Emotional Control Issues and Violence in Relationships

Q: Emotional Control Issues and Violence in Relationships

Hello： It is common for individuals with mental illness to be reluctant to seek medical treatment, and this is a frequent occurrence. <br>Based on your description of your boyfriend's situation, it seems he is experiencing early signs of social withdrawal and low mood, which may

Emotional regulation issues with tendencies towards violence?

My boyfriend is 40 years old and works in the insurance industry.
When we first started dating, he was a polite, introverted person who appeared graceful to outsiders, had a good temper, and rarely became impatient or blamed others when faced with problems.
However, after changing jobs (still in sales), he struggled at work, and after a year, he returned to the insurance industry.
He has become lazy and has not gone to work, staying at home for almost two years now.
Whenever I urge him to go to work or handle client matters, he always procrastinates.
He also dislikes going out, prefers to stay at home playing video games, and does not like to shower, often only bathing once a week, with 2-3 days between showers being common.
Even when I invite him out for meals, he often refuses, saying, "I don't want to go out, I'm afraid to go out, I don't like facing crowds." Once he is in a crowded place, he becomes anxious and wants to leave immediately.
I feel that he is unwell.
While it doesn't seem like he has depression—he doesn't talk much at home and prefers to be alone in a small space—when he does speak, he avoids negative comments and often encourages me to think positively.
Recently, his mood has worsened; he dislikes being nagged or even spoken to loudly.
During a few arguments where I raised my voice, he has become physically aggressive, and this behavior has escalated.
His temper is increasingly hard to control, and this morning, in front of his father, he smashed a table and told me not to scream or cry loudly.
He has been hitting and kicking, and if things don't go his way, he becomes irritable and throws things.
I accidentally discovered that my boyfriend received psychiatric treatment during his military service, and his diagnosis included "schizophrenia" with tendencies for hallucinations, as well as "emotional management issues" with tendencies for violence.
Since I found out about this, I have had a clearer understanding that my boyfriend may be ill.
However, he appears to function normally in daily life, interacting with others and resolving issues without apparent problems, although he does struggle to concentrate.
To outsiders, he doesn't seem sick.
I once suggested he see a psychiatrist, but he thought I was joking and refused (I didn't let him know that I discovered his schizophrenia diagnosis).
As far as I know, schizophrenia can improve with treatment during adolescence, but could my boyfriend's current condition still be related to schizophrenia? Is it possible that he has bipolar disorder? Additionally, he tends to be slow to react and somewhat oblivious, but when someone touches him in a way that feels threatening, he reacts with exaggerated defensive movements.
Doctor, just now he was nervously throwing things at home and even picked up a lighter to throw, which poses a life-threatening risk.
I don't know what to do.
How can I help him in this situation? If he is unwilling to see a doctor, are there other ways to assist him? Is he truly unwell?

Mita, 20~29 year old female. Ask Date: 2017/04/13

Dr. Zhang Fangrong reply Psychiatry

Hello: It is common for individuals with mental illness to be reluctant to seek medical treatment, and this is a frequent occurrence.
Based on your description of your boyfriend's situation, it seems he is experiencing early signs of social withdrawal and low mood, which may indicate issues related to depression.
His recent irritability and violent behavior could also suggest a worsening of depression.
Additionally, the possibility of a diagnosis of schizophrenia should be considered for evaluation and treatment, which can be entrusted to a physician.

The most challenging aspect currently is how to persuade your boyfriend to seek medical attention.
It is advisable to involve his family in encouraging him, using terms he can accept, such as psychological counseling, therapy, employment assessment, and training.
Prior to seeking medical help, it is also important to ensure your own safety to prevent any violent incidents.
If necessary, after an incident of violence or destruction, it is recommended to immediately contact the police or fire department for assistance, which can include escorting him to receive medical care (it is advisable to communicate with his family beforehand to reach a consensus on the escorting process).

Wishing you mental and physical health.

Chia Nan Psychiatric Hospital
General Psychiatry
Dr.
Fang-Rong Chang

Reply Date: 2017/04/13

More Info

It sounds like you are dealing with a very complex and concerning situation regarding your boyfriend's mental health and behavior. Based on the information you've provided, there are several key points to consider regarding his emotional control issues, potential mental health conditions, and the impact on your relationship.

Firstly, your boyfriend's behavior appears to have changed significantly over time, particularly after his transition to a new job and subsequent struggles with work. This shift could indicate underlying mental health issues, such as depression or anxiety, which are often exacerbated by stressors like job loss or dissatisfaction. His reluctance to leave the house, lack of personal hygiene, and withdrawal from social interactions are common signs of depression. Additionally, his increasing irritability and violent outbursts are concerning and suggest that he may be struggling with emotional regulation.

The history of mental health treatment you discovered, particularly the diagnosis of schizophrenia and issues with emotional control, raises significant red flags. Schizophrenia can manifest in various ways, including delusions, hallucinations, and disorganized thinking, but it can also lead to difficulties in managing emotions and interpersonal relationships. While schizophrenia is typically diagnosed in late adolescence or early adulthood, symptoms can persist or evolve over time, leading to challenges in daily functioning.

Your boyfriend's violent reactions, such as throwing objects and physical aggression, are alarming and indicate a potential risk not only to himself but also to you and others around him. This kind of behavior can stem from a variety of factors, including unresolved trauma, stress, or a mental health condition that affects impulse control. It's crucial to recognize that violence is never an acceptable response to frustration or anger, and it is essential to prioritize safety in your relationship.

Given the severity of the situation, it is vital to approach this matter with care. Here are some steps you might consider:
1. Encourage Professional Help: While you mentioned that he has previously rejected the idea of seeing a mental health professional, it is important to continue to encourage him to seek help. You might frame it as a way to improve his overall well-being rather than focusing solely on his violent behavior. Emphasize that mental health professionals can provide support and strategies to cope with stress and emotional challenges.

2. Safety First: If his behavior escalates to the point where you feel unsafe, it is crucial to prioritize your safety. This may mean removing yourself from the situation or seeking help from friends, family, or authorities if necessary.

3. Open Communication: Try to maintain open lines of communication with him. Express your concerns without being confrontational. Use "I" statements to share how his behavior affects you, such as "I feel scared when you throw things" rather than "You are violent."
4. Educate Yourself: Understanding mental health conditions can help you navigate this situation more effectively. Researching schizophrenia, bipolar disorder, and other related conditions can provide insight into what he might be experiencing.

5. Support Networks: Encourage him to engage in support groups or community resources that focus on mental health. Sometimes, hearing from others who have similar experiences can be beneficial.

6. Set Boundaries: It is essential to establish boundaries regarding acceptable behavior. Let him know that while you care for him, you cannot tolerate violence or aggression.

In conclusion, your boyfriend's situation is complex and requires careful consideration. While he may not fit neatly into a specific diagnosis, his behavior suggests that he is struggling with significant emotional and psychological challenges. Encouraging him to seek professional help, prioritizing safety, and maintaining open communication are critical steps in addressing these issues. Remember, you are not alone in this, and seeking support for yourself is equally important as you navigate this difficult situation.

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