Potential first time episode of pyschosis?

Hello there,
I am new to this community, and I’ve been trying to do research to help my partner, though there seems to be a lot of nuance in the world of psychosis and symptoms. We’re both close to our 30s now, and I want to be able to confidently help him.

He’s had some serious issues with paranoia in the past, largely due to CPTSD - he had a truly nightmarish childhood. Several years back, when we were still living with my parents, he used to claim to hear the sounds of people having intercourse in the room above us. I didn’t think much of it at the time, since it was a real possibility. Years after, he had a few “episodes” where he adamantly believed that I had been having an affair or cheating on him in some way. He would be stubborn about this belief for a couple of hours, and afterwards we would talk and he would apologize. We attributed these outbursts as a culmination of stress and insecurity (he does not work) in our relationship, and we haven’t had an incident since. It’s been years since the last one.

Lately though, he has been petrified in the evenings. He will be up late with terror that he can hear one of the neighbours being sexually assaulted. A few nights ago he was so shaken with fear and so sure of what he was hearing that he called the police to do a wellness check in the neighbourhood.
The trouble is, this fear has been persisting almost every night for the past 2 weeks. I cannot hear any of what he is claiming to hear. He has taken recordings and tried to point out where he is hearing screaming or cries for help, but it simply is not there for me. He has admitted a few times that there’s a possibility that his hyper-vigilance has caused him to confuse the noise of the vents in the house for voices, but I don’t think he really believes that.

Each night he is up with worry deep into the early morning hours, and now he is convinced that the “perpetrator” is going to break into our home to scare us for calling the police.
I woke up this morning to the doors lightly barricaded. He says he can hear their voices so clearly that he doesn’t think he’s just “hearing things,” and I think he’s terrified of doing nothing in case what he’s hearing is real. His justification is also that, because he isn’t constantly hearing voices (only at night) that he must not be “going crazy.”

When he called the police, he was sweating, shaking, and absolutely wild with fear. He told the police that the neighbours could hear us, and that’s why he was whispering into the phone. It hurt so much to see him so terrified, he was practically babbling. I’ve never seen him that way before and it scared me.

During the day he seems mostly fine, but once we get into the evening it starts to change. We’ll be watching something relaxing on TV and he will periodically mute it to listen for whatever he can hear happening outside.

I can never hear what he’s hearing. Even going outside, I can’t. He says that he can only hear it because of the vibrations of the noise going through the walls of the house. He keeps assuring me that he won’t let anything happen to me or the pets, and I keep telling him nothing will, and that we are safe.

I’m not sure what my next steps should be. He really doesn’t want to go to his doctor, and I think a lot of that stems from the fear that he has whatever his mother had when he was younger, or that what she did to him might have permanently “damaged” him. It’s territory that I have a hard time navigating, and I want to convince him to speak to his doctor without offending him or losing his trust. He was already so hurt when I initially implied that the source of what he’s hearing might not be really what’s happening.

Any help or support is greatly appreciated. I just really don’t know what to do. I’m ordering some multivitamins and going to make sure we get a nice walk outside each day, but outside of these basic things I’m at a loss…

Please get him to see a professional, have them do an evaluation, he is obviously in some distress and could benefit from some professional care. God bless you.

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I agree. You need to get him to a medical professional to get him assessed. It is a little odd how it seems to be manifesting in the evenings. I think he needs a full check up. That kind of behavioural change could indicate something other than an episode of psychosis due to mental illness. There maybe be some other factor in play.

Agree with the others. Please get a copy of I Am Not Sick, I Don’t Need Help! How to Help Someone Accept Treatment

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I would re-emphasise that this might not be a schizophrenia or mental health related condition. Behaviour like this can be related to other serious health conditions. I did not want to cause a scare, but to be explicit, it is not impossible to exhibit this kind of behaviour when suffering from a tumour. There is no hard and fast rule as to how schizophrenia manifests, and others may have a different opinion, but it seems a little unusual that he is not having symptoms during the day. With the onset of mania and psychosis you would tend to see them fall out of routines and exhibit strange behaviour around the clock. Maybe it just comes down to him having a fear of the night.

Is he consistently having problems in the evening? Is there any time in the last few weeks he has not had the problem in the evening? Does he ever have the problem during the day? Is there any food or medication he has every evening that you could try cutting out and seeing if there is any difference?

If you can not get him to the doctor I would see if you can get a doctor to come out to see him.

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Schizophrenia can be insidious, the slow advancement tends to peak in a person’s late 20’s - early 30’s.

Paranoia can present as the first notable symptom. Have you met his family?

As @caregiver1 mentioned, get a copy of Dr Amador’s book “I Am Not Sick, I Don’t Need Help!” Don’t tell him he is hearing things, he may start to feel paranoid toward you and paranoia is a difficult wall to dismantle.