Randi Kreger, coauthor of Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder, and the founder of BPDCentral.com, recently wrote a great post on her Psychology Today blog about how to leave a partner who has a personality disorder. Since this is a topic she is well-versed in, and I could not write about this topic any better than she has, I encourage those of you who are considering leaving your partner to go read it for advice.

Leaving a partner with a mental illness is a difficult decision, and can be a challenge to execute, as I had addressed in a two-part blog post earlier this fall. But if you have a partner with a personality disorder, there are extra layers of complexity, which Randi addresses beautifully in her post.

In a perfect world, recovery from a psychiatric illness would be like getting over a cold: once it is gone, it’s gone. Our bodies would build immunity to that illness, and we’d never be sick in the same way again.

Unfortunately, it doesn’t work that way with mental illness. It can come back, and when it does, it is often stronger than it was before.

When I release clients from my care because they have recovered to a place where we have decided therapy is no longer necessary, one of the questions I ask them in our final session is, “How will you know if you need to check in with me? What are some of the red flags that will tell you that perhaps you are relapsing?”

This information is good to share with partners, because the person who has the illness may not notice the red flags at their earliest stages. The person may also be in denial, or frustrated that they are ill again, and resisting returning to treatment. As the supportive partner, you have an important role in making sure your partner gets the help they need, whether it’s the first time, or the 57th time, or somewhere in between.

“Black Friday” gets its name from the fact that on the day after Thanksgiving, retailers finally make enough money for the year to “be in the black”–in other words, profitable.

For your partner with a mental illness, “Black Friday”–or really, any day this time of year–can feel darker than usual.

Since yesterday was Thanksgiving, it’s likely that you and your partner were with family and friends for the holiday (and they may even still be in your house now!) That “family togetherness” may have stirred up tensions that lay dormant the rest of the year, creating additional anxiety and depression for your partner.

Or perhaps you and your partner were alone, and that brought up other feelings, depending on the reason for not being with others. You could live too far away, or people you used to celebrate with may have passed away since last year, or perhaps your partner is too ill to participate in family get-togethers. Your partner may be grieving the loss of holiday traditions, or feeling anger, guilt, or shame if the reason you didn’t participate is because of their illness.

Daylight Savings Time here in the U.S. ended a few weeks ago, and shorter days/longer nights are with us for a while. Many people notice a shift in their moods when the winter months come, but some people experience a depression that starts when the weather turns colder and lifts when the weather warms up again and the hours of daylight increase. Does this sound like your partner?

If so, your partner may be suffering from Seasonal Affective Disorder, or SAD for short. It’s estimated that half a million Americans suffer from SAD each year, so your partner is not alone. Common symptoms include feeling down, sadness, irritability, increased sleep, weight change, and less interest in activities that once brought pleasure. If you are thinking those symptoms sound the same as major depression, you would be right. The difference is that SAD resolves once the warmer weather appears; major depression will not lift.

Most people don’t like snakes. Many don’t like insects, either. Or bats. Or rats. Or anything that falls into the “creepy-crawly-slimy-gross” category. Some people fear storms, refuse to use elevators, or panic on planes. Still others break into a cold sweat at the thought of giving a speech, using a public restroom, or having a procedure done that includes the potential sight of blood.

If your partner has a phobia, the dislike of whatever the phobia is centered around goes way beyond just an “Ewwww!” reaction. By definition, phobias are irrational fears about something that is not posing a danger. People who have phobias generally know their reaction is overblown, but feel powerless to try to change their thoughts. Many don’t even know the origin of their phobia, although many phobias do develop around a traumatic experience (such as having a fear of dogs after being bitten as a child).

Witnessing your partner having a negative reaction in response to encountering a phobia trigger can be frightening. Having to change your plans in order to accommodate your partner’s phobias can get annoying, such as driving a long distance because your partner won’t fly, or not being able to live in your dream apartment because your partner refuses to use an elevator. What can you do to help your partner deal with their phobias?

