“I’m sorry I don’t understand where all of this is coming from. I thought that we were fine.
Your head is running wild again, my dear, we still have everything, and it’s all in your mind.”
- Nate Ruess in Just Give Me a Reason
With Valentine’s Day drawing near, the folks at Hallmark would have us believe that all the world is searching for the perfect way to tell someone special that we love them. Images of flowers, and candies, and cards, and smiles fill our screens as it becomes very easy to believe that happiness and romantic connections are simply a matter of combining the right person with the right purchase. Unfortunately, for the 43.8 million people in the United States (1) who will experience mental illness each year, or the 21 million people in the United States who are currently struggling with addiction (2), giving and receiving love is not that easy.
The nature of mental health and addiction can make it difficult to establish and maintain healthy relationships with self and others. So, for those courageous romantics who are currently in a relationship with someone who is coping with a mental health or addiction issue, we offer the following suggestions:
- Boundaries matter in all relationships, especially yours.
Ryan Howes, M.D., a clinical psychologist from Pasadena, CA defines a boundary as, “the line where I end and someone else begins.” Howes believes that personal boundaries act like state boundaries in that they define which rules govern an interaction. Boundaries also bring clarity because they define who “owns” that emotional space. (3)
While healthy boundaries are crucial for all couples, this is even more important when one or more individuals are coping with a mental health or addiction. Without these boundaries, the intense emotional content offered by someone who is coping can be overwhelming. Very soon, there are no lines that define the interaction and the person who is coping often dictates the terms of all interactions. This may not even be intentional but over time, a pattern or “sickest person wins” can develop and that can lead to anger, resentment, and repeated stonewalling as the needs of one partner come to dominate the wants of the other.
Establishing clear boundaries early and often can have a positive effect and prevent the development of those relationship killers. When emotions are low (because nothing really gets solved when emotions are running high), communicate your boundaries. Remember that boundaries don’t have to be negotiated, they just must be communicated. Then do the difficult thing and follow through. Over time, this will create a culture of mutual respect and you will both be able to enjoy being together more fully.
- Show how much you love by learning as much as you can.
In the United States, the Diagnostic and Statistical Manual of Mental Disorders (produced by the American Psychiatric Association and known as the “DSM”) has been the ofﬁcial American classiﬁcation system since its inception in 1952. In 1952, there were 128 different diagnoses identified. The most recent version of the DSM, the DSM 5, was released in 2013 and it contains 541 separate diagnoses (4). No matter what we believe about this explosion in possible disorders, it is obvious that there are a lot of ways in which people can potentially struggle. Throw in the fact that this does not include the countless combinations of diagnoses (known as co-occurring or dual diagnosis), and you can see that truly understanding your loved one’s situation can be a complex and difficult task.
Adding to this complexity is the fact that even if two people are coping with the same disorder, they will do so differently. This means that just because you have a friend who copes with anxiety, it does not mean that you will be successful in helping a loved one cope with the same diagnosis.
Despite these barriers to understanding, it is important to know that understanding is possible. It is well worth the time to research the diagnoses that a loved one is dealing with. This will bring perspective and a general set of suggestions to attempt. From there, it is also important to discuss what you have learned with the person who is coping. Many people will skip this step for fear of upsetting a loved one or “triggering” them. However, given the personal nature of mental health, there is no better way to identify individual challenges and individual solutions than to access their individual experiences.
- Love is forever, and this may be as well.
There are a few words that you need to remove from your list of expectations if you are in a relationship with someone who copes with a mental health or addiction. Words such as “cured”, “healed”, “all better”, “over it”, and “used to” will inspire false hope and unrealistic expectations. These, in turn, will invite disappointment, resentment, and hopelessness.
Mental health exists on a continuum and people tend to move along that continuum as they cope with a mental health condition. Some days it will seem that the issues have been completely resolved. Your partner will seem completely “normal”. It may seem like that for more than some days. That feeling may last for a very long time. The reality is that “normal” is different for each person and that is also true for people coping with a mental health or addiction issue. Some days the symptoms are clearly present. Some days it seems like they never existed in the first place. Some days it’s sunny. Some days it rains.
Addiction is the same way. According to Elements Behavioral Health CEO, David Sack, M.D, “We have to recognize that addiction, like many other chronic diseases such diabetes and cancer, is here to stay.” (5) While Dr. Sack is speaking about addiction in societal terms, his point is equally true for the individual. Once a person’s reward center has been hijacked, a “cure” for addiction is impossible although lifelong sobriety is a very realistic goal.
Mental health and addiction, like general health, has good and bad days. If that’s too much, remember that those days are made up of good and bad moments. The goal is not to focus on achieving the unreachable status of “cured”. Instead, invest in those good moments and appreciate them when they arrive.
Part of reducing the stigma around mental health and addiction is to acknowledge all the commonalities between a life coping with these issues and “normal” life. The reality about these special relationships is that they are just relationships. Like all relationships, they will have their ups and downs. Like all relationships, they will feature unique characteristics that make them special to all involved. And like all relationships, they feature people who are simply trying to find their way, together.
If you, or a loved one, would like additional information or assistance in finding your way to cope mental health and addiction, please do not hesitate to call us at 1-844-584-7284 or use our contact form. You can also reach us and find additional resources on our website www.pathihc.com
1 – https://www.nami.org/nami/media/nami-media/infographics/generalmhfacts.pdf
2 – https://www.usatoday.com/story/news/nation-now/2016/11/17/surgeon-general-1-7-us-face-substance-addiction/93993474/
3 – https://psychcentral.com/blog/why-healthy-relationships-always-have-boundaries-how-to-set-boundaries-in-yours/
4 – http://apsychoserver.psych.arizona.edu/JJBAReprints/PSYC621/Blashfield_etal_2014_ARCP.pdf
5 – https://www.psychologytoday.com/us/blog/where-science-meets-the-steps/201207/will-there-ever-be-cure-addiction
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