or we take adequate care. As we all know there are further complications and long-term effects of these illnesses too and require regular medications and always an acute risk of deterioration. So what do we do? The other angle is what if our loved one (brother, sister, child) develops Schizophrenia, do we leave them to the fate of god. The other way to look at this is what if we ourselves develop Schizophrenia, how would we feel if our wife/spouse decides to leave and take away the children too. I think your decision should be based on considering some of these angles and deciding the best course available. Mental illness like any other medical illness can affect anyone irrespective of caste, creed, gender, age, economic status, and occupational status. What the suffering individual requires is love and affection, adequate and right medications, and further support to fight the illness rather than rejection by the family, or society, which can leave them nowhere. Do read ‘A beautiful mind’ and probably watch it too. It would be readily available in the country you are in.

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