Could someone please help me understand dhs mental health issues?

[Swellarella]

Please could anyone help me? Obviously we are going to get proper advice as soon as he can speak to a psychiatrist but we have no idea when that will be .

He is a lovely man. Genuinely kind loving protective sweet funny generous hardworking loyal.
He has major childhood trauma and adhd. He had a breakdown 3 years ago was given 4 months off work. Since then he has been on 150mg of serttaline and he wants to come off so has been on 100mg since last august. He has weekly trauma focused therapy.
Yesterday followibg a trauma trigger he came home kind of white and I was expecting we would get on with jobs cooking then going out to do some nice bits in town. He was monosyllabic I asked what was wrong and he just seemed to morph didn't look like himself and started speaking in what seemed like some kind of wicked wirch / Yoda voice and he started saying terrible things - he didn't seem like himself and I was like oh my god go and rest you don't seem well and I meant this very genuinely I was concerned but he kept raising his voice in this weird way. Hard to describe but I was really scared as it was freaking me out. I was like ok you seem ill I'm going out please rest and the last thing I remember him saying was 'swellas got an ill partner poor swella she's got an ill partner' in this creepy witchy voice.
I left the house for 2 hours cried my eyes out in the supermarket carpark spoke to Samaritans and when I got home he was asleep. I woke him up and asked if he was ok and said if he did the whole devil voice again to me he would have to go to a hotel. Ar which point the devil voice started up again and I was like that's it enough you are terrifying me you need to go. So he drove off. He came back and hour later crying and saying sorry I said if you do that again you go, you are frightening me.
He started a tiny bit I was like that's enough and he stopped. We had people coming over he then cleaned and prepped with me and then was quiet at dinner but not noticeably odd or out of sorts. This morning we have talked I was like what the hell? And he said he has no memory of speaking like that and behaving like that and I asked it it was involuntary to talk like that and he said yes he has no recollection and doesn't know what he was saying. He seems to have some control as when it was the option of the hotel he stopped and he was fine in front of friends.

Is this mental illness like psychosis I've got no idea?
Or is this deliverable behaviour desisnrd to control?

I have no idea how to help and feel I'm at my limit.

He’s more likely to hurt himself than her. Verbally, yes, he might be hurtful but this is a huge stigma psychosis sufferers face. Statistically speaking, he’s most at risk of self harm

I agree with previous posters that this is dissociation. I don't think it's psychosis. It is a good idea to have someone see him. It may not ever happen again

Oh sorry I didn’t know that.

It’s ok, please don’t apologise. It’s good you raised it so people can learn. Stigma comes from a lack of understanding most of the time, not malice.

No, you were frightened. It's ok, please don't beat yourself up. x

I wouldn’t try to explain anything at the moment. What he says may or may not match his behaviour or symptoms. Assessing an acute mental health episode is very difficult. This is why you need professionals.

I would say to anyone who is absolutely terrified by their partner to find a safe space, whatever the cause, even if that means leaving them alone.

Yes it was poorly handled, the trouble is we teach cpr but not mental health first aid. So dealing with it can be scary and we react in ways which don’t help. But cant turn back time.

1. During a trauma trigger the prefrontal cortex can effectively shut off (read The Body keeps the Score” by Van der Kolk for a simple explanation on this. The prefrontal cortex governs speech and reason. This would explain his mono syllabic thought.
2. at the extreme of the fight or flight response is freeze once this breaks and it the individual can’t physically run they will often dissociate - their mind will run, sometimes a simple feeling of not being connected to the body, sometimes the apparent take over by an alter ego.

You need to be patient and learn how to create a feeling of safety and groundedness as a way of offering mental health first aid

Your son needs professional help. Please help facilitate this.

Things that can help in an immediate time of crisis

1. making people feel safe is top priority - speak calming but clearly and firmly - tell them what is happening, under no circumstances stand over them or be confrontational
2. Dont not expect them to answer questions, understand anything complex. Use the word safe a lot
3. if safe for them get them to take the attention to their breath, tell them they are getting enough air in, their body in taking care of that they need in blow more out, you can do this by counting 4 in, 5 out, 4 in 6 out etc, if to complicated get them to hold hand up and blow away
4. ground, ask them how their socks feel, soft or hard, warm or cold, snug or loose? Etc

please seek professional help

Op a hospital is where you need to get him to- don’t leave him alone when he’s having an episode just get him in the car and to the hospital

You handled this incredible badly. I’m finding it baffling that you acknowledge he experienced a trauma trigger but you still thought he’d be ok to “get on with jobs cooking then going out to do some nice bits in town”. I can’t even begin to imagine the lack of insight you’d need to think that.

He might be having sertraline psychosis.

Antidepressant discontinuation syndrome - Wikipedia https://share.google/4ddQsGgjPgNAcHSdq

OP has recognised that she handled the situation badly and is trying to get help for her DH, and support and advice for herself so she can respond more appropriately in future (if necessary). Continuing to berate OP is not helpful to anyone.

I'm not sure it matters whether the behaviour is deliberate or uncontrollable. Either way, if it's making you frightened then you do need some distance. If your husband is doing it on purpose to scare you, he could be hostile and a danger because of that. If he is so severely ill he doesn't know what he's saying and it's manifesting as hostility, that's dangerous too.
Please don't try to diagnose him. The advice should always be the same regardless. If you're scared of a man, get away from that man. Where you go from there, whether that's to support him through illness or end the relationship needs to be decided from a place of safety. Ask him to go back to the hotel and contact his health care team.

Which is very easy to say when you are not alone with a man during a psychosis. OP dont liaten to anyone judging you. It's natural to go into fight or flight mode in a scary situation and usually we dont think we do. He does need help though, contact 111 and find out what is available in your area in terms of community and crisis support.

when I was using the word dangerous I was referring to the threshold for involuntary treatment or ambulance intervention.

op should first look after herself but she also wants to support her husband. if she feels she is in danger then that is an immediate ambulance and going somewhere safe. Nobody has argued with that.

I haven’t judged her at all. I’ve explained psychosis. I haven’t told her to be alone with him at all - I was actually the first to direct her to appropriate support?

please don’t put words in my mouth. Op asked me to explain her husbands symptoms. I have given her advice on how to interpret it. Others have given her safety advice and judged - not me! I even said stigma was due to a lack of understanding.

Ok.

I hope you’re ok, contrary to what others are saying I would run for the hills, a life with someone with considerable mental illness is a life sentence! The carer is that, with no support! After ten years it was the best thing I ever did

I wasn't commenting in response to anything other posters had said. Merely stressing that the OP needs to prioritise her safety. For both their sakes, actually, as if he harmed her while ill, thats a heavy burden to carry. Situations can escalate very quickly and her husband's condition appears inconsistent and unpredictable. She can support from a safe place.

ah ok fair enough, I felt I wanted to explain what I meant in terms of my use of the word dangerous in this context.

She has the support of the 111 mental health team. He’s unlikely to harm her - it’s incredibly rare statistically - but it is a risk. I expect (and hope!) the nhs have advised her on early warning signs and what to do in an emergency.

It could very easily be dissociation linked with his childhood trauma but it actually doesn't matter what caused it, it was frightening for you. Imagine how frightening it must be for him.
Persuade him to see the GP urgently tomorrow to discuss his medication and what happened.

If it happens again, make sure you are safe then phone for medical help. If he falls asleep, leave him to wake up naturally, so long as you can see that he is breathing. And if you have guests expected, cancel them.

I am not a mental health expert and can’t diagnose him.

Psychosis and other MH issues also look differently for everyone.

My family member has had a couple of episodes of psychosis and although she’s never changed her voice, she is not there it’s almost like a different person.

Although she was able to lessen it around other people, she could not hide it fully. Even shop staff etc could see that she was unwell.

However, I apparently had psychosis from PND and it looked very different to my family members.
I was able to hide it a bit but I also locked myself in my home and so technically didn’t have to see people.

Mine were hallucinations of people that weren’t there but my family member never had that, she would think that we were pretending to be other people and stuff or trying to kill her.

I would tell him to go to the gp and ring 111 or 999 if you’re ever in a similar situation.

Your DH is experiencing a mental health crisis, so you leave and call the Samaritans for yourself? He needs urgent menial attention.

If I were you OP I'd report your original post to MNHQ and ask them to move it to the Mental Health board. Lots of people on AIBU are after entertaining themselves, often by shitposting on other people's threads. You will not get useful advice here.

More likely yes, but not only likely to hurt himself. Its not uncommon for psychosis to lead to thoughts that others are better off dying with the person or fearing that someone close to them is a danger to them and plotting against them etc and then harming the person.
It doesnt always happen, but it does happen and isnt an extremely rare situation.

Yes this is quite common in postnatal psychosis for example. But I’m also trying to reassure/prepare the OP and that’s why I chose the epilepsy comparison. Someone having a seizure can definitely hurt you. You take precautions. But they’re more likely to hurt themselves. Do you see what I’m trying to say? Please don’t put words in my mouth, I said she needed urgent support and explained why an ambulance wasn’t appropriate. They deal mostly with involuntary treatment. 111 is more appropriate here