Author: Poorna Bell. Original story: The Guardian 10/07/2017
There is no lightning-bolt moment when you realise you are losing your sense of self; just an absence.
When you are caring for someone you love, your wants and needs are supplanted by theirs, because what you want, more than anything, is for them to be well. Looking after a partner with mental health problems – in my case, my husband Rob, who had chronic depression – is complicated.
Like many people, Rob and I were not raised in a society that acknowledged, let alone spoke about, depression. The silence and stigma shaped how he dealt with his illness: indeed, he struggled with the very idea of being ill. He told me fairly early on in our relationship that he had depression, but I had no idea what this entailed – the scale, the scope, the fact that a chronic illness like this can recur every year and linger for months.
I didn’t know what questions to ask. And Rob struggled to articulate how bad it was. He wanted to be “normal” so he expended a lot of energy trying to pretend he was OK when he wasn’t. In 2015, Rob took his life. The reasons are complex, but I believe it was a mix of depression and an addiction to the opiates he used to self-medicate.
Although I am painfully aware of how Rob’s battle ended, I am often asked about how I dealt with it when he was alive. Hindsight is always bittersweet, but I did learn a lot – especially about taking care of my own mental health. Here’s what I learned:
Look after yourself
Feeling that you have to handle everything is natural, but you have to look after yourself or you won’t be any use to your partner. “That pressure to keep it all going can feel too much,” says Dr Monica Cain, counselling psychologist at Nightingale hospital in London. She advises “taking that pressure seriously. It’s something that is very difficult to manage even at the best of times.”
Remember that depression isn’t just a mental illness
It used to drive me mad that Rob wouldn’t get out of bed. It took a while to realise that he “couldn’t” rather than “wouldn’t”. I was so sure he would feel better if he came out for a walk or met his friends, but depression is a physical illness, too. As Dr Cain says: “Physically, depression impacts energy levels. People sometimes feel very tired and want to stay in bed all the time.”
Don’t stop doing the things you love
When your partner can’t get out of bed or come to social engagements with you, there can be anger and frustration. Jayne Hardy, founder of the Blurt Foundation, which helps those affected by depression, says the “feelings of helplessness, hopelessness and unworthiness” depressed people may have mean they often “place loved ones on a pedestal”. She says their skewed perspective means they can “struggle to see what they have to offer you”.
On more than one occasion, Rob said to me: “I feel like I’m ruining your life.” I stopped doing the things I loved and, because I stayed at home with him, it made him feel guilty that I was missing out.
Take charge of admin and finance
People with depression find even mundane tasks, such as opening the post or going to the shops, impossible. Often, they keep their finances hidden, says Dr Cain. “It can feel quite shameful for them to say: ‘I’m finding it difficult to stay on top of it.’” This can be stressful for their partners. As Dr Antonis Kousoulis, a clinician and an assistant director at the Mental Health Foundation, says: “Being the main source of support for a partner with depression can add a lot of pressure.” But it is still better than not knowing what’s happening with your partner’s finances or admin. So, to maintain your own mental health and avoid unnecessary stress, it may be easier to have an agreement with your partner that, when they are ill, you will be in the admin driving seat. And when they feel able, they will sort it out.
Talk to your friends and family
You may fear that friends and family won’t understand. But trying to maintain appearances while supporting your partner is exhausting. “Opening up conversations to friends and families, and getting them involved usually makes a big difference in tackling the stigma and building a circle of support,” says Dr Kousoulis. Hardy adds: “All the advice we would give to someone who is unwell with depression also applies to loved ones who support us: make sure you are supported, reach out for help in understanding more about the illness, keep the channels of communication open; don’t be afraid to ask questions, and prioritise self-care.”
Don’t take it personally
There is the person you fell in love with, who makes you laugh until it hurts – and then there are the bad days, when you are dealing with a stranger who won’t let you in. “Depression can magnify or alter emotions,” says Dr Kousoulis. “A person can have emotional highs and lows in equal degrees, so it is important not to take changes personally.”
This can be easier said than done. I found my own coping mechanisms – therapy, exercise and lowering my expectations of what I needed and wanted from Rob when he was feeling bad. I knew that somewhere inside this person was my husband, so from time to time, I’d leave him postcards telling him how much I loved him. He didn’t react in an effusive way but I know it got through because he kept every one in a memory box.
Above all, hold on to your love. “You won’t always feel as though you are making any progress,” says Hardy. “You, too, may feel helpless at times. But your patience, kindness and understanding make such a difference.”
In Australia, the crisis support service Lifeline is on 13 11 14.