Loss, Loneliness, and Love: Navigating Mental Illness in Relationships
Dozens of books, articles, and other resources devoted to helping those with mental health conditions encourage them to reach out to loved ones for support; similarly, entire support networks have been set up for those loved ones. But what happens when both parties in a relationship, whether romantic, platonic, or familial, experience mental illness?
Mental Illness as a Chronic Condition
Many wellness practitioners and mental health advocates talk about the Spoons Theory for chronic illness: one only has so many spoons per day, and those with chronic illness, including mental illness, may have fewer spoons than others, or require more spoons for the same task. It typically takes a lot of spoons to be emotionally available to someone—actively listening, sympathizing and emphasizing, and offering physical and/or emotional comfort. If one has fewer spoons, it can be hard to be supportive. Thus, when both parties in a relationship have fewer spoons, it is more likely that someone may feel unheard or unsupported.
Moreover, people tend to see themselves reflected in loved ones; our values, preferences, and activities tend to mirror those of our friends and family, but so do our negative experiences. When both parties struggle with mental health issues, it can exacerbate symptoms.
Establish a daily check-in. You can stick with the spoons metaphor by asking, “How are your spoons today?” or just generally ask how the other is doing. Make a guideline that it’s okay to respond minimally if need be. Even a simple “I hope you have a good day” can work wonders.
It can be helpful to establish boundaries or, if you live together, separate your spaces. Set a schedule: if one person gets off work later than the other and needs decompression time, the other can be supportive by relinquishing the living room to them at that time, for example.
Depression and Anxiety
Depression, as people with the condition well know, is much more than being sad. It involves lethargy, recurring negative thoughts, and occasional feelings of self-harm. Navigating depression in a relationship involves overcoming intrusive and usually untrue thoughts, such as that loved ones “hate me,” and summoning sufficient energy to perform in the relationship. Depression can prevent someone from doing chores, emotionally responding, spending time with others, or becoming intimate — all factors that can seriously harm a relationship. When both parties experience depression, these problems are compounded.
It is helpful to be flexible and accommodating when one’s partner is in a depressive state; for example, picking up the slack on chores is certainly preferable to shaming the depressed partner for not doing said chores. When both parties are depressed, it might be helpful to have a ritual together that requires little energy but involves pleasant events. The ritual might be watching funny YouTube videos together, playing with pets together, or other positive, low-stress activities. To address feelings of self-doubt and intrusive thoughts that one’s partner does not love them, it can be helpful to have a list of affirmations to consult in those moments. Sit down together and make a list of things you like about each other, then exchange lists.
Post-traumatic stress disorder (PTSD) is a complicated condition that often is comorbid with depression and anxiety. In relationships of any kind, PTSD symptoms can spur arguments or make it difficult to deal with normal relationship stress. Especially in cases of prior relationship abuse, a current (non-abusive) relationship can accidentally trigger PTSD symptoms even through innocuous actions or events. A triggered partner may become very fearful or even act as though they are currently in the traumatizing situation or relationship. This can be demoralizing and distressing to the other. Of course, this is even more challenging when both parties have PTSD and one’s triggered state might actually be triggering to the other.
Increasingly, research shows that negative memories associated with PTSD need to be restructured in a safe environment (source). In other words, when a triggering event occurs, rather than dismissing or avoiding it, it is crucial to address it and incorporate positive information. One can support a triggered partner by acknowledging the trigger and offering a positive experience, e.g. “I’m here for you.” Keep boundaries in mind—many triggered people do not wish to be touched or hugged, for example.
In situations where both parties have PTSD, it’s best to establish in advance a manageable ritual that both can safely use — for example, retreating to mutually agreed upon, separate safe spaces, or saying, “I hear what you’re saying.”
Obsessive-compulsive disorder (OCD) can negatively impact relationships of all kinds, as those with the condition engage in rituals, often self-harming or disruptive, that assuage a painful obsession or illogical compulsion. Loved ones may struggle to even understand the ritual, let alone intervene. Many tend to accommodate the ritual or avoid addressing it out of fear or misunderstanding (source). In situations where both parties have OCD, both may accommodate each other’s rituals to avoid conflict, or even trigger each other’s rituals.
Acknowledging the rituals is the first step toward treating OCD symptoms. In addition to therapy, it may be useful to sit down and make a list of the rituals and their triggers, as well as warning signs of their onset. As with other conditions, deciding upon pre-approved mantras or positive rituals can be quite helpful.
Putting It All Together
Each type of relationship has its particular challenges. For example, familial relationships typically involve authority structures, such as parent to child, that can complicate attempts at self-mediation, while romantic relationships between two people with mental health issues often experience negative effects on intimacy. And while families and couples might feel obligated to each other, friends may feel especially put upon or neglected in such situations. In addition, the individual personalities of those involves have a huge impact on how solutions can best be implemented. In general, it’s best to have an honest talk and make individual maps of how each party’s respective conditions can be navigated. Make a plan of action for when things get bad. In general, establishing boundaries, affirming mantras to say to each other, and go-to rituals are good first steps in navigating mental health issues in a relationship.
Reaching Out For Help
At True You Southeast, we can help you cope with the loss of a relationship or help you rebuild your relationship with your partner. You can reach out to us at 404-800-7586 or contact us on the contact form.