Hi, I have been knowing my SO for a year now, I like to believe that we have a great connection. He has told me in the beginning that he has trust issues and have a hard time letting people into his life. He doesn’t have many friends and he prefers to be home on his own which at first I had no problem with because I am a homebody myself. However, after a while, I noticed he had intimacy issues which then rose quite a few problems within our relationship. He distances himself quite often, becomes very cold. He also shared with me that he was sexually abused when he was young but he didn’t go into detail and I did not ask questions because I felt like he didn’t want to talk about it so I comforted him and we have not spoken about it since. I also know he did not come from a good background. He has also gone through my phone and found some messages from social media. The trust was fully broken then but after a couple months of separation, we decided to work out the relationship. A couple of days ago, he became very distant and I began to worry what was on his mind. He finally opened up and told me he suspects his roommates are plotting to get him. I reassured him that that was all in his head and to stay positive. He also bought a knife for protection which I didn’t think much of. However last night, he smoked a little bit of marijuana (he has before and has never acted weird) and after an hour, he began to shake uncontrollably. I had asked him what was going on but he told me he was just cold and told me to go to bed. As I am laying next to him, I couldn’t help but notice his behavior. He was still shaking, his heart was pounding and he was looking straight at the door and noticed he was holding a knife in his hand as he looked like he was prepared for whatever was going to happen. I began to worry even more and he suggested we leave his place.. it was 2am. While we were in the car, he began to suspect I was hiding something from him. He kept saying “What’s going on” and began interrogating me and went through my phone again believing I was out to set him up. I was afraid for my safety and I told him to get out of my car, he got a lyft and just left. I have not heard from him since and I am still worried about his mental state. What should I do? I deeply care for him but he doesn’t trust me and believes I am out to get him. I believe he has paranoia disorder but he doesn’t have medical insurance and I am afraid it is going to get worse. I don’t want him to hurt himself and I want to help but I don’t know if he wants help from me.
It is very difficult when the people we love and want a relationship decompensate, and I admire your tenderness and compassion. However, a paranoid delusion is nothing to try and deal with on your own. There is potential for him to hurt you, someone else, or himself during these states and justify it with these irrational thoughts. This is a situation that requires professional assistance with an evaluation from a psychiatrist or psychiatric nurse practitioner.
Set a clear boundary with the primary goal of protecting yourself physically and emotionally. This is not an opportunity for you to reason with or convince him. This is a situation you must view as a self-care priority with your well-being coming first and foremost. Individuals can recover from these episodes, but it will require professional guidance and (most likely) medication. An evaluation for him is imperative.
It is not uncommon for intimacy to be the trigger for such episodes and you may not be able to offer more than your compassion from a distance. If he is sleeping with a knife he intends to use it if he feels it is necessary—and that necessity may be determined by a delusion. Worse—the use of drugs may exacerbate his anxiety and disordered thoughts.
Set clear boundaries for yourself. Explain that his actions and behavior are such that you are concerned and cannot be with him until he finds some help. I know this seems difficult, but your well-intentioned acts can easily be misinterpreted and used to justify his paranoia. Don’t put yourself in harms way.
Wishing you patience and peace,
Dr. Dan
