Relationships, Caregivers, and Mental Illness
Friday, 8 October 2004
Relationship in a mental illness situation is a difficult subject to broach, yet is one of the more common concerns visitors to my site write to me about. I have read about frustrations when a loved one with mental illness would not seek help (or admit it), when relationship has become strained due to the behaviors of the partner with a mental illness, or even more devastating consequences thereof (adultery, financial devastation, violence).
There is the issue of “how do I know which is You and which is the Illness?” This is tough to determine unless both partners proactively educate themselves and each other about symptoms of a mental illness and the many physical forms (behaviors) the symptoms manifest.
“Support” Means Mutual Support. Often when we think about support, we automatically think about the person managing a mental disorder. A relationship is a dynamic state involving at least two persons; both need support in a situation where emotional pain is prevalent. Support for a person managing a mental disorder is crucial in encouraging him or her to seek help and to stay on medication. For the “caregiver” (or personal associate), support becomes especially important during the phasic manifestations of the highs (bipolar disorder) and the lows (depression or bipolar disorder).
Caregivers and personal associates can become confused, frustrated, angry, and scared when they are confronted with bizarre behaviors that can erupt during an episode. Sometimes, symptoms can be more insidious and begin with subtle changes in mood that is accompanied with hurtful remarks and concerning behaviors. It can be difficult to catch these early symptoms. We can decide that the other person is just being a jerk (and sometimes that is the case), and fail to monitor more drastic changes that are telling of a depressive or manic episode.
Seeking support is a way of validating our feelings. We want to feel how we feel about a situation without being judged. Separating oneself from the disorder is critical in maintaining a healthy perspective during trying times. This recognition of “who the person is” versus “what the disorder looks like speaking through the person” is a step toward open communication in a relationship. Gaining this recognition involves actively educating yourself in what symptoms of mental illness “looks like” during episodes, and choosing the best coping method when the situation arises.
Prior agreement between partners can work well in many cases. For example, you may want to have a signal that you both to “signal” the onset of a symptom when the waters are calm. You then have an agreement about what you both can do when early warning signs appear. When a person is in midst of a mood storm, he or she may not be able to perceive behaviors that are out of the ordinary. Prior agreement helps to remind the patient that something is happening and needs to be monitored to prevent worsening the situation.
Establishing boundaries is healthy. For example, when a patient experiences depression symptoms, her partner may try to “cheer her up”. This sometimes will not work, and the partner may end up feeling helpless and frustrated. The partner’s feelings of frustration and helplessness will then make the patient feel even worse, and she may additionally blame herself for the situation.
You don’t want to turn your back or cut communication with a person who has become depressed; instead, free the burden from yourself to always have to “fix” a depressed person, even when you have the best intentions. Let the person “be”, and let him or her know that you’ll be there if he or she needs to talk. When you set boundaries and accept that you do not have to assume responsibility to cheer up a depressed person, and that it is not your fault if you cannot cheer up someone who is depressed, you will be less drained emotionally.
There is nothing wrong or unusual in feeling angry, hurt, helpless, frustrated, grief, drained, sad, or scared – but you can make choices with how you want to deal with those feelings.
To Caregivers: There may come a time when your loved one is in complete denial, and is behaving in destructive ways. From my own personal experience with severe depression, I can vouch for having moments of mental clarity where I knew that I had behaved in self-destructive ways, and where this behavior lead to “collateral damage” (hurting others). Although I don’t take responsibility for my depression, I am still accountable for doing something about it, especially when I realize that my behavior can be hurtful both to myself and to other people.
I then have choices. I can refuse to accept that anything is abnormal (denial). I can acknowledge that something isn’t quite right and do nothing about it (disregard for responsibility). I can acknowledge that something is wrong and seek help so destruction doesn’t happen again. Only one of these choices take me to a better quality of life for myself and my loved ones.
During early adulthood, when my depression symptoms were most rampant, I sensed that something was wrong, but I denied that it was anything but my being obstinate or unreasonable. Nothing prevented me from “double-checking” the symptoms of depression, but nothing mattered to me enough to double-check. This lead to unhealthy relationship dynamics, many of which still make me cringe when I recall those interactions. When I got married, I was misdiagnosed with bipolar disorder, and my husband purchased a book about bipolar disorder to learn more. Shortly thereafter, I made a decision that I wasn’t going to repeat the same mistakes that I had made in the past, and I was going to take control and be accountable in managing the depression.
