I will begin this post by saying an entire blog itself could be (and should be--anyone out there an expert??) dedicated to the topic of PTSD, and the havoc it wreaks on the lives it touches. This blog entry is mostly to acknowledge the partners and relationships that are struggling under the weight of PTSD from past trauma, and it will be a topic I return to from time to time. When I think of PTSD and therapy clients, I think of experiences such as military service, rape, sexual abuse, and traumatic car accidents, and the subsequent paralyzing symptoms of nightmares, flashbacks, the inability to relax (hyperarousal), intense fear of something bad happening again, and panic attacks. What I don't often hear about is the role the non-traumatized partner has in the life of the partner with PTSD. Again, this blog entry will just touch the tip of the iceberg, but it will be a start and guide you towards other helpful resources. Also, in this entry, I will be speaking generally about PTSD, not to specific causes, such as military experience vs. sexual abuse history, which can look very different.
Your partner isn't with you when you show up to the party, again. People ask where they are, and you wonder, "Do I tell the truth, or do I say something else?" This is not the first time you've been in a position of feeling as if you need to make an excuse for your partner's absence, and it's getting old. Deciding whether or not to be honest about your partner's illness is a personal decision. Like any secret, not being open and honest can eat away at your self-esteem, and leave you feeling isolated. On the other hand, is this a privacy issue, especially since you are not the one with the illness?
When you look at the list of symptoms for various mental illnesses, they can sometimes parallel the traits we generally do not desire in a partner, such as: lack of interest in activities mood shifts (often unexpected) elevated self-esteem impairment in completing activities irritability How do you know if your partner's behaviors are truly due to mental illness or if they are just personality characteristics? And what do you do if you suspect that your partner is blaming their behavior on their illness when that is not the real reason it's happening?
Your partner, who has been experiencing mental illness, just said to you, "I love you, but I'm not in love with you." "Excuse me? After all I've done for you and all you've put me through?", you think. Next comes: "Wait...what does that mean, anyway?" It could mean a lot of things. Let's take a poll as to what it means when your partner has a mental illness: A. Exactly what they said: they still care about you, but the romantic spark of being "in love" is gone. B. They never loved you in the first place, but are just realizing or admitting to it now. C. They are struggling so much with their mental illness that they are incapable of feeling emotions of any kind, including love. Therefore, "feeling no emotion" = "I must not love you any more."
The problems often creep in slowly. Your partner may express unhappiness about work, or about your finances, or about the kids. At first, it seems pretty normal--after all, no one is happy all the time. Gradually--or sometimes not--you realize that the person you thought you knew is not there anymore. That person now calls out sick from work frequently, sleeps all the time, lets chores and other responsibilities go by the wayside, doesn't have any interest in a social life or sex, and is generally unpredictable. Maybe they even talk about how life would be better if they just weren't around anymore. Depression affects millions of Americans, and you are not alone if you are in a relationship with someone with depression. However, this situation can be lonely, especially when not only have you lost the partner you once knew, but you don't know how or where to get help. Anne Sheffield, author of Depression Fallout (and several other books about the impact of depression on partners), discusses the stages partners might go through when they are living with someone who is depressed.
Boundary-setting can be challenging in the best of times, trying to balance your needs with the needs and wants of your partner. When mental illness exists in the relationship, boundaries can become non-existent as you try to compensate for your partner. Why is setting boundaries so hard? Common reasons include: You may be uncomfortable expressing your own needs and wants. You may be afraid of being seen as selfish. You may be feeling guilty about setting limits because you know your partner is struggling. The problem is, without boundaries, you are going to burn out. Virginia Morris, author of How to Care for Aging Parents, urges people caring for a loved one to get rid of the little voice in their heads that says, "I can do it all. I am responsible for everything…and whatever I do, it’s not enough."
A popular book by Dr. Gary Chapman, The Five Languages of Love, describes five different ways people express their love for people they care about. He explains that trouble in relationships often occurs when the partners are not “speaking the same love language,” such as when one partner shows love through physical touch but the receiving partner really values receiving gifts as a sign of love more. Reconciling those differences and making an effort to “speak the language” of your partner can make a difference in the relationship. How can this apply to your relationship with a partner who experiences mental illness? You can look at it from two perspectives: identifying your partner’s “language of health” and their “language of illness."
Wednesday's post discussed obsessive-compulsive disorder (OCD). Hoarding--with lots of debate--is currently considered a type of OCD, but deserves a blog post of its own because of its unique impact on you and your partner's life. Let's start with a definition so that we're clear that "hoarding" is not the same as "pack rat." Drs. Randy Frost and Tamara Hartl of Smith College are credited with the widely accepted definition of compulsive hoarding. It is the behavior that consists of: "accumulation of a large number of possessions that seem useless to others; creating living spaces that are difficult to use; and being prone to impairment such as indecisiveness, disorganization, perfectionism, procrastination and avoidance that isolate them from others." In layman's terms: if you as the non-hoarding partner decide one day that you are "gutting the place" because you can no longer sleep in the bed, take a shower in the bathroom, or get to the stove because of the sheer amount of "stuff" around, your hoarding partner is most likely going to have some serious issues with you.
You did it again. You didn’t fold the laundry right, you didn’t wash your hands long enough before touching the lettuce to make a salad for dinner, or you threw away what looked to you like trash, but now has your partner rifling through the garbage can to retrieve because it was “important.” The rest of the day is ruined and your partner can’t relax until they do something to “make it right again.” Welcome to the world of obsessive compulsive disorder (OCD). What people often don’t realize is that OCD is a form of extreme anxiety for the person experiencing it. They can’t stop the thought in their head that they need to do whatever the behavior is, even if they realize the thought is distorted, unrealistic, or out of control. People with OCD have a “short” in their brain’s wiring system that controls the brakes on distressing thoughts. Like all other mental disorders, it is not something the person can just “snap out of,” although they desperately wish they could. What must it be like to live with a brain that says you are constantly in danger, and the only way to protect yourself is to perform a certain behavior? And as the partner of this person, what can you do to help?
You come home from work and he’s lying on the couch, much in the same position you left him eight hours ago. She doesn’t want to go with you anymore to do the things you used to enjoy together. You find yourself making excuses to others as to why s/he isn’t with you at the party. Nothing you do seems to help to bring a smile to their face, despite your best efforts, time and time again. This is the face of depression. Depression affects not only the person who is struggling, but everyone else the person interacts with as well. As the partner of a depressed person, you can easily wear yourself out, both physically and mentally, trying to make the situation and relationship better. Not only is that not healthy for you, but it is not healthy for the relationship. So how do you keep things in balance?