I don't know if I can take it anymore

First, thank you for reading this.

This is the first time i've reached out for help regarding my boyfriend, we'll call him Sam. Sam believes he's suffering from the beginning stages of schizophrenia, and definitely suffering from severe anxiety/manic disorder. The catch is, he's never been diagnosed or seen a therapist for this before. He's afraid of seeing a therapist.

We've been dating for about 4 years now, and i'm not sure if he's better or worse. He has social phobias, panic attacks, memory faults and strange behavior that all tie into his mental state. At the same time, he is extremely intelligent. He will read half a novel in a day, and retain 90% of everything he's learned and read. The problem with this is, when we have arguments, he'll recreate what he said, having 'memory faults'.

For example, he'll be upset and say "This REALLY pisses me off!" we continue to argue, then when I say "You said it pissed you off" he'll reply with "No, you must have misheard, I said I was upset". It's gotten so bad to the point where now I have to record our arguments and play it back just to hear what actually happened. He's very good at making me question my own memory and (now) sanity.

We've made plans to get married, but i'm so unhappy with him now that I constantly question the relationship. He's unemployed and is determined to go to school full time so he can get a good job in Japan and "leave this ******* country for good!" I'm supporting both of us, and I believe i'm developing some depression/anxiety myself because it's so stressful working and supporting someone with an attitude/disorder like that.

There's more information of course, but if anyone can give me advice about how to deal with someone who doesn't want to be helped... i'm all ears. Thanks

Have you told him you're questioning the relationship?

I think it would be very hard to "make" him seek help, and unless he was a serious and immediate danger to himself or someone close, outside agencies are very unlikely to get involved without his agreement. However, if he values you, that push might be enough to get him moving.

But you'd need to be prepared for what happens if it isn't enough, if he'd rather watch you leave than seek help. To me, that would say that there's not much of a relationship there, that he's unwilling or unable to assess his own contribution to the breakdown, and that you would be doing the right thing by moving on. It probably wouldn't feel like that to you, though.

Relationships are a balance, and there are many times when one partner may be supporting another, financially, emotionally or physically. But both should feel like this is a gain overall for the relationship, like it's making it stronger in the long-term, rather than being either one being "used". It doesn't seem like there's a balance for you in this.

That makes sense. Balance is necessary for happiness for both people. To give you more detail, i'll extend on the 'leaving the country' problem... The other night we had a discussion about moving to Japan. I tried to keep an open mind about the idea, but in my heart I miss my family and I want to move closer to them. Right now we live 6 hours away. In Japan? I'd be 15 hours away.

First, he's asked me not to tell anyone about us moving anywhere. Period. Once he overheard me talking to my mom about hypothetically moving somewhere like Ireland, and he felt betrayed that I broke his trust, and was very upset. I told him I may not be able to keep the promise, and he's told me he would be furious if he heard me talk to people about it. I'm the kind of person who likes to get input and advice from others... asking me to do this feels like suffocation.

Second, he clarified that if he had the chance to leave the country right now, he would leave in a heartbeat. Japan has is one of the world's safest countries, has some of the best healthcare, all these statistics are things that attract him. He thinks the US is going to go into an economic collapse in a few years and he wants to get out while he can. He also hates the way our country is run, the way our society behaves, alot of other things. He's stated that if I don't choose to go with him, I would be left behind.

Third of all, like I just mentioned, he wants to leave the US as soon as possible. He's working for his bachelor's degree right now so he can get a relocation offer overseas. When we were discussing the problem, he said there is absolutely no way he will stay here. That's what i'm supporting, and that's the future I have to look forward to.

Now, I will come home and he'll have dinner cooking. He does a load of laundry to help keep the house clean. He puts on a movie that we can watch together while we eat, and we snuggle in the same bed at night. I do love him, but should I keep living in this state of suspension? As far as I understand, i'm going to be miserable both ways - I either support him and move to Japan against my wants and happiness, or break up with him and try to pick myself up after 4 years.

I'm so very lost.

That's an awful choice to think about. Have you talked to him about how homesick you'd be? Are there other options that could be a "practice" run, for a year, perhaps? Canada's the usual one. Has he been to Japan before? It has some attractive features, but it can also be quite unfriendly to foreigners. I don't mean to offend Japanese people, the UK is the same. I think most countries are, to some extent. But particularly where there's a such a large language and culture difference, it's unlikely to meet his idealised dreams. And his mental health issues are going to make it even more difficult to settle down.

It also seems to me there are some major control/trust issues in your relationship, if he wants to do all this in secrecy and not involve anyone else. It isn't natural for most people to NOT discuss such a big change with friends and family. To be fair, I have done exactly that myself, so I can understand his impulse to that extent. But most people would talk it through with those they are close to first. And I would never have forbidden someone else to talk about it.

