When you have a partner with mental illness, you are likely always on alert for behaviors that might indicate the illness is progressing. Was that laugh too loud, and a sign of impending mania?…Does the fact that he doesn’t want to go to the party mean his depression is coming back?…Did he forget to pick up the dry cleaning because he didn’t take his ADHD meds?…Did she skip dessert because she’s full or because her eating disorder is telling her she should?…Is he jumpy because of his PTSD or did he just have too much coffee this morning?

As the supportive partner, it can be exhausting to have these thoughts all the time. You have likely been through the mill with your partner’s behaviors that are due to their illness, and having these kinds of thoughts are a defense mechanism to protect yourself from being caught off guard again.

But there’s a flip side to this story, too: your partner may not be feeling as if it is okay to be themselves.

The world can be an unfriendly place, and defense mechanisms are how we survive. If you have a partner with a personality disorder, the way they use defense mechanisms can be confusing, frustrating, and crazy-making. You may continuously be taken by surprise when something that seems logical to you is twisted into something else that puts your partner into a rage.

As a result, you yourself likely use defense mechanisms in order to survive and try to maintain some harmony in the relationship.

Here are some of the common problems that play out in relationships where one person has a personality disorder:

1. Splitting: One moment, you are perfect and can do no wrong; the next, you are being screamed at, ducking thrown objects, and rescuing items from being destroyed. People with borderline personality disorder (BPD) in particular struggle with the “gray” areas of situations, meaning that they tend to think in all-or-nothing terms. This then leads to either you and your behavior being “all good” or “all bad.” The famous book about BPD, titled I Hate You–Don’t Leave Me by Jerold J. Kreisman and Hal Straus, depicts another example of splitting. As the partner, it can be scary to wonder when the next turn is going to come, and what will trigger it. 
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Today’s post is Part 2 on how to help kids who have a parent with a mental illness. In Part 1, we discussed how kids think about and react to having an ill parent. This post will address how to talk with kids when their Mom or Dad has a mental illness, and provide helpful resources.

Talking with kids about mental illness

Experts recommend that you address these main topics with kids when Mom or Dad have a mental illness:

1. What is it?, Will I get it?, and Will Mom/Dad get better?: Obviously, this will take a little research on your part ahead of time so that you can accurately answer your child’s questions. It is okay to say, “I don’t know, but I will find out,” instead of lying, stretching the truth, or ignoring your child’s question if you aren’t sure of the answer. See the next topic for more on that…
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When a parent is mentally ill, children are often confused, scared, angry, and/or worried. Depending on their ages, how long the parent has been symptomatic, and experiences with Mom or Dad being sick, children need appropriate levels of education and support.

Children of parents with mental illness are at risk a range of mental health problems, including depression and anxiety, alcoholism, and personality disorders.

In this two-part blog, we’ll first look at how kids perceive, react to, and think about having a parent with a mental illness.  In Part 2, we’ll discuss how to best help kids and offer resources.

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.

If you have a partner with borderline personality disorder (BPD), the phrase “walking on eggshells” likely defines your life. People with BPD struggle to regulate their emotions, even though the emotions they experience are the same as the rest of us.

The difference is in the intensity of how they feel those emotions. Marsha Linehan, PhD, the founder of dialectical behavioral therapy (DBT), compares those with BPD to third-degree burn victims: “Lacking emotional skin, they feel agony at the slightest touch or movement.” What might just be a small slight for you might mean off-the-charts upset for your partner.

In the DSM-IV-TR, four of the nine criteria required for a diagnosis of BPD have to do with how the person handles emotions. These include:

• frantic efforts to avoid real or perceived abandonment
• intense and quickly changing moods, including irritability and anxiety
• inappropriate anger or the inability to control anger
• chronic feelings of emptiness

What does this mean if your partner has BPD?

Sociopaths are all around us. When we hear that term, people like Jeffrey Dahmer, Ted Bundy, and Bernie Madoff come to mind, but reality is that most of us will encounter someone who is a sociopath during our lives. Some of us will get sucked into a relationship that is very hard to get out of and is very dangerous; others of us will escape unharmed, but potentially have interesting stories to tell about the insane things the sociopath talked us into doing.

At first, your partner may have seemed too good to be true. Sociopaths are fabulous at making people feel special, oozing charm, wit, humor, and (what appears to be) affection. Once they have reeled you in, though, some of the more noticeable features that will surface are manipulation, grandiosity, lack of emotions (including the ability to love), pathological lying, lack of remorse, and the need for stimulation. Sociopathic characteristics start before the age of 15, and does not seem to be influenced by upbringing, so if your partner is indeed a sociopath, chances are there is a history of these behaviors long before you came into the picture.

You are likely not their only partner, either.

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.

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.