The Crusader of Mental Health

Case of the Suspicious Wife

Rama* has been having delusions since 30 years. The first episode occurred when she was 35. She thinks her husband is having an extra marital affair. During her severe delusional phases, when he came home from outside, she sniffed his clothes, or grilled him about where he had been. She would say that she was certain that he was having an affair with another woman. She would demand to know who the woman was. She would be angry when he denied it, and would refuse to serve him food. She would not allow him to talk to any woman in the neighborhood.
“I am getting messages that you are having affairs with women. I know which place you went today to a see woman, I have my sources of information.”

One midnight, she announced to her husband that she was leaving him. She walked out of the house despite his pleas. In the morning she was found by the priest in a temple. She asked to be allowed to stay there as her husband was ill treating her. People gathered around. Seeing that she came from a well to do background, the priest and others asked her to go back to her husband and resolve the issues. She became violent and threatened to commit suicide or kill people if when was taken away by force. By then her family had found out where she was and had reached the temple. She was brought to NIMHANS involuntarily.

She was shouting when CRC saw her. “I am not mad. Doctor! You ask him to be faithful to me, and not go to other women. I am a respectable woman, with 2 daughters. Why would I run away from my home? My husband is responsible for my plight. He refuses to change. I am normal, he needs treatment or he should be sent to jail for cheating on his wife.”

Later, she declared, “All of you doing an injustice by putting a sane woman into a mental hospital. This is a plot by my husband to have me declared mentally ill, get sympathy from everyone, and marry again to satisfy his desires.”

Over the next few days, she would narrate this to the nurses and other staff. She would blame the doctors for giving her injections which were harming her. “They want to numb my brain and make me a zombie, so that my husband can have his way.”

She became better after treatment and was sent home.
During the last 30 years this story has been repeating itself: her refusal to take medicine, becoming paranoid, and being admitted to a hospital for treatment, being administered injections, recovering and being discharged. She experiences some side effects of the medication. Then she stops taking medicine, and when asked, insists that her husband is giving her drugs to destroy her mind, declare her mentally ill, and desert her to live with another woman. During the mild episodes, when she is brought to CRC, she is not aggressive. CRC counsels her that these thoughts arise within her mind and have no basis; her husband is loyal to her. She does not argue with him, and agrees to take medication.

Except for this problem, Rama behaves normally in all other ways. She is a good housewife and loving mother. Both the daughters got married in time.

Over time, she develops a dislike for the doctor she is consulting with. She says that the doctor does not listen to her, and instead he supports her husband. She refuses to go the doctor. The helpless man agrees to take her to a new doctor. He has taken her to NIMHANS, Prasanna Counseling Center and other doctors in the city. After trying out many doctors, they start at the beginning of the list of doctors again.

Like most mentally ill people, Rama too has never become aware that her mind is ill. Patients do not want to be labeled as a mentally ill person. They are concerned about the side effects of medication. All these lead to the patient’s resistance to taking medication. It is a constant struggle for the doctor and care-givers.

During most periods when she is normal, she says all men are the same, and accepts that she has no proof of his infidelity. “He does not love me as much as I want him to, this is what makes me doubt him,” she once said.
Her husband has experienced a gamut of emotions and reactions over these three decades. What has kept him sane is the conviction that she still cares for him beneath all the jealousy and craziness of her mind, and the knowledge that if he divorced her, her condition would become worse and there would be no one to take care of her.