Given that he himself believes that he has some mental issues, I think I would probably refuse to discuss a move until he started seeing a therapist, on the grounds that I would not want to be stranded in a strange country with someone with problems that are very likely to be worse there. You mentioned in your first post that he's afraid of seeing a therapist. Is that a trust issue again? Or afraid of what they might say is wrong?

His reponse to therapy is to just man up and deal with it himself. He's had even worse anxiety/panic attack issues in the past, and he's gotten over his panic attacks "with sheer willpower". He also isn't very good at opening up his feelings. He's been hurt so many times in his life, from his family, his friends, that he's learned to be stubborn and closed off. He opens up to a select few people close to him, including me, and trust is probably a constant struggle for him even then.

He accepts the idea of therapy, but puts it off and doesn't bother to make an appointment with the free neighborhood clinic. He says since we have options, he "doesn't want to use up their resources". Options as in, if we get married, he goes under my health insurance. Before he considers therapy he wants us to be insured. He would rather have that than find a full-time job with benefits. (If he did go to work full time, he couldn't keep up with school full time, thus his dream of graduating and leaving the country is even farther away)

Now i'm considering sitting him down to tell him I want to go to couple's counseling. I want us to work, please believe me. He has so much potential to be happy, I want to help him find that. If we go to couple's counseling, maybe he wont feel like he has to go one on one with someone who "shouldn't be in our business in the first place".

We did consider Canada. That was actually our first option a few months ago. I was warming up to the idea, but then he suddenly decided he doesn't want to go to any western/european country, and now Canada is absolutely out of the question. (again, I tried to talk to him about it, he got angry because I brought it up)

I have many issues myself, such as missing my family. I want to move back home. I want to spend time with my mom and dad, my grandparents, my brother, my friends, all these people I have there. When I mentioned I wanted to move back to Wisconsin, he says we can move there for a couple years until he graduates, and that's it. He never wants to move back to the states again. When we discuss the idea of moving to Wisconsin, he thinks i'm dependent on them, and says that it's the guilt of moving out that makes me want to go back. I reassure him that it's love, that I am much more of a family person than he is and want to be around them, and I even genuinely considered whether I had a mental issue here... but wanting to be around your family isn't abnormal. I've been away from them for over 4 years without desperately moving back or constantly begging for money. I'm confident each day that what I feel is love to be with my family, but I'm not sure what it'll take to get him to believe me.

Couples counselling seems like a reasonable approach, but I'd be really cautious if I were you about making this "your" problem, if it is mostly or entirely on his side. I appreciate you can't change him and you can change yourself, but there's a danger you'll bend yourself out of shape trying to fit around him.

In terms of him believing you about wanting to be with your family, if that isn't how he feels about his own family, I'm not sure he'd ever be able to understand. You do not have a mental issue there [if you did, some sort of over-dependence, you'd probably wouldn't have left them, certainly not for so long.]

If his problems can be solved by "manning up", then they either aren't serious, or he isn't genuinely dealing with them, just coping with some of the immediate symptoms. From what you've said so far, I suspect the latter. "Using up resources" is a rather lame excuse, if you don't mind me observing. If there's nothing wrong with him, they'll do an assessment and then he won't need to go back. Waiting until you are married is, again if you don't mind me saying, an awful idea. If he needs it at all, [and it really seems like he does] he needs to work with what's on offer, and stop bargaining and procrastinating. He's REALLY lucky to be in this relationship with someone emotionally and financially supporting him. It seems a little like he's starting to take that for granted?

Is he starting to take it for granted? Yes. It feels like it. I've pointed it out a few times before, and he shuts down. He has acknowledged it once or twice and said he did take it for granted and would try to be better. As any cycle goes, he improved himself a little while, then falls short again. A relationship takes two to build, so I feel partially responsible, but I can't control his actions or how he feels.

After talking out the situation here and trying to get my thoughts and feelings clear, I believe I know what I want to do. This winter, when we get our refund checks, i'll tell him I want to move back to Wisconsin. I wont go with him to Japan. I've been afraid of making my own decision because i'm here without my friends and family close, and I don't know what will happen with my cats. The bottom line is i'm not ready to start a new life in another country. Even if things here get bad, I would rather stay and fight to make things better here than escape somewhere else.

Other countries may think Americans are ignorant but i'd rather be that one person to help make things better. I have no idea what to do though. The reason i'd wait for our refund checks is because we're completely broke. I don't want to leave him stranded either, so he would at least have something to fall back on himself. I'm not truly happy with him. He's a good guy, and he has many problems to go through, but he's making his own decisions to deal with it and he wants me to support him regardless of my own feelings. I'm so scared, I don't know what to do, or how to do this. I have to wait until February to tell him any of this, otherwise he may threaten to kick me out like he has once before. On top of that, we're broke. I have $8 in my bank account for the next two weeks, so hopefully we have enough gas and groceries to last.

I think above all, I want to know i'm making the right decision. What i've described here is just the tip of the iceberg, so thank you very much for your advice. I just want to be happy.

