Mental illness and relationships: the third wheel.

Mental illnesses can often be a third wheel in relationships.
Their presence is like an elephant in the room.

It is hard to look after yourself when struggling with a mental illness, sometimes showering seems like too hard a task, let alone seeing friends and putting on your ‘happy face’.
Society conditions us to feel the need to be on our best form with friends. No one wants to hang around with someone who is depressed, as they feel it brings a damper on the mood. Therefore it is hard for people struggling with depression to socialise as they cannot just be, they have to be the best version of themselves. That pretend happy go lucky version. This masquerade that many people with depression feel that they have to wear is draining, exhausting. Many feel that friends wouldn’t want to hang out with them if they were having a depressive episode, which is probably partly true as people generally prefer to be in a good mood and have fun, and so when the sufferer can’t put on a good front they have to cancel on plans. In some ways this is to protect themselves from having to make effort to put on a good front, which at that time they just cannot manage. But in other ways they are protecting their friends from the darkest parts of themselves, perhaps to spare them worry or sadness. No person wants to see their friend utterly unhappy, a mere shell of the person they thought they knew. Some friends run when faced with the prospect of having a friend who is mentally ill. They don’t understand, and people generally avoid what they cannot comprehend. Or they may be too hurt watching the person suffer, or may be selfish and want to only focus on the good things in life.
Many people with mental illness find it difficult to commit to plans as they don’t know how they are going to be feeling each day. Some days are harder than others to continue living. And for friends, this lack of commitment and cancellation of plans can seem tedious and flaky. As if the person doesn’t want to see them, and so after a while they stop inviting them to things. This can be painful for the person suffering because they cannot control their illness, yet it seems to ruin their friendships. And after a while, when they are no longer asked to hang out it can make them feel unwanted and unworthy. This thinking is of course the disordered thoughts, but it doesn’t take away the sheer realness of the pain of their deteriorating friendships due to their illness.
In my experience, it is hard to sustain strong friendships in the wake of a mental illness. But through talking about what you’re going through with your friends you can help them to understand what you’re struggling with. Although they may not understand, it is important to try and talk to them, else they’re left in the dark. Communication is key in these situations as otherwise, to an outsider, the behaviour of someone with depression can be selfish. And it is. It is a selfish illness. But the illness isn’t the person. The person themselves aren’t selfish, it is the illness. It is vital that people suffering remember to protect themselves first. Of course that doesn’t mean hiding away from everyone for all hours of the day. You have to find the balance between protecting yourself and challenging yourself. But it is not your fault you are ill, and you need to look after yourself before you can look after anyone else. I suppose that is another sore point in friendships. Because you can’t always give your friends the support and time they need when you’re battling your own demons. You should not feel ashamed or guilty for any of your behaviour. It is extremely difficult for healthy minded people to begin to comprehend the idea of depression, the idea of the emptiness and the exhaustion. If they understood they would most likely act in a different way towards you. But humans cannot always practice compassion and sympathy, they get frustrated and angry and confused. And that is something we have to accept when battling mental illness. The journey you are partaking in alongside your friends has an extra passenger, the illness. And though you have your own identity individual to your illness, it can be hard to separate the two sometimes. The illness can devour you and the person your friends once knew.
You should never feel like you have to apologise for being ill. It is out of your control. The way you behave can be governed by your illness. That doesn’t excuse abusive or nasty behaviour, but it does take into account behaviour such as cancelling on plans because you feel too low. I think something that many mentally ill people struggle with is putting themselves first. The idea that your life could be worth something. But is is perfectly ok to put yourself first. Because you cannot live freely until you have got rid of your demons, and only you know your limits-how much you can challenge yourself.

Another illness that seems to be third wheeling friendships is an eating disorder. Eating around other people may prove difficult. For people with bulimia or types of binge eating disorder it can be hard to eat around others because they prefer to eat in private, and eat large amounts. It is hard to binge infront of someone else, exposing yourself and your illness, and so they may refrain from eating around friends. This can cut into the social aspect of sharing a meal because no one wants to eat alone at a dinner table for two, and so they dispose of the idea altogether. A big part of friendships are about making memories, and this can often involve food such as meals out, and so it impacts their relationship. That bag of popcorn that you would have shared in the cinema, that slice of cake that you could’ve eaten on their birthday, that pizza you could’ve shared at a sleepover. They are all sacrificed to the eating disorder. This constant hassle surrounding food often is frustrating for the friend. It is again an elephant in the room.
I myself find that eating impacts my friendships a substantial amount. I prefer to eat in the safety of my own home, and find meals out distressing, and this can put pressure on my friendships. Especially when I am hanging out with someone one to one. It is easier to hide the avoidance of food when you’re in a group with a simple ‘I’m not hungry’, or ‘I’ve already eaten’. They feel more comfortable eating because there are other people eating, and so you haven’t completely sabotaged their meal. Still, you sit there wondering what would have happened if you joined in and ate.
Eating disorders are often deceptive. The hiding of binge food, binging and purging in secret, lying about the food you ate. This deception leaves a heavy weight on the shoulders of your friendship.

