Married to Mental Illness

As a physician who has suffered from severe depression in the past, I am finely tuned into the suffering of my patients with mental disorder.

I care for a couple in their 40s.  He is a hard-working administrator.  She suffers from bipolar disorder as well as alcoholism.  Although she has been in and out of therapy and had several affairs, he continues to love her, care for her and raise their beautiful young children.

Interestingly, this scenario is not uncommon.  Although, I am not a professional psychiatrist, nor a therapist, as an internist I deal with depression, anxiety, OCD, etc. on a daily basis.

Here are a few observations I've made over the years.   

  1. Unlike physical ailments, mental disorder cannot be seen (like a broken bone) which makes it more difficult for both the sufferer and the partner to recognize and to seek treatment.
  2. Unlike physical disorder (such as a missing leg) mental disorder can directly hurt the very person who is supposed to be subject of love, such as the spouse, often breaking the bond of love.
  3. Most often, it is not only one person that suffers from mental disorder but both people involved- hence often couple's therapy is necessary if the choice is made to continue the relationship.
  4. The "healthy" partner will frequently become the caretaker but while resisting becoming an enabler further strains the relationship.
  5. The caretaker will feel a range of emotions and will go through stages of grief: Shock and denial, anger, bargaining, depression, acceptance. Anxiety, insomnia, guilt, shame both of staying in the relationship and wanting to leave are components of the recovery process.
  6. With cancer or terminal illness, the caregiver who decides to stay fully devotes love to the care of the sick. But with mental illness, the care is more choppy both because it is not visualized and hurtful, and also because the partner is not only trying to heal the sick but to change the underlying “flaws” in the character. The struggle to change the other becomes a lifetime battle that can destroy the relationship and both parties.
  7. The relationships which work are those where both partners approach each other openly, honestly, giving only love (as in a care of terminal patient) and where a relationship is built knowing all pitfalls.
  8. We all live with someone (spouse, sibling, parent, ourselves) who has suffered from depression or anxiety of varying degrees.
  9. Those who decide to stay in the relationship build their joy out of giving, caring and loving.
  10. None of us should shame someone for either staying in a relationship or leaving a relationship because of mental disorder. We simply can't understand unless totally immersed in that relationship.
  11. There is no perfect relationship.

I welcome your kind comments, suggestions and personal anecdotes.  Professional opinions would be very much appreciated.

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