A middle-aged individual came to my Neurology and Psychiatry Department. After he arrived, I asked him, “Why have you come?”
He replied, “I feel extremely scared, my heart pounds, I sweat, and I feel like I’m going to die.” I asked again, “What else happens?” The patient continued, “It’s like this; sometimes I also feel like I’ll die from a heart problem, my chest feels heavy, and it feels like my breath is stopping. Initially, it happened about once a week, but now it’s almost daily.” After that, thinking his problem must be an anxiety disorder, specifically the subtype panic disorder, I made a diagnosis. Since he was in a state of extreme distress, I gave him medication for immediate relief, called him for counseling on Saturday, and gradually listened to everything.
According to the patient, he had been married for about 18 years, and now his wife was divorcing him. I asked why. He said, “I used to suspect my wife. Now that she says she’ll leave, I’ve become very scared, and I came to you fearing my home would fall apart…” I asked him, “Have you ever seen her with other men?” He replied, “No, I haven’t, but I know. When I’m not around, she takes the opportunity to flirt with men; she’s involved with others…” Then I said, “In that case, isn’t it okay? If she doesn’t love you and has a relationship with someone else, what’s the problem with a divorce?” He didn’t speak for a moment and started crying. I also paused. He later said himself, “I want to live with her… I can’t leave my wife.”
After that, I told him, “If that’s the case, you should bring your wife to me, and let’s plan for couple’s counseling.” The patient said, “My wife has already signed the divorce papers and gone to her maternal home; she won’t come, nor will she listen to me.” I said again, “This is your last chance. Bring her somehow. After this, I won’t call you again.” After I said this, the patient said he would try and left. In about a week, both of them came.
After they arrived, I asked the patient’s wife why she was seeking a divorce. The wife said, crying, “Not for one day, not for two days, but always suspicious? If I say it’s not true, he’ll be quiet for a day or two, then it’s the same again. How much can I endure? If I step out of the house, my own husband follows me to see if I’m with someone else. I can’t even laugh and talk to any man. He always checks my mobile, internet, clothes, and purse. He picks fights over these things and other issues too. Many times, he even resorted to physical violence. What can I say, whom can I tell? I’m tired of trying to make him understand. How much can I explain? It’s been 18 years, haven’t I said I don’t have any other male friends? I can’t take it anymore… I only came here because you asked. I don’t have any love for him now. I’ve already decided to raise my daughter at my maternal home.”
Then I looked at the patient; he also looked helpless, not knowing what to say. Then he looked at his wife and said, “Forgive me this one time, I won’t do this again from now on,” but his wife didn’t agree. After that, I asked the husband about his relationships before marriage. The patient said, “In 12th grade, I was in love with a girl. Then, without telling me, she got into a relationship with another boy. One day, while I was walking on the road, I saw her flirting with another boy. After that, I started to trust girls less, and I always feel suspicious. What should I do?”
I had both of them sit together and explained that this is a mental health problem called P.D.D. (Persistent Delusional Disorder) and it’s possible to overcome it with treatment. I also requested the wife to give her husband one chance and started the treatment. Initially, the wife was hesitant, but during a later follow-up, the patient said that his wife had returned home and their relationship was good. Thus, a relationship that hadn’t been good for 18 years improved within 2-3 months with treatment, and the patient’s fearfulness also disappeared.
This problem is Persistent Delusional Disorder, in which the individual is under the delusion that whatever they think is true. Even when family members repeatedly tell them otherwise, the person is not ready to accept it and, on the contrary, considers the person trying to explain as foolish or wrong. This problem falls under the subtype of P.D.D. known as delusion of infidelity, and this problem is seen more commonly in individuals who consume alcohol. Many times, the husband himself may not be able to express these suspicions to his wife but may express his anger through other means.
We can see many such individuals in our families and society, and they may need appropriate help. Let us also be aware regarding alcohol and inform others about the treatment for such issues.
