When A Partner Struggles with Physical and/or Mental Health Challenges

In this episode, we explore how people can navigate health challenges when they arise. We discuss how to be supportive when your partner is struggling, how to discuss health challenges with your partner, and how to take care of your own mental and physical health while supporting a partner who is struggling with their health.

Transcript

SPEAKER_01 0:04

Welcome to Couples and Connections, a conversation with clinical psychologist Dr. Cynthia Post. We're covering a wide range of mental health topics related to couples, families, singles, and relationships. I'm health journalist Teresa Talvin Barger. Hello, Cindy. How are you? Hello, Teresa. I'm well, thank you. How are you? Good. We're discussing coping with your partner's challenges. And that could mean mental health, physical health challenges. It could be workplace stress, family, extended family stress. It's something where you're the person you love is dealing with a problem and you want to be supportive, but don't know how. So I guess to start is if you have a person you care about who's dealing with something difficult, how can you help that person without overstepping and without doing something that's going to backfire?

SPEAKER_00 1:01

So one of the questions inherent in your question is is this person aware that they're having a big problem? Sometimes people are aware that they're having a problem and sometimes they're not. So that may sound like an odd thing to say, but like they may not realize how challenged they are by their mental health issue, as an example, that they actually are getting more depressed, or that they're under a lot more stress than they're acknowledging at work, or something like this. So some of it, it's not uncommon that the other partner who's not experiencing it as much is the one that sees it first. And then it might be the person who's not experiencing it who has to bring it to the attention of their partner and say something like, Look, I see that you're struggling. It looks to me like you're struggling, and to check in with them and say, here's what I'm seeing, and I want to talk with you about what's happening with you and how can we work together on this. Now, when you have such a conversation, you want to make sure that you approach it really well and that you set up a scenario where this can be a positive exchange. So you don't want it to be a drive-by conversation that you just sort of casually ask it. You want to say, hey, I want to bring something up. When is a good time to talk? And you make actually an appointment.

SPEAKER_01 2:25

Okay. So this this I'm thinking of a situation where I was maybe really, really cranky from a very stressful job and I was working many, many, many hours. My husband may have seen that it was a bad, stressful situation. He may have been afraid to bite my head. I would bite his head off if he asked me, I want to talk to you. And I might have been like, well, what do you have to say? You know, I might have been really sharp and snappy because I was stressed and overworked. And so how does the person who sees their loved one under, you know, whatever the situation is? You said try to schedule a time, but how do they even broach the subject?

SPEAKER_00 3:05

Well, I guess the way I would say it is, you know, something's on my mind that I've been wanting to talk about. And I was wondering if there's a good time to talk, because it may be that when they first come home from work, they need to relax, take off their shoes, you know, eat some dinner, who knows, go through the mail, whatever. Or maybe early in the morning they're too tired. Maybe on the weekend they want to sleep late. So finding a time is one of the first things and really making a point to have a conversation.

SPEAKER_01 3:34

But I think what you said is really important. I have something I'd like to talk about. You're not saying I'm concerned about you. You're just saying I have something I want to talk about. So they don't, they may not get defensive.

SPEAKER_00 3:46

I think that that's better. And if they say, well, what is it? You can say, well, you know, I really would like to just sit down and talk when it's a good time to talk. Now you don't want to scare them. So you don't want them to be worried, what's the topic? Like it's a big mystery topic. So you might say, you know, I'm just noticing that there's a lot going on for you. And I want to be of support and understand what's happening. Just a moment to connect and touch bases. That's kind of a first point of entry, I would say. Just to really reach out to your partner, let them know that you're seeing some things and you're wondering what you're seeing. This is what you're seeing. What's happening on their side of the equation that you may not even understand?

SPEAKER_01 4:24

Okay. And in your experience, what are the conversations that the partner has with their, you know, their loved one where things go went well, where they approached a topic that was, you know, maybe the person was dealing with a mental health issue or a substance use issue or a work stress issue. And how did that go well? What did the, what was the, what did that look like?

SPEAKER_00 4:49

What I've observed is that people are deliberate about their actions and deliberate about their word choice, how they're approaching their partner is very important. So to say, something along the lines of, so here's what I'm sitting with. I'm seeing you coming home looking really tired and seeming really down, more down than usual. And I'm hearing you talking about having a lot on your plate. And I'm just wondering, what do we need to do here at home to support you in the situation you're in right now? How what do we need to do that would help?

SPEAKER_01 5:28

And what if the person says, there's nothing you can do to help, just leave me alone?

