Convincing Him to Seek Help for Psychosis
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Q:  Convincing Him to Seek Help for Psychosis


My husband has bipolar disorder, which he feels comfortable acknowledging. What he refuses to accept, however, is that he seems to be having psychotic episodes. He has a textbook case of delusional parasitosis that causes him to stay in the bathroom for over 8 hours a day, washing himself. He digs at his skin, burns himself & occasionally hears voices. I am concerned for his quality of life as well as the future of our marriage. But when I try to encourage him to seek help for the psychosis, he goes into a black rage & says that I am accusing him of insanity. Please tell me how to convince him that he desperately needs help.
Thank you.


Dear Maggie --
Eight hours a day in the bathroom is not quality of life in anybody's book, no matter what one is doing in there. Would he reject his psychiatrist, if he has one, were the psychiatrist to comment on this problem? (e.g. if you were to call the psychiatrist and leave a voice mail -- no release of information is required for a doctor to take information -- describing this problem and wondering if it could be incorporated into the treatment).

Or, if he doesn't have a psychiatrist, maybe he could get started with one, targeting just the bipolar disorder he acknowledges, then pursue the above strategy over time?

You must wonder if there's some connection between the bipolar disorder and the parasite-delusion (or I wonder if this could be some variant of "body dysmorphic disorder", which you might check out for comparison). I would wonder that too and nurture some hope that treating the bipolar disorder might target the skin issue indirectly. Good luck with all this.

Dr. Phelps
 

Published November, 2003

 

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