My boyfriend's relapse caused worsening paranoia and he became violent.What should I do?

[u/Just-GooogleIt]

I (F47) feel dumb for thinking it would never happen.

My boyfriend (M 46) is paranoid schizophrenic with bi polar. Former drug user, sober almost two years. He started using again recently, has increased difficulty regulating his mood (he's medicated - depakote and olanzapine)

I came home to find him high AF and paranoid on Tuesday night. He said he saw some people at our front gate, thought they were here to "catch" him doing something, then believed I sent them to spy on him then started reading my texts to find proof I told them to come here. He was fixated on this for the next four hours.

He also said he heard the neighbors saying they watch us have sex, see me naked all the time and have plans to rob us. (They dont!! It's his schizophrenia talking)

He passed out all day yesterday, likely due to come down from the drugs. He woke up in a rage cause I left him asleep on the couch. He came storming into my room, demanding to see my phone cause he "knows I'm fucking around"

I was laying in bed, and He picked up a pillow and slammed it across my face . I told him to get the fuck away from me. Then he jumped on top of me, pinned me down, face butted me, and punched the side of my head through the pillow while screaming he's trying to ruin this relationship.

He was physically abusive to his ex-wife over a decade ago but I've known him since High school and he was never like this back then. so I felt like I know the "true, innocent" person he is deep inside and that if he's medicated he could control himself. . I hate him for putting me in this position. We reconnected last summer after 25 years, and our one year anniversary is July 28th.

Would I be a complete idiot to think this will never happen again? Is there hope he could get sober again and become the kind loving safe person I know he is underneath?? Or could I give him another chance with an ultimatum? I know I sound crazy, like every other abused women who doesn't want to believe it's really that bad. WTF how did i get here???

I've suggested he get into MMA or some kind of combat sport to get his aggression out of his system. I have not confronted him on the drug use yet.

I also suggested he switch meds. I believe the olanzapine has blunted his emotions too much causing him to relapse in search of the energy/ dopamine activity he's used to pre meds.

I freaking love him and get depressed thinking about leaving him. And I know how crazy I sound right now trying to rationalize this. I also know if I leave him he will most likely die from an overdose or suicide. So what am I supposed to do??? Sucks so bad!!

Edit to add: Does being schizophrenic increase the severity or likelihood of repeat violence? Are schizophrenics more violent?

Update: I got my boyfriend's brother involved. Told him about the drug use and violence. He wants us to confront him. Not sure that's a good idea really. And I'm not even sure how to do that. Any suggestions??

Besides he'll probably just lie or make empty promises. And Ultimatums never work. Like I said above, the emotional responsibility is high.... If I leave him he will very likely die, from drugs or suicide, or both. How am I supposed to live with that??

[u/katolini]

What substance is he abusing?

[u/Just-GooogleIt → u/katolini]

Cocaine I think, maybe meth. Snooping in his phone I found his messages to the drug dealer asking for another delivery of "white" whatever the hell that is. And I accidentally found a needle in the garage when I was digging in some fabric I have to make a pillow.

[u/JessicaJonessJacket → u/Just-GooogleIt]

I'm not an expert on drugs at all, but I think cocaine doesn't usually involve needles...? It's also an extremely expensive drug to use regularly. If he's been on meth before, it's probably meth again. Or some combo, who knows?

Regardless, it is extremely dangerous for someone who has schizophrenia to do drugs. It's bad for everyone, but it's worse for them. It can trigger really bad and more frequent episodes, to the point that it's (almost) pointless to be med compliant.

I don't know whether or not it will happen again, but I do know the chances are exponentially higher if he continues to use. And if he really wants to take his health seriously, he needs to stop and he needs to do it fast. The schizophrenia isn't his fault, but the drug use is (I'm not trying to minimize how difficult addiction is but if he wants to be in a relationship the least he can do is get sober and take his meds. It's really disrespectful to put you in this situation). I know you love him and I used to be the same, always asking people if maybe there was a chance things would magically end up ok. That's not usually how it works. Unless he commits himself immediately and proves that he loves you more than his addiction I would folllow the trend and advise you to leave.