How Mental Health Affects Relationships: Navigating Love, Communication, and Support
written by Micah Brown
With all the available media on how to make relationships work, one would think that there would be a plethora of easy-to-find information on mental health and relationships. Social media is rife with stories of how various mental health issues have destroyed relationships and what type of mental health issues to avoid in potential partners. For those who suffer from mental health issues, seeing these types of stories circulate through social media can make them feel hopeless.
Despite the perpetuation of these stories, the truth behind mental health and relationships is much more complex and, dare I say, hopeful than the likes of TikTok would make it seem.
In 2021, according to NAMI (National Alliance of Mental Health), 22.8% of adults suffered from some kind of mental illness. That accounts for approximately 1 in 5 adults having dealt with some kind of mental illness. Considering the numbers, the likelihood of finding somebody who has a mental health issue of some kind is going to be pretty high.
To make a relationship work with somebody who suffers from a mental health disorder will take effort from both sides. A popular quote from Marcus Parks has been making the rounds recently: “Your mental health is not your fault, but it is your responsibility.”
My interpretation of this isn’t that he is being ableist in any way, but that he’s trying to say that should somebody have a manic episode and hurt somebody during that time, they don’t play it off as “not being their fault.” Instead, they acknowledge their actions during the episode and apologize for them. Do not try to pass the blame off on your disease.
Taking the steps to try and better understand and treat your mental illness is taking responsibility for it. On the other side of the coin, a partner needs to understand your limitations and understand them.
Understanding Depression and Anxiety in a Relationship
Mood disorders, including depression and bipolar disorder, are the 2nd most common mental health issues diagnosed in the United States, with the first being anxiety disorders. The thing with depression and anxiety is that they are often comorbidities of each other. This can make the distinction between the two a little blurry and not as easy to separate as there are many overlapping symptoms.
Being anxious all the time and worried about all the possible things that could go wrong at any given moment can quite easily cause feelings of despair and helplessness, which can be read as depression. On the other hand, being depressed can cause one to start to worry about various things in their life, which can manifest in symptoms of anxiety. The two are often diagnosed together because of how well they play off each other.
Before going any further, it is essential to note that not everybody who suffers from depression is going to be constantly fighting off suicidal thoughts or feeling as though everything is hopeless. Major Depressive Disorder can certainly end up with those sorts of feelings swimming through your head, but not always. You can also find suicidal ideation in the thoughts of those who suffer from severe anxiety and who may just want the constant worry to stop.
The good news is that both anxiety and depression are two of the most manageable mental health disorders to treat. A combination of medication and therapy can work wonders for many people who suffer from these disorders.
So, what can you do if you find yourself in a relationship with somebody who has anxiety and depression? You may not know they suffer from either of these things when your relationship begins. If they are taking meds and keeping up with their therapist and doctor, there may be no symptoms of these disorders displayed at all.
If your symptoms are well controlled, talking to your partner about these issues is still ethical. Even those who have their symptoms under control may find themselves having a severe depressive episode that could require assistance from somebody to get the help they need. Even people who are familiar with a major depressive episode can be scared when such happens to a loved one. Imagine not knowing what is happening and attempting to navigate your way through it as your partner refuses to get out of bed or eat (symptoms will vary depending on the individual, and a medical professional should be consulted if you feel you or your partner may be suffering a major depressive episode).
If you or your partner suffer from depression, make a plan for what to do when a major depressive episode hits. What steps must be taken by the partner not suffering from the episode? What kind of support can they provide? Talking about these things beforehand will mean that the helping partner is better prepared to assist – whether calling a therapist or knowing when to call emergency services.
If a partner is suffering from an episode of increased anxiety, make sure there is a plan in place to approach the anxiety on terms that can help calm them down. Talking about these things before it happens is important to its success. Telling an anxious person not to worry about something that may seem trivial to you will never go over well. Instead, talk about how you can de-escalate using other language or distractions. I have a friend who can be distracted away from anxiety by specifically playing Mario Kart, however, they will never choose to play this on their own, so their partner will guide them to it.
Managing Bipolar Disorder: Communication and Support Strategies
An acquaintance said this to me about her own experience with bipolar. She went on to describe how amazing the manic episodes felt. She was unstoppable, flying through tasks and projects around the house with crisp efficiency until some part of her brain clicked. She realized that all the things she’d accomplished had nothing at all to do with what actually needed to be done - and that realization could then send her straight down to the depressive side of bipolar and stop every single thing.
