As a patient with mental illness, I am very grateful to my partner. He has stayed with me throughout, been there for the difficult times, and still takes me to my regular ECT maintenance sessions. I hate going for these; the treatment is no fun, but I also hate having to go there with him when I look my worst, hair unwashed (what’s the point?) make-up unworn, my face pale and dark in places. I look unwell, and frankly unattractive.
I don’t remember, when we married each other all those years ago, whether we mentioned sickness or health – I simply don’t remember. But I don’t think either of us thought that mental sickness would be an issue. Mental health is much more talked about now, and I’m very glad of that, but severe mental illness and its treatments remain stigmatised. I don’t talk about getting ECT to many friends at all, even though I think most of them know. Perhaps it’s harder for them to talk about because I don’t mention it specifically myself, but it’s difficult. It’s not like a lot of physical illnesses – I know that some of them may also be hard to mention, but there is something different about mental illness. And I don’t really like to say, for example when I go to the dentist or optician, that I’m on lithium, an antipsychotic and an antidepressant, or what my diagnosis is. So I usually fudge it.
I love my partner very much, and I really do think that he feels the same about me. Yes, we’ve had our ups and downs, but we’ve had a lot of happiness. If it wasn’t for him, I wouldn’t be able to have out-patient ECT, as there would be no-one to take me. Yet, I have friends whom I might ask to take me for treatment for a physical illness, so what would stop me asking them for this? Both shame and self-stigma (something which is not, in my opinion, caused by the self), and also not wanting to be seen at a time when I am mentally (and physically) vulnerable. But I let him see me then. I look at myself in the mirror and am appalled, but he still smiles at me.
Would I do this for him? Of course I’d like to say of course, but I’ve not been tried, so I don’t know for sure. Would I find him unattractive, needy, repellent – all the things I see myself as being when unwell? And does that stop you loving someone? It shouldn’t, perhaps, but you can’t force love.
I think my partner is able to distance himself to some degree, and that helps. Maybe he thinks of the person I was – funny, even pretty once – and can separate himself from the greyness and the pain, when it’ comes back. If you stayed in the moment always, trying to answer nonsensical questions, trying to talk sense into nonsense, then you’d burn out pretty quickly. This doesn’t negate his love in any way, but it may help him to cope. I couldn’t do it.
But I do still wonder why he stays with me. I don’t think he talks about my illness to anyone, not unless he has to. There’s no reason why he should, of course, but I still think severe mental illness is hard to explain or talk of. There are still the stereotypes of film and literature, and it can change the way a person is perceived – not just due to illness, but also their character. So it is easier not to mention it.
The worst scenario is that my views reflect my own opinion of mental illness, and I have to admit this could be possible, given that I have difficulty in believing in myself as a person with severe mental illness. It’s just a step from saying that I don’t have an illness – so maybe others don’t either. However, I don’t think this is true. Although, as a psychiatrist, I try my best to think what it would be like being someone else – the bottom line is that it’s unimaginable. I see someone’s exterior, the doubts for me are deep inside. Sometimes it makes you wonder if you believe in anything, as you only have this one tiny vantage point, but it’s just something that has to be accepted. And, in the same way, I have to accept what my partner tells me and shows me – that he loves me. He gets irritated with me (that makes total sense), and he gets very cross with life at times – for example, raging last night at his mobile phone because it’s facial recognition had failed. ‘Am I too ugly?’ he snarled. But we were both able to laugh at him – me immediately, him eventually.
I suppose that I should try to accept his love more readily – it’s not flattering to him if I keep asking him why he loves me, or saying he shouldn’t, and puts doubt on his choice. Casting myself as the mentally ill patient who is hence undeserving of love is in itself profoundly stigmatising. I think I am less confident than him overall, but mental illness has added to this; however, the best return for love is love.
Ultimately, I think it is of course important to acknowledge the helping, or even caring, role that any partner has in a relationship. However, it’s also vital not to over-estimate the role of the mentally ill partner as somehow less deserving or harder to be with than someone who is physically ill. It may sometimes be the case, but not always, and hopefully people stay together because they love each other. Mental illness is just one of life’s challenges, and the need for support should not increase the stigma that is still often present. Recognising it is the first step to addressing it, in all our relationships.