Things will only get bad in the US for four years at worst, I simply can't believe it would go on longer than that. And it makes sense to me to be part of the solution. It's such a big country, with so many points of view, that it's always going to be hard to stay in harmony. Small countries aren't any simpler, though [thumping my head over my own government right now.] And as I said before, I think he'll find Japan very hard in other ways.

I think your plan seems sensible [he might come round to therapy, or a new idea for the future in that time] but would also suggest if you can start tucking a little money aside when you get paid, that gives you more independence if things break down earlier than that. I hope they won't, of course, and in that case you just have a nest egg for whatever you choose to do next, whether that's with him or just you.

But, re. being kicked out, how come he has that power over you, if you are the one earning?

You keep on looking after yourself. You've got all the common sense you need, I really wish you all the best, and am hoping for a best possible solution to all this still.

Radeona wrote:He has social phobias, panic attacks, memory faults and strange behavior that all tie into his mental state. At the same time, he is extremely intelligent. He will read half a novel in a day, and retain 90% of everything he's learned and read. The problem with this is, when we have arguments, he'll recreate what he said, having 'memory faults'.

This doesn't make sense with schizophrenia. If memory faults or incorrect recollection are associated with interpersonal issues, but not with e.g. reading a novel - it sounds very psychological. Also social phobia is usually rooted in how people relate to themselves and others...

I went to the dr and asked them to run full physical tests because I just couldn't believe what I was experiencing was fully psychological, I thought there must be some sort of physical cause, until the results came back stating i wasn't just ok I was extremely healthy. That helped me a lot with accepting the causes in my case, but i did a lot of looking around for other "more plausible" causes.

How long has he been experiencing the symptoms he's worried about being prior to schizophrenia? 4 Years would be abnormally long for a psychotic prodrome. Academic studies have quoted much shorter averages, e.g. 21 weeks, and prodromal phases have now been accepted as prior to all psychoses, not just schizophrenia.

In the UK, they have "early intervention in psychosis teams" which normally work with people up to about the age of 35, with the goal of permanent recovery from psychosis and gradual return to a functional life. They're not based mainly on taking medication, instead they're based on a lot more practical helpful interventions.

The results and attitudes suggest psychosis can be pulled back from, and is not some sort of "life sentence diagnosis". I've seen a lot of people who "made it back to normality" with the right support, and people's diagnoses gradually having pieces removed from them that are technically "supposed" to be permanent like schizophrenia etc. So even psychosis can be responsive.

The excuses about not wanting to waste time remind me a lot of my own excuses. I make a lot of excuses, when it comes down to it they're all various types of ambivalence coming through, and in my experience this supports that much of the problem is psychological too.

Radeona wrote:There's more information of course, but if anyone can give me advice about how to deal with someone who doesn't want to be helped... i'm all ears. Thanks

I won't tell you what to do, just bring up a few points -

It depends what you're trying to achieve? You could give him an ultimatum if that's what you mean, but if he doesn't take it and your objective is just trying to persuade him to get help, it will have backfired on you and he'll be left feeling let down.

If its affecting or placing limitations on your relationship, you could tell him that truth, and point out that without help, there are some things you may not be able to have together, which is also you showing him an existing ultimatum and telling him to get help, but without trying to manipulate his choices if your immediate intention isn't to split up.

It takes time for people to be ready to get help, in my experience it comes in stages, and is about getting others to help you help yourself. You could also explain to him you're willing to help him get help when he's ready to makes that choice.

Yeah this derailed a little bit from his mental condition... but you're right, now that I think about it, he may not have the first signs of schizophrenia, just severe anxiety and fears that he may have it. He started smoking weed when he was in his teens, and since then he started to get severe anxiety and panic attacks. When he has these severe anxiety episodes, he's completely closed off. He doesn't respond to me and will forget entire conversations we have. He doesn't know how to handle crisis situations calmly, such as when we couldn't afford rent once... he was furious and it took awhile for him to calm down. We've been to the hospital a few times when he thought he was having a heart attack, and wasn't. He doesn't exercise at all (not even short walks) because he doesn't want his heart rate to increase. He thinks therapy will help but isn't comfortable with actually going... The severe issues haven't happened in a long time, but i'm wondering if that's because he thinks we have a set plan to leave this country. It could be the catalyst for his self-esteem and stability right now. I agree too... you can't go anywhere and be happy if you're not happy with yourself.

I'm majoring in Psychology and I wish to become a Clinical Psychologist one day. I see him as my sort-of first patient, and because I love him, I want to help him more than anything. But because of the things that happened in the past, it's effected how I feel, and now the whole 'moving to Japan' thing is the final straw. Like I said, I told him I would try it for a year, but now I want to move back to my family. I feel terrible that I led him on like that.

The worst thing is, even if he did get better, I don't know if he would be the person i'd want to be with the rest of my life. Isn't that something you'd want to be more than only 50% sure of? This all happened after years of dating, so I guess that's just life.