I feel that my boyfriend may be developing sz, or may be at risk for it. He finally saw a psychiatrist in December, but the psychiatrist gave him Wellbutrin and suggested talk therapy. Wellbutrin is an amazing anti-depressant, but it is not recommended for people with anxiety. I could not understand why he was prescribed it, because my bf’s primary complaints are depression and anxiety. Wellbutrin turned out to be a nightmare. One night in particular he exploded, was violently destructive of my things and we got in a huge fight. He seemed to have lost his mind and I know one reason was that he drank on it. The other is that he has anxiety. The fight was not based on anything, he basically just got angry at me. Luckily he stopped taking it but is now back to no medication or treatment. We both agree that he should see someone else but getting him to do something is like pulling teeth. And if I remind him too often, or encourage him too enthusiastically, he accuses me of trying to control him, nag him, or tell him what to do. It has now been three months and he is still waiting for an email from his mother with the name of his former doctor.
He is absolutely certain he does not have sz. However, when I look at his symptoms, it seems obvious to me. Of course I am not a med professional so I wanted to share his symptoms and see what someone else thinks who is more familiar.
First, his dad has “bi-polar”. From what I read bp is extremely similar to sz except that in sz there are delusions and possible hallucinations. Well, I found out within the last 6 months that his dad had a big psychotic episode. He had to be hospitalized because he was thought the government was after him, spying on him, etc. Even so, his dad apparently told my bf that he has bp, and that episode was only because he was sleep deprived. His dad is on heavy medication, but I have yet to find out what he takes. The only reason this is relevant is because of the increased risk of bp or sz if a parent has it.
My bf’s symptoms:
Self-reported anxiety. General anxiety, like if we are sitting down somewhere he will get antsy and have to walk around. If we are sitting watching a movie, he sometimes will fidget with his hands. If he is sitting down, he might start bouncing his leg and need to get out on a walk. He sometimes paces in circles. He does not seem to be in a bad mood when he does this, just that he has extra energy to get out.
Social anxiety. When we go out in public, say to a bar, he seems very distracted, sometimes unable to keep looking at me. He has a hard time staying on the conversation. I ask him whats’ going on, and he tells me that he thinks other people are looking at him, laughing. He thinks that at work people talk about him behind his back, and don’t like him.
He doesn’t hang out with his friends very often. He has just a few friends in the first place, which in my opinion is just fine, as long as you’re good friends with them. But when I suggest he see what someone’s up to, he just doesn’t feel like it. I think he’s happier when he’s with friends, but somehow lacks the motivation to try to hang out with them.
Self-reported depression. Sometimes he just says he’s not happy but doesn’t know why. He doesn’t sit around and cry or anything I think he just feels empty in a way.
He says he has negative thoughts sometimes. I’m going to try to figure out if these are more like voices or thoughts.
He has a history of cutting himself, and has been suicidal. He can be very reactive to us getting in a fight.
He is highly sensitive to any criticism. He will literally freak out if I am upset with him for anything. If I make any minor criticism, like mention he has left trash in his car, he will get super upset and storm away.
Low motivation. He will prefer to sit on the couch and watch shows or play video games.
He is nice to me but doesn’t really do much for me if it’s something he doesn’t also want to do. Like I have a really hard time getting a foot massage from him. Even if I convince him to do it, it literally has no appeal to him. Like when I am giving someone a foot massage or head scratch or something, I might not want to start it because I’m feeling lazy, but if I do start it, I sort of enjoy it as well because I’m making them feel good. He literally hates every second of it, and hardly puts any effort into it and then quits as soon as possible. I mean this in and of itself is not a huge problem, I could go get a foot massage I guess. It’s just weird to me that he doesn’t seem to get any enjoyment out of making me feel good.
He does like doing nice things, like cooking, or buying me food I like. But he always eats the food too, and I think he likes doing it because he’s proud of it. He bought me my new favorite ice cream recently which was nice, but then when he discovered that he really liked it after trying it, he expected me to let him have it instead. When I said no, I really like it, he still tried to convince me to let him have it. When he gave up on me giving him the whole thing, he kept asking for bites. After like the third bite I was like buzz off! There were three other things of ice cream in the freezer, you got me this one, let me eat it. Another example, he expects me to let him have the chocolate I got from my parents recently because I was taking a long time to eat it. I had four chocolate bars total, and I gave him two of them, and then let him have a few pieces of one of the bars I kept. Then he still wants me to give him more. He said “you won’t let me have any”. I said I gave him more than half. I wonder if it has to do with a brain imbalance, like too much dopamine and not enough prolactin. Apparently sz get a bigger dopamine release than controls from taking amphetamines (and maybe from ice cream and other things too?). Eating sugar and ice cream gives a dopamine high. So does sex which he always wants. It’s also related to anxiety, aggression, impulsive sensation-seeking, compulsions. If we haven’t had sex for two days he gets really aggressive and angry, and irrational. Then afterwards he turns into his normal self again. He doesn’t gamble or smoke cigs but he has a strong desire for both. He loves drinking although doesn’t get drunk (its 11:48 am and he’s drinking a beer).
