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.

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.

If you have a partner who is addicted to meds or alcohol, doctors are prescribing a new way for families to approach getting treatment.

Read the full article here and submit your comments/thoughts 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?

First off, let’s define “ACOA” for those who don’t recognize the acronym: Adult Children of Alcoholics. Is your partner one of them? Being an ACOA does not mean your partner has a mental illness, but the effects of having an alcoholic parent can greatly affect your partner’s mental health, especially if the parent is still abusing alcohol (or other substances…addiction does not discriminate!)

The effects of parental substance abuse are far-reaching and often last for the adult child’s entire life. As a child, your partner may have had the following characteristics:

Drug abuse doesn’t just happen with illegal substances like heroin and cocaine. It can happen with any kind of medication, including over the counter and prescription meds.

Any time a medication is used for something other than what was intended, it is being misused. It can be very easy to justify the use of meds for alleviating symptoms– especially if you already have the medications in the house–but it’s also all too easy to cross the line from occasional use to dependence and abuse. With psychotropic medications (those prescribed for mental illnesses), the risk of abuse is even higher, as some of those medications are not meant for long-term use and are easy to become dependent on. This happens commonly with anti-anxiety meds, such as clonazepam (Klonopin®) or alprazolam (Xanax®).

On the other hand, your partner may not be abusing their prescription meds, but instead using alcohol or marijuana as another means to alleviate their pain, whether that pain is physical or mental. Substance abuse and psychiatric illness–especially for people with anxiety, bipolar disorder, and schizophrenia–often go hand-in-hand. Your partner may be trying to self-medicate in order to relieve their symptoms, but mixing alcohol with prescription medications can be a deadly combination. Medications that are sedatives, such as those prescribed for anxiety or sleep, combined with large amounts of alcohol, can result in your partner’s breathing and heart rate to slow to the point of stopping.

“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.

What if rendering help to others in a mental health crisis was as widely accepted as giving CPR to someone in cardiac arrest or doing the Heimlich maneuver when someone is choking?

Mental Health First Aid USA envisions that what they call “Mental Health First Aid” will become as common as CPR and first aid training during the next decade.

According to their website, through their 12-hour course, participants learn:

• The potential risk factors and warning signs for a range of mental health problems, including: depression, anxiety/trauma, psychosis, eating disorders, substance use disorders, and self-injury
• An understanding of the prevalence of various mental health disorders in the U.S. and the need for reduced stigma in their communities
• A 5-step action plan encompassing the skills, resources and knowledge to assess the situation, to select and implement appropriate interventions, and to help the individual in crisis connect with appropriate professional care
• The evidence-based professional, peer, social, and self-help resources available to help someone with a mental health problem.