No roses without thorns, Supporting someone through crisis

| From Natalie Karpushenko's photo series, lovers glowing in the dark.

by Dinara Murzalina

Long-distance relationship can be distressing under the best of circumstances, but if your long-distance partner is going through mental health issues, knowing how to support both them and yourself is crucial for the relationship.

“Imagine loving a person who doesn’t want to live,” Olga, 22, begins her story.

London-based student and a popular blogger manages to maintain a relationship with her boyfriend Pasha, 23, who lives in Moscow. It’s especially difficult as her partner is going through a severe depression.

A survey by the mental health charity ‘Time to Change’ showed that a greater number of people would turn down a date with someone who had a mental health problem than someone they found physically unattractive. In terms of disclosing a mental health difficulty to a prospective date, depressingly, people with a mental health problem are more likely to be turned down for a second date if they reveal their difficulties than if they had disclosed that they been in prison.

Nothing could stop her: not the 1500 miles of distance, nor her boyfriend’s depression.

Even though there are still plenty of those who do date and marry people with depression, anxiety or any disorders, many of them say it’s a challenging experience.

“It breaks my heart,” Olga acknowledges. “Every time you see your beloved one suffering …it just breaks your heart”.

Olga knew about her partner’s struggles when she met him. She says it was a conscious choice. Nothing could stop her: neither 1500 miles distance, not her boyfriend’s depression.

Coming from quite a patriarchal society, Pasha had a hard time admitting he has a problem and needs to be diagnosed. “It made it so much easier when we he agreed to be analysed”. Filled with relief and hope, Olga really is determined to overcome all the struggles together.

“I love him and because of my feeling I made it clear I accept the responsibility and will be with him no matter what.” Olga says that despite all the difficulties, "there are no roses without thorns".

However, there are still people less lucky than Olga’s boyfriend. The problem is said to hide in the way males express their mental distress which makes it difficult to be open with their partners. Many researches show that men experience more externalising difficulties, such showing irritability, aggression, hostility, and using substances. This behaviour could be instead of internal expressions of distress (such as sadness and regret), or, as clinicians might like to term it, ‘male depression’. Both cases can have a direct impact on communication and could lead to conflict rather than compassion between partners.

“I was taught that mental health is a sickening disease,” tells Aizi, 23, a Malaysian-born music producer. “I was told many times that sums up to this simple sentence 'crazy people are stupid'.” Raised in a relatively traditional society, the young man was terrified to admit the diagnosis. Aizi has a bipolar disorder, previously known as a manic depression.

“Sometimes giving your partner space is a huge support as well.”

Two extremes, feeling of apathy and a manic need of activity, switch from one to another. Although it may sound like a regular mood swing, the episodes of depression and mania can last for longer periods of time. Bipolar people rarely experience a "normal" mood in most cases.

Aizi says, his condition ruined his relationship. “She couldn’t deal with it,” he says, “She told me to man up numerous times, so I had to let her go.”

| Lovers' vulnerability expressed in the dark, from Natalie Karpushenko.

In the opinion of family psychologist Aliya Aldanazar, ‘toxic’ masculinity is what damages relationship, not mental health. It doesn’t mean woman shouldn’t think about themselves. “It’s important to be self-sufficient, being able to know the limits and not to fully merge with the problems of your husband,” says Aliya. “Sometimes giving your partner space is a huge support as well.”

Anne (name changed as the resource preferred to stay anonymous), 47, lives with her anxiety-affected partner for more than 20 years. She shares her story.

“I first saw him dealing with anxiety soon after we started going out with each other, but I didn’t understand how he felt. On one occasion he was really worried he’d left a window open at work and I just reassured him verbally that it was ok.”

By “really worried” Anne, of course, does not mean he mentioned it twice and asked someone to close the window. She means he was in panic, repeating himself and expected something bad to happen.

It was only a few years later, when he was 30, that she began to understand that he had a physical reaction to anxiety and often did really struggle.

Gender has never been an issue for the woman: frustrations about her husband’s mental health are rooted in wanting a true equal partner. She also admits it is a generational and cultural thing.

Supporting your partner through hard times is challenging, but can also be rewarding.

“I work in a educational institution in Plaistow and many of the families I work with would have a different attitude to men’s mental health. Sometimes I see families of different heritage whose approach can be really underdeveloped.”

Despite it seems like a perfect example of stable relationship with an emotionally unstable man, Anne reassures it has not always been easy and admits she did consider a divorce at one stage. There are still things she finds annoying. Sometimes her husband’s mental state makes him focus on himself too much and forget about others, which causes her feel quite isolated in the relationship. Another thing is that he needs constant reassurance that he’s doing ok from her and their children.

Over the years, Anne has found certain strategies to support her partner and save their relationship. When her partner’s behaviour looks like he’s feeling depressed or anxious, he can be ‘outwardly grumpy’. Anne tries to call him out on this, asking if anything is wrong, so that he has an opportunity to verbalise what he’s feeling. “This often seems to make him feel slightly better, as if he’s had a chance to air his feelings,” she says.

It’s still impossible for Anne to imagine life without her husband. “He is a kind-hearted man, he is a father of my children, he cares about me,” she says.

| Understanding your partner's feelings, from Natalie Karpushenko.

While it’s not clear whether it is the sense of burden, attachment or feelings that keeps couples together, there is something to learn from these women’s stories. Supporting your partner through hard times is challenging, but can also be rewarding.

Mr Michael Shankleman, clinical psychologist at Salomons Centre for Applied Psychology, gives his advice on the matter.

• Try to understand your partner’s feelings

While there is not one ‘right way’ to support each other, being human, and showing empathy can go a long way. Hopefully this will help create a safe space to be in and can pave the way for seeking help if that is what is needed.

• Don’t force someone in to seeking treatment

In fact, seeking help in the form of therapy can be counter-productive if someone is not ready, as it can put them off accessing it again later if their first experience was not successful. The exception to this is if you think someone is in a crisis, and are at risk to themselves or others, then then seek help immediately from A&E.

If you do decide to seek help, a good first port of call is your GP, as they are the gateway for further advice and support.

• Think differently (about treatment)

In terms of long-term help, the good news is that psychological treatments have moved on from the days of extensive psychoanalysis, long beards and couches. IAPT services (Improving access to psychological therapies) are common throughout England, and offer more convenient ways of accessing talking therapies. Often support is via telephone or over the internet, which any men may find easier than sitting face-to-face in a room.

• Be supportive at times of potential crisis

Another way of looking at the problem of male help-seeking is by examining the way our health services are organised. For example, some current research by Sophie Fenton at Canterbury University is looking into how men experience the transition to fatherhood, and the ways NHS services are set up to support them. Parenthood is a big time of change and stress for both partners, though traditionally services have catered mainly for new mums.

Perhaps if we organised services differently, we may catch men at times of crisis and offer support, rather than wait for things to get worse.

For some the idea of going to therapy conjures up thoughts of laying on a couch for weeks or months on end. The good news is psychological treatments have moved on greatly from the days of extensive and costly psychoanalysis. IAPT services (Improving access to psychological therapies services ) are common throughout England and offer more convenient ways of accessing talking therapies using Cognitive Behavioural Therapy, CBT. Therapy can take place via telephone or over the internet, which some people find much easier and convenient and normally last less than a few months.

If you are really worried about someone and think they might be at risk, more urgent help can be sought from your closest A&E who can help keep them safe.

MIND, the mental health charity, have a number you can call for more help and advice on a range of helpful topics. It is 0300 123 3393

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