SPEAKER_00 5:33

I think you have to pick your battles, you have to choose carefully, you have to look and be attuned to your partner and notice when they seem to be more amenable and less amenable. So you don't want to suggest having a talk when you're already picking up this person is very tense. You do want to try try to talk at a time when things seem to be a little calmer. Maybe they've just had a good night's sleep, they're just getting up in the morning, maybe it isn't a work day, something like that, where and that you have privacy. Be sure you have privacy that other people are not overhearing this. And that you know that you're saying and that you're not saying things like I'm worried about you, which is very much a top-down, a top-down way of talking. You don't want to say I'm worried about you, because when you say the phrase, I'm worried about you, it's as if you're looking down at them, being worried about them.

SPEAKER_01 6:26

Okay, so what's the way to say it?

SPEAKER_00 6:28

Well, I think a better way to say it is something like so here's what I'm seeing. I'm seeing you coming home seeming tired. I see that you are staying up late, you don't get a lot of sleep because you're working so hard, and that it doesn't look like your experience with this is going very well. And I don't know what else is going on, but I just first of all want to learn more about what's happening and then understand if there is a role for me to play that would be a value here. Is there something I could do to be of support at home?

SPEAKER_01 7:01

And what's what's an example of an exchange where you've seen that one part of the couple had to discuss something that was difficult, um, and it didn't go well. The, you know, whatever maybe nothing, the relation, nothing improved, whatever the issue was, it didn't get resolved.

SPEAKER_00 7:22

These are situations I would say this is a situation where the person with the problem ends up looking like they're asking without asking for help. And what I mean by that is that they are they are struggling and they're telecasting it, and it's really in like big flashing lights, and it calls upon the partner to respond. So the person isn't getting out of bed in the morning, maybe they're not showering, maybe they're not eating, something big is happening, and now the partner is getting nervous about it, and they feel they must bring it up, and there is no good time to bring it up. The person continues to sleep, or you know, they're not going to work, or it could be any number of things that are happening. So then in those situations, they really may not be amenable, and some of that can often require one person to have to actually do something more significant about it. You know, I am observing, well, I'm observing that things don't seem to be going very well right now, and we do need to figure out what to do about this because it it doesn't look like it's improving. And I'm here to be of support to you, and I have some thoughts and I want to hear yours, but not talking about it is not one of the options on the list. And those are more difficult conversations to have. So we don't have to talk about it now, or we can talk about it a little now and a little later, but not talking about it as all isn't is not on the list. And often these are the kinds of conversations where the person who's asking to speak has been put off several times. So you may just have to lay down the law and say, we have to talk about this. This is no longer a thing that we have the option not to talk about it.

SPEAKER_01 9:04

What if this you've tried this and the person says, I don't want to discuss this issue with you. I've got it under control. And the person says they're going to go for therapy but never does, says they're going to change whatever the habit is. Maybe they're drinking too much or eating too much or watching too much TV or playing too many video games, but nothing changes month after month, and the person refuses to discuss it.

SPEAKER_00 9:34

Those are the really tough conversations. And this is a situation where there are a couple of different ways to intervene. I mean, one way to intervene is to say, I understand that you don't want to talk about this. I'm going to back up and make room for you to get to the point where you're willing to talk about it. I'm going to give you this much time, and then I will be following up so that there's some idea, like I'm giving you space to come back to this, but us not talking about it at all is not one of the options. Then another thing, you know, sometimes people make interventions of different sorts and they reach out to a family friend or they reach out to one of their colleagues or something, and and that they have more of like a discussion, like a bigger conversation with the person and someone else to say, we're all here because we're worried about you, and this is not a good situation. And here's some here's some ways we can respond, but not responding at all is not one of the options. Often in this kind of situation, we we have a situation where there's more than one issue going on. Like maybe it started with work stress, and now the person's actually getting really anxious or really depressed. So we have comorbid mental health issues along with a real life stressor, or maybe somebody just died or they got divorced or something else, in addition to another issue. So when things start mounting up, people can quickly start getting overwhelmed and become unresponsive. And that's when sometimes you have to take action. This is what I mean by asking without asking. Their behavior is telecasting, help me, help me, but their words are saying, no, don't help me. So often people in this scenario feel like they do have to take an action. They have to do something.

SPEAKER_01 11:23

You are listening to Couples in Connections with clinical psychologist Dr. Cynthia Post. I'm Teresa Sullivan Varger. We were just talking about um having possibly having an intervention. And I wonder, do interventions ever really work?

SPEAKER_00 11:39

You know, so first I just want to step back from this for a minute. This is kind of a whole continuum of responding. So, first of all, at one end of the continuum is just kind of a soft, gentle engagement with your partner saying, look, I'm observing something here, and maybe it all goes well, and your partner is open and curious about what you're saying, and you can have a very useful conversation. That's at one end of the continuum. Then at the very other end of the continuum is where they're not listening, they won't consider what you're saying, maybe they have a fair amount of denial, they might be feeling really afraid, they're kind of digging in their heels. So that's at the other end of the continuum. And when that happens, that's obviously a much harder kind of conversation to engage in. And this is where you may need to kind of take some more significant steps. Interventions are when there's more than one person in the room and you're talking to the person about some patterns that you're seeing that really are of concern. And do they ever work? Sometimes, but often these are situations that are very hard.

