How I Do

How I Do
December 20, 2007 Jon Armstrong

Several of you have made the request over the years that I share my perspectives on living with someone who has chronic depression. I’ve been reluctant to share for many reasons. The biggest reason I haven’t is that part of living with someone who can spiral downward and inward means that I have to be careful about what I say and do. If the fire is raging, you don’t throw fuel on it or add gunpowder to it. Day to day, I’m probably being overly cautious. During stressful times of the year or during stressful events, those days where I need to be careful are more frequent. It seems like we’ve barely been able to catch our breath until very recently and now it is holiday season. Which, as you are aware, contains no stress at all.

Fixing It by Not Fixing It
As a heterosexual man attracted to a woman, I have a range of emotions and ways of dealing with whatever life throws my way. One of those things is to look at a problem and want to fix it. Men like to be fixers, for the most part, and this is great for things like a clogged drain or dead car battery. Also great if the satellite dish isn’t picking up the latest “Nature is Sad” show on the educational channel because it’s buried in snow. It is not so great if your partner needs for you to help her by listening.

I’m not certain this is entirely gender-related, as I’m certain it is just as likely that a woman can be a fixer as well. It just keeps coming up for me that I can’t fix it and I need to shut up and listen. Almost two years ago, Leah Crawford interviewed me for her site, Leahpeah and asked me how Heather’s illness had affected my life. I wrote then that people in relationships, particularly the man, often have a strong desire to fix things. What I neglected to say then is that one of the best ways to help somebody is to shut up and listen. This is extraordinarily difficult for me as a talker. I’ve really had to stop myself and let it go. I have to tell myself that I need to LISTEN and to tell myself to SHUT UP. It’s doubly important when somebody is anxious or depressed and needs to get it out. I have only met a few men who are great listeners, and those were professionals I was paying to listen.

So. Listen.

Stress Management & Meds
In our case, Heather handles stress very differently than most people I know. She is a master internalizer and the whiff of brooding energy she emits outward is usually an indication that there is a much larger inner storm raging. I’ll usually try to get a calm moment when just the two of us can talk and I’ll have to ask her about five or six times if something is wrong or if she needs to talk. Having lived with her for awhile now, I can say that I can see this coming a few days off. Especially given some of the big things we’ve done in the past two years. Starting a business, selling our house by ourselves, moving, her projects, professional and occupational stress, etc. have all proven to be major stressors. I view my role as to simultaneously get things done and listen when called upon. I don’t regret this role, and I don’t begrudge it. I view every conversation as a chance to learn something new. And a chance for me to tell myself to listen.

As part of intense stress periods, I always have to ask, sometimes repeatedly, about medication levels. The professionals who successfully treated Heather for post-partum depression came up with a drug cocktail that saved Heather’s life. It’s my job to help her stay on those meds and help her assess whether or not they are working like they did in 2004. This will be an ongoing thing for the rest of her life. There are good days around the prescription discussion and not so good days. As with all chronic medication consumption, it is only natural to assume that one feels better and can taper off the meds. There have been several instances where I’ve noticed a higher state of anxiety and a certain tone in conversation, a withdrawal or unusual comment from Heather and felt the need to bring up medication as a state of emergency. Luckily, Heather responds and if she has changed her dosage, after we discuss (sometimes more pointedly than others) she takes it back to the levels that were prescribed. When the meds kick in, it’s like I’m living with the Heather who can cope and get through life. If she’s changed her meds, it’s not pretty. The stress on me during these times builds and builds. I have to be careful in how I release that stress. I also have to make time for me. I have had to learn that most of what is bothering Heather has nothing to do with me or our relationship. It has to do with her internalizing stress and how she deals with life when it gets overwhelming. To be sure, there are those times when I’ve done something wrong or I’m not doing enough or I’m caught up in a project and it causes friction. Just like every other relationship.

Our life is such that we must become adept at crisis management. Home ownership, parenthood and business ownership means that things are going to happen, sometimes all at once. I have to be in a good place to have a clear head to deal with whatever life is going to throw at me. This is not easy. I do a lot of self talk (sometimes freaking Heather out) to either practice conversations I need to have or help me work through a situation. I also have to be strong and assertive most of the time or else I’ll be blown over by the power of the illness.

I have to have a good amount of sleep to face the next day. I get this by taking an antihistamine that helps me sleep and dries out my perpetually runny nose. Side effect: used to be prescribed as a mild anti-depressant. Getting enough sleep makes it so much easier to listen and/or take over if Heather can’t function.

