In Sickness and In Health . . . Lessons Learned From My Patients

Gabrielle Giffords  and her husband Mark Kelly have made a few appearances lately, telling their story of bravery and determination following the horrific shooting in January that left Giffords near death.  Giffords’ has made a near miraculous recovery, due in large part to a hefty dose of luck, and the determination of those around her, most notably her husband.  The films of him encouraging her to do her best are inspiring.

But what of the spouses of MY patients?

For many of my patients who battle severe mental health issues, the lifeline provided by their husband or wife is the only thing that keeps them going.  Becoming severely depressed or overwhelmingly anxious can lead a patient to be unable to work . . . unable to socialize . . . unable to participate in a relationship in much the same way that a physical illness can.  But with the admission of a severe mental health issue comes the stigma of having a mental health issue.  Even in these “enlightened” times where it is clear that mental health issues result from organic dysfunction of brain tissue, people with mental health issues are viewed as flawed, not sick.  This thought process is insidious and can destroy a relationship from the inside out before it is even recognized for what it is . . . an unconscious (and societally sanctioned) view that someone with mental health issues is flawed and unacceptable. People with mental health issues typically end up isolated from others and on their own.  You’ve heard the statistics about the percentage of homeless people who have mental health issues.

How many of you out there have friends or relatives who’s relationships broke up because one of the partners got severely depressed, anxious or otherwise incapacitated due to a mental health issue?  I see it all the time in my practice.

Now, how many of you have friends or relatives whose relationship broke up because . . . one of the partners got cancer . . . or had a heart attack . . . or a stroke . . .

Not so many, huh?

What would you think if Mark Kelly turned and walked away from his wife because it was “just too hard to deal with”.

What would you think of a man who left his wife because she got breast cancer and he “couldn’t deal with it”.

What would you think of a wife who left her husband because he couldn’t work and provide for the family because of a severe back injury?

I have been blessed to have a number of couples in my practice who have held together despite one of them having severe mental health issues.  In their interactions, I see shades of Mark Kelly.  They are pushing their spouses to be their best, but are understanding of their spouses’ struggles and limitations.  They don’t lose track of where the relationship was . . . and view themselves as partners going forward into an uncertain future . . . and hoping for the best.  They struggle.  They have their good days and their bad days . . . good weeks and bad weeks . . . but they hang in there.  Many benefit from their own treatment, since the rate of depression in spouses with mental health issues is quite high.

But what could help them the most is an outpouring of understanding from those around them.  If you had a relative battling a serious medical illness, you would make an extra phone call.  Send over a casserole.  Write an encouraging letter.  Drop by and say “hi”.  If you know someone who is struggling with mental health issues, reach out and let them know that they are not alone.  That someone out there loves them and values them.  That somebody cares.  In this age of enlightenment about the root causes of psychiatric conditions, it’s time we start acting enlightened.  It’s time to stop looking the other way.  It’s time to stop soothing our discomfort with mental health issues with sarcastic jokes and comments. It’s time to be kind to those around us who have nervous system dysfunction that manifests as changes in mood or behavior.

–Dan Hartman, MD

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