SPEAKER_01 12:47

When you have a partner who's struggling in some way, shape, or form, how do you take care of your own issues, take care of your own needs, um, so that you don't end up resenting your partner, but at the same time, you don't want to abandon them?

SPEAKER_00 13:06

Well, so I would say this is where we want to employ both verbal engagement as well as non-verbal engagement. So if you're observing that your partner seems really stressed and they're just sort of not taking care of things, maybe you just pick up some of the things that they're not doing. Maybe you share cooking responsibilities. Maybe you just say, What the heck? This week I'm just gonna cook every night. And that you know they're really working, working, working. So you just say, Hey, I wanted to let you know dinner's ready. Well, I can't join you. No worries, the dinner's on the table when you're ready. It's just ready to warm up when you want to warm it up. So you just kind of quietly engage and quietly help with some of the things that maybe they're not able to do. And this isn't a bad way to respond when they're not that available to talk. And the hope is that they'll get back to you when they are. But if it goes on like this for more time, that may not be a good plan long term. You may need to say, look, I see that these things are continuing, and we really do need to have an update about what's happening here. I'm a little confused or I'm concerned, and I want to be able to talk with you about this so that we look we can really work together.

SPEAKER_01 14:15

Again, I guess I come back to what shouldn't you do?

SPEAKER_00 14:19

I mean, what I think you shouldn't do is start criticizing the person for how poorly they're handling it, or start exhibiting your own frustration in an unproductive way if you can avoid it. This is one of the places where couples can really get into trouble sometimes because they feel like the partner isn't listening to them, and the other person feels really overwhelmed with whatever they're dealing with. And so it scares both people because they may feel that they're doing the best they can, and you may feel like you've got the weight of the world on your shoulders trying to figure out what to do and how to respond. And so it's not easy for either person. I would say that as a support person, as the person who's not struggling with it, getting some support for yourself is probably gonna be really important. Having somebody else that you can talk to, uh, something else that you find that helps you with your own stress management, because let's face it, when your partner is stressed, you're stressed too. So the whole couple relationship is stressed then. So whatever you can do to keep your own head above water is gonna be really important when you go through harder times.

SPEAKER_01 15:27

So let's say your your partner's say, let's just say just for sake of discussion, your partner's depressed. The person is functioning, but is kind of in their own world.

unknown 15:40

Right.

SPEAKER_01 15:40

So you're just you you just be supportive, you pick up the slack, you show them love, and you get your, you know, you sort of you get your support from from other people, and you hope that in time the circumstances change and the person maybe isn't depressed anymore. That just is that realistic?

SPEAKER_00 16:02

It it can be that it can be, it can happen that way. I think one of the important components here to consider is time. How long is this going on? How long has it been going on? So sometimes not a bad first step of intervention is to go to the medical doctor. There could be something medical going on, and you do want to rule out medical issues before you get into mental health issues, because you know, I've seen situations where it sure looks like mental health, but actually there was something going on physically that once the physical issue is resolved, the person was really much better. And often, sometimes you can have a thutual third party that is known to both of you, who's a professional who can give you some more objective advice or input on what they're seeing and what they're hearing from you as the partner that will help them maybe listen a little differently. Or even if they won't listen on that occasion to say, you know, I see that this is what's going on. Why don't we plan to follow up in a week? And then that person in the maybe in the medical field is in a better position to be able to really assess and say, gee, I don't know, it's still happening. Maybe we need to take further action here. And they may not like it. Probably they won't like it if they're scared and overwhelmed. That could happen, but that the professional then is there to help the partner deal with that person in that situation.

SPEAKER_01 17:35

Okay. I'm just thinking, what if you're the person, you know you're the person who's dealing with a problem? You're dealing with depression or anxiety or conflict with family or whatever, a dip, a really stressful work situation. And you're leaning on your partner so much, and you're maybe worrying you're leaning on your partner too much, and you're going to stress your partner out. I mean, that's one of the reasons we have partners because sometimes, you know, one person's dealing with something, and sometimes another, the other half of the couple's dealing with something. So I don't know, is there a healthy way to ask for support without being too needy, without asking for too much?