As far as I’m concerned, I’m always open to trying medication if I think I need it. Heather has suggested I try a few things in the past, but I’ve so far not had a steady course of anti-depressants. Typically, getting enough sleep, changing my life (sometimes with talk therapy) and managing my stress have helped me through the hardest of times. If I’m being a jerk, no medication is going to fix that. I have to recognize I’m being a jerk and work on it. I think everybody on the planet goes through jerk phases and being aware is the beginning to living a life that is less difficult on those around us.

Openness Leads to Success
I have to be open. Being raised as I was and given my own propensities, this is extremely difficult for me. I have admired Heather’s openness and willingness to share, but there is always that part of me that worries if there will be a cost later. I can’t decide if I was meant to be a risk management assessor, tin foil proponent or character in either an E.M. Forster or M. Somerset Maugham novel.

Talk therapy has been something that has saved me, saved my relationship with Heather and made our lives together stronger. It is hard work and difficult to hear and learn things about oneself, but I believe that every single person on the planet would benefit from talk therapy. Maybe one doesn’t need it all the time, but I view it as something that I can turn to and use to help navigate through life. I don’t think that because I’m living with Heather, I’ll do more therapy because of her illness. I need it for myself and together, we’ll need it for our relationship. It’s not weak or lame to face ones issues. It’s not strong to live in denial. It’s not strong to live in fear of talking about the dynamics of how we process life events or why we react the way we do. I only wish I had sought therapy after my father died and that in my first marriage, I had sought therapy earlier. I’m not sure that my life would be different, but perhaps better. I’m very happy now, and I love where I am, both professionally and personally. Most importantly, for Leta, I love where we are. She needs happy and healthy parents.

As with any chronic illness, any form of treatment needs to be done carefully and with supervision from professionals. I can’t stress enough how lucky we have been to have had doctors willing to try certain combinations of medicines. We’ve taken it into our own hands in the past and sought different doctors when it was clear that Heather was responding to medicine or a particular doctor has a propensity for a certain diagnosis or treatment that wasn’t helping. The saddest part of treating depression is that most doctors want to ramp up the medicine (for good reason) and it’s very difficult to see a response sometimes. I wish there were a better way to deliver a clinical dosage of meds on an outpatient basis. Most of my experience in this area comes from watching Heather start a medicine for a few weeks and have it either make her worse or have no effect. In order to deliver the dosage and right cocktail, Heather had to be in a hospital/facility where she could be monitored. There was no ramping up. And that is exactly what Heather needed.

One of the biggest and most detrimental side effects to being a partner of someone with a mental illness is that there is the impulse to not share the hard stuff with them for fear they can’t handle it. Likely corollary to that is that the disease is a part of our relationship, meaning it needs its own space. The meds and therapy continue to help, but the disease is always there. I have to be aware of those times where nearly every exchange, every gesture and every non-verbal cue is related to the illness in some way. This adds a burden to any relationship and ours is no different. One of the hardest things to write, is that Heather’s illness means that sometimes she can’t be there for me in a way that I need her to be. I learned this early on, but I still have a hard time making room in our relationship for the largest side effect on me of her illness. It’s not maliciousness on her part. It’s not ignorance. It’s that the disease is all-consuming. I do stand up for myself and I have to be more verbal than I’ve ever been about stating clearly that I need her or I’m having a rough day. Fortunately, those times are fewer as things have smoothed out career-wise and I’ve learned how to tell her that I’m struggling or I need to talk.

In every relationship there is work to be done. There is no such thing as a perfect relationship. There are people who are likely to be better suited for one another, but there is no magic. While this post might sound like it’s not worth it or that Heather and I are having problems, I should clarify that it’s not like that. If I didn’t care about Heather, or wasn’t willing to do the work that a relationship demands, I’d be worse off in my life. Living with Heather is worth it. I’m in love with her and willing. I feel that she shares this feeling about me and that makes all of this so much easier to live with and deal with. In my past, I’ve shied away from doing the hard work in a relationship and in looking back using talk-therapy and a few great therapists, I’ve been able to see that my own laziness and unwillingness to work has harmed myself and others. I’d be a fool if I didn’t take what I’ve learned from therapy and apply it to the best relationship I’ve ever known.

Get Help
To the people out there who denigrate mental health awareness and treatment, I say this: You aren’t helping. You are making it worse. Stop being an arrogant know-it-all. You aren’t right. You are wrong. If someone tells you they need help, your opinion means less than that of professionals. Stop being ignorant. Stop being obstinate. Stop insisting that your loved one, partner, child or co-worker “get over it”. They won’t get over it until you let it go and encourage them to seek help. There are many different approaches and ways to treat mental diseases and conditions. The first step is letting go. You could probably use some time talking it out yourself.