…if your partner has a mental illness, that is.

With the holiday season upon us, our regular routines can get thrown into chaos: travel to family gatherings, time with extended family, irregular eating and sleeping schedules, and perhaps consuming more food and alcohol than usual. In addition, there’s pressure to spend a lot of money, to find the “perfect” gifts, to make appearances at parties, to host get-togethers, and to fulfill the expectation that this is “the most wonderful time of the year.”

For most people, we can tolerate the changes fairly well, but for people with mental illnesses, even one of the above changes can wreak havoc on mental stability. While it can be challenging, and may mean making sacrifices and disappointing people, being deliberate about how you and your partner with mental illness approach the upcoming holiday season can make the difference between your partner staying stable versus needing serious interventions come January (if not right in the middle of the festivities–no one wants to be in the ER on Christmas, trust me!)

Thanksgiving is just a few days away, and the gluttony of the holiday season is upon us. For people who enjoy food, this is the best time of year. For those who have eating disorders, the time from now until the festivities are over in January is torture. Food is everywhere: at home, at the office, at stores while you are doing your holiday shopping, at the holiday parties, and at holiday gatherings of friends and family.

For people who have eating disorders, not only is the food itself often frightening, but so are the potential comments from others when they notice your partner either is not eating (possible in the case of anorexic behaviors) or eating too much (possible in the case of bulimia or binge eating disorder).

Well-meaning friends and family may try to cajole or guilt your partner into eating more, saying, “Just try a little bit,” or “You have to have some of Grandma’s cake–her feelings will be hurt if you don’t!” On the other hand, comments about how much your partner is eating, or how much weight she has gained since last year can be incredibly shameful. Comments like, “You are eating all that???” or “Wow, you must really like food…” can drive your partner even further into her shame and guilt, triggering further eating disorder behaviors, and continuing the downward spiral.

“If you leave me, I will kill myself.”

“You don’t really care if I live or die. Why don’t I just kill myself–then everyone will be happy.”

“If you loved me, you would do what I tell you.”

If you are on the receiving end of threats like these, whether they come from your partner, your parent, your sibling, your child, or your friend, it can feel like a bucket of ice water has been poured over your head.

Mental illnesses come with the risk of suicide. Some diagnoses, such as borderline personality disorder, come with a 10% suicide completion rate, although there are often many attempts that are unsuccessful or are simply an exaggerated cry for help. Other disorders, including depression, eating disorders, and substance abuse, carry suicide risks as well.

If the person in your life truly wants to die and/or has a suicide plan and a means to carry out that plan, you need immediate assistance. Call 911 or your local emergency number for assistance. Alternatively, you can call the National Suicide Prevention Helpline at 1-800-273-TALK (8255).

Always take threats seriously and follow through with calling for help.

When help is needed, people are usually surprised by the outpouring from others. Family and friends may overwhelm you with offers to help. People you didn’t know were friends step up to contribute. It seems like everywhere you turn, someone is asking what they can do.

That is, until the crisis has passed, and life returns to “normal,” whatever that is. Other people have lives to get back to, yet you may still have a very ill partner to care for. You may have a variety of reasons why you feel you cannot or do not want to ask for help, but the fact of the matter is, you will likely need help. Maybe a lot of help, and your friends and family may not be able to provide it, or know how specifically to be helpful.

That’s where these resources come in.

Peter Gabriel sang the song “Love To Be Loved” on his 1992 album Us. Do these lyrics sound like you?

So, you know how people are
When it’s all gone much too far
The way their minds are made
Still, there’s something you should know
That I could not let show
That fear of letting go

And in this moment, I need to be needed
With this darkness all around me, I like to be liked
In this emptiness and fear, I want to be wanted
‘Cause I love to be loved
I love to be loved [x2]
Yes, I love to be loved

Sure, the message probably sounds familiar to most of us…after all, who doesn’t want to be loved?

But does your need to be loved go beyond typical relationship love to a need for your partner to be sick so that you are needed, too?