Helping spouse in a foreign country

Family
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Hello,

I am new to this forum. I have been reading a lot and wanted some advice from fellow caregivers as I am completely lost. My husband was diagnosed 7 years ago. We dated 6 years and have been married for 5 years now. I was with him through his diagnosis and recovery. We’ve been through 1 hospitalization when he was first diagnosed for a full month, 2 panic or psychotic attacks and now he’s on this third episode. He was doing great for 4 years unmedicated through therapy and a busy daily routine.

He just had a panic attack 1 week ago, and this time around miraculously he did ask me to take him to the hospital (after his trauma of hospitalization, he is scared of hospitals). We went to ER in the middle of the night and was prescribed 1 mg of risperidol oral solution. He usually reacts really fast to meds. He was asleep within 30 min. after his doze. We got discharged because the psychiatrist saw no signs of harm or danger. He told me to come back if he has another attack. He didn’t. He devotely took his meds for 5 days, but now he is refusing. I asked him why, and he says the voices tell him not to. I told him I love him too much to see him in pain that he should take his meds to get better and if he loves me more than his voices, he should take the meds. He did respond and took his doze right away, but that was the last doze he has taken. Ever since, he stopped talking to me. He doesn’t want to go out, he stays all day watching YouTube on space and planets. I know I shouldn’t take it personally, but when I ask him if he loves me, he doesn’t respond and refuses to sleep next to me (sleeps on the couch). In my previous experience, in his last episode, he was able to brush it off within a month without any meds. However, the difference then is that he was very active. He knows taking walks helps him. I kept him distracted by taking him to different museums, exhibitions, sightseeing and going to the beach.

This time around, he seems to be acting so differently. It was amazing he accepted medication for the first few days, and now he is completely in denial. What can I do? We are currently overseas. We wanted to travel and I was able to get a remote job to make this dream come true. I am feeling the insecurity and the newness to the environment is triggering his anxiety. He will not get on a plane because he feels that he is going to die in an accident.

I know I may not be very coherent right now, but I need help from experienced caregivers. We do not have any sort of support here. I reached out for a rehab center, but it is out of our budget and we have no insurance here. It’ll also take a 1 hour plane ride to get him to the rehab center. Should I wait for him to calm down a bit more and take him home? We have insurance back home, and support from family as well. I am completely lost here and cannot tell his family he is not doing well. I know this is selfish, but getting constant phone calls worrying about him only makes me more stressed and anxious.

How long will this episode last? Previous episodes did not last over a month. On his second week, he was active, talking, eating healthy, and willing to go out. Is there an average time? Would it be safe for me to arrange things back home in four weeks to get him admitted to a facility? Right now, he doesn’t seem distressed but he is in mute mode. Yesterday, though, he took the initiative to write me on his phone saying that he is feeling better. He told me not to worry if he doesn’t talk. He wanted to go out shopping and helped me all day doing laundry, washing the dishes, grocery shopping, etc. Today, he is completely in limbo again. This is his third day with no medication. He is just sitting watching YouTube and refused to eat the lunch I made him, so I ordered food for him and he ate it all and did his own dishes! I am so confused by his behavior. Please help!

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Hello abc and welcome to this forum. It is a great resource for getting real life lived information, from those who have lived this path of loving someone with schizophrenia.

I am sorry that you find yourself in a strange environment with your husband off meds and still suffering from delusions and hallucinations. To answer your question: I do think that going back home is the best thing as you have insurance there and a family support system. Whether you tell the family what is happening or not is your own private decision, but perhaps it would make YOU feel better to have them around rather than being surrounded by strangers only in a foreign country. I personally needed my close friends and family to help me be mentally stable when my daughter was mid episodes. And only with community support and medical insurance was she finally gotten onto meds and stayed on her meds (for over 3 years now stably).

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but perhaps it would make YOU feel better to have them around rather than being surrounded by strangers only in a foreign country.

I was not very clear about the support I have with his family. We come from a country where you eat pasta with chopsticks. He was raised with a tiger parenting dad and a helicopter mom. I know they do their best to take care for their son, even though we were married, his mom supported him with monthly allowances to keep up with his expensive hobbies and what not. Whereas his dad, is the scary person in the family who would threaten him to the extent that he will not see him ever again if he finds out he is not taking his meds (he actually did cut off his big sis for getting divorced). I don’t know how to better explain the culture we are from, but I do get support, but we also get the unnecessary stress from the different/conflicting parenting styles. I know they will be ALL support in times of need, but this is the very reason why we came overseas. We wanted independence as a married couple. We cut off all financial support to help him feel empowered of his own life. Thus, this is why I am reluctant to call and even tell them his son is struggling right now. I rather have them be mad at me for not calling and telling them the truth. His current major breakdown was triggered due to his family (his second sis), for blaming him for “running away” to a foreign country when his parents are sick (mom has a heart condition, dad has prostate cancer, but both are stable and in good health after surgery). He helped them through times in need, he helped them get hospitalized, took diligently to the hospital through recovery and chemo, even if they were hospitalized at the same hospital he was diagnosed and traumatized at the psych ward. Enough was enough after two years of taking care of them and he really needed to some time off from all the “expectations” of a good son in an Asian family. I really cherish him for his strength of mind. I just want to respect his words when he was OK, he made me promise never to tell his family if he ever gets sick because he doesn’t want to disappoint them. But, I’m at a crossroads now. I know as you say that I need support, but the consequence would be constant pestering on taking meds and constant calling. But also, if I told them, that would mean financial support to get him into a health/rehab center here to help him recover much faster. I am so confused right now. I just wanted to know if based on experience, you would think his episode will end soon based on his average time during his last relapse. I have not experienced such a strong psychosis episode and it breaks my heart to see him going through it. It takes us at least 4 weeks to get an appointment with his doc. back home who is in high demand. But again, I don’t know how I would put him on a plane involuntarily (sedated?). If we decide to go home, I would take him to his doctor myself without even telling his family we are back home. I apologize if my English doesn’t come off the right way at times. This is my second language and thanks for replying!

