On Partnership: Suggestions for Care and Support within Them

My partnership is our marriage.   It is the most supportive aspect of our lives together.  It is, it turns out, quite a bit stronger than mental illness.  Yours may be another partnership – marriage is not the required word, but supportive is.

46 years. That’s how long we have been married.  And it was 50 years ago when we first dated, a sweet memory today.  Jim has always been the very kindest, most fun and interesting man I know.  Our kindness toward one another is a key to our relationship, especially when the water wasn’t so smooth due to effects of mental illness on my thoughts, feelings and behaviors.

We had a stroke of luck early in our marriage that served us well through the years. During the first years of our marriage, Jim spent two years working part-time with the chairman of the department of psychiatry at the UW Medical School.  His tasks, which were not directly related to psychiatry itself, nonetheless enabled him to attend and learn from the people around him.  Jim learned about mental illnesses and about what people are like when they develop an illness like major depression. This background meant that when I became ill with major depression during my second pregnancy, my husband already had an understanding of mental illness as a no-fault disease. So I was never blamed for my illness or made to feel guilty. His familiarity with people with mental illness also meant that he was not afraid of me when I was symptomatic. I was always warmly loved and accepted.

Happily for us, we had two children, a girl and a boy, 5 years apart. I was diagnosed with major depression and became suicidal with the second pregnancy. My illness became a real crisis for us in our 10th year of marriage. Our families did not know how serious a problem we were dealing with.  But my man held me up day after day; at times, minute after minute. I have a whole separate grateful and inspiring entry to write about how my Jim taught me how to hope in the presence of utter despair, when I was sure I was too unworthy to go on living.  The illness has not gone away, but hope had returned, and with it, the process of recovery and healing.

I’ll brag:  Our children, Rebecca and Benjamin, have been the highlight of our partnership from their birthing until the present. Along with our son-in-law Joel, all three are wonderful adults and good friends. Plus now we have two grandchildren, a girl and a boy – Zinnia and Abraham – the source of their grandparent’s joy and unconditional love.  Yet I must admit also:  Our lives had really rough times too, but these we struggled through because our partnership had become a partnership of shared support.

The present years are a delight, a real reward. I find my mate even kinder, more fun and interesting than when I first meet him. We are living intentionally now that we are retired.  Thoughtfulness and our ability to support one another have grown to fullness. We have a coffee break together twice a day and can’t stop talking to one another. We are blessed.

 

I asked my husband to join me for this next section on partnership. We had several long talks scattered throughout a week of days to help us pinpoint what actions/beliefs helped maintain our marriage/partnership while standing up to mental illness.

Here are some thoughts we offer as suggestions from Jim and Gail Louise:

Realize that an individual’s life course makes for differences in how each spouse/partner views and reacts to learning that one partner has a mental illness. Partners may have had good examples and role models in their repertoire, or they may have neutral or poor examples of coping and living with what is certainly a major change in one’s married life and partnership.

Always anticipate that you will take care of one another. This outlook will enable you to manage the mental illness together – rather than managing the spouse or partner with mental illness.  Surprisingly, living so gives you the freedom to pursue personal goals as well.
Increase your mutual support circle i.e., neighbors, colleagues, friends. This will increase the chance of both partners not only improving but thriving.

Seek professional help for the partner who is well.  We worked with a marriage counselor whom we saw together, a psychologist who worked “our” side……he helped advance our marriage. Although we started out guardedly, these sessions once or twice a month, progressed into real help for managing our relationship and family matters. We actually began to look forward to them. They were a steading influence as we went through some major life changes, moving homes to a new city, moving children to new locations, illness and death of parents, impending retirement, etc.

Life is not fair in so many ways to so many people. Rarely does a person go through life without a major difficulty. Expect change and anticipate that you will be able to find the support to meet it.

Make sure the illness and its course are aggressively treated. Get second opinions. If the physician doesn’t approve, get a new physician.

Go to the top for the best medical care for the person with the mental illness you can.  And take NAMI’s Family to Family education course also. You can read [LINK]more about it here. It is for the family member without the illness.  For the partner with the illness, explore [LINK]local support groups and Peer To Peer classes, etc.

Learn about forgiveness for yourself and for each other.  This difficult and important process can be so important, for guilt and shame only impede recovery and poison partnership.

 

Here are some current recommendations we both support [not an exhaustive list!], both from my experience and from the current progressive literature on mental illness:

  • Although they may have similar mental illness Dx, individuals are different persons and their course of illness may vary, even within the same type of illness.
  • People first! Say persons with a mental illness, not the mentally ill. Saying person first helps one to acknowledge and respect the person; using such language breaks down stigma and stereotypes.

