How to Navigate Mental Health Issues in Relationships

The effects of living with a mental health disorder can touch every part of your life, including relationships you have with the people most important to you.

If you've found yourself having difficulty navigating relationships with loved ones because of their mental health issues or your own, you're not alone.

"Most of us, at some point in our lives, will either have a mental illness or know someone that does, because it's that pervasive," said Jon Lasser, a practicing psychologist and professor at Texas State University's School of Psychology.

The number of Americans living with mental health issues is significant, as the National Institute of Mental Health reports that nearly 20 percent of adults in the United States live with a disorder of some kind, while 1 in 20 is coping with a serious mental illness.

Given how widespread mental health problems are, it's important to know how to effectively support a loved one who is struggling and how to ask for the help you need.

According to Lasser, empathy, respect, patience and understanding are the most important things you can offer to someone coping with mental health issues.

"It's often not helpful to give people a lot of direct advice or tell them what to do," Lasser said. "And I think often family and friends misunderstand anxiety and depression. They sometimes believe that people could just simply make different choices and move on with their lives, but mental illness can be crippling, and it can interfere with our capacity to do the things that we ordinarily do."

While mental health disorders vary widely in their severity and symptoms, they all share a commonality—mental health disorders cause changes in emotion, thinking and sometimes behavior.

When you see a loved one—whether a romantic partner, family member, friend or colleague—having a difficult time coping with their mental health, it's only natural to want to help them. However, it's important to remember that how you try to help them can make a tremendous difference. Lasser said a good precursor to explicitly suggesting that someone seek professional help is to start by asking if there's anything you can do to help them and what they would like to do about whatever issues they're struggling with.

"Open up the conversation, and sometimes they will say, 'Well, I could use help finding a therapist, but I just don't know where to start,'" Lasser explained. "Then the idea is coming from them, and that truly is more effective than suggesting directly to someone. Sometimes people are unaware of how bad their problem is, so they may need some guidance around that. And in that case, you can ask, 'Have you considered finding a therapist to help you with this?'"

The importance of communication cannot be underestimated when it comes to relationships, especially when someone's mental health is affecting their feelings and behavior.

"After all, communication is the only method to let others know how we feel," said Lindsay Zilling, M.S., a registered behavior technician and a doctoral candidate in the psychology program at Hawaii Pacific University.

"As convenient as it might sound, human beings are not mind readers," Zilling added. "Nonverbal cues can provide insight, but sharing your emotions and thoughts are vital. Everyone has unique perspectives and experiences, which shape their version of reality. Thus, communication is the best way you can help your loved ones understand what you're going through.

"Without communication, these pathways begin to break down," Zilling continued. "Communication is also about mutual respect: Be aware that some people may not have the capacity to embody the support you require and deserve."

David Schlosz, a licensed professional counselor who works with children and adults at his private practice in addition to teaching at St. Edward's University in Austin, Texas, and Texas State University in San Marcos, Texas, said that timing is an important factor in ensuring that communication is effective.

For example, if your loved one has an anxiety disorder and they start to panic or feel anxious, they may not be able to immediately identify the cause of their feelings.

"All they know is that in their body, they're feeling overwhelmed, that their heart rate is increasing, that they are feeling like they can't think straight or that they feel like bursting into tears," Schlosz said. "When we press for answers like, 'You've got to know what you feel' or 'Think about it a little bit,' that often just exacerbates the problem. During that time that they're manifesting whatever it is that they're struggling with, give them the space to feel it."

When a loved one is in the midst of their anxiety, your role should be to act as an anchoring and supportive presence, Schlosz said.

"Give space initially, and then when they're not in a state where they are triggered or activated, you can broach it then in a caring and careful way, so that it doesn't come across as blame," he said. "Because after the fact, when they calm down, it's easy to feel shame regarding the reaction."

You should also avoid saying things like, "Oh, it was just a bad day" or "Don't worry, you're fine" when trying to comfort your loved one with regard to their mental health struggles, because while your intentions may be positive, it will likely have the opposite effect.

"Those responses may come across as dismissive and make it seem like you're minimizing their experience," Lasser said. "And it suggests that perhaps you don't believe that they have serious mental illness, and rather that it's just a bad mood or something that they can get over."

Relationships can be complicated all on their own, even without the added stress of mental health struggles. But when mental health issues enter the picture, communication becomes even more imperative to maintain a healthy relationship—but this isn't always easy to do without some outside help.

"It doesn't matter which partner you are, whether you're the one with a mental illness or challenges or you're the partner that doesn't have the same challenges," Schlosz said. "A third party that's there to facilitate healthy communication can be so helpful, because we tend to mishear what the other person is saying."

Schlosz said he often sees in couples therapy that communication breaks down because the delivery between partners can prevent each individual from really hearing and understanding what they're attempting to convey.

"Couples counseling is incredibly useful not only for the partner that doesn't have the mental illness so that they know what triggers their partner and how to support the partner," Schlosz explained, "but also for the partner with mental illness to know that, you know, this is impacting the relationship in a particular way, and the responsibility is on both of you to communicate in a healthier way."

According to Schlosz, going to couples therapy can help partners learn how to tell each other when and how they are struggling so they can properly communicate their needs. It also helps each partner to better recognize when their counterpart is having a hard time so they can offer support.

"Couples therapy helps people realize it's not all on the partner without the mental illness, that it's really a joint, team effort for both of them," Schlosz said.

While the stigma surrounding mental health has decreased over the years, there's still a lot of work to do before enough people feel comfortable and safe to open up about their mental health and to ask for help when they need it.

"I think we normalize it by talking about it," Lasser said. "We start talking about our own experiences of pain or loss or suffering, then it becomes part of the conversation. Like I said, all of us over our lifetime will either experience or know someone who experiences some kind of mental illness. So to be able to bring it out of the shadows and have conversations about it really helps."

Schlosz added that he struggles with diagnoses in general because they can often be used to ostracize the people they label.

"Labels can make us think that's all there is to us," Schlosz said. "For example, for me and my depression—there is a part of me that is depressed that oftentimes shows up and wants to take center stage and steal the scene. But there are also other parts of me that are healthy, and that cope well, and that love this part of me. They don't reject him. They don't want to put him in a corner or lock him in the dungeon. They're there as part of the team to support each other. So the depression part of me is just one of many parts of who I am."

Your mental health doesn't solely affect your outside relationships, but the relationship you have with yourself as well. So it's important to make sure that those effects are positive.

"You have to realize that we're complex," Schlosz said. "None of us are at any time just one thing. We are all multiple things at any one moment in time. To me, that's really helpful, because if your identity is based purely on your diagnosis or your struggle, it can become really unhealthy for you."