How to Support a Partner with Paranoia and Mental Health Issues?

My girlfriend is exhibiting moderate symptoms of paranoid delusions (schizophrenia). How can I gently guide her towards seeking medical help?

I have been in a relationship with my girlfriend for over four years, but due to my studies abroad, I have been unable to closely monitor her mental state.
Recently, she has exhibited the following concerning behaviors:
- A month ago, she claimed to be bullied by several online users (on PTT) and that they hacked into her phone to monitor her.
- Three weeks ago, she began expressing feelings of being spied on through her phone's camera, believing that a governmental entity was surveilling her.
- Two weeks ago, her family started questioning her mental health and suggested she see a psychiatrist, which she refused, claiming that her family had installed surveillance cameras in her room.
- A week ago, she felt that the residents of her town were hostile towards her, and when she went to the police station alone, she was dismissed as having mental health issues.
- Currently, she has left her home but has very few contacts remaining; I am one of the few.
I provided her with some money to rent a place to escape from the perceived threats (in her mind).
Everything seemed normal before, but her mental state has changed rapidly, and the long-distance relationship has made it difficult for me to observe her psychological changes.
Since the separation, she has spent a lot of time at home, only interacting with the outside world through the internet, which has led to her developing a fear of society due to various provocative comments.
I have the following questions:
1.
Given her current mental state, is she considered a severe case?
2.
Due to the coronavirus, I will not be able to return to Taiwan for another month.
How can I assist her during this time?
3.
Upon returning to Taiwan, what should be my first steps for her? What should I do if she refuses medical treatment?
4.
If she undergoes treatment, how long might the process take? Can someone she no longer trusts assist in her treatment?
I do not wish to pathologize my girlfriend, but the situation has escalated beyond my control.
I hope the doctor can provide me with professional advice.
Thank you very much!

Mr. Zheng, 20~29 year old female. Ask Date: 2020/05/31

Dr. Liang Sunyuan reply Psychiatry

Hello Mr.
Zheng, based on her symptoms, it seems she needs to seek medical attention.
It is advisable to encourage her in a way that she can accept, such as discussing her symptoms like insomnia, restless sleep, or muscle tension, and see if these physical symptoms can motivate her to seek care.
Alternatively, you could suggest consulting with a professional physician on how to cope with environmental stressors as a way to encourage her to seek medical help.
Paranoia and persecutory delusions can be treated with medication; typically, some improvement can be observed after regular medication use for two to four weeks, with more significant effects seen after six to eight weeks of continuous treatment.
Once her symptoms improve, it may be easier for her to develop insight into her condition.
After you return to your home country, if she has not yet sought medical attention, it is recommended that you accompany her to see a doctor, framing it as a consultation for professional advice on how to cope with adversity.

Reply Date: 2020/05/31

More Info

Supporting a partner with paranoia and mental health issues can be incredibly challenging, especially when you are physically distant. Your girlfriend's symptoms, including feelings of being bullied online, beliefs of being monitored, and distrust of her family, suggest that she may be experiencing significant mental health challenges that could benefit from professional intervention. Here’s how you can approach this situation:

1. Assessing the Severity of Her Condition
Based on the behaviors you’ve described, it seems that her condition may be serious. Paranoia, especially when it leads to isolation and distrust of those around her, can be indicative of underlying mental health disorders such as paranoid personality disorder or schizophrenia. The fact that she has expressed fears of being monitored and has rejected suggestions for treatment from her family is concerning. It’s important to recognize that mental health issues can escalate if not addressed.

2. Providing Support from a Distance
While you are unable to be physically present, there are still ways you can support her. Here are some suggestions:
- Stay Connected: Regularly check in with her through calls or messages. Let her know that you care and are there for her, even from afar.

- Listen Actively: When she shares her feelings or fears, listen without judgment. Validate her feelings, even if you don’t agree with her perceptions. This can help her feel understood and less isolated.

- Encourage Professional Help: Gently encourage her to seek professional help. You might say something like, “I care about you and want to see you happy. Talking to someone who can help might be a good idea.” However, be prepared for resistance, as she may not see her situation as needing treatment.

- Provide Resources: If she is open to it, you could help her find online therapy options or mental health resources that she can access from home. Many therapists offer virtual sessions, which might feel safer for her.

3. Planning for Your Return
Once you return to Taiwan, your presence can be a significant support. Here’s what you can do:
- Encourage a Professional Evaluation: When you are back, gently encourage her to see a mental health professional. You can offer to accompany her to the appointment if she feels comfortable with that. Emphasize that seeking help is a sign of strength, not weakness.

- Create a Safe Environment: Ensure that she feels safe and supported in her home environment. This might involve discussing her fears and helping her to feel secure.

- Be Patient: Understand that recovery can take time. If she is resistant to treatment, continue to express your concern and support without pushing too hard.

4. Treatment Duration and Trust Issues
The duration of treatment can vary widely depending on the individual and the severity of their condition. Some people may see improvement in a few months, while others may require longer-term therapy. Building trust with a new therapist can be challenging, especially if she has a history of distrust. It’s crucial to find a therapist who is experienced in dealing with paranoia and can create a safe space for her to express her feelings.

Conclusion
Supporting a partner with mental health issues requires patience, understanding, and sometimes professional intervention. While you may feel helpless at times, your consistent support and encouragement can make a significant difference in her journey toward recovery. Remember to take care of your own mental health as well, as supporting someone with these challenges can be emotionally taxing. It’s important to seek support for yourself if needed, whether through friends, family, or counseling.

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