How do I deal with my anxiety-ridden partner?

February 6, 2013 12:04 PM

My partner of three years has some pretty fierce obsessive anxiety issues, and I would like some help to deal with this.

My partner moved to a new city recently with me for a few years while I started a post-doc, with the intent of finishing their degree at my new university. Since arriving here, she has not really made any friends or developed a support system of any kind other than me. While for the most part I can handle this, from time to time this becomes very challenging to deal with.

Specifically, she starts to obsess about what their long-term plans regarding their degree are, and worries about whether she is productive enough at her coursework. It ends up rapidly spiralling downwards, with her paralyzed by anxiety about how little coursework she feels she is doing, which leaves her unable to do any work, which makes her feel worse, etc.

She seems to get paralyzed by an inability to make choices because she doesn't know what the best possible choice to be might be, so she doesn't make any at all. And all of this spins around in her head (to hear her description of it), with no ability to stop and just let go.

The problem is that in some sense, the only answer that I feel that I can give when she asks me what to do is that she just has to do something, that it might not matter how crappy she feels, that she just has to work. Or make a choice. Or something.

However, I know that this is not a very supportive answer, and it isn't really helpful because she already knows that; she just can't do it. It's hard to help her, since I don't know what to do, and in the end it starts to detract from me being able to do the things that I need to do to take care of myself and of my work.

So what am I supposed to do? It'd be easier, I think, if she had made friends here, at least someone that she could unload on sometimes other than me, but she suffers from a lot of anxiety at the idea of making new friends, which tends to make her hide out at home unless I make a strong effort at bringing her out to socialize with people that I've met.

I love my partner, and I want to make this work, but I'm finding it harder to know how to deal with her increasing anxiety. What can I do to help her?

posted by anonymous to human relations (18 answers total)

I don't see you mention medical care. You tell her she has a medical problem that she needs to get professional help for. Make the appointment with her permission and bring her if that will help her. Ultimately she is responsible for her health and if she resists medical attention you should make it a condition of your continued relationship since it is having a negative impact on you. This isn't something you can talk her out of or new friends will help her; she needs to recognise there is a problem, look into medical help (medication, mindfulness, CBT, talk therapy are some options) and then build up social support.
posted by saucysault at 12:14 PM on February 6 [9 favorites]

Dude, as saucysault says, this is a medical issue. Celexa is an excellent anti-anxiety drug and worked wonders on me.

I'm just sayin'
posted by Ruthless Bunny at 12:19 PM on February 6 [1 favorite]

Yeah my husband got me to make an appointment to deal with my anxiety. I start next week woo!

I think the thing that finally made me realize I really needed help was when I got the Worry book, and took the quiz inside. I got a score of something like 82 (moderate borderline danger-zone amount of worry)... and my husband got a score of 8. Out of 150. I was like how the fuck is that possible?!?... oh damn I must be really not well then.
posted by The Biggest Dreamer at 12:19 PM on February 6 [4 favorites]

I think it might be worthwhile for you both to speak with a therapist. For her, to work on some coping strategies with her anxiety (maybe medication) and for you, to see how you can best be supportive during the times when her anxiety is overwhelming.
posted by xingcat at 12:44 PM on February 6

[This is a followup from the asker.]

My partner had been regularly seeing a therapist before we moved, and has started seeing one a few months ago since we arrived here. She is not taking any medication, which (I would assume) is at the discretion of the therapist.

posted by cortex at 12:45 PM on February 6

She is not taking any medication, which (I would assume) is at the discretion of the therapist.

Unless the therapist is also a psychiatrist, they can't prescribe medication. Do you know if the therapist has suggested that she see a psychiatrist?

Also, if she's been seeing a therapist regularly, you can ask her to come to a session just so the therapist can give you some advice as to how to support her through this.
posted by griphus at 12:48 PM on February 6 [1 favorite]

Academia is a fountain for this kind of Anexity, reading Anne Cvetkovich's new book, about depression and anxiety, or the chapter about Brantley in this book about Chaucer might reframe it as a systematic problem of the instution, and might move the discourse away from the medicalised other, which might be freeing.
posted by PinkMoose at 1:04 PM on February 6 [4 favorites]

I think there are a couple of things you're doing in an effort to be helpful that might be making things worse.

The first is telling her to "just do something." If it were that easy, she would already be doing it. Have you tried helping her to do things? I know that you're probably very busy as a post-doc, but you can also do things with her that work around your schedule. For example, if she's struggling to get her homework done, set up a study hour at your kitchen table where you work on what you need to do and she does her homework. You don't have to fill out her worksheets or write papers for her, but sometimes it helps to just have someone there who is working and expects you to be working as well. Coffee shops and libraries are great for this--it gets someone out of the house and out of their own navel a bit and it also reduces the distractions.

