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My fiancÚ is experiencing a month long psychotic episode. Help!

About a month ago my fianc of two years, partner of three years, went into a psychotic episode and has yet to come out of it with treatment. He's currently in his third hospital stay, on two antipsychotics and lithium. A month ago he was a grounded college senior about to graduate, and now he's delusional, erratic, paranoid, aggitated, and can't sleep more than three hours with medication.

I've even witness him talking to no one for at least 15 minutes. The doctors asked him if he's hearing things and he says no. His sentences tend not to follow the normal pattern and end up going about three different directions. His thoughts are so jumbled he cannot even remember my major, and has told people all about the hobbies I enjoy only in his reality.

It seems like doctors are leaning towards a bipolar diagnosis and treating him as such. He's shown no improvement and it looks like he's got a couple of months to go in the hospital. Right before this all happened, he was on a six month heavy marijuana binge he had no control over. Was that depression? Or could the "Mania" be drug induced psychosis? His brother is worried about schizophrenia. Whatever it is, it's lasted a month even with medications and long hospital stays. Is he going to come out of it or do some people just lose their minds forever? CT scan was normal, and the toxicology test was only positive for THC.
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replied June 10th, 2012
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Honestly, I think a month is too long to call it an 'episode,' there's clearly something else going on there; after reading your post, I'd be thinking about schizophrenia too. The lithium should help with mania (it is the front line stand-by), but those just might not be the right antipsychotics for him, especially when he doesn't seem to be responding to the ones he's currently on. Do you know if they have tried different antipsychotics? I'm guessing they're working with atypicals, but I know some people who have only responded well to the old-school antipsychotics (I knew a girl who saw giant glass spiders shooting laser beams, nothing touched her hallucinations until they tried thorazine).

You know, the more I think about it, the more it sounds like schizophrenia--and I should know, as that happens to be my disorder. Bipolar can often show psychotic symptoms, true, but it's not uncommon for bipolar to be misdiagnosed as schizophrenia, and the other way around, too.

As for the marijuana, there's no real evidence that it causes psychiatric disorders, but there is some that indicates it can exacerbate what's already there. So yeah, that could have been a trigger, but only if he had a predisposition to to whatever his disorder actually is.

There is hope--proper meds and therapy can make a HUGE difference. And sadly, yes, some people do snap and never come back. I think a month is way to early to be thinking along those lines, though.

Hope things get better for you. Post back if you want to talk.
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