Very distractible. It takes him such a long time to do anything. Yesterday for example he was going to go on a walk but it took him two hours to get ready and leave.
He is very self-conscious. He thinks that “there is something wrong with his eyes”. The first time he told me this he was practically in tears. He was so self-conscious about it. He has also had feelings that “he looks weird” and “is gross.” I told him how we all feel that way sometimes. But this is persistent and I don’t really understand why he feels this way.
You would think that someone so self-conscious would be super vigilant about taking care of their hygiene. However, I often have to remind him or insist he brush his teeth or hair. Lately he’s been really good about doing it on his own. But it puzzles me how he doesn’t see the need for it himself, it’s almost that he’s just doing it because he knows he’s suppose to, but doesn’t feel the urge to do it for the sake of it.
He had the idea that his feet smell. This was a persistent thing that has been subsiding lately. I was so confused because his feet don’t smell. His shoes don’t smell. I smelled them up close and they just smell like shoes – the leather or cloth they’re made of. He has like 7 pairs he rotates. He started putting them in plastic bags in the closet, to prevent the smell from making the closet smell. This whole obsession was really freaking me out, just because the fact that they didn’t smell. So I insisted that he would not put them in bags and threw them out. For four months I’ve been insisting they don’t smell. I’m wondering if my insistence has helped his obsession subside. I am wondering if it was/is some sort of smell/olfactory hallucination?
Since we started dating two years ago, he has consistently had delusions I’m cheating. He has gone so far as to see a text on my phone that was never there. I forget the name, but he had a name that he saw on my phone. For example, he was like “who is Steve?” I was like I don’t know? And then he finally said that he saw the text from him. Well I don’t know anyone named Steve. Once or twice he has thought I was hiding someone in the closet when he got home. Most of the time I think he is aware that this is just a worry of his and it’s not true. But the feeling still persists with him, and I feel like he continued to have trouble shaking the feeling that I’m talking to someone else.
His legs twitch in his sleep sometimes. Like major jerking, as if he’s kicking something. He laughs in his sleep sometimes. I’ve seen him sleepwalk a few times. One time he opened the door to go outside. The next morning he didn’t remember it.
He laughs to himself sometimes when he’s awake too. I think everyone does this sometimes, but he does it fairly often, like once a day maybe? I asked what he’s laughing at and he was just like “oh I couldn’t explain it.” Then he was finally like “I had an image of my old cat sitting in a funny way.” Another time recently, he was laughing and then told me it was because a sign said “Beer Snacks and Soda.” He said it in a country accent. I guess it could be funny if you were in a punchy mood. It’s just that a lot of times he’ll start laughing at stuff that isn’t really all that funny. Then sometimes when I think somethings funny he doesn’t. Like the movie box trolls, the guy is eating the cheese and blowing up from an allergic reaction. It’s an animation and it’s definitely funny. But he doesn’t laugh at all. I asked if he didn’t think it’s funny and he’s like I guess so. Other times we’re talking about something that I think is funny, and when he doesn’t laugh when is expected I try to explain why it’s funny. Then he gives some sort of fake laughter. I’ll have to take note of some other examples. Basically it’s strange to me that things that most people think are funny enough to laugh a little, in conversation or a movie, usually don’t make him laugh. But he thinks some things are super funny, goofy things like him talking in an accent, or a cat online.
Also in that animation movie, he sad he was getting tripped out by one of the character’s faces. They were a little weird/trippy, but I think he even got a little scared by it. I’ve read that sz makes you use bottom-up processing when it comes to faces more than top-down. This can make you less likely to see something as a face. I wonder if that’s related to him getting freaked out by the animation faces. He loves scary movies and horror movies though. He seems to not be scared by them at all. He thinks they’re cool and entertaining. When I’m scared he’s always surprised and is like “it’s just a movie!”. He doesn’t even look away from gruesome scenes, or make a gross face. If anything maybe he would laugh at it in an isn’t that awesome and sick way. I guess he could be used to them by now considering how many movies like that he’s watched. But I think it’s surprising that he doesn’t seem grossed out at all, or scared by the movies. I just looked online and it says “gore watchers typically had low empathy, high sensation seeking, and [among males only] a strong identification with the killer”. It seems that my bf is low on empathy in some ways, so maybe that’s related.
He mutters under his breath a lot.
Sometimes he talks gibberish. It’s funny so I play along. I don’t think this is a symptom? He doesn’t think the words mean something, he just thinks it’s fun to sound like he’s talking in a foreign language.
He is really confusing to listen to a lot of times. He will just leave out some important piece of the story which leaves me confused as to what he is saying. Or just say “he” without first telling me who he’s talking about. Then on top of that he gets really irritated when I don’t understand his story. I end up asking a lot of questions to figure it out. I guess at what’s going on. This is annoying to him, because he thinks he’s explaining it clearly. Then when I finally figure out what he’s saying, I try to explain what part he left out. He seems to not get that he left it out, or why I didn’t understand it anyways.