SPEAKER_00 18:20

I think that depends on the couple. So you can check in and say, you know, I'm I know I'm asking a lot of you. There's been a lot going on. I want some feedback. How are you doing with this? I think that's always so much better in a couple. That represents a partnership where there's an awareness that, you know, we both have needs, we're both dealing with a lot. And I want to hear from you. I want to know if it's getting to be too much. I don't want to overwhelm you with my problem. And that is reasonable in a partnership to be able to say, you know, I'm not sure I can listen right now. I really care about what's on your mind, but I think I'm dealing with a lot myself right now, and I'm not sure I can really listen to what's going on with you. And that can happen in lots of relationships, whether it's with a friend or a family member or your partner, that it's okay to admit, you know, I'm not sure I can do a good job listening. And it would be better for you to say that than to look like you're showing up and not really be there. So it's okay to set limits, and it's okay to ask if you're worried that you're asking too much.

SPEAKER_01 19:25

And and this is going to sound like the kind of the opposite end of the spectrum. Let's say you're you're you've been talking or you've been trying to discuss an issue with your partner for a long time and it's going on for more than a year, even more than, you know, maybe it's going on for many years, and you don't really see much change. When do you say this relationship isn't working? Or or you maybe do something more drastic, like you've already mentioned intervention.

SPEAKER_00 19:55

I don't think there's one right answer, but I think what you don't want to do is just let something continue on and on and on over years, and the quality of life for all concerned, maybe the parents as well as the children is really suffering. So the healthier, more aware person has to make some really tough calls. And they might need to say something like, I see that you're struggling, I need your help with this, we need to work together on this, and I'm asking you to do something about this. And here's what I'd like to do. And you lay out with them what you need to see happen to feel more comfortable. I wouldn't start with threats, I would start with assertive, clear communication with requests. And hopefully that'll resolve it, you know, and and maybe you even give them a little time to think about it. You say, look, I I appreciate that you may not like what I'm saying right now. I don't much like it either, but we need to be able to talk about these things. I guess we could say that this falls in the category of a tough conversation.

SPEAKER_01 21:00

And I'm guessing you there's no such thing as forcing someone to go to therapy. Someone has to be receptive to therapy for it to work.

SPEAKER_00 21:07

I'm I'm well, you can ask them to go, understanding that they may or may not be willing to go. And also, I think it's very important that people feel agency over their own lives. So you can say, look, I found a couple of names for you to call. Why don't you talk to them and see which one you'd be willing to schedule an appointment with? Now, if they're not well enough to to make that appointment, then you could offer to help them with that.

SPEAKER_01 21:33

At what point do you say, uh, you know, I this relationship isn't going to work out? You know, when do you when do you kind of pull the plug? Or is that just is it you can you not is there's no quick, easy way to say that.

SPEAKER_00 21:47

I don't think there's an easy answer to that. I don't think there's one right time or one wrong time to do that. I also do think that where children are involved, you know, it becomes a lot more complicated. I don't think it's wrong when you've been hanging in there with someone for a long time and they are not really addressing the things that are of concern to you, that you at some point say that this is not working for you. I think that that is a reasonable decision to make. I think people might feel racked with guilt if that happens and it's not what they want. And that's all very understandable. I think it's an okay thing to decide that you don't know that you can continue on at a certain point for your own sense of your own well-being. So I I do think that that happens sometimes.

SPEAKER_01 22:37

Yeah, I'm thinking of somebody who was married to an alcoholic and tried and tried and tried and tried. And the person just, you know, wasn't work lost their job, wasn't, wasn't doing anything but drinking, and just the wife just felt like it wasn't a healthy situation.

SPEAKER_00 22:57

Yep, those those things come up. And when they do, at a certain point, someone might say, you know, I think I'm done here. And that's a very personal decision to make. That's a hard decision, obviously. Nobody wants to leave their partner in a time of need. But when you've been trying and trying and the person is unresponsive, that just may be where you are.

SPEAKER_01 23:19

Well, one of the things you you say is something to the effect that um about how so it's so important to take care of yourself before you get into a relationship. I forget you have a an expression.

SPEAKER_00 23:32

Oh, yes. The idea that self-regulation trumps intimacy and that you can't really have a relationship with another person if you're not doing well yourself. So when you are in a partnership, you have a responsibility to your partner to kind of keep yourself up. You know, that's part of being in a partnership. You've joined another person to share a life, and sharing a life means just that sharing a life. And that means being accountable to yourself and your own partner for understanding, wow, there's a lot going on with me. Boy, maybe I need to look into this in fairness to me and to my partner.

SPEAKER_01 24:10

Okay. This is helpful. Thank you, Cindy. Thank you. What is a good way to for people to get more information or to reach you? Cynthiapostph.com. You've been listening to Couples and Connections, Conversations with Clinical Psychologist Dr. Cynthia Post. I'm health journalist Teresa Sullivan Barger. For more information, visit CynthiaPostPhd.com. That's Cynthiapost PhD.com. Listen for new episodes on Fridays and tell your friends about couples and connections.