In regards to romantic relationships I suppose the same applies as with friendships. The key difference between friendships and romantic relationships is the sexual part, a different kind of love. For people with low self esteem connected to their mental illnesses e.g depression, anxiety, eating disorders, it can be hard to accept this love. Many may feel like they are not worthy of being loved, and wonder how anyone could ever be attracted to them. Their self doubt and hate interferes with their ability to form a healthy relationship. Also, they may struggle with body image, which can prove a big hurdle in a romantic relationship. Their sex life may be restricted by their negative body image, or perhaps body dysmorphia. They may be afraid to be naked for fear their partner would not be satisfied with how they look, or for fear that they’ll think them fat. I know I personally struggle with my body image, and avoid relationships for I worry that my partner would prefer to be with someone else because I’m not good enough. The way I look, my personality, everything about me is not good enough for myself, let alone someone else. These feelings can be common with many healthy minded people also, it is not irrespective of them. However, they will not struggle with the intrusive thoughts to such an extent as someone with a mental illness. For a sufferer of an eating disorder for example, the negative feelings towards their body are heightened, they’re extreme compared to that of a healthy minded individual. The impact of their thoughts and feelings have a stronger hold over them, often negatively influencing their lives. Low self esteem is common with young people especially nowadays, yet it is incomparable to that of the low self esteem relating to mental illnesses. Too often we normalise these feelings that sufferers experience, sometimes belittling their problems as ‘everyone struggles with disliking what they look like’. But this is wrong. This takes away the inordinate struggles that many mentally ill people suffer with.

The suffering friendships and relationships are fuelled by the misunderstanding of what someone with a mental illness is fighting. It is too hard to expect a healthy minded person to completely understand your struggles, yet through communication there can be light shed on the subject, strengthening your relationship. The act of trying to explain your struggles to a friend or partner can demonstrate the desire to fix what is broken within your relationship, and sometimes this is enough to sustain your relationships. I encourage people to communicate to their loved ones, although it may be difficult, because even if they don’t understand, at least you gave it your all. The fact that you are fighting for your relationship in the wake of your illness shows your strength, and if that is not enough for someone then they are not worth bothering with. You get to choose the people you surround yourself with in this world. You get to choose your friends and partners. So surround yourself with people who are willing to understand, willing to grow, willing to wait. Surround yourself with people who lift you up, and make you feel like your old self again. Because as cliche as it sounds, life is too short to be around people who bring you down, who won’t try to understand, who won’t wait.

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Mental illnesses and triggers: how to avoid triggers..can you avoid them?

For some people recovering from mental illnesses, reestablishing your direction in life can be arduous. For those who are hospitalised and are reintroduced into reality it can be even more difficult, due to the safety net a hospital treatment setting provides. From my experience in a children’s psychiatric ward I found that I was sheltered from the real world. There were nurses around 24/7, you had scheduled meal times and activities, and you rarely left the ward besides from attending the hospital school, or if you had a visitor during the specific visiting times. It was easier to focus your full attention on recovery when every minute of everyday was structured, and the right people were around to help you through your struggles. Fast forward to real life and everything is overwhelming. You can’t control what people say or do. Nor can you rely on your supporting nurses to tell you what to eat, and how to manage the guilt. Although, you’re not entirely thrown in at the deep end, as there is often outpatient treatment put in place for your reintroduction into society.
But whether sufferers of mental illnesses have been hospitalised or not, reclaiming your life after, or while recovering, is extremely difficult. Deciding the best course of action to protect yourself from triggering situations can prove to be near impossible. And this is why many people struggling with mental illnesses relapse during recovery.

