Thursday, March 31, 2011

Marriage and Mental Health and Wellness - my POV

Long story short, my husband and I eloped when we got married nearly 8 years ago. We were in love and who knew it would last this long given my mental health condition. I knew I had found my "missing piece"! And I hoped he had found his, too.

I am dealing with a bipolar type 2 diagnosis, hypomania. I manage it with medications and therapy. If I change it on my own volition, which I have done before and I say I do not need either of those treatment options, within two months I am "out of control" - sobbing, impulsive, fighting, disheveled, no one can talk to me, nothing sinks in, and my ability and freedom to make quality choices about my wellness is impaired. If I want to stay married to a good man, I do not deviate from my current treatment plan.

The issue with the general public's opinion on mental health and wellness is that it is a choice that people like me make. I really wish it were that simple. I wish I I could CHOOSE NOT to feel the way that I do. That I would not have to take medications, hide from the mental health stigma and not have to see a therapist. But I know that if I do not, this condition will worsen to fainting spells, memory loss and suicide ideation.

I get these interesting emails from Smart Marriages: The Coalition for Marriage, Family and Couples Education
is dedicated to making marriage education widely available. They have a "newsletter" still sent by email -- tidbits to stay married, marriage enrichment, and family support during trying times. These days with a poor economy and so many people out of work, such as myself for greater than 3 years, these are truly trying times for a marriage and its longevity.

One of the Smart Marriage's newsletter authors posted this ignorance about mental health and wellness (verbatim original context):

Ouch, I really stepped on a live wire with the post about the book, The Emperor’s New Clothes (that “explodes the antidepressant myth”). I APOLOGIZE to those who were offended by my promotion of this book – who wrote to say antidepressants have literally saved their lives and/or the lives of loved ones and/or their marriages. I send my SYMPATHIES to those who, on the other end of the continuum, feel they have basically lost long stretches of their lives, their loved ones, their marriages because of the side-effects of antidepressant treatment. And, I also STAND very much CORRECTED by those who reminded me and quoted myself back to me – that I have always maintained that Smart Marriages is focused on increasing access to Marriage Education and that we don’t have the time or energy to wade into other battles and campaigns. It turns out that antidepressants are as divisive a topic as any you can name – abortion, gun control, vaccines, immigration, etc. – there are as many blogs, websites, bumper-stickers in the antidepressant pro and con campaigns as any other. Several of you also pointed out that this book is not, by far, anything new – there are many books that rail against “legal drug pushers - people licensed by the govt and paid huge incentives by the billion dollar pharma industry to push antidepressants.” You said if I want to blow the whistle, blow it about the 10’s of millions of children being put on antidepressants. (Hmmmm, 10s of millions?) And one of you wrote that I should consider myself blessed that I’ve not (yet) felt the need for antidepressants. Some of you said I could use your letters and your names, including your diagnosis and suicide attempts. I don’t think that’s necessary. I get it. And, as I said, my apologies and I do stand corrected. - diane

This is not the first time that Smart Marriages has sent emails filled with insensitive vitriol. In fact, this newsletter is about the only misinformed "marriage related" without peer reviewed scientific research literature base. It is nice to have "tidbits" that a user can decide to accept or not accept, but to cyberbully by fear tactics is irresponsible, especially when it involves the issue of HEALTH CARE -- specifically, MENTAL HEALTH CARE!


Because the brain is an organ, too. It can get sick like any other organ, heart, liver, lungs, muscles, blood, etc. Would the same cruel and mean-spirited comments be made to someone who suffered from a heart attack, stroke or cancer? Then why are they being said to someone who is dealing with and managing a mental HEALTH condition?

Through my own trials and tribulations in my marriage, and developing a "wellness recovery action plan" or "WRAP" by Mary Ellen Copeland, I have discovered, that to keep my marriage with my husband, he needs to be trained in true medical caregiving or what is now called "attending". The idea of a physical health issue, like Alzheimer's Caregiving can be adapted to Mental Health Caregiving.

My husband needs to know how to handle me on good days and bad days. The good days when I seem fun to be around, but wait - is it over the top? Are they manic like? When I am asked about my thinking or process, do I have one? Because if I do not, I am in the process of setting myself up for failure that can spiral me into a depression down the road. There are tactics one can learn from Caregiving to minimize and communicate to me as to what it is I am doing: i.e. when is the last time I have communicated with my psychiatrist, etc.?

On my bad days, which are looking more like forgetfulness and impatience, and then the "water works" start, he needs to learn some tactics that can keep him sane. Thes tactics I cannot teach him, nor are they in a book. These are tactics that are trial and error and learned through resourcing. What he would be doing is consulting with a professional resource so he can be better equipped to handle me if and when I am unmanageable. It is liken to patient who suffers from lung problems and his or her breathing becomes belabored requiring a nebulizer - what does the caregiver do when that happens? The professional resource SHOWS him or her what to do! In my husband's case, he actually does know how to deal with a nebulizer, but he does not know for a mental illness.

Lastly and most importantly, he needs to know how to take care of himself. When it feels to him like he is in over his head and what can he do to relay that to me, so that I HEAR him. He deserves to be honest with me. Because I know, caregivers do get exhausted and want their own lives. And I think there are some good methods that couples can develop to handle that. In fact, I think it is one of the most personal and creative ways that a married couple can manifest -- it is the "what makes this work" in our own marriage.

My husband is a wonderful man. He is very understanding, patient and kind. And with my bipolar issue, which I still have a tough time letting it get the best of me, he has supported me, in all my endeavors while we have been married. I appreciate and thank him for that. Lately, I have gone to my providers and started asking questions if my health regimen requires changing, and it did. I can just tell there is a difference and it is not placebo. Yet, I am suffering from physical pains, which may be a sign of many other things. But the one thing that keeps me afloat, is when I see my husband's smile that he feels like he is doing "right" by me.

Mental health in a marriage requires:

  • Health caregiver support just like other health conditions.

  • Research and best practice training can be clinically developed to enrich marriages

  • There can be a spiritual component, similar to that seen in Hospice if desired.

  • Lastly, if we are about removing stigma, ignorances must be deflected by "laymen talking points" and advertised on all media channels with experts, rather than incivility.