An often undiscussed symptom of bipolar in the United States is hypersexuality during manic phases. During these times, one’s libido may be increasingly high, and the act of sex itself may not satiate the individual’s desires, pushing them into doing more risky behaviors. These periods of hypersexuality often appear as the stereotypical view of nymphomania, with an increasingly high and impossible-to-satisfy sex drive. For a new partner, this may seem very exciting at first. Still, it is unlikely that the average individual would be able to keep up with somebody amid a manic, hypersexual episode.
The truth behind these episodes is that the shame and embarrassment that follow the decline into a depressive state can make that depressive state worse than it might have been otherwise.
Hypersexuality can also lead to infidelity in those who are in the midst of a manic episode. Even for those who are involved in ethical non-monogamy, there can be infidelity when there is no appropriate communication about additional relationships. This sort of behavior can be very hurtful.
How you approach a partner who manages bipolar disorder depends on how well their treatment plan is going. Talk openly about bipolar with your partner. No sort of psychological issue should ever be a taboo subject when one of you is managing it. All parties need to be a part of the conversation around what needs to happen in any circumstance.
How ADHD and Autism Affect Relationship Dynamics
Two more mental health issues have some pretty severe comorbidities and can often be mistaken for each other.
Autism is perhaps the more misunderstood of the two. As an autistic myself, I seem to have met several people in the world who all have the same non-verbal five-year-old nephew with “severe” autism, and I don’t look like him! Well, first of all, I should hope not. I’m not five, and I don’t think I’m related to you…
Over recent years, a plethora of new information about Autism has become available that can help explain it and provide new insights into it as a whole. I will not try to delve into the nitty-gritty parts of it as that would turn this into a rather large article, possibly becoming its own book on the subject (there are plenty of books on the topic written by people smarter than me).
Many folks equate ADHD to the idea that we are easily distracted by a squirrel in much the same way a dog might be and that we are completely unable to sit still. This is not always the case. There are two primary types of ADHD - the hyperactive type, where the individual has trouble sitting still, and the inattentive type, where the individual has trouble paying attention and may become easily distracted (think the squirrel analogy, but also understand that it goes far deeper than just seeing a shiny object and forgetting everything else).
There is overlap in some of the symptoms for both ADHD and autism, especially when it comes to the inattentive type of ADHD. In both cases, an individual can seem to hyper-focus on a topic and let the rest of the world fall away. In the case of ADHD, there is a constant search for dopamine happening because the brain doesn’t function in the same way a neurotypical person’s would. Dopamine is released as a “reward” for having accomplished something. In people with ADHD, that reward center doesn’t work the same way. Dopamine is still a reward, but it is only produced when something is accomplished that has caught the individual's interest.
This can lead to obsessive-seeming behavior around a singular topic. The person will absorb everything they can until dopamine stops being produced for the topic, and they move on to something else.
Somebody who lives with autism may also become hyper-focused on a single topic and learn everything there is to know about it, though in this case, there is rarely a point at which that desire to learn ends.
Considering how closely these things can mirror each other, they could be the same disorder. As I am not here to write a scientific article on the similarities and differences, I will simply finish this brief overview by saying that living with both is possible, confusing, and amazing.
It is likely that when you are with somebody who is on the spectrum, diagnosed with ADHD, or who is AuDHD (Autistic with ADHD) some things can become frustrating.
Because I am AuDHD, I will use myself as an example. I’m also intimately familiar with those around me and how I impact them.
First of all, I am terrible at organization. This includes keeping rooms clutter-free (to clarify, I don’t manage things being dirty well, but I don’t tend to see the piles of paperwork and books I leave all over the house), putting things back in “their place,” and remembering important dates. Yes, there are technological tools that help me with all of this, as well as some classic analog tools as well, but between that and meds for ADHD, one might think that I’m “fixed” and able to think and live just like a neurotypical might.
This approach would be frustrating for you and stressful for me. As with many mental health disorders, the medication helps to control the disruptive parts of it, but it doesn’t magically fix the person taking it. Thanks to meds, I can now concentrate better at work and get my projects done more quickly and with fewer moments of distraction. The meds don’t help by the time I get home, and the clock for the time release has run out. This would make it hard for anybody who sees their partner as somebody to help out around the house and sees me come home and walk past the pile of papers and books that has sat on the side table for weeks and still not do anything to take care of it.
Partners often say they do not want to parent their partner. They do not want to have to tell their partner what to do or how to do it. There is such a thing as weaponized incompetence within a relationship, but for those who live with ADHD and/or autism, that is not the case. We want to be helpful, but we often do not understand how to be helpful in ways that meet the other partner's needs. We do not always understand what is needed unless it is clearly spelled out. From the autistic side of things, once we understand, then whenever we do it, it will be done the way you instructed. From the ADHD side of things, the issue will always be remembering to do it, especially if it is something that does not provide a hit of dopamine afterward.