Mental illness may sometimes lead to extramarital affairs and adulterous behaviors that destroy the trust in a marriage and destabilize the home environment. Sometimes the patient’s denial can deteriorate the trust in a marriage by committing adultery or by financial choices that set up the family for ruin (spending sprees, for example). The spouse’s anger and confusion is confounded by the knowledge of mental illness, and whether to forgive his or her partner because the partner is mentally ill and “know not what s/he does”.
Mental illness can never be an excuse or even a valid reason to endure violence or continual physical/emotional abuse. A case can be made for bearing the pain inflicted during the wake of mental illness, but not when the patient continues to refuse treatment or chooses denial about the illness. Even emotional pain, however invisible, can leave deep scars and are as destructive as physical pain. I am especially concerned when there are children involved, and the spouse is struggling with the toll of a mentally ill partner. When children are involved, forgiveness must be dealt with a judicious hand, and with the condition of the patient getting treatment and taking responsibility for his or her mental health.
No. 1 — August 27th, 2005 at 7:35 pm
This article hit home. A man I know suffers from depression, panic, anxiety and agoraphobia. We had become friends but recently he ended the friendship. I think he felt that the relationship was getting too personal. He did things that hurt me. He wouldn’t let me ride in his car, would not call me unless I was at work (tho. he would text message me at my home every night), and the only time I would see him was in my office or his office. He is divorced and has lived with his parents for several years. He cannot eat in restaurants, go to weddings, theaters etc.. As time went by, he got to where the only relationship he had with me was via email or text message. When I pushed him on why that was, he decided to just end the relationship. He was institutionalized for 5 days last year after he abruptly took himself off of a tranquilizer. He stopped going to therapy and doesn’t seem interested in going back. Anyway, he did some things that hurt my feelings. It was hard to tell if he was just a jerk or if his mental illness was the cause of his behavior. He had a real fear of being hurt and once told me that he had a fear of hurting others. He had had an extramarital affair during his marriage. I hope at some point he gets help and wants to get help.
No. 2 — August 28th, 2005 at 9:00 am
Jennifer, many can relate to your story, thank you for sharing. It sounds like you have developed a healthy and realistic perspective of the situation, did what you could, and ultimately had to accept that he was not yet at that point where he’s ready to face his illness head on and take responsibility for becoming healthy again. Best wishes, Jane.
No. 3 — February 9th, 2006 at 5:06 am
i have been living with a man for 5 years and i have an eleven year old daughter from a previous relationship. I am unsure as to whether this man is sick or whether in fact he actually enjoys hurting us. Everything has to be “his” in material aspects i.e. the house in his name (although I have contributed greatly) money in his bank account ( I have no access) and complete control with the attitude “if you don´t like it there is the door”. However he still calls me a thief, a fat cow and my daughter is a “brat”. The worst part is the violence. He absolutely does not care if he hits me in front of my daughter. He has broken my teeth, ribs, bruised my legs, stabbed me between the fingers with car keys etc and never apologises. He has a weird relationship with his mother and his father is not his real father who adopted him and his sister when they were small under the condition that the real father never saw them again. The mother has told him that she doesn´t like me, that I am a horrible person and now wants to come visit again under the condition that I am not here in the house when she comes. I am actually making plans to try to get out but it is difficult with not a lot of money. I just wish I knew why he behaves in this way. He was never that bad before but had an accident recently when a roof collapsed onto his head and I am wondering if that has made him worse. I don´t know if he is a bad person or a sick person.
No. 4 — February 9th, 2006 at 2:55 pm
Theresa, the situation right now is one where your obligation is to remove your child and yourself from danger.
No. 5 — January 26th, 2007 at 8:57 am
Hello,
I am very confused and concerned about my husband and his strange, devious actions that are meant to hurt me and try to make me think I have problems. Is that just him or does he need help. In my opinion and from research, YES. He thinks I am just bringing my concern up to hurt him or win(I say win b/c that seems to be his lifestyle with me). I have so many examples I am about to give(some), but I need to find a professional who will just send him some info. on the matter. Anyone besides me will be good. There is no point in not being honest here, so let me say there are drugs involved and I know this made the situation 10 times worse, and when he is high of course, his lies, and devious, spiteful actions are worse. On that part I am not innocent but I am trying to stop together. I take full responsibility for my decisions, but he knows what makes me want to the most is when we are fighting and his feelings and emothion is gone sober or not. There is no problem for us to stop together, it was recently done but for months he has been doing it behind my back. Since, I have realized that and he is aware of me knowing. Strangely, he may not be doing drugs at a particular time but he wants me to think he is just to get a reaction and for me to accuse him. He goes to wierd extents. For ex., he will start flickering a lighter, leave something laying out for me to see, he will try and act loaded by doing the extra examples he would do while high(remember this is sober).