This is something that works for me, but it doesn't work for everyone. When I'm overwhelmed and paralyzed by anxiety about it, I sit down and write a list of all the things I need to do. It is never as long on paper as it feels in my head and it's usually pretty easy from there to start to prioritize and come up with a plan. Could you maybe sit down with her every day or every couple of days and help her make a list of the homework she needs to get done? But again, this may not work for everyone.

The second is telling her that she needs to go make some friends. You're not wrong that she should do this, but if I were her I would probably feel like you were getting tired of helping me and that I'm becoming a burden. And that seems to be how you're starting to feel, and you're not wrong to feel that way. It can be really draining to be around someone with anxiety issues like these. Rather than encourage her to go out and do something that causes her anxiety, can you suggest that she get in touch with her existing friends and her family? Does she have any hobbies, like knitting, that she likes to do? Suggest that she go to meetups or clubs where the focus is on a common interest. As much as you can, continue to take her out with you to social events because I think that will show her that getting out and meeting people is not as bad as she fears it will be.

It probably isn't a bad idea for you to ask if you can go to a therapy session with her to talk to the therapist about how you can support her. You might mention in the session, with your girlfriend there, that you're worried because the anxiety seems to be getting worse and you're not sure how to help. I would also suggest that you ask your girlfriend before the session if she's talked about medication with her therapist. You might also ask your girlfriend and her therapist what kind of therapy they're doing. Cognitive Behavioral Therapy, commonly abbreviated as CBT, can be really helpful for this kind of anxiety. You don't need to stage manage her treatment from the wings, but you could maybe suggest that if they're not working on some of the practical needs in therapy--like her ability to do her homework--that that's something that you think would be really helpful.
posted by Colonel_Chappy at 1:22 PM on February 6 [3 favorites]

Medication is not the discretion of the therapist; she needs to be engaged with her health care team and take ownership of solving this challenge. It is completely fair for you to express to her that her choice to not fully address her health issue (by stepping up appointments/changing therapists/expanding her health care team/investigating medication) is impacting you and your relationship and she needs to make changes. Honestly, support for someone not taking care of themselves can start to lean into enabling/blocking them from accessing the services they need. I would suggest professional services for yourself as well but my personal experience has been two extremes - either dump the person who is not taking care of their health or the therapist would push much of their job on me because of their heavy workload.
posted by saucysault at 1:22 PM on February 6 [2 favorites]

On a more practical level, some time when she's in a good state of mind, have her come up with a "Spiral Action Plan". It should have a small number of Very Specific activities that help her feel calm or productive.

The idea is that when you say, "babe, you're spiraling" she can go to the list and pick one thing that will distract her focus and break the cycle. By accomplishing one very small goal, it can help clear her head and gain some momentum.
posted by itesser at 1:27 PM on February 6 [2 favorites]

Echoing that this is a medical issue and one that medication and more frequent therapy appointments could absolutely help with. Cognitive behavioral therapy is basically made for this sort of thing.

I also recommend looking at dietary factors. Does she drink coffee, or consume caffeine in other forms? I deal with anxiety/obsession issues, and even green tea makes me batty. I've also had to give up chocolate and ginseng. And I've started taking a B complex vitamin, which has been ridiculously helpful. When you're stressed, you're usually working with low B vitamin levels.
posted by guybrush_threepwood at 1:32 PM on February 6

I was your girlfriend. When I got into these cycles, I was crippled with whatever issue it was to the point where I could barely function, and was like a jack russell terrier chasing my tail...around and around and around. It's exhausting, scary and miserable.

This is a medical issue.

I first saw a psychiatrist who put me on an anti-depressant (depression and anxiety are comorbid) and gave me a prescription for Klonopin. If I have one of these attacks, the Klonopin seriously dials it down so I can think through my problems and act accordingly, even if there is still some worry.

I'm also doing talk therapy once a week and it's helped leaps and bounds. I can be as crazy as I want to my therapist, and then my loving boyfriend is spared.

It's tough, but I seriously try to exercise often. It helps calm nerves.

Make sure she's getting enough critical vitamins - B, D, C, and fish oil/Omega 3s.