For people with eating disorders, for example anorexia nervosa, the triggers can include: seeing someone extremely thin, seeing someone eating less than you, having friends or family talk about calories and diets, and exercise. It is certain that a recovering anorexic will encounter many of these triggers while in recovery. In this day and age the media can also prove triggering by putting pressure on people to look a certain way. This cannot be avoided unless you resign entirely from all forms of social media, and then still you may glance at an article online or in the paper. There are triggers all around.
For people with depression, the triggers could be from someone saying things such as ‘there are people worse off than you’ or ‘you’re so lazy’. Phrases like these can set off feelings of worthlessness and prompt thoughts linked also to the low self esteem that many people with depression struggle with. When people struggling with depression see all their friends going out, perhaps through social media, it can be hard to suppress the feelings of loneliness, which leads to feeling unwanted and hopeless. With depression, it’s a fine line between challenging yourself and protecting yourself. It’s different to an eating disorder like anorexia because you have to eat to survive, whereas you don’t have to leave your bed if you don’t want to, or go out and do activities that you used to enjoy. I suppose the triggers for depression are more complex and are more likely to be more individual to the person than the triggers for an illness like anorexia.
Overwhelming situations are different to everyone. For some, what may be overwhelming e.g. going to a public place, may be a piece of cake for others. Recovering from anxiety can mean that anything and everything can trigger your anxious thoughts and feelings. For those suffering with social anxiety, we can identify that the anxiety is triggered by social situations where the sufferer feels uncomfortable. Perhaps they can avoid these more anxiety provoking events and situations in their everyday lives, for example big occasions such as weddings or parties. Or perhaps the anxiety is provoked by even the smallest social interaction e.g. having to talk to the person at a supermarket checkout.

There is a general idea that certain places can trigger you because you are reminded of past behaviours, or more difficult times. Take binge eating for example. Often, binge eaters eat in solitary, and so if you used to eat alone in your room during binges it may prove difficult for someone in recovery to eat in their room again without feeling triggered.
For people recovering from depression or anxiety, perhaps they too spent a lot of time in their room or a particular place when they were feeling very low or anxious. And perhaps returning to that room for too long can provoke those same feelings. Associating a place with particular feelings is often a causal trigger.

Now there is the question. Is it possible to completely avoid all these triggers?
The answer is no. You can’t avoid your friends because they conform to a society advocating diet culture. Of course you can choose the people you want to be your friends, so in that respect we do have an element of control in protecting ourselves from triggering behaviour. But there is no predicting what they will say or do that could be a trigger for you.
You also can’t avoid ever seeing someone thin, or someone exercising.
You can’t avoid speaking to people in fear that they’ll say something wrong.
You can’t avoid certain places, e.g. your bedroom, where you feel triggered.
The harsh reality of all of this is that we can’t control the world around us. We can only control ourselves. And many mental illnesses are indirectly linked to feeling out of control. But we can control our own actions. We can choose to be triggered and act upon it, resorting to old and destructive behaviours. Or we can choose to recognise the trigger and challenge it. We can speak up if we hear something that makes us feel a certain way, e.g if talking about calories makes you feel uncomfortable, or if talking about something is making you anxious. We deserve to be heard and respected. Granted, we can’t speak up about every little thing that makes us feel uncomfortable because we have to find ways of coping with our emotions healthily, but there are some things that we can speak up about. We can ask to change the subject in a conversation if it makes us anxious, or ask to leave a shop if we feel too overwhelmed. Obviously we cannot ask to leave a restaurant halfway through a meal, or ask to change the subject at every moment we feel anxious, but we can make certain small gestures to protect ourselves from triggers. We can also try our best to remind ourselves that the thoughts and feelings which were prompted by the triggers, do not define us. For example, that feeling of loneliness one may feel when they see other people going out and having fun together, is just a feeling. It does not have to escalate to thoughts of being a burden, or being unwanted, or even feeling hopeless and possibly suicidal. It is through intervening with these depressive thoughts that we can challenge them.
I think I have come to the conclusion, that living with mental illnesses nowadays, whilst encompassed by the influence of social media in particular, is hard. And while I do believe in a full recovery, I believe it takes a lot of work, patience and time to be fully recovered. The battle against any mental illness is a long and difficult one. And it is not made easier by the reality of the world we live in with all its triggers. But I think that sufferers need to first find a way to cope healthily alongside a society filled with triggers before they can begin to fully recover. They need to embrace the triggers as challenges to their recovery in which they can only win and move forward from. These challenges will only aid in shaping the recovery process. It is fight or flight, and I believe that running away from these triggers, giving into your thoughts and mental illness, is never the answer. “If it doesn’t challenge you it doesn’t change you.” Fred Devito