Sunday, October 20, 2013

you are a lighthouse, not the life raft.

To my dearest Sab,
This is a letter to you as you sit in hospital recovering from a serious, strange and unusual condition in Hong Kong...apart from expressing my love and hope that you will make a full recovery, this letter is mainly to help you deal with something which I'm afraid to say, completely broke my heart. That is, loving someone with a mental illness and choosing to stay anyway. It is not fair that it hurts as much as it does, but I believe honesty is the key when talking about mental I will admit that is it probably the hardest thing I have ever done, and potentially the most painful. But without it, I wouldn't be who I am today. Again, I am so sorry you are hurting right now, but I am awed by your bravery and unwavering support of your boyfriend. You deserve recognition for your strength and your deep love. So here we go with the tricky do you go about loving someone who is struggling, whilst remaining sane and remembering all the beautiful things that made you fall in love with the person in the first place?

Firstly, when someone with depression (I'm going to use the general term depression even if he might have another official diagnosis) says they cannot feel anything, please do not take this as literally as it sounds. I used to plead and wail with Pod; how can you not feel anything? What about now? What about when you laugh? What about when you kiss me? The problem with depression is that it constricts your thinking, so maybe you felt happy an hour ago, but you can't remember what that felt like because you hurt now, and that now becomes both the past and the future, it stretches infinitely until phrases like 'I am never happy' or 'I haven't felt anything for months' is both completely true, yet so completely false. Depression is a cruel paradox, but that does not mean the person is lying or exaggerating; they truly believe what they say when they talk about their feelings, perceptions and mood. Please do not underestimate or illegitimise this pain because no matter how self-destructive they might seem, no one would choose to hurt like they do. Try to have faith and believe that mental illness will not be the victor. When you feel particularly frustrated with his mood or behaviour and you think it might be coming from a mental illness perspective, ask him to explain how it feels for him - ask about how it feels in his body, in his head and what is happening in the room around him. Studies have shown that depressed patients (especially those with a high risk of suicide), rate their psychiatric pain on equal levels as the Holocaust. Imagine feeling so deeply and physically distressed that the Holocaust is comparable...this is psychiatric pain. So take a big breathe in and out, smile and kiss him. Everything will be okay. 

When he tells you that he is faking happiness, please do not despair...think about what he is doing and why he is doing it. 'Fake it till you make it' is effectively the auto-pilot of someone with depression, so remind him that as long as he is able to remember how to look and act happy, he will be able to retain within himself what it's like to be actually happy. There is nothing wrong with a little play-acting because one day he'll forget his sadness for a moment and feel pure and complete happiness and it'll be worth all the 'faking'. He is pretending to be happy for you, so that he can be together with you and your friends. It is a selfless attempt to hide his pain and just be normal. It is probably the hardest and most powerful act of love that he can give you right now. Treasure it and hold it close.
Depression is a self-deprecating disease, full of doubts and worries. In an effort to combat this, Pod and I had a 'full disclosure' policy. Obviously this can be painful when your lover asks you to leave them alone or admits something you'd rather not hear, but it is vital to maintaining an understanding of not just the person you are in love with, but also your own sense of self. He is your boyfriend after all, he still needs to be able to support you emotionally and be able to hear things that might be hard (this includes criticism of his behaviour no matter how much of it is his illness and how much is his own self). Silent resentment will only breed contempt. Secrets and harbouring fantasies of when everything is completely fine again, will only make you resent the person you see in front of you. Instead, plan things to do together that are happiness focused; cute date ideas or low-key activities that might lift his mood. Oh, and, sex is important! Not necessarily in the literal sense, but intimacy and physical contact is key. Some classic cognitive distortions of someone with depression revolve around being a burden, believing no one cares or will ever understand their pain. Sometimes a hug, or lying together in bed can silently communicate the opposite of all these hideous ideas. Besides, intimacy is often the only difference you might feel between being his best friend or therapist, so savour those times together and delight in making him happy (and hopefully he will endeavor to do the same).
Finally, please remember: you are not responsible for his happiness or safety. No one wants to be the tearful girlfriend standing beside the grave. No one wants to lose someone because it hurts too much to be in a relationship with a mental illness, not a person. No one wants to watch someone drown, but don't jump into the water too. Repeat after me: it is not my job to save him. It is your role however, to take stock of the situation, apply perspective and guide him through the pain. Some very short practical solutions for when you cannot physically be there but he is in 'crisis' or a 'depression spiral' as you so aptly called it, are as follows...tell him to take a shower (either super warm or super cold), tell him to get some ice cubes and trace them across his arms or legs (people who feel the urge to self harm find this a safe mess free alternative), remind him that you love him and will always support him (keep telling him, because he will often forget), tell him to go to bed and assure him you will be there to talk it through in the morning (sleep cures the most darkest of moods and I would suggest inquiring about a safe sleep medication if night time is a triggering time for him), suggest he watch TED-x talks on YouTube (they are very engaging and inspirational talks on a wide range of topics and can be a perfect distraction tool), ask him to list five good things that have happened that week or make a plan to do something fun together in a weeks time (a gentler form of a safety contract), encourage him to eat or drink something (depressed people can forget to eat or simply do not feel hungry and so food can stimulate feel-good hormone release in the body) and finally, set boundaries between you and him; encourage him to talk about his feelings but limit it to half an hour maximum, or clearly state before you begin talking that you have to go at a certain time and stick to it. Repeat after me: it is not my job to save him, only love him through this pain.
I wish you the best of luck for your own recovery and your continued relationship with your beautiful beau. All my love, E. x
PS. Books, movies and TV shows about mental illness help...empower yourself with information and spread the word to others.
Say no to stigma and silence!