From anxiety and depression to bipolar disorder and addiction, mental illness shapes the daily lives and loves of those who experience it. This includes the symptoms of the illness themselves, but it also includes pervasive ableist discrimination against people with mental illness—including stigma within intimate relationships. If we don’t experience mental illness, but are in a relationship with someone who does, we may wonder how to best support our loved one while respecting their agency and self-determination.
According to Grazel Garcia, a licensed marriage and family therapist with certifications in Emotionally Focused Therapy and therapy for addiction, domestic violence, and trauma, these worries are normal, human, and “something people experience a lot.” In good times, we struggle with being a better ally to an experience we don’t share. During periods of turbulence, we may be unsure how to decide whether to leave or stay.
There are steps we can take toward concrete expressions of support and respect. We can educate ourselves about mental illness and health, deepen our communication skills, and work on setting healthy boundaries. We can question our own ableism, and our own understandings of what it means to be mentally ill and well. Most of all, we can realize that we are not simply a universe of two people, but rather nestled in communities we can consciously build and draw on for support.
If you don’t have the same mental illness as your partner, it’s impossible to understand exactly what your partner is experiencing. Even if you do, each of us experiences our mental health differently. But you can develop more insight and empathy for your partner’s perspective by educating yourself and questioning your assumptions.
“Gain more knowledge about the mental illness your partner is experiencing,” says Garcia. This will make you better able to support them, help you understand the context of their symptoms, and give you insight into their experience on their terms, rather than as a negative reflection of you or your relationship.
For example, says Garcia, someone with depression may feel lonely, but that’s not necessarily because you’re not being a supportive partner. Someone with anxiety may ask you a lot of questions about future plans in order to gain reassurance. “It may seem that they’re judging, but it’s mainly because they’re feeling anxious,” says Garcia. You can learn more about specific mental illnesses on the National Alliance on Mental Illness and other mental health advocacy resources.
“Learning what your partner is feeling is a good way to show you’re concerned without stigmatizing.”
When it comes to substance abuse and addiction, you can educate yourself on how your partner’s preferred substance can affect their physical health and behavior. You can also educate yourself on potential signs of overdose (and if they use opiates, get Naloxone training and keep Naloxone on hand).
Practice Healthy Communication
While educating yourself is important, the best expert on what your partner is going through is your partner. “Learning what they’re feeling is a good way to show you’re concerned without stigmatizing,” says Garcia.
Garcia advises using non-judgmental, open-ended questions, which demonstrate support without coming across as pushy or overbearing. “Is there something I can do for you at this time?’” Garcia suggests asking. Asking your partner what they need, rather than assuming you know, communicates basic trust and respect, and pushes against the patronizing assumption that people with mental illness can’t make decisions for themselves.
When your partner does communicate what they need, you can validate them with active listening skills. Garcia suggests mirroring back what you’re hearing your partner says and asking kind, gentle follow-up questions. If your partner says they feel overwhelmed, for example, you can say, “It sounds like you’re overburdened right now. Is there anything I can do to help?”
When expressing concern, it’s important to speak from your personal experiences, rather than making assumptions about theirs. “It’s always good to use ‘I’ statements,” says Garcia. By speaking from our own perspective, ‘I’ statements can help us express concern without coming across as pushy or censorious, since they make us take ownership of our own responses and behavior—ultimately, the only things we can truly control.
Finally, healthy communication also involves communicating your boundaries, and taking space when you need it. “Setting boundaries is a way of taking care of yourself,” says Garcia. That’s a particularly important practice in times of heightened tension or conflict. Garcia suggests communicating your boundaries firmly, yet lovingly, with language such as, “I need a break, but please know I still hold you close to me and I’m not going away.” That way, says Garcia, “They know you’re not detaching because you’re going away from them, you’re detaching because you need to and you still care and love them.”
We tend to talk about relationships as though they are just made up of the partners involved. In reality, all relationships take part within communities. “You can’t really do it alone,” says Garcia. “You need people who understand your suffering and your struggle.” When our relationships go through rough patches, that’s not necessarily a sign that anything is wrong with us: It may signal that we simply need more support.
Your concern for your partner’s wellbeing may actually be turning into control.
It’s important for both people in the relationship to have support centered around their unique experience. Without these supportive communities, says Garcia, you and your partner risk becoming codependent. In a codependent relationship, partners bond over a perceived sense of being unable to function without one another. In contrast, in a healthy relationship, each partner recognizes what the other brings to the table, feels supported in their vulnerability, and is celebrated in their strength.
“Some of the codependent behaviors may look like overcare, like taking too much responsibility,” says Garcia. “Some of the behaviors may look similar to controlling behaviors or avoidant behaviors.”
If you find yourself unable to take time for yourself, or disrespecting your partner’s choices about their own body, wellbeing, and medical care, you may be developing codependence. Garcia recommends seeking out a co-dependency meeting, where you can process with other people experiencing something similar. Couples’ therapy can also help.