Learning one has a serious illness can bring fear, darkness and feelings of abandonment. The well relative must assure the person that their help will be there and that the well relative will walk by the affected person’s side.  Therefore:

  • One of the most important phrases you can say as the spouse who is well when mental illness first is diagnosed in your partner is, “We will get through this together.”

I suggest learning about the recovery movement and what recovery means. Also that the two of you discuss recovery as a goal of care and life:

  • Start with small goals but I do suggest goals and a working towards positive outcomes in incremental steps. It’s appropriate to assume a degree of recovery is possible [It always is!].
  • Look for a recovery orientation in the treatment team and in the physician(s) who cares for your loved one.
  • Again, do seek counseling for yourself as the partner of someone who has a mental illness
  • Both parties, the partner with the illness and the well partner together can make a commitment to knowing as much about the illness(es) you are dealing with as possible. Know the illness as best you can and keeping up to date means you can communicate with the treatment team, ask good questions and make requests for changes in treatment because you are well informed.
  • Also keep records of medical visits, lab tests, appointments with psychiatrists, community agency visits, good/bad days, etc. It’s so easy – if records aren’t kept – to forget what really happened and when med changes occurred, for example.
  • Don’t buy into the stigma all around you. Recognize stigma and myths about mental illness.

“There are times when we cannot be that person. [Partners] need to take breaks before they burn out from emotional exhaustion. If you are feeling overwhelmed, isolated, and scared about your loved one’s mental illness and its impact on you, then ….. This is hard. Taking a break does not mean that you don’t love the person. It means you are taking a break. Getting some space and time away is healthy, creating time for self-reflection ….. Sometimes taking a break or time apart can help you gain perspective.”

Get the right treatment(s); that is, know what is recommended in medication currently and what has worked for your partner AND be informed about other treatments. Know what other traditional and alternative treatments are available as TOOLS that may be of help to your partner. Exercise, getting involved as an advocate, yoga, mindfulness, and for those with schizophrenia, Cognitive Enhancement Therapy, therapy pets, etc. Find out what your role in treatment as the spouse/partner should be.

  • For example, in the early 1990’s when a medication finally worked for me after trying many categories of antidepressants, we didn’t stop there. My good doctor, a psychiatrist, got me interested in CBT , Cognitive Behavior Therapy. Well at first, I wasn’t interested as I thought it was just a variation of “think positive”.(Long story cut short:   I finally learned CBT with the help of one-to-one training sessions with a psychologist completing his Ph.D. I did the CBT homework consistently and presently my severe negative thought patterns lessened and became less negative altogether. It became a regular practice. I learned the techniques well and as time passed the techniques became automatic. My doctors have credited equal parts of my recovery to medication and to CBT.)

The two partners or spouses should develop a Crisis Plan together and keep it handy. The WRAP or Wellness Recovery Action Plan from the Copeland Center addresses mental health status from the initial hints of problems thru a post-crisis stage. I and several friends have made out WRAP Plans, which have been very valuable. With a Crisis Plan in place partners are prepared if a relapse should occur or a medication stop working, or there is a need to change doctors, for example.

  • Recognize progress! Find ways to use as much positive reinforcement as possible. Praise new beginnings and accomplishments
  • Know the course of the illness as it plays out; find out from the treatment team what the prognosis is expected to be. Then you can thoughtfully set expectations.

For those of you dealing with depression specifically, I  recommend reading What to Do When Someone You Love Is Depressed by Mitch Golant, Ph.D. and Susan Golant ( second edition) 2007 published by Henry Holt & Co.. Full of practical, compassionate helpful tips, especially good at improving communication and what to say and what not to say.

We feel that our willingness to make things work and our love for each other went a long way towards keeping our marriage strong and finding recovery and healing. In 2019 we will celebrate our 50th Wedding Anniversary. We will celebrate it with family and friends and also with a very special dream of Gail’s come true……

 

In the pleasant months of 2019, life willing, we will walk a portion of The Appalachian Trail(the “AT”) . I had wanted to do that since young adulthood.  In my 50’s I’d just about given up the dream. But in January of 2014, I began working with a personal fitness trainer 3 times a week (And actually I’m in the gym 6 days a week!)  My short term goals are to be able to camp with Jim; my long term goal is to hike a portion of the AT. Well, Jim loved my working out, so we quickly turned the hike into a goal that we could both realistically meet in 2019 at age 72 (!)