He hardly ever wants to have conversations. Unless he’s telling me a story about his day, he pretty much will just listen in a conversation, or answer yes or no. Whereas most people would give a lengthy answer to keep the conversation going, he’ll just give a one word answer. I’ve tried to explain that in conversations, you might try to add something interesting, or ask a related question. I even went so far as to do conversation practice, where I would say something about a topic. Then I told him to say something he knew about the topic, and follow it up with a new question, or related question. He sort of was able to do it, but didn’t really seem to get the point of it.
He really struggled in school, especially in writing. Basically it is the same situation as a conversation, just in the form of writing.
He pretty much avoids all social situations, but in the rare situations we have been in a group convo, he is slightly confusing. And you know, everyone says something that’s slightly unclear sometimes, and I think others think this is the case with whatever he said. Except I know that almost everything he says is slightly unclear. He forgets things easily, especially when in a noisy social situation. We were at the bar, and I got the beer special. I told him that the beer special was dark because he doesn’t really like dark beer. When he came back from the bar, he was carrying the special, and really bummed that it was dark and he didn’t like it. He said he forgot I had told him the special was dark. I don’t understand how he could have forgotten that, I had talked about it in length (and he was paying attention) less than five minutes before.
Sometimes he has thought he said something but didn’t say anything at all, and I think he heard himself say it when in fact he didn’t say it out loud.
He gets angry often out of nowhere and doesn’t know why. He will say he doesn’t know why he’s irritated or mad at me. Sometimes he will recall what happened incorrectly. For example, I was lying on him watching a movie. He was repeatedly moving his hand but it was in front of my face so I couldn’t see. I gently moved his hand to the side. He put it back in front of my face. I gently moved it. Then he freaks out and throws me off of him. I was obviously upset. He tells me: you were being really mean, and I thought you were going to hit me so that’s why I moved like that. Completely made up story. He finally admitted to what actually happened, and apologized.
He is rather superstitious, and knocks on wood for a lot of things. He’s afraid of getting jinxed. Like I said something about car accidents before he was going to drive somewhere and he thought this might jinx him.
He has a tendency to want to blame me for a lot of things. Like if he doesn’t do something, it might be my fault because I reminded him to do it, which made him really not want to do it. He usually doesn’t seriously blame me as in mad at me, but he just sort of tends to blame others for influencing him. Sometimes he’s serious about blaming me though. One time we were in a clothing store and he asked what I thought about a shirt. I said it was ok, nothing great in my opinion. He put it back. When we left the store, he was mad. Finally he explained that I had told him not to get the shirt but he had wanted to. I went over what actually happened, and how he had asked for my opinion. I said if he wanted it he should go back and get it. He ended up not being mad anymore even though he didn’t end up going back to get the shirt.
He gets kind of thrilled about coincidences. He seems to find meager coincidences and feel like they are unusual coincidences. Like once we were talking about a car maker and then later that day that a car of that brand was driving in front of us. It was a common brand, but he seemed to think this was a coincidence worth commenting on. Like, he has the same reaction to a meager coincidence as most people would have about a major coincidence. And for some reason it makes him supremely delighted.
You would think after all of this that he is awful and grouchy, irritable depressed seeming person. But he’s anything but. He’s usually in a really good mood. He’s really goofy and playful. This is why I had a hard time believing he’s depressed, because usually he seems really happy. But then randomly he will get really irritated or in a bad mood, or mad at me for something. Lately he’s been doing a lot better than he was about 4 months ago.
He is appalled at the idea of having sz and thinks it’s impossible. Even though I explained it’s a continuum disorder, and it’s very similar to bp, and nothing like what they show in the movies. He doesn’t even really want to think he has bp. He just thinks he is depressed and has anxiety. However, it seems to me that he has some thought disorganization symptoms and delusions of jealousy and paranoia, and it seems possible to me that the “negative thoughts” he has could be close to hearing voices in his head, and that him “seeing a face” in something is bordering on visual hallucinating.
Everything has been going really well recently, with minor incidents like fighting. Everything I described still goes on but doesn’t really affect us much. But in the past, things have been going really well and then there will be a month or so where all of a sudden things are not going well – more stress, anxiety, upset, fighting, sleep walking, and everything that is weird is exaggerated.
So, what does this sound like to you? As far as sz goes, his symptoms seem mild, or prodromal, or that he is just at risk for it. Or does anyone think something else is likely?
Also, what is the best way to get him to see someone? Basically I’ve just been saying how I think he should find someone to see for his depression and anxiety, and making sure that person is qualified to work with people with sz and bp. However the last doctor prescribed him Wellbutrin after talking to him for 15 min which was ridiculous and irresponsible and ended up a disaster with my property getting destroyed in a fit of rage, that was definitely brought on by Wellbutrin combining with his anxiety (and alcohol). Because of these bad experiences, he’s starting to hate doctors which is definitely not good. So, what gives, with these doctors? How can I find a good one?
