THIS POST CONTAINS POTENTIALLY TRIGGERING MATERIAL REGARDING EXTREME PHYSICAL VIOLENCE.
Dear Doctor, my husband has been diagnosed with Schizophrenia when he was 18 years old. He had negative symptoms, since his parents understood about his disease after one or two years. After a romantic relationship failure in his life, he started his delusions. He was so negative towards his father. He always said that he was trying to kill him or trying to stop him from being successful and so on. His brother told me that he used to hold awkward postures for very long hours. He was under treatment; however, sometimes he avoided taking the medicine which most of the schizophrenic patients do. I met him 4 years ago. At that time, I know he was sick and knew all the details about him. However, he never admitted that he has schizophrenia. I got married 1 year ago. While we were renovating our apartment to live together, about seven months ago, he found his father sat on the lounge lonely. With big knife that he has hidden from a long time ago he killed his father violently. He had tried to kill him before that time twice. Now he is in the psychiatric hospital and I am visiting him everyday. My feelings towards him are very strong and I know that he is not a violent or a bad person and he just needs help. However, in the hospital they just tried to give him medicine and they do not have effective psychiatric sessions with him. Everyone tells me that I should get divorced and continue my life. It is really a hard situation for me and I am not sure how I should deal with this disease when he gets home. Thank you for your help in advance.
You are dealing with a very challenging situation. You said that you know your husband is not a violent person. You believe that his violent behavior was the result of his untreated illness. That may be true. Studies show that people with schizophrenia are no more dangerous than the general public except when they are under the influence of illegal substances and are psychotic or when they are not taking their medication. From what you wrote the incident occurred when your husband was not actively taking his medication and thus is consistent with what studies show. But the concern of course is that he could be violent with you. Studies also show that a history of violence is the best predictor of future acts of violence.
You know that there are times when he resists taking his medicine. You also know that when he is not medicated he has the potential to be violent. He murdered his father while off his drugs. This is a very serious action. He took a human life. You can love your husband and support him but you must also be fully aware of his potential for violence. Upon his return, you need to be absolutely certain that he consistently takes his medication. Focus on what you can do to ensure that he takes the medication at all times.
One way to do this is through injections. I am not sure whether injectable versions of antipsychotics are available in your country but they’re worth inquiring about. Usually an injection of antipsychotic medication lasts 30 days. They are given once a month and are administered by a nurse practitioner or a doctor. Injectable medicine might be the most effective way to ensure medication consistency. If it’s available and an option for him then I would highly recommend it.
Also, inquire about what home support may be available to you. You may need assistance with your husband after he returns home. Inquire with the hospital about what psychiatric services are available for you and your husband. Questions to ask may include (among others): can he attend counseling sessions and where and with whom? How often? Are their support groups he can attend? Are there support groups for family members who have a loved one with schizophrenia? What do I do if he becomes angry or agitated?
As I mentioned above, it is imperative that you find a way to make certain that your husband remains on his medication at all times. Consider injections if they are available.
Lastly, as you have alluded to, your situation is a struggle and a challenge. The goal for you is to gain as much support from the hospital or other psychiatric programs within your community when he comes home. Be open to as much support as you can garner. Align yourself with individuals who are sympathetic and who understand your ordeal. Surround yourself with caring and supportive people who can assist you. Don’t remain isolated and alone. Also, become educated about the disease of schizophrenia. Arm yourself with this knowledge. Thanks for writing. I wish you luck. Please feel free to write back with any future questions.