The other side is that we can go down a rabbit hole to learn how to do things around the house. Who wired the garage for a charging port for the new electric car? Who demolished and installed a dishwasher in a home that was purchased without a dishwasher? Who knows how to change the brakes and rotors on most vehicle models now, as well as how to disassemble a V6 engine to replace all the sparkplugs? That would be me.
How to Communicate About Mental Health with Your Partner
After one marriage and some relationships that didn’t stick, my current partner never approached my lack of organizational skills as an inherent flaw within me. Instead, her approach is to play to my strengths instead of trying to push my weaknesses. This is how we saved money on the dishwasher installation. It is the fact that I can keep things clean even if I cannot keep them neat (I am also the dishwasher magician and can fit in all the things that nobody believes can fit).
I am only a single person who can share my experience with how we make it work in this specific circumstance. Still, based on other people I’ve talked to, I believe that focusing on your partner's strengths instead of picking on the weaknesses will help keep things running smoothly if not always fully organized.
The idea of trying to communicate your own mental health issues to a partner or prospective partner can feel overwhelming. After years of being judged for behaviors I didn’t fully understand, it can be frightening to approach somebody new and tell them why you act in specific ways in certain situations or what your struggles are with various forms of affection and your approach to communication itself. I wasn’t diagnosed myself until I was in my 40s, and it changed how I perceived the entirety of my previous relationships as well as my previous experiences in school and my professional life.
Taking the time to communicate your issues clearly as early as possible within a possible relationship is not only a kind thing to do for yourself, but it’s the ethical thing to do for your partner. Hence, they know how to approach specific topics with you. If you suffer from Rejection Sensitive Dysphoria, the idea of being rejected for your mental health issues can be even more frightening. Practicing how to talk to a partner about these things may sound silly, but having a script and committing it to memory may help you get through the hardest parts of the conversation.
If your partner is bringing up their mental health issues with you, let them talk! Let them tell you what they need to tell you. If you are not invited to ask questions when they are done, ask them if it is okay to bring up questions you may have. Be gentle with them. What may not seem like a big deal to you may be an incredible mountain for them to have conquered just to tell you about themselves. Their past experiences with telling partners may not have gone well for them, and they may feel they are taking a big risk by bringing this up with you.
Be compassionate, kind, and honest. Do not let somebody’s mental health issues frighten you away from a possibly wonderful relationship. Remember that every relationship is work, even between neurotypicals, and that each relationship will always have items that need to be worked through. Set aside time to check in on any mental health topics regularly so that struggles can be aired out before they become bigger problems.
The Role of Medication in Mental Health and Relationships
Medications are one of the most effective ways to treat a variety of mental health issues. The research and dedication to finding ways to help those who must live with these neurodivergences daily has been life-changing for millions of people. That is not to say that the medications are not without some risks and side effects.
Treatments for depression are often talked about in terms of how they can make you feel numb or feel nothing at all. Others talk about the effect that some of these medications have on their sex drive or ability to achieve orgasm during sexual activity. Sometimes, the side effects can be so frustrating that a person may stop taking their medications altogether just to get past them.
I am not a medical professional and cannot say whether you should stop taking your meds if you are frustrated by any of the side effects. Instead, I encourage you to talk to your doctor or a medical professional about your concerns. In many cases, they will have solutions to the side effects that can help you get past the bump in the road.
As partners of those who are medicated, you must talk with your partner about their medications, how they are feeling about them, and what side effects they may be living with. If they ever start talking about coming off the meds, make sure to push them into talking to their doctor before simply stopping the meds.
Some of the SSRIs that treat depression CANNOT be stopped cold turkey without some serious side effects. You will want to talk to your doctor to find the best way to wean yourself off the meds so that you don’t suffer some of the more horrendous side effects of stopping the drug. Even then, you may find yourself with some discomfort. Talk to your partner before and during the process so they know what you are going through and how they might be able to assist you.
Conclusion
There are so many different mental health disorders out there it becomes impossible to touch on all of them. Substance Abuse Disorder is a significant issue with romantic relationships, and maybe an article that we put out later since there is so much to be discussed around it. Moreover, disorders such as Schizophrenia and Borderline Personality Disorder can present so differently in different individuals that I was not comfortable trying to write about them in terms of relationship dynamics.
I will end this by simply saying that communication will always be the best way to approach any sort of discussion about mental health. Be open with who you are when getting serious with a partner. That includes telling them about your mental health.
