Hi, so very sorry for what you are going through right now.
I answer your questions based on my many years of experience as a full time caretaker for my own adult son (now 34) and my interactions with other mentally ill family members in my family.
I would say that although you say he has reported to you that he has been on clozapine for 10 years now, I would question the truth in that for several reasons, #1) is he accurately reporting how he feels and the voices and other self beliefs to his psychiatrist (many patients do not)? I would guess not because if he was his psychiatrist (if he is worth his salt) would have made med adjustments accordingly.
While his voices are active he is truly out of control of what he thinks and how he behaves because of what he thinks. This is the nature of the illness.
Typically, clozapine is a drug choice of last resort-prescribed when all others have failed and often (but not always ) has the best outcome for reducing voices and delusions over time. It has worked well in that regard for my own son.
Either your boyfriend is not on the right dosage or it simply isn’t working for him anymore or he says he takes it as prescribed and he actually doesn’t.
Clozapine legally requires monthly CBC blood draws to check the white blood cell count so there’s that. Perhaps he has mentioned that?
2/ If he is not stable and by your descriptions of what he has said and what he believes and the presence of active voices -He is not stable right now. That fact leads me to say that this is not a good time for a relationship (or moving in together) where he is concerned. I am basing this only on what you have reported about him and what I know of those things personally in my own life.
Maybe he has “muddled by” okay before he met you -before he was in a relationship at all or maybe it was just a case of there not being anybody present daily to observe his illness up close and personal, no checks and balances so to speak.
Now you are in the picture and you can see things clearly and for him regardless of how sweet or kind or loving you are toward him …being in any relationship for a mentally ill person is full of stress, stress can come from both and good and bad events in life…many people with mental illness do not and may never possess the tools to deal with or cope with added responsibilities that come with adult relationships. There are the rare few that have the insight and cognitive ability to conquer that with the right treatment and support but it is not the “norm”.
Do you know his family?-does he have any and if so can you talk to them about you’ve learned so far from him? Perhaps even they don’t know the things you have discovered about him. Maybe they can help him get on the right path?
My best advice based on what you’ve said so far is no he is not ready to be in a serious relationship while he is still unstable and maybe you can remain friends in some capacity, maybe encourage him to tell these fears to his psychiatrist, maybe even consider writing a “letter of concern” to his psychiatrist if you know who he or she is.
Of course the psychiatrist cannot share any personal details of his or her treatment protocol with you but it may alert him or her to ask your boyfriend more probing questions at his next visit and perhaps monitor him closer.
I would reduce your boyfriend’s stress by saying (if you choose to) that you have heard what he has said and thought about it and it is fine to remain just friends if that is better for him, and that you can hear the stress and anxiety in what he saying and that you only want the best for him which I am sure you do. I am only making a suggestion here.
If you decide to take the friendship route and you don’t even have to do that if you don’t really want to. But if you do I would highly recommend contacting a local NAMI chapter if you have one. They are a wealth of knowledge, referrals and free peer support classes that help tremendously for someone new to all of this. Here is a link: https://www.nami.org/Find-Support/Family-Members-and-Caregivers
What ever you decide will require careful thought and consideration, pushing for a seriously relationship right now as things stand will undoubtedly throw you squarely into a “caretaker” role which if it can be avoided I would before you are married or with children. Even the most enthusiastic person ends up drained, depressed and depleted throughout the process and there is no guarantee of a successful end to the care taking, sad to say. There are also some studies that point to mental illness being in some cases a genetic disease although there are many other factors that play a role in becoming active in anyone’s life.
I wish I had happier answers but I am all about being honest because anything less is not helpful. I wish you and your boyfriend the best going forward. Take care of yourself, and yes take his threatening fears seriously, he may not be able to control any of it in his state of mind. Try to remember his words are not really personal even though they feel very personal, they are yet another symptom of a very serious mental illness.