On Mental Illness: The "R" Word

By Jack Bragen
Monday June 20, 2011 - 10:18:00 AM

About twenty years ago, when I spoke to the late Herb Putnam, (founder of the Putnam Clubhouse in Concord, who also served as president of NAMI, Contra Costa), about writing for the NAMI newsletter, he suggested that I might have something to say about relationships for persons with mental illness. At the time, (just as at many times), I was doing poorly in the area of employment but didn’t have much difficulty getting a date. 

Some of the points I will make below are applicable to everyone, and are not unique to those with a psychiatric illness. My qualifications to write on this subject consist of personal experience and self education, but do not include formal credentials. These ideas can be taken or discarded at the reader’s discretion. 

To begin with, a relationship can never happen if a person’s social fears are excessive to the point of not being able to interact. On the other hand, if a person forces the fears into submission, he or she could end up with bravado to the point of obnoxiousness. Desensitization, done gradually, as one would do with other phobias might be a good way to tackle social fears. 

Relationships for persons with mental illness can be more difficult, and can require more work, from the very beginning, and continuing. There are also persons who receive mental health treatment who can not handle a relationship, and may or may not know this about themselves. If seeking a relationship with another person with mental illness, it is important to distinguish if a person whom you are pursuing is emotionally on the same page as you, or if having a relationship is not an option.\ 

Readiness is not the same thing as willingness. A person could be ready for a relationship with someone, but will not necessarily be interested in having one with the reader. If someone isn’t interested, you can’t make them that way. Many persons with mental illness date mostly others with mental illness because the singles in “mainstream” society often will not consider being with a disabled person. Unfortunately, any offspring that get produced when both parents have a mental illness have a very strong genetic predisposition to having a mental illness when they grow up. Moreover, two mentally ill parents may not have sufficient means of providing for a child. One or both parents may be working at the time of producing the child; yet, relapse and the inability to work can recur for severely mentally ill persons despite all expectations to the contrary. 

Additionally, when a woman with mental illness becomes pregnant, she must temporarily discontinue most of her psychiatric medications. Most psychiatric medications are not safe during pregnancy. The result is often that the pregnant mentally ill woman will suffer from acute symptoms of mental illness while pregnant, and may require a stay in a locked facility to remain supervised, to prevent doing something wild that will harm her or the fetus. 

A mentally ill couple also may have more difficulty than would a non-afflicted couple in caring for a newborn. Most persons with a severe mental illness can’t handle as much stress as the “normal” population. And I understand that it is very stressful to care for an infant. 

Because of all of this, if a person with a mental illness wants a relationship, that person must be certain of having a good method of birth control. The exception to this is when a couple is independently wealthy, such as are movie stars, and can afford to pay for a twenty four hour nanny as well as the best available medical care. 

Some persons are harder to get along with than others. Some persons in general, mental illness or not, are argumentative, mean and/or warped; you would rather climb a barbed wire fence than cohabitate with them. It is good to discern as early as possible in a relationship if there are factors that will make it impossible to get along with someone. A nice person may not be as captivating as one with charisma and a lot of problems, but someone nice is better to live with; and that charisma often comes from narcissism. 

If you would like to have a relationship with someone, ask yourself the question: Does this individual appear ready to have a healthy relationship? There are numerous ways in which someone may not be ready. If someone has a history of being abused by, or abusing others, and has not dealt with this yet in therapy, that person may attract or create destructive relationships. 

Secondly, are you ready? Readiness for a relationship is a completely different issue than wanting one. You could want to have a relationship, but may not be emotionally strong enough to handle one yet. One of the issues that will arise in relationships is that of jealousy. This is a powerful instinct that appears to be ingrained in the human nervous system, and it can lead to tremendously destructive behavior. While you may not be able to eliminate jealousy from the circuits in your brain, you should at least learn to recognize and handle it so that it doesn’t take charge of your behavior. 

Another question you ought to ask yourself is: “Is this person at a similar level of intellectual/cognitive development as I?” If one partner is a lot more mentally developed, it can create loneliness in the relationship. 

A relationship will not solve your problems. Sometimes the problem of not having a relationship shifts, once you have one, to the problem of how to deal with the relationship you have, or even, how to get out of the relationship, if you have decided it is a bad relationship. A good “rule of thumb” that you ought to give some thought: If you are unhappy without a relationship, you will probably continue to be unhappy with one.