She needs to realize that medication or any of this stuff is not a stigma or a scarlet letter to her, and she also needs to realize that this is HER issue to fix...not yours. You can be there to support her, but you also need to take care of yourself. Good luck, and be well.
posted by floweredfish at 1:53 PM on February 6 [2 favorites]

I had similar problems to your partner when I was younger, especially when I was in school. The main issue was that I have a very idealistic, principled, perfectionist-personality and while it helps me in many ways (educational attainment being one of them) there is also a point at which the over-analysis and "what if this isn't EXACTLY RIGHT?" becomes paralyzing in your daily life. "Just do something" is not remotely a helpful response, as "doing something" that is "wrong" would be worse in this mentality than doing nothing - taking you in the wrong direction, as it were. I think your partner needs to bring this up specifically with her therapist and think really seriously about her approach to perfection and idealism, and what is the worst thing that can happen if she chooses "wrong," and what that even means. Of course, if restructuring her perspective does not work, or if the anxiety is a deeper trait, she can look into medication; but I think that a lot of anxiety stems from misplaced perfectionism/idealism and that doing some deep self-reflection about that can help a lot (it did for me. Well, that and just getting older and having more experience to draw on.)
posted by celtalitha at 1:53 PM on February 6

ACUPUNCTURE.

A good acupuncturist (yelp, ask around, etc) can work wonders with this type of problem.
posted by jbenben at 3:13 PM on February 6 [1 favorite]

Sorry if I missed this in your question, but is your partner working on an undergrad or a graduate degree? In either case, she might benefit from (if available) a counseling program at the university which specifically deals with career/long-term goals -- or even just going to the Career Center (whatever it's called). I had a similar problem (I am very much like floweredfish's description above) but therapy and medication didn't help me at all. What I dearly wish I had done was find someone to help me come up with a real, post-degree plan.

Also, this:
She seems to get paralyzed by an inability to make choices because she doesn't know what the best possible choice to be might be, so she doesn't make any at all. And all of this spins around in her head (to hear her description of it), with no ability to stop and just let go.
sounds so much like me. Lists and spreadsheets of pros/cons, etc... help me in this area, to a point. They probably don't work for everybody, but they make me feel like I am doing something, which in turn, motivates me to actually make the decision faster than if I was just turning it over and over in my head.
posted by sm1tten at 4:11 PM on February 6

Your question reminded me a bit of issues that come up when one partner moves for residency after medical school and takes a spouse with them (its a post-doc of sorts too, kinda). Spouses of residents are often super anxious, lonely and depressed, and even more so if they move to a new place where they don't know anyone. Many residents are maxed out with work demands and find it difficult to come home to stressed out spouses who have spent the whole day alone and are depressed, anxious, resentful or all of the above. Physicians are usually get-it-done kindof people and can be really overwhelmed by their spouse's difficulty in doing things like resettling the household, getting a job or going to school, meeting new people, and maintaining control of their emotions. If you re-frame the issue in the light that your relocation for the benefit of your career was part of what has caused this situation, you might find that you have other thoughts or feelings of compassion toward her that can help defuse the situation a bit.

In my experience, there are no easy solutions, but many residencies that are very high stress/long hours have spouse support networks. Your department may not have something like that, but can you involve her in departmental social events? Do any of the other post-docs have wives who might be looking for daytime company and who could relate to her situation? Do any of your departmental colleagues know people in her new department who could offer some advising or support? You also don't say how long ago you moved, but in my experience if you move without an immediate network (like at work, as you have), it takes at least a year to meet people and make a few friends.

Also, if by any chance you are still living out of boxes, or the house is messy and feels chaotic, this may be having an impact on her mental health as it sounds like she is home all day. Having a calm, clean house and normal couple routines (meals together, enough sleep, exercise/walks together, intimacy) is something that you can take the lead on, and that might help the situation. It will also give you something you can control, which may help decrease your anxiety.
posted by artdesk at 7:56 PM on February 6

Your partner may not be comfortable, or may flat-out hate, departmental social events. Particularly if she has little interest in your field, or the discrepancy in your respective educational levels is at all troublesome to her. (Even if non-academic significant others actually do attend, it's not going to be fun for a depressed, anxious trailing SO. I am totally understating this.)

It would probably be worthwhile for you both to seek relationships without an affiliation to the school. She'll feel better if she can find the initiative to make choices and develop friendships on her own, too.
posted by infinite joy at 10:03 PM on February 6

Nthing the suggestion of medication. Zoloft has made a world of difference in my anxiety -- I can actually leave the house now! And I don't have daily panic attacks! It's brain chemistry, and sometimes it needs a little adjusting. Her therapist can't prescribe meds for her, but he/she might be able to refer her to someone who can.

I also tend to have more issues with anxiety when I haven't been sleeping enough. (Of course, the anxiety makes it hard to sleep, which leads to more anxiety, etc., etc.)

Beyond that, I have found that it's much more helpful if my husband just listens to me without trying to tell me what to do. Sometimes it just helps to vent the repetitive thoughts.
posted by sarcasticah at 4:19 PM on February 7