In sickness and in (mental) health

Over the previous 8 blog posts, it’s been pretty clearly established that relationships are not the easiest of things to manage. They generate a bit of work for us. But overall, having people in our lives is pretty worthwhile. (I cannot believe I’ve just summarised all those words into 3 piddly sentences).

In a very similar vein, when we love someone who is experiencing a mental illness it can be bloody hard work. Bloody hard. But probably worth it in the end.

I’m a bit loathe to write this post because there are plenty of articles floating around titled “how to love someone with a mental illness” or even “why you should love someone with a mental illness.” And it makes me cringe up a bit. For a number of reasons:

  • It perpetuates the “us versus them” mentality. People who experience a mental illness may have specific medical and psychological symptoms they have to deal with, but that doesn’t mean they’re something other than human. Would you love some with diabetes differently? Or need advice on how to love someone with athlete’s foot?
  • Doesn’t’ everyone have their own shit to deal with? Experiencing the symptoms of a mental illness may require certain lifestyle adjustments and more care at specific instances, but so do other things in life. Like when we take on way too much stuff at work. Or when the kids are really sick. Or when we change jobs. Lose our job. Are struggling financially. Lose someone in the family etc etc. Dare I say we all need specific care at certain instances in our lives, mental illness or not.
  • Even if there are unique ways in which people who have mental illnesses need love and care, that’s largely on an individual basis. We all have specific needs at certain times in our lives. These needs have to be communicated with the people around us — our friends, family, significant other, colleagues, etc. Because articles with “tips” about how to care about someone who has a mental illness may not be what every individual person needs nor wants. The person with the mental illness is responsible for knowing what they need to stay well and being able to communicate that.
  • Stigma is usually why these kinds of articles exist. I wouldn’t have to write about this if social stigma didn’t exist because then we would realise that we don’t need to try to love someone who is perceived as different in one way or another. We would simply love people because we are humans and we should care about each other's welfare.

Having noted all of that though, sometimes when we love someone who is experiencing active symptoms of a mental illness there’s particular things that are a real struggle for us. We might be worried we are not saying the “right” thing. We could be constantly concerned for their safety. We can be frustrated that they’re not improving. Or that they’re not seeking treatment. Or that they can’t see that there are any problems with their health at all.

All of these struggles though come from a place of love. If we didn’t feel these things about the person close to us, then we wouldn’t feel so strongly about them. And here’s a really, really, really important thing when someone is experiencing a mental illness, love is really, really, really important.

In the book A General Theory of Love (2001), a trio of psychiatry professors, Lewis, Amini and Lannon, describe love as an interaction of neurotransmitters and hormones in our body:

“Our nervous systems are not separate or self-contained; beginning in earliest childhood, the areas of our brain identified as the limbic system (hippocampus, amygdala, anterior thalamic nuclei, and limbic cortex) is affected by those closest to us (limbic resonance) and synchronizes with them (limbic regulation) in a way that has profound implications for personality and lifelong emotional health.”

Interestingly, we can actually see evidence of these connections when we explore research in this area related to stress management, depression, anxiety.

The ability to adequately cope with stress, is one of the protective factors against mental illness. British psychiatrist John Bowlby, known for his seminal work in the area of developmental science, defined attachment as a “lasting psychological connectedness between human beings.” In Attachment (1969), Bowlby showed us the crucial importance of the secure relationship on the development of adaptiveness and coping capacity. And throughout our lifetime, this remains true.

‘Allostatic load’, a psychological term coined in the 1980s, represents the physiological consequences of chronic exposure to stress. Positive social experiences and higher levels of social integration and support are associated with lower allostatic load in both young and older cohorts. From childhood until old age, being connected to others in secure and loving relationships helps us better deal with stress.

Currently depression and anxiety disorders are the most common psychiatric conditions that are experienced in the Western world. And social isolation is clearly linked to higher rates of depression and anxiety. According to a Health and Human Services report, getting married and staying married reduces depression in both men and women. And research in the areas of physical health has shown that high levels of social support may actually improve prognosis in such conditions as cancer and myocardial infarctions by reducing symptoms of anxiety and depression that can often be associated with these illnesses.

And when people seek treatment for depression it will often focus on interpersonal relationships as a way to improve depression as is the case in attachment therapy in children and interpersonal therapy in adults. In addition, Emotionally Focused Therapy (EFT), which focuses on transforming relationships into ones that feels safe, secure and connected, have also been found to be effective in significantly reducing the symptoms of depression and anxiety. Ultimately, encouraging our people with a mental illness to be involved in loving and stable supportive relationships can potentially help in their recovery.

Though there are times when people need to “take a step back” from someone experiencing active symptoms of their illness, this generalises to any situation where one simply needs to create boundaries with another person in order to maintain one’s wellness.

Mahatma Ghandi once wrote, “Where there is love there is life.” Loving and stable relationships can help to improve a person's ability to manage stress and can help to decrease anxiety and depression. We are all social creatures, whether we experience mental illness or not.

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