Now try and get off the fact that drugs are in this because I am aware of drugs making things appear probably similar. I am able to stop but that part is hard for me when he is doing it right there. Anyway, some examples, throughout our uninfluenced days: The lies are to an extreme and not the typical relationship lies.
A couple days ago he called a # that was offering money through a sweepstakes thing (something the both of us would usually throw away), but he called and a couple minutes into it I noticed him pressing the hang up button on the wall. He then was talking to no one and the reason he played this game was simply because I asked him not to call and then asked him to hang up with them. I said “Richard I know there is no one there”, kept pretending and then I grabbed the phone and I was right. He still deny’s playing games(this is nothing). There are alot of pretend things he tries to make me think he is doing and they relate to the things he is doing and should not be. Almost, as if he is punishing me for knowing. He has been on several dating sites, which really does not fit the Richard I thought I knew personality. I was able to get into the compputer and even pull up his profile with his picture. He lies about that to this day and it is still going on and I do not know the reason. I really do not think he would go through with it, unless it was right there in his face. We are always together. 3 nights ago he was on one and I figured it out and he denyed it, of course. The worse part of that is last night I was on the couch and he was on the computer and he purposely would do certain things for me to think that is what he was doing. He was expecting a response, but I did not acknowledge his wierd actions. Again, I am getting punished, mentally for being human. He is so emotionless, I could be crying in pain and he would not even ask “what is wrong”, nothing, and this was recently. I have tried every direction to talk to him. I have softly pointed out these and ALOT more things and my concern, I have tried ignoring him, yelling, you name it. My ring is off my finger and I do have intentions to get and apt. in about 30 days if he does not get evaluated but I do not know if he sees it like I do. I do know he sees alot and knows some things may be mean. He told me one time that he does not think these definitely “wierd” actions are wierd. I could not believe it because I can not understand since I would never do such strange things period, but especially to my husband. I express this phrase with the deepest sincereity, “how can a human be so inhumane”, and that is how I try to explain what this is doing to me mentally. My son, who is 7 and Richard being the only father he has ever really known is feeling this and Richard is also aware of this. He will use him and his friends against me to make me mad. This is getting long but one last thing, he seems intimidated by my inteligence. He will never give me credit for anything, and does not even want to here me talk about subjects, which show knowledge. I like to find a subject and learn about it. Sometimes, when I do find something very interesting I want to read a paragraph to him, he blows me off. Even if he does not like the subject it is communication and just pretend and listen for a second.
This situation in my life is the hardest time I have ever had to deal with. I did the best I could to explain what is going on but for some reason what is happening is very hard to explain.
No. 6 — January 30th, 2009 at 6:26 am
I have a mental illness. I am very proactive in my therapy and trying to make the best of my illness. I would like to have a relationship, but feel no one would want me for that reason. How do I find a patient and willing companion?
No. 7 — February 3rd, 2009 at 9:18 pm
Dear Cindy, thank you for being proactive in your therapy, and for making the best of the situation that you are in. Relationships can be challenging for anyone, even people without depression! Are you in support groups? You can focus first on getting support for yourself – and building that supportive peer and social network to help your healing process. This can engage you in new social situations where you may meet new people, and connect with those who understand what you are going through. From there – you never know what can happen. Please stay in touch and let me know how you’re doing. Jane.
No. 8 — February 22nd, 2009 at 8:34 pm
It’s good that she is seeing to herself and that you are supporting that, but what comes after that, is I think her question.
Can she hope to find a patient and willing companion?
Could a patient and willing companion be cultivated and what are their needs in that situation.
Thanks.
No. 9 — January 6th, 2010 at 9:05 am
I am a patient and willing companion Cindy. There are many of us out there. I am in a relationship with someone who was later diagnosed with anxiety and depression. It takes alot to deal with a mentally Ill person. Especially one who chooses not to take their medication. But if you let your potential mate know after you see it is becoming serious, they will rarely leave . Just make them aware of the symptoms and how to deal with your episodes when they arise. You will probably have more longevity with those of us whom have had mentally ill parents. For that is why I stay. I was forced to adjust to her behavior and know that it can be done. But your risk is that when your behavior begins to harm them, they must leave.