Relationships + Mental Health = Complicated

illustration by Monica Nguyen-Vo

When discussing mental illness, the conversation is often centered around the individual. But talking about the intersection of mental health and interpersonal relationships can be a lot more complicated. After all, the topics of mental health and relationships don’t come up easily and are both still largely taboo. The two topics are also inexorably linked — a decades-long 1938 Harvard University study found that quality relationships were more important to one’s mental and physical health than money, status or work.

Maintaining quality relationships, however, is far from a simple task — especially when mental illness is a part of the equation. Be it your significant other, your friends or your family, mental illness is going to add a new complication in how you deal with other people. So how do you go about it? And how much of an obstacle does it really pose?

Coping Together

When 2015 Kennesaw State University graduate and psychologist's assistant Skylar Seigler — who has been diagnosed with depression and anxiety – went from a community college to one hour away from home, symptoms of her mental illnesses began to manifest for the first time.

“I think it was a combination of being away from my family, being in a new place and that my roommates weren’t very nice,” Seigler said.

The shock of these drastic life changes triggered bouts of anxiety and depression that she hadn’t experienced before. Her illness kept her from completing her degree on time, extending the last two years of her college education by another year.

“I just kind of spiraled, I guess,” Seigler said.

Though she was separated from her traditional support systems, Seigler’s then-boyfriend — now husband — remained as a stabilizing force throughout her struggle with mental illness.

“Me and my husband actually met in high school and dated throughout, so he’s been with me through the whole thing,” Seigler said.

Having her husband as an emotional baseline gave Seigler vital perspective into her own mental state.

“I guess it was good that he was there because he knew what I was like before,” Seigler said.

Seigler’s husband learned to be a supportive force in her struggle with mental illness. But it can be tough to be in a relationship when your partner is suffering from a mental illness.

Communication is important in any relationship, and clearly defined lines about healthy and unhealthy boundaries is a must when mental illness is in the picture, according to Adriana Rogachefsky, a Rochester-based licensed marriage and family therapist.

“I think that it’s really different for each couple — no two couples would have the same line or same boundary of where healthy turns unhealthy. I think it’s more about communication and having them talk to each other and seeing what feels best,” said Rogachefsky. 

Seigler’s experience is far from unique — according to a study by the American Psychological Association, one in three first year college students suffer from at least one mental health disorder. These students often don’t possess the skills to emotionally cope with these new stressors. And while Seigler was fortunate enough to have a supportive partner, things might not always go so smoothly.

Self Harm and Care

Donovan Wolfe, a second year ASL Interpreting Education major, has depression and anxiety. He dated someone for a year who also had depression and anxiety. According to Wolfe, having this in common helped them grow closer as a couple.

“It was difficult, but it was also kinda nice that someone else I was close to understood everything I was thinking and going through,” Wolfe said. “Our boundaries were different because we were open about asking pretty personal questions.”

But regardless of the common ground, mental illness created tension in the relationship.

“His depression was so much worse than mine. I would constantly be waking up wondering, ‘Hey, I wonder if he’s going to wake up too,'” Wolfe said. “I didn’t really try to deal with it. I would not think about it and when I did think about it I would start doing self-harm stuff."

According to Rogachefsky, this can be a common pitfall for relationships that have to deal with mental illness.

“Help yourself first and make sure you're stable,” Rogachefsky said. “You can’t be an effective partner or an effective pillar of support if you’re not taking care of yourself.”

“You can’t be an effective partner or an effective pillar of support if you’re not taking care of yourself.”

Though that relationship turned toxic, it wasn’t Wolfe’s only experience dating someone else with a mental illness. Wolfe’s most recent ex-girlfriend suffered from bulimia and depression, an issue that would cause them to fight daily. These experiences have led Wolfe to take a break from dating.

“I don’t know if I could handle a relationship that’s that intense again. So it’s a struggle trying to find the balance,” Wolfe said. “What I’m doing for self-care is not looking for a relationship because I need to focus on myself for a little bit.”

Taking a bit to focus on yourself is a tool Rogachefsky frequently recommends to her patients.

“Even if you're not in a romantic relationship, it’s still important that we date ourselves,” Rogachefsky said. “Often times we treat other people way better than we treat ourselves.”

Staying Together

A source who wished to remain anonymous, a second year Management Information Systems major, has attention deficit hyperactive disorder  (  (ADHD). He is in a relationship with Cayla Boyce-Wright, a second year Political Science major who has anxiety and depression. In past relationships, his ADHD had posed problems.

“Basically it’s pretty much affected every relationship I’ve ever been in,” he said. “I go through stages. At first I idolize them — I get obsessed with whoever I’m with at the time."

This experience is characteristic of those who suffer from ADHD, a disorder characterized by mood swings and unstable relationships.

“Then bits and pieces of their actual selves start to reveal themselves and then I kinda degrade in my mind,” he said.

Although the source is now more mindful of his disorder, it still manifests in his current relationship.

“On a day to day basis, she’s the girl I love. But sometimes a switch will flip and emotions do their thing I guess,” he said.

“On a day to day basis, she’s the girl I love. But sometimes a switch will flip and emotions do their thing I guess." 

