Does triple divorce occur to an absent wife when it was issued by the husband while he was in a state of extreme anger, withdrawal, and nervousness, for which he is undergoing treatment?

Your friend's utterance of divorce falls into one of two categories: if he was conscious, his divorce is effective; if he was unconscious, it is not. The triple divorce is a matter of disagreement among jurists: the majority of jurists hold that it counts as three divorces, and the woman becomes irrevocably separated, while others believe it counts as a single divorce. The presence or knowledge of the wife is not a condition for the divorce to be effective. If it is highly probable that the person is afflicted with something in his mind, then doctors must be consulted, and he should be treated with legal ruqyah (definition).