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How old is your husband?

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He is 43 years old, I am 40 years old. He was diagnosed in his mid thirties. It’s a bit hard to understand the dynamics in his family as I am also Asian but born and raised in a Western environment. It is complicated, but yah, that’s us. It was hard to even tell he was sz when he was helping his parents out fight their own medical conditions.

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My son had an episode once that lasted over 2 months.

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I see. I know it is hard to generalize, but I can see there is potential for episodes to last longer than usual. Thank you so much!

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Was he unmedicated during the episode?

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Seems like you just answered your own question maybe? In the end, you and his parents just want to help him the best way you can. I would think that there is no way you can involuntarily get him on a plane, in my opinion, unless it is a medical transport.

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Thank you so much for your advice and support! I will consider my own answer to the question as a potential solution. Last night, he slept next to me. Today, he is reading his favorite book series and ate all the meals I prepared. Could we say he is getting a bit better? Fingers crossed~~~ OMG I just keep adding meaning to any changes he shows in his behavior…

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My son was always unmedicated. I think the long episode was a reaction to a major stress occurring.

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One of the often repeated bits of advice is to keep stress levels down. Sounds simple but difficult to do because everything seems to cause them stress. My NAMI instructor taught that ALL changes even happy changes cause stress.

I wish there was some way you and his parents could find a way to work together. You both have his best interests at heart.

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Thank you so much for your feedback. Just simply typing out and reading your feedback really does help me feel comforted and healed in a way to know that we are not alone in this long journey. I just can’t stop blaming myself for trashing 4 years of good times without relapses and therapy for the pursuit of a fantasy per say to travel and leave all worries behind and family “duties.” We thought this would bring better changes to our lives, and I didn’t know happy changes can be also triggers to anxiety. I wish I had known better before. I just hope he keeps getting better. I really appreciate your feedback! Thank you so much again.

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You are welcome, many of us do tend to blame ourselves when there are relapses. We really shouldn’t, life will always bring changes. I had asked your husband’s age as many of our family members have their peak years of psychosis in their 30’s. Recently I lived with my 41 year old son for 18 months and I could see how he had set up a calm, quiet environment for himself. I tried to not move anything and kept me and my stuff in my room. I wore earbuds to silence my laptop viewing, and kept my phone on silent.

Your husband will get better, just be patient as it may be a long time. Best to you.

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Messaging a friend last night helped me feel a lot better! After all, no man is an island. I had also isolated myself from my friends without sharing my experiences because I did not want to burden them with my stories. I was able to vent and my friend was completely shocked to know how much was going on in my life for the past few years (she never saw him on his bad days, so she had no idea he was living with sz). It’s amazing how we are talking about two different individuals, but our daily habits are so similar. I’ve had my phone on silent mode for the past 7 years. I try not to talk on the phone when I’m home, and sometimes it seems that watching shows on my phone makes him uncomfortable. Earphones and headsets are a must in our house too. I really appreciate all your pieces of advice based on experience. It really helps! Does he also have candles all over the house? This worries me a bit cuz sometimes the candle jar cracks open due to overheating. My husband has a bit of OCD which I think is a good thing cuz he keeps up with his personal hygiene. He can’t stand the smell of trash, food, cleaning sprays, etc. He never goes out without wearing his mask and so do I, and we are one of the few ppl in our family and circle of friends who haven’t had Covid.

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That’s great! Small wins are often the path to bigger wins in any episode.

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He didn’t have candles, but he did keep some lights on 24/7. Yes, sensitivity to smells was a big issue and he only went without a mask at home. Also, he kept his cupboard and pantry doors open. He said he couldn’t find things if the doors were closed. You and I are both lucky, my son was also fastidious about his personal hygiene. I know lack of personal hygiene can be a big issue for many families.

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He seems to be doing much better than when I first posted. He is sleeping well, eating all his meals, stopped walking in circles, and doesn’t look awfully anxious anymore. But, he refuses to go out other than to his physical therapy and does not want to talk to me at all. He writes me on his phone or sends me text messages. On Saturday, he had a crazy moment and I am going to blame the Full Moon for that. He was acting up and wrote me that I am a fake wife. He thinks I am going to abandon me, so he told me to go back home alone cuz he feels that my presence is suffocating him. I wrote him back apologizing and wrote him two letters telling him how much I love him and that I am very sorry for having said I would leave him if he wouldn’t take his meds (I screwed up so badly in hopes that he would continue taking his meds. he was compliant for 5 days, I should have just left him say no). He is still convinced that I am going to leave him. He says he is not mad at me at all and that I shouldn’t be apologizing cuz I am going to leave him anyway. How can I regain his trust? The LEAP method doesn’t work quite well cuz we don’t verbally speak! Anyone experienced a similar situation?

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A difficult situation when our loved one is living in another reality- with a SMI- remember this - you didn’t cause it, can’t control it and can’t cure it- you /we must take care of ourselves.