Note: The use of the male personal pronoun "he" is purely for convenience.

For almost a decade, I was in a relationship with someone who suffers from anxiety and depression caused by a condition that isn't often mentioned: Delusional Disorder -- in this case, the persecutory variety. Thanks to the original post, I also learned for the first time that the Delusional Disorder is just one manifestation of the larger Borderline Personality Disorder. While I was well-aware of the former, I was not aware of the latter, but in any case, I too neglected my own mental health in a long series of failed attempts to stabilize our situation so that I could finally convince him to seek long-term therapy.

I just want to interject here that if you suspect your loved one has Delusional Disorder, learn how to approach the situation. For starters, there is a good article on WebMD authored by the Cleveland Clinic. The key is that you must coax the sufferer into getting help for the associated anxiety and/or depression rather than just to "cure the delusions." Any hint of that will create resentment and resistance, while a symptomatic approach addresses the pain which is real to your loved one. Obviously, if the individual affected by delusions could separate what is real from what is delusional in his thinking, he wouldn't have the delusions. So trust me on this -- tell him that there is help for the anxiety and then go into treatment together so that you can both discuss the underlying reason(s) why he is feeling anxious. And don't be shocked when your therapist doesn't dismiss the delusions either. That's how the professional has to play it because it's the only way to get the patient to stick around long enough to make progress.

In case you're wondering, my former partner has never made any progress against his delusional worldview, and in fact still harbours the idea that a highly organized, technically advanced, powerful group of people with contacts all over the globe are intent on gunning him down, poisoning his dogs, destroying his interpersonal relationships, and causing his complete breakdown. Members of the conspiracy include total strangers, neighbors, acquaintances, (formerly) close friends who got tired of the cold shoulder, and probably now, even me. Delusional Disorder doesn't come with an ammo box full of effective medications, and the prognosis for complete cure is poor, but sufferers can learn to question their own conclusions and can at least know relief from the associated anxiety and depression through effective antidepressants.

Needless to say, he wasn't like this when we met, although there were warning signs such as alcohol abuse and financial irresponsibility. When he got sober early on (and stayed sober for all of our remaining time together) I thought our problems were solved. Well, a big one was solved for sure, but others were just beginning to manifest themselves. Delusional Disorder's median onset is at age forty, and sure enough, that was about the time when the underlying feelings begain to insidiously and progressively take over his life -- and mine.

Obviously, no two situations are the same (hell, no one situation is the same!) but in our case, my partner refused to admit that he was mentally ill at all. After a few weeks of months of depressive hell, he'd obtain a quick script for Wellbutrin SR, then brighten up considerably and would at least recognize the pernicious effects of depression. On the medication, he was able to gain insight and exhibit emotional memory. He was able to see how effectively the feelings of hopelessness and anxiety could be counteracted via self-medication via the Wellbutrin SR. But every time, he would decide that he no longer needed the medication for one reason or another (the latest being the complaint that it slightly raised his blood pressure). His newfound insight would lead him to confidently believe that he would just "know" when he needed to go back into the medicine chest, but of course, depression doesn't conveniently denote its next onset on the calendar, and within a short time he'd be in the quicksand again with the outcome always in doubt and me on the receiving end of sullen stares, angry intonations to "back off" and interaction so limited that I had at times a more satisfying relationship withe plumbing fixtures. So my point here is that unlike the situation in the original post, my partner wouldn't use his depression as an excuse for bad behavior until after he was feeling much better.

Even with the medication, though, the underlying problems -- the Delusional Disorder and Borderline Personality Disorder -- went unaddressed. There's a huge difference between serious therapy and a quick visit to the clinic for a fresh Rx of Wellbutrin SR. One is a visit to the gas station -- sometimes after the car has run out of gas -- and the other is a complete engine rebuild, to whatever extent that such an overhaul might be successful.

Nosprings' original post beautifully summarizes precisely the emotions I have felt throughout this roller-coaster ride. When I left, I gently told my partner that this was a separation and not a breakup, because I will not surrender all hope. However, I now no longer harbour any illusions. I recognize now that my heart was not ready to give up until now, and that I enabled his behaviour by allowing him to become a virtual recluse behind closed blinds, by paying all of our bills, and by keeping his secret from his family because HE felt like to tell them would be some sort of betrayal.

When I left, because he had become 100% financially dependent on me, I supplied enough money for him to get back to his mother's home, with additional funds to follow for about three months. She has a place ready for him and can offer a small inheritance recently received from his grandfather's estate. I made sure that she knows that he is deeply troubled and in need of immediate intervention. I didn't cut off his cellphone service right away, and I gave him our shared laptop because I had a spare, to ensure that he could communicate online. I'm detaching with love, but I am detaching.

I know that others will read this, and ask why I stayed in this relationship for so long? Anyone who has been in my shoes will understand, though -- you stay in it because the good times can be really good. My partner often lavished me with attention and spoke positively about my future and occasionally, about his own. He is artistically brilliant -- an extraordinary horticulturist and landscape designer whose talent seems to have been bestowed by Athena herself. Also, the bonds of love are actually, in a bizarre way, made more powerful by the understanding that if you bolt, this person won't just feel bad for a few days or weeks, but may actually end up in the street, dead, or both. In such a situation, one literally tears oneself in two even contemplating the idea of getting out. It's just unthinkable until such time that you can face yourself in the mirror and know that you've done all you can do. And yet, sometimes still, even now, I wonder. That's how powerful this bond has been.

I resisted leaving because I knew that accepting reality would result in a devastating tidal wave of raw, painful, wailing emotion accompanied by an avalanche of grief, heartache, sorrow, guilt and pain. I won't lie to you -- I got all that -- but I also tapped into my support network and gave myself full permission to grieve not just for him, but for the loss of our shared hopes and dreams. I am still grieving now, but every tidal wave subsides and every avalanche eventually comes to a stop.

The last thing I told my partner is that I could no longer try to save him. I told him that I was drowning and begged him to GET HELP, that it didn't have to be this way, that he deserved to find love and happiness and that he was still now and would always be my friend. I supplied specific information on free resources in our area for counseling and psychiatric therapy. I also shared one last hope -- that in the future, if in fact he becomes an indpendent person and if we both wanted it -- we could potentially explore recreating our future together. But really, that was just my way of offering both of us a shred of promise that all was not lost. It's not a false hope, but an honest hope, and there is a difference. I wished him, more than anything, peace.

The pain has been immeasurable, but at least now one of us will survive. I still have dreams, I still have hopes, but like Nosprings, I too recognize that the mold is indeed largely cast by environment, upbringing and personal experience. I've done my best, and I won't be afraid to express love and support, but I've given all the money and time I can spare. I had to save myself and allow him to meet his destiny on this earth. When our souls dance together across this universe, perhaps his gratitude will fill the extraordinary pain I feel with eternal joy and peace. That's my ultimate hope, and I shall never surrender it.

If you're in a situation akin to mine, or know someone who is, get professional help and join a support group for caregivers. Break the code of silence and let your loved one's family and friends know that you need help as well. Take care of your soul, learn to listen to your intuition, and never be afraid to be honest with your loved one or yourself. You're only human, though, and only you can decide when you'll have to save your own life, but for your own sanity do so in a way that lets you keep your head held high. You'll never regret that, and you'll always cherish the good times and never look back in anger.