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What’s Love Got to Do with It?

By Lisa R. Rhodes

Globe

About a decade ago, I was dating a man for the first time in several years. We had been dating for about three months and he expressed an interest in marriage. I had just started a new job at a weekly newspaper and I was working with a psychiatrist. There were no symptoms of my paranoid schizophrenia and I had even dropped a few pounds. I was at a good place in my life and I felt great.

Since life was so good, I stopped taking my medication. Not long afterwards, I became symptomatic and was hospitalized. My family told Michael about my mental illness. He called me at the hospital and told me that he would hold my hand through the experience. He even offered to visit me, but I said no. I felt too vulnerable and didn’t want him to see me at my worst.

Eventually, I was sent home and immediately saw my psychiatrist. We discussed my relapse and the necessity of staying on my medication, all the time, no matter how I good or bad I felt. I then made the commitment to be compliant.

When I was able to, I meet with Michael and explained my mental illness. He listened and restated his desire to hold my hand through the experience. I told him that not everyone can deal with someone who has a mental illness, but that I would always be honest with him. I also told him that I was committed to staying on my medication.

Within several weeks I was back at work. One Wednesday, Michael called me at work and announced that he was breaking up with me. He gave no clear reason. To be honest, I can’t recall exactly what he said, but he was short and curt. When he hung up the phone, I was in shock. Later, when I tried to meet him at his home, he refused to open the door.

Several months later, I called Michael just to ask why he had broken up with me in such a cowardly manner. Once again, he was mean spirited and implied that he had done me a favor by dating me.

I hung up and had a good cry. I haven’t thought much of him since.

But the experience has made me wonder how much the disclosure of my mental illness had to do with his decision to end the relationship. I decided to ask Dr. Shannon Kolakowski, a psychologist and relationship expert, about the challenges people with mental illnesses face when they are trying to decide whether or not to disclose their condition in a romantic relationship. Dr. Kolakowski specializes in treating people with depression and anxiety and has a private practice in Seattle. Here’s what she had to say.

Why are supportive relationships so important to people with mental illness?

Years of research have shown that having social support is an essential part of recovery in mental illness. Supportive romantic relationships in particular are important for depression, because a good relationship can help bolster someone who’s going through a depressive episode, while a bad relationship can trigger depression or make pre-existing depression worse.

What are the obstacles that often prevent people with mental illness from forming romantic relationships?

Without help or intervention, mental illness can drive a wedge between people for many reasons. It’s difficult to connect with others or be a good partner when the mental illness makes your world chaotic or unstable. Problems vary depending on the specific disorder; some types of mental illness can make people withdraw from others, or be fearful or distrustful of others, have trouble having empathy for others, or make people act impulsively or inappropriately with others; all of these can be obstacles to forming romantic relationships.

Why is it often difficult for people with mental illnesses to disclose their illness to their romantic partner?

There is still a great deal of stigma associated with mental illness. Despite psychologists, public figures, and advocates attempting to de-stigmatize mental illness by talking about it and providing education, people can still be fearful of mental illness. They are usually fearful when they don’t understand it, or have misconceptions about what the mental illness really is. Because of the misconceptions and stigma that exists, people with mental illness are reluctant to disclose their disorder; in the past they may have had negative reactions from people, and don’t want to lose the new relationship by disclosing their illness.

Many people often decide not to disclose their illness in a relationship. Is it important to disclose? Why or why not?

Eventually, a long-term partner is going to have to know about a mental illness. It’s better to disclose the illness in a way where you can talk about it openly and calmly to have a productive conversation, rather than waiting until a crisis or episode arises. In terms of timing, it’s not something people need to disclose on a first date or right away, but as intimacy builds and your relationship becomes more committed, it’s probably something that needs to be discussed.

What impact does disclosure have on a relationship?

In some instances, a supportive partner will feel closer to the person after they learn of their mental illness. They’ll take the time to learn about it and find ways to be supportive of their partner, and it can be an opportunity to grow together through the disclosure. In other cases, it’s a non-issue—the partner still loves you and recognizes that everyone has their struggles—yours happens to be mental illness. Other times, it can be hard for the partner to learn about the mental illness—disclosure may rupture or end the relationship if the partner is unable or unwilling to continue in the relationship. It really depends on the relationship as well as the type of mental illness, as well as if the person with the mental illness has received treatment and is currently doing well.

What responsibilities, if any, do romantic partners of people with mental illness have in a relationship?

In any relationship, it’s important to set loving but firm boundaries. When someone is in a relationship with a partner with a mental illness, they have to learn to love and support their partner without sacrificing their own mental health or wellbeing. Couples who are successful have a big support network, including a psychologist or therapist, family and friends, and also each make an effort to take responsibility for self-care. The couple has to learn to communicate regularly and work together against the mental illness, rather than let the illness come between them.

What advice/tips can you give to people with mental illnesses who may want to disclose their illness to a partner?

Again, it’s best talk about it during a calm time when you’re not actively struggling with an episode of anxiety, depression, psychosis, or mania. It’s helpful to have books or online reading about your disorder readily available for them to look at. Tell your partner what steps you’ve taken to treat your mental illness and what’s worked well for you, and talk to them about what you have learned about yourself through the process.

What tips can you give to help people with mental illness attract and maintain a healthy, loving romantic relationship?

When you’re living with a mental illness, the best things you can do are to be proactive about taking care of yourself, know your triggers, stay consistent with your treatment plan, and get professional help right away when you start to feel symptoms arise. When you take care of yourself in this manner, your relationship will benefit because you are emotionally healthy.

In terms of attracting a relationship, think about it in terms of what you’d like in a partner. It’s likely that others are looking for what you’re seeking, so it’s important to cultivate the aspects of yourself that make you a good partner. And know that you are deserving of a loving, healthy relationship and that it is possible to have a strong, thriving romantic relationship even when you have a mental illness. It’s about having realistic expectations—knowing there will be difficult times, but also recognizing that you can get through those difficult times.

Dr. Shannon Kolakowski is the author of When Depression Hurts Your Relationship: How to Regain Intimacy and Reconnect With Your Partner When You’re Depressed and Single, Shy and Looking for Love: A Dating Guide for the Shy and Socially Anxious.

Lisa R. Rhodes is a mental health writer and a member of NAMI Prince George’s County, Maryland.

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