I have been in a relationship for five years with a man who was diagnosed with schizoaffective disorder, depression with psychotic features. For the most part, his disorder does not have a negative impact on our relationship. He has trouble keeping his place clean and he is slow to take actions that move his life forward in positive directions. But he is on the right track now, returning to school and looking for a better job.
He was in the military for six years. Two of these years we were in a relationship. He told me about some episodes he had before we were together, which included months he could not remember. He moved to my town almost two years ago. He has some auditory hallucinations, but he has learned to ignore them. Since he was discharged from the military, his symptoms did not extend beyond that.
This weekend, I left town for the weekend and I asked him to check my cat. I realized halfway through the weekend I had not given him my spare key. I called to ask him if he checked my cat and he said yes, saying he got in with my spare key. I thought he was lying, which did not make sense because it was a strange thing to lie about and I have never caught him in a lie before. Today I came back and saw he definitely was not here. My cat’s water bowl was completely dry and her litter box was filthy. I talked to him about it, still thinking he was lying, and came to realize he sincerely believed he was here. I gave him evidence to the contrary and he was visibly concerned. I told him I was scared and he said he was too. He said he does not think this has happened in years, but I suppose there’s no way to be certain. Of course I love him and I want to help him. For the most part, our relationship is very good and I would hate to end it. But I am very concerned how things could go in the future. If I can’t trust him to check my cat, how could I trust him with a child? I don’t know how to move forward.
Also, he has not been on medication since he was in the military. When he was, I think it was for depression only. He does not have insurance for psychiatric help right now or the money to pay out of pocket.
You are correct to be concerned. Dating is about attempting to determine if your partner is someone with whom you could spend your life. If you continue in this relationship, his mental illness is a reality that you must face.
People with psychotic disorders can have successful relationships, but they are not without their challenges. The success of those relationships is often dependent upon receiving effective treatment. The concern is that your boyfriend is not participating in treatment. The cat feeding incident is evidence that his cognitive state is a problem and may be the result of his not participating in treatment. The extent of his symptoms and how this impacts your relationship is apparently not able to be determined at this time.
Whether he needs to be on medication or could benefit from other mental health interventions, should be evaluated by a psychiatrist. Even though he doesn’t have health insurance, most community mental health centers offer free or low-cost treatment. Having been in the military means that he has access to government treatment through the Veterans Administration (VA). He should be eligible to receive free treatment through the VA.
Untreated symptoms will impact the quality of your relationship. If he is unwilling to participate in treatment despite having symptoms, then you may want to rethink this relationship. You may also want to consider consulting a psychotherapist for short-term counseling about this issue. It could help you objectively evaluate whether or not this relationship is healthy and sustainable. It could help you to navigate the relationship, should you decide to stay. Please take care.
Dr. Kristina Randle