Maintaining a strong community isn’t just for moments of crisis: It’s an enduring way of maintaining healthy and joyful relationships. If you’re looking for ways to access greater support, but you’re not in an emergency situation, you can reach out to a trusted friend, talk to an individual therapist, or call a mental health warmline, a 24/7 phone resource staffed with counselors who can help you strategize on how to access needed resources.
Know the Signs of a Healthy Relationship
All of us, regardless of our ability status, deserve relationships in which we’re seen and loved for who we are. Experiencing, or partnering with someone who experiences, mental illness requires us to practice additional sensitivity, caring, and understanding toward one another. But it doesn’t fundamentally change the love and respect that characterize healthy relationships.
In popular culture, we often see depictions of people with mental illnesses as more likely to be abusive. In fact, mental illness does not cause someone to behave abusively, and people with disabilities, including mental illness, are at a particularly high risk of becoming victims of relationship violence themselves. Abuse can also increase likelihood of mental illness, with many intimate partner violence victims experiencing increased rates of depression, anxiety, and PTSD.
Because of this close relationship between mental illness, trauma, and abuse, it’s important to understand potential triggers, both your partner’s and your own. What past experiences are sensitive for you? What vulnerabilities do you want to keep protected? What are your personal boundaries or red flags?
It’s also important to be honest with yourself about signs that your concern for your partner’s wellbeing may actually be turning into control. People with disabilities of any sort, including mental illness, have a fundamental right to bodily autonomy and dignity. If you find yourself blaming or berating your partner for their mental illness, withholding needed medication, or cutting them off from their community, it’s a good idea to take space and call a domestic violence hotline or talk to a therapist about your behavior.
While mental illness doesn’t cause abuse, people with mental illness can behave abusively in relationships. Conditions like alcohol addiction can particularly increase the likelihood of severe partner violence. If you and your partner are going through a rough patch that makes you uncomfortable, Garcia suggests looking at how your partner’s behavior is affecting your sense of self. “When there is a power and control dynamic, the partner who is being controlled can exhibit low self-esteem behavior,” says Garcia.
Make a Crisis Plan
It may also be the case that your partner’s behavior isn’t controlling or abusive, but is erratic or disturbs you in some way. If your partner has bipolar disorder, for example, their behavior during manic episodes—such as sleeplessness, extreme energy, and taking emotional or financial risks—may be alarming.
If your partner regularly behaves in a way that frightens or disturbs you, it’s normal to question whether this is the right relationship for you.
If your partner sometimes experiences psychosis, perhaps as part of a condition like schizophrenia, it can be frightening to see them experience a reality you don’t share. They may become intensely emotionally aroused, frightened, or agitated. They may react to you in ways that are unpredictable. It’s important to remember that someone in psychosis is in a different reality than yours. Their symptoms are about them and their illness, not about you.
Agitated people are more likely a threat to themselves than to others; if they are aggressive, they are usually responding to a perceived threat. Because of this, in a moment of acute distress, you can de-escalate the situation by making your mannerisms non-confrontational and non-threatening; softening your voice; speaking in short, reassuring sentences; and avoiding behavior that may be seen as confrontational or disciplining. If you are afraid for your own physical safety, it’s okay to exit the situation and call for help.
Depending on your partner’s illness, it’s a good idea to work together to create a crisis plan so that you know how to respond in escalated situations. Your safety plan might include calling a trusted friend or mental health professional, or taking them to a psychiatric hospital.
If you feel uncomfortable about something that’s happening in your relationship, that’s a sign that you deserve more support. In an emergency, you can call the National Suicide Prevention Lifeline, the National Alliance on Mental Illness hotline, or the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 24/7 National Helpline. You can also call the National Domestic Violence Hotline anytime you need relationship help or simply want to talk about what’s going on—you don’t have to suspect abuse.
You Always Have the Right to Leave
We can’t support other people unless we’re first supporting ourselves. Sometimes, caring for yourself may look like exiting the relationship entirely. If your partner regularly behaves in a way that frightens or disturbs you, or you’re worried for your own safety, it’s normal to question whether this is the right relationship for you. If you feel ill-equipped to support your partner, or you feel unable to care for yourself or maintain your own boundaries in the relationship, those are gut instincts you should take seriously.
Still, you may feel guilty for wanting to leave a relationship with someone you care about. “It’s okay to exhibit those behaviors of feeling obligated to stay or afraid to leave,” Garcia says. At the same time, we always have the right to leave relationships that aren’t serving us. We can both care about someone and decide that being together isn’t the best thing for us at that time. Garcia suggests couples’ therapy as a way to collaboratively work through a respectful breakup.
Ultimately, taking care of ourselves requires reminding ourselves that we are never alone. During rough patches, we may feel that our partner is the only support we have, or vice versa, and that can inspire us to cling onto a relationship that no longer makes us happy. But care goes beyond the couple. When we build our support networks inside and outside our relationships, we can make decisions from a place of deep love and respect, rather than fear or dependence. Coupled or uncoupled, there is more than enough care in the world for all of us.