Side effects and the city

Seaneen Molloy explores what it’s like juggling a mental health difficulty and a relationship

Shock! Horror! Despite what the hysterical tabloid press may (mis)lead the public to believe, people with mental health difficulties are not just, ‘quiet loners’ who split their time between dribbling and scaring the populace. They’re also boyfriends, girlfriends, wives and husbands. Imagine that.

Across the land, people are taking time out from their full time occupation of having a mental health problem to kiss their partners, argue about wet towels and to curl up with a film that probably isn’t going to be worth the ninety minutes of their life they spend watching it.

I have bipolar disorder, also known as manic depression, and I’ve been in a relationship for four years. A good friend of mine has a schizoaffective disorder and has been loved up for eighteen months. We’re both managing our relationships but have learned that, although all relationships have their ups and downs, a relationship when one or both of the people involved have a mental health difficulty can come with its own unique challenges.

With physical disability, it can be easier to see what the person with the disability needs. When it comes to mental illness – which can be equally disabling – it’s more difficult. Even acknowledging the challenges can be daunting. ¬†Mental illness, by its nature, can be both unpredictable and relentless and touches upon every aspect of the person’s life. It can also lead to perceived changes in personality and mood; for example, a normally calm person may suddenly become angry for no reason, or depression can descend quite unexpectedly. Or somebody may begin to lose touch with reality, which can be intensely frightening for both of the people involved. Such changes may be insidious or they may be more dramatic.

Love and treatment

Sometimes, the treatment itself can be a problem. Many mental illnesses are treated with medication and psychiatric medication is powerful stuff. The side effects can be tricky to cope with and can give your self esteem a kicking. Some psychiatric medication has weight gain as a side effect. Others, such as antipsychotics, can make you sleepy. You might have to adjust your clock and be more active when you’re least tired. If someone you love is taking medication that has side effects they’re struggling with, you need to be as supportive as you can and also reassure them about the fact that side effects lessen as time goes by.

All couples have ups and downs…

There is a basic misunderstanding about mental illness in that it’s assumed that people are constantly in crisis. This isn’t true. Ongoing mental illness is just like physical illness or disability in the sense that it is always there but there are times when it’s worse than others. It is a part of life, and being honest with those close to you about it and about how it affects you can be the best way of dealing with it. Educate them and yourself. If your partner knows what to expect, then it may be easier for them to understand what happens if a crisis hits or if symptoms suddenly worsen.

In the context of mood disorders such as depression or bipolar disorder, there can be swings in terms of energy and motivation. During depressive episodes, the basics of life can be daunting. Things such as leaving the house or cooking a meal can provoke unbearable anxiety, or just a feeling of ‘can’t be bothered’. It can also kill your sex drive and your desire for… well, anything.

Likewise, during the manic episodes of bipolar disorder, your sex drive can go through the roof. Hypersexuality sounds good in theory but in practice it can be one of the most destructive aspects of manic depression. Hypersexuality involves a heightened sex drive and a tendency to seduce that can be indiscriminate. So, you can be aggressively demanding of your partner but, in more severe cases, you might find yourself propositioning strangers or being unfaithful. It’s never sexy to be dragged away from someone you don’t know and bundled into the nearest taxi.

Changing roles

None of these things is easy for someone to cope with. Because of the flux of illness, there will be good and bad periods. During the bad periods, the dynamic in a relationship can subtly shift from one of equal partnership to one of patient/carer. This can cause resentment on both sides. Often, people with mental health difficulties may feel that they’re a burden to the people that they love and in turn the people that they love can feel helpless. It can be even harder when the things you need help with are physical or if, for example, during a manic episode your partner might have to intervene in your finances to stop you overspending, which can be galling and embarrassing.

During times of crisis, people can worry about placing too much on their partners or partners can feel overwhelmed. If you’re under the care of a Community Mental Health Team, it may be useful to exchange numbers. Give your Community Psychiatric Nurse, social worker or psychiatrist the number of your partner and give your partner the number of the Community Mental Health Team or any other professionals that help you regularly. This can take the pressure off you and your partner, and can help your partner to feel involved in your treatment and help you get the care you need.

Resentment on either side is not inevitable. In order to be open enough for someone to care for you, you have to trust them, and this can actually bring couples together and forge a deeper relationship. Likewise, the person who ‘cares’ is less likely to stand by feeling helpless and overwhelmed if they feel involved in your treatment and recovery.

Remember, every single relationship is complicated and unique. Having a mental health difficulty doesn’t preclude having a relationship and the challenges you face together don’t have to be a negative thing. They can make you stronger, as individuals and as a couple. And hey, it can actually be exciting.

This article first appeared in the Summer 2009 edition of One in Four magazine

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