My Boyfriend's Anxiety
April 17, 2018 9:13 PM   Subscribe

My boyfriend of seven months is lovely -- except when his (clinical) anxiety flares up. Which is pretty much all the time lately. He is receiving no treatment and seems to have lost perspective on how disturbing his current behavior and state of mind actually is. How do I have a productive discussion with him about getting help? Because, frankly, either the anxiety goes or I do.

Current situation:

I love this man, but his anxiety is tearing our relationship apart. We went on a short vacation recently, and although we did a lot of cool stuff, his anxiety frankly made the trip as a whole very difficult. For example, on the drive back, we went to order coffee at a drive-thru and he got panicked to the point of frantic near-shouting and wild hand gestures as I was ordering (because I ordered one coffee and then the other, instead of ordering two together. But he also froze up and didn't say what he wanted to order when I asked ahead of time, which is why I just ordered mine first and gave him some extra time to think. So I dunno). Or, as another example, on the drive to the vacation spot, he was writhing in the passenger seat because he was plagued by thoughts of his leg bone and believed he could feel the bone (mentally). Those are just two small examples that he would probably not even remember but that I found very disturbing -- and disturbingly typical. There were many more similar examples throughout the trip.

Also, when he is in that panicked, anxious state he tends to be pedantic, impatient and rude. His social skills disappear. He's usually a very kind, thoughtful person -- which is one of the things I love about him. But the more anxious he is, the less kind and thoughtful he becomes. Soon, he's either giving constant nervous laughter but is otherwise silent or he's doing stuff like sighing, mumbling complaints/told-you-so's, and rolling his eyes. And he gets into that anxious/unsociable state in many, many social situations, which has not endeared him to my family and friends. Even at rest, he wears a pained expression constantly nowadays. He can't watch a movie or TV show without doing extensive research beforehand or even during it, because he feels too much tension to watch unless he already knows how it ends. He is often extremely inhibited and passive even alone with me, let alone in public, which is frustrating -- it feels like I can never cut loose, either, because he's always silently freaking out at best. And it makes me feel lonely and unloved to try and interact with someone who's in that frantic, upset, solipsistic state of mind -- because, frankly, he IS likely to reject my attempt to kiss or hold hands when he's feeling like that (and he doesn't initiate, either). That's not to mention all the small adjustments he makes to his life that I believe are because of the anxiety and that even he sometimes has the perspective to say are irrational (i.e., completely unplugging all lights/etc when leaving the apartment, out of fear that the landlord will come in and see the lights/etc plugged in and decide to evict him based on the supposed fire hazard). In other words, even though his anxiety was an even bigger problem on this recent trip than it is in daily life, it is still a major problem in our daily life together.

He is brilliant, interesting, insightful, whimsical, and can be a lot of fun. I don't want to lose him -- for the most part, I treasure my time with him -- but I also can't live in the way that his anxiety is making him live. I feel like things are coming to a head. I feel like maybe it's time they should come to a head.


His mother and brother both have anxiety but I don't believe (though am not sure) that either are getting formal help. He has actually been rushed to the ER in an ambulance for a panic attack he suffered at work (approx. 1.5 years ago), but that resulted in no further formal treatment, either. He refused to take any of the medication prescribed at that time for the usual imo anxiety-created reasons (i.e., he didn't want to take the medication soon before traveling, etc). He walks a lot and is naturally ascetic, so honestly, he already exercises and eats healthier than I do (and probably better than the average person), although I guess he could theoretically exercise more and eat healthier.

I have had my own mental health struggles, but dealt with depression rather than anxiety. That was an extremely rough period in my life (which both resulted in the depression and was aggravated by it), but I sought help, took medication, and have since changed my life considerably. The nadir of my depression was 2013-2015 -- I have been doing better and better since then and have even been off of medication for over a year. I also have a lot of familial experience with mental illness. So this current situation is probably both more familiar and more frightening for me than it might be for someone else.

Also, we are in our early thirties, and I feel ready to settle down and like I don't have a ton of time to waste.


In order to stay in this relationship, I need him to get a handle on his anxiety. That means that he needs to get professional help. Even if results are slow, I need to know that he is making a real, concerted effort to solve this and isn't just adjusting to it (and expecting me to adjust, too). And if results are extremely slow or don't come at all, I may have to go anyway. Like I said, I love this man and I don't want to lose him. But I also know that I can't have the life I want with him, given the current state he's in.

How do I say this in a respectful, supportive way? I don't want to make an ultimatum, because I think that they poison relationships, but the truth is that this IS a deal-breaker for me. What kinds of expectations is it appropriate for me to have? Basically, how should I have this question, and what can I/we hope to get out of it?
posted by static sock to Human Relations (35 answers total) 4 users marked this as a favorite
Show him this post and describe the impact his anxiety is having on you. Tell him you love him but cannot live like this. Then ask him to seek help. The rest is up to him.
posted by St. Peepsburg at 9:34 PM on April 17, 2018 [4 favorites]

Imagine the difference between a doctor telling you to wear a CPAP machine for snoring, and your lover telling you they can't sleep at night and asking you to fix it. Don't tell him for his own good but for yours.

"I love you and it hurts to see you suffering so much with anxiety, but the way you handle your anxiety is impacting me too. When you have an anxiety attack we can't connect, and the atmosphere is so tense that I can't relax. I miss connecting with you and being comfortable with you. Please get help. I'll do my best to support you if you do. I really want to be with you, but I can't live this way anymore."

But don't forget, If he gets help but you still feel it's too stressful anyway, you're still allowed to go. His getting help might be an amazing turnaround -- after all, he was already someone you fell in love with --but his seeing a therapist and/or MD for anxiety still isn't a contract that you have to stay if it doesn't improve enough for your comfort level. Remember this especially if you want to start a family with him.
posted by velveeta underground at 9:51 PM on April 17, 2018 [9 favorites]

If it’s a deal-breaker, let it break the deal.

He is an adult and fully capable of seeking help for his debilitating anxiety. He doesn’t do that. You are not going to make him successfully handle this. Believe me, you do not want to head into a lifelong partnership where you feel like it is your responsibility to manage his mental illness.

Sounds like you’re bargaining, hoping there’s a way this will magically be solved