When the source began his relationship with Boyce-Wright, the topic of their respective mental illnesses came up quickly.

“I think it was probably a week or two after we started dating,” he said.

“Not even,” added Boyce-Wright.

This open channel of communication proved to be a vital factor in keeping the relationship strong and healthy.

“I wanted openness in the relationship so I put everything on the table immediately,” the source said. “I know a lot of my problems stem from me keeping a guard up. When I begin to let that guard down and become more trusting, that’s when the solutions begin to arise."

But even with communication and clear boundaries, Boyce-Wright and the anonymous source still face challenges.

“I have a habit of caring about his well-being more than my own. I make his problems my problems, but don’t let him make my problems his problems,” Boyce-Wright said. “In my head I just assume that if I let him into all this, he’s going to be like ‘euggh.’”

Boyce-Wright’s impulse is not uncommon.

“If someone has a mental illness or is in therapy, they themselves can be self-deprecating about being in relationships,” Rogachefsky said. “There’s definitely still a stigma in young adults still trying to figure themselves out — there’s still some hesitation with sharing things that we’re struggling with and sharing vulnerability.”

When Rogachefsky notices this hesitation or self-deprecation, she finds that they often need a nudge to see their situation more objectively.

“If you are in their shoes — in a potential partner’s shoes — would you not date them or see them anymore because they’re struggling? That usually helps debunk that one,” she said.

Caregive and Caretake

Mental illness doesn’t just limit itself to romantic relationships, though. Our relationship with our parents is often the most consequential of our lives — and potentially the most complicated. When a parent has a mental illness, the typical caretaker/caregiver relationship can become flipped.

“When there’s an insecure attachment, it sort of messes with care-giving and care-taking. So what happens is the child will end up going out of their way giving emotional, logistical, tangible supports to sort of compensate for the adult,” Rogachefsky said.

Wolfe described a similar dynamic with his parents, who both suffer from PTSD and anxiety — especially during their worse episodes.

“When I was a kid, I had to be like ‘Ok, what can I get for you? How can I help you in what kind of way?’ It was very much reversed,” Wolfe said. “It was tough at the time, but at the same time I didn’t think about it.”

This situation is unfortunately common, Rogachefsky mentioned.

“It’s when we’re not taking care of ourselves and not having insight around who we are and what we’re doing. It tends to come out especially on our kids,” Rogachefsky said.

It can also be difficult for parents without mental illnesses to relate to their children who have a mental illness. For example, Boyce-Wright’s strained relationship with her great-grandmother — who raised her — negatively affected her mental health. Boyce-Wright's great-grandmother raised her as a Jehovah’s Witness, a strict denomination of Christianity with unorthodox medical views.

“She would send me to the people in the religion who would tell you what was wrong with you,” Boyce-Wright said.

Because of this, Boyce-Wright received multiple diagnoses from different sources and did not receive the treatment she needed. Religious values became a point of contention in Boyce-Wright’s home, among other things. The constant conflict took its toll on Boyce-Wright’s mental health.

“I grew up with people basically instilling into my brain that I’m the problem,” Boyce-Wright said. “When you get told that nobody cares about what’s in there, then what’s the point?”

This toxic home life coupled with a lack of support caused Boyce-Wright to internalize the thoughts caused by her illness. 

Though this certainly wasn’t the intention of Boyce-Wright’s family, their negative impact on her psyche remains.

“At a very young age I developed a hole somewhere, and as I got older the hole got bigger,” Boyce-Wright said in reference to her upbringing.

“I think of parents as big kids. They have struggles and issues too and a lot of the times they don’t realize the impact they’re having,” Rogachefsky said.

Clearly communicating what that impact is can be vital in repairing strained or damaged relationships. But in cases where the relationship becomes particularly unhealthy, Rogachefsky recommends more drastic measures.  

"There are certain situations where people might have to behaviorally act, meaning don’t answer the phone, or don’t make contact,” Rogachefsky said.

Your health comes first, even when family’s involved.

Be Curious

In relationships where one or both parties have a mental illness, it seems the fundamental markers of successful relationships still apply — communication, empathy and honesty are still key. But there’s also no sense in pretending that it’s not an added factor, according to Wolfe.

“I don’t think you should change who you are if you’re dating someone with mental illness, but I think you need to acknowledge it’s a thing,” Wolfe said.

“I don’t think you should change who you are if you’re dating someone with mental illness, but I think you need to acknowledge it’s a thing.”

Drawing lines between supportive and enabling behavior is a must to keep the relationship healthy.

Rogachefsky discussed how one of the most important things in understanding a loved one with a mental illness is the sincere desire to understand.

“Curiosity in relationships is so important. We can never assume where someone is coming from,” Rogachefsky said.

If both parties are comfortable, actively participating in therapy can be a good way to start the dialogue.

“Ask if you can come into a session with them. I think those conversations are really important,” Rogachefsky said.

With both increased prevalence and awareness, ignoring mental health as a factor in your relationships is no longer an option. Navigating the complications created by mental illness, in a healthy way, is a vital skill, especially when it comes to those closest to you. Regardless of your particular relationship with mental illness, being curious about the inner lives of your loved ones can only create stronger relationships.