Last week’s Mental Health Awareness Week (13-19 May) theme was Movement.  Simply making time every day last week to step outside in daylight and increase my steps made a significant change to how I felt and managed my stress.

Working as a couples ‘therapist for over 25 years I am acutely aware just how many more of us are struggling with mental health or that of their partners. Thankfully now there is much more awareness and understanding of mental health conditions but sometimes it’s difficult to make sense of how mental health issues impact on a couple relationship.  

How does mental illness affect the couple relationship and how does a partner navigate these difficult times?

We all experience ups and downs in our relationships but if one or both people in the relationship are having mental health problems this often brings extra challenges and we underestimate the impact this can bring to the strongest of relationships.

The mental health problems that often present in working with couples are:

Acute Stress, Depression, Anxiety, Addictions, Self -Harm, Grief, Pre and Post -Natal Depression, Eating Disorders, Obsessive Compulsive Disorder (OCD), Bipolar and Borderline personality disorders.

Although our romantic relationships should provide security and comfort, they can also be a source of depression, anxiety and stress.  A question that’s often asked is whether relationship difficulties contribute to mental illness or whether mental illness causes relationship distress.

This is a difficult one as there is often no clear answer.  Highly conflictual relationships can cause significant stress and where individuals are more vulnerable to mental issues relationships can trigger mental health symptoms.

Here are some examples of issues in relationships that can affect our mental health:

1.Communication breakdown.  When one or both partners are experiencing poor mental health, communication is often the first thing to break down as they struggle to make sense and articulate what is going on for them.   It feels easier to just closedown and withdraw or to keep fighting and arguing in the same old way. A breakdown in communication and distancing from each other often leads to couples feeling alone and isolated, often increasing depression and anxiety. Partners can feel impatient and discouraged when they see no signs of improvement.

2.Addictions and Alcoholism

Partners with addictive behaviours can bring additional stresses into a relationship which can cause or exacerbate mental health issues.  Alternatively, a partner with a mental illness can resort to addictions to serve as a coping mechanism and numb the pain.

3.Finances

Financial difficulties, job stress, long working hours, job loss, career change, retirement can be key major contributing factors for mental health problems.

  1. Health

Poor physical health, acute illness, operations, hospitalisation, having a baby, post- natal depression, going through the menopause and caring for family members can all be difficult to navigate for a partner with mental health issues.  Partners can become overwhelmed with becoming carers for their partners and families and eventually get worn down and resentful suffering with their own mental health problems.

5.Parenting

Changes in parents ‘mental health can often affect children.  They often pick up on your low mood and anxiety. Dealing with your child’s mental health can often prove very stressful and overwhelming leaving very little space or time for the relationship.

In my practice I frequently hear how a client can struggle to cope when a partner is affected with mental illness.  What used to be a shared partnership in work, finances and parenting, becomes the sole responsibility of one partner to keep all the wheels turning.

At times if these feelings aren’t acknowledged, resentments grow.

  1. Depression and Anxiety

If a partner lives with depression, they often seem very withdrawn and disinterested in you and the things you both once shared together and enjoyed. This emotional distancing can be harmful in the long term.  Displays of excessive worries and feelings of guilt and shame, confused thinking and extreme mood changes are examples of mental health problems.

  1. Intimacy Issues

Partners with mental illness may suffer with low self-esteem and lack confidence about how they feel sexually as well as performance anxiety. This can result in disinterest in sex and intimacy, leaving partners feeling rejected and unloved.  Anti- depressant medication can often result in decrease in libido and performance anxiety.

HOW TO STRENGTHEN A RELATIONSHIP WHEN A PARTNER HAS A MENTAL ILLNESS

1.BE PATIENT

At times this can be a really big ask, but the more patience you can show for a partner the more it shows that you are really trying to understand what they are going through.

2.BE SUPPORTIVE AND CONSIDERATE in the way you show your love, empathy and compassion as you both try and navigate your way through this difficult time.

  1. ENCOURAGE A PARTNER TO BE MORE OPEN AND HONEST ABOUT HOW THEY FEEL. This often takes time to build the trust to feel you are there for them and you do care. It may be easier to write a text or email than talk face to face initially.
  1. LEARN AND READ AS MUCH AS YOU CAN ABOUT THE ILLNESS. The more knowledge and understanding we have reduces the misconceptions and stigma so often associated with mental illness.
  1. LOOK OUT FOR POTENTIAL TRIGGERS  Be more aware of identifying and recognising triggers.  Experiences of trauma are particularly vulnerable to triggers.
  1. SEEKING THE RIGHT OUTSIDE HELP and showing support through this process. Take time to research the right help from organisations or therapists who you can talk to or meet up online. Online forums and chat lines are a useful place to meet people who are having similar experiences. Going to couples therapy can be hugely beneficial.  A regular session can offer a safe place for both your thoughts and feelings to be shared and understood.  It can very much help to minimise damage to the relationship and help you both to enjoy being in it.
  1. LOOKING AFTER YOURSELF is vital otherwise it can be very difficult to be continually supportive. Ensure you keep doing your normal routines. Meet with friends and get plenty of exercise and rest.  This can give partners parameters to help them improve and get well.
  1. REMEMBER POSITIVELY WHY YOU ARE TOGETHER

 Often a partner will feel ashamed and guilty for bringing this difficult problem to the relationship and may feel they will be abandoned by you.  It is also likely that the carer in the relationship will often feel overwhelmed and can’t carry on.

Mental Illness in a relationship can be very challenging for a couple to handle and can often lead to a relationship ending.

However, it’s important to stress that with the right help and guidance we can recover and manage mental illness better.  I often share this quote from Noam Shpancer:

Mental Health …..is not a destination, but a process.  It’s about how you drive, not where you’re going

.

Dawn Kaffel