It’s no secret that health insurance is expensive, and paying for mental health services can be outrageous as well. When you and your partner have a large pile of bills to pay, it can make a difficult decision to forgo mental health appointments and psychiatric medications appear–on the surface–to be easier.

No money = No care, no meds. Period. End of story. Right?

Unfortunately, you and your partner may have already discovered what happens when mental health treatment is stopped abruptly. Or if you are considering this possibility, you may be in for an unpleasant surprise.

The ramifications of not getting appropriate treatment go much further than just a depressed mood or anxious thoughts and feelings. It could result in an untimely death.

“One minute, my wife is smiling and joking with me, and the next, she’s looking at me like I’ve grown a second head, and walks away angry. I think she’s bipolar.”

“My partner has to be bipolar…I never can predict what his mood is going to be, and the littlest things get him upset. But then, a few hours later, he’s fine again.”

“My coworker never seems to need sleep! She sends me emails at 3:30 am, and wonders why I’m not awake to answer them. But then, she misses deadlines and is furious when projects don’t run as she would like. Does she have bipolar or something?”

Bipolar disorder has a bad rap, and is largely misunderstood by lay people with no mental health training. Even those of us who are trained in psychology can sometimes be mystified by the presentation of bipolar disorder.

The above examples illustrate that people understand bipolar disorder includes having extreme ranges of emotion, but the key element that’s missing is how quickly those emotions change. People with active bipolar disorder experience their depression or mania for days, weeks, months or (unfortunately) longer–not in short increments that can be measured in minutes or hours.

One of my three cats, CJ, has a unique purr. Her purr can be heard across the house, or over the phone by unsuspecting callers, and her sound has been compared to a pigeon or turtle dove. It’s nearly impossible not to smile when she is purring (unless it is 3 a.m., because if she wakes up, she purrs then as well!) My other two kitties like to snuggle–often at inconvenient times, such as when I am trying to type a blog post!–but there is no doubt they love me. They tend to stick especially close when they sense I am unhappy or not feeling well.

One of my colleagues at Duke, Jennifer Strauss, was featured recently about volunteer work she, her husband, and their dog, Murphy, do at a camp for children who have lost a parent, sibling or other significant person in their lives within the past two years. In the article, Jennifer discusses the connections the children make with Murphy, and how his presence seems to allow them to express feelings that may not be so easy to share with adults.

The physical and mental health benefits of having pets are numerous. If you and your partner already have pets, are you getting the most benefit? If you don’t have pets, is it time to consider getting one?

Bringing up the topic of a partner’s mental illness with family and friends can feel tricky. In some cases, it might be obvious that there is something wrong, but many mental illnesses can’t be detected from the outside. However, that doesn’t mean you and your partner don’t need and deserve support from understanding family and friends.

Asking for that support can feel uncomfortable, though, given the stigma that still exists around mental illness, and cultural perceptions that we should keep personal problems to ourselves.

Every so often, I like to share with my readers resources that I have found elsewhere on the Internet. Today I’d like to introduce you to “Patient Voices,” a New York Times online resource that highlights multiple patient stories for myriad illnesses, including ADHD, bipolar disorder, eating disorders, OCD, PTSD, and schizophrenia. If your partner has one of these illnesses, or perhaps another type of physical illness, these interactive clips may give you new insight into your partner’s experience.

Let me know which ones you watched and what you thought. Also, what are some of your favorite resources for learning about mental illness? Post them in the comments below!

Jim’s drinking was clearly out of control…he had been up for over 24 hours, and the beer bottles lying around numbered over thirty. Yet he refuses to see a counselor, saying that he “doesn’t have a problem and doesn’t need help!”

Jane’s mother, Sally, age 76, can barely make her way through her own house because of the clutter and items she has accumulated. Jane is concerned for her mother’s safety, but Sally will not allow Jane to clean the house or throw anything away. The more Jane insists, the stronger Sally’s resistance. It’s gotten to the point where Sally has told Jane she is not welcome to visit anymore, and Jane cannot figure out how to help.

Josh has not been feeling like himself for a long time now: he lost his job six months ago and his girlfriend of two years broke up with him a few weeks ago. He’s finding himself sleeping through the day and staying up all night, gaming online and looking at porn. He knows he should be job hunting, but really, he doesn’t care anymore. He’s lost 20 pounds, and when he does see his friends, they are shocked at the changes. But when they ask questions, Josh blows them off and says, “I’m fine.”

All three of these people are great candidates for therapy, but none of them will go. Why?

The American Psychological Association released its annual Stress in America report earlier this month, and the findings were clear: those caring for people who are aging and/or chronically ill (including those having a mental illness) are under more stress than the average American. According to estimates from the National Alliance for Caregiving, 65.7 million Americans served as caregivers for an ill or disabled relative in the past year.

Not only that, caregivers reported that they are less successful in making changes that could improve their quality of life, such as eating well, exercising, managing stress, and getting enough sleep. If you read this blog regularly, you know that I often reinforce the importance of these strategies, but the results show this is still difficult to put into practice.

You may have told your partner during your time together that he or she is “one in a million,” but if they also have a mental illness, they are more like 1 in 5 Americans, according to a recent report from the Substance Abuse and Mental Health Services Administration (SAMSHA).

According to the report:

A new national report reveals that 45.9 million American adults aged 18 or older, or 20 percent of this age group, experienced mental illness in the past year. The rate of mental illness was more than twice as high among those aged 18 to 25 (29.9 percent) than among those aged 50 and older (14.3 percent). Adult women were also more likely than men to have experienced mental illness in the past year (23 percent versus 16.8 percent).

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health also shows that 11.4 million adults (5 percent of the adult population) suffered from serious mental illness in the past year. Serious mental illness is defined as one that resulted in serious functional impairment, which substantially interfered with or limited one or more major life activities.

As the well partner, what does this mean for you?

Last Friday’s post discussed how stigma is–unfortunately–still a major force in mental health.

Today, I want to share with you something you can do about it. Many positive things in the world have happened because someone has had a loved one go through a negative experience, and decided to instigate change. The National Alliance on Mental Illness (NAMI) has just the thing: Become a StigmaBuster!

WebMD has a great collection of resources about all things medical, including mental health. I recently took their “Myths and Facts About Your Mood” quiz, which had 13 questions related to how music, food, and interactions with strangers affect mood, what mood means you are more likely to catch someone in a lie, whether older people are more likely to be in a bad mood, when seasonal affective disorder is most likely to occur, and more. Go check it out…I learned some new facts, so I’m sure you will, too!

As the partner of someone with mental illness, it can be hard to separate fact from fiction. The above-mentioned quiz might clear a few things up, and here are ten more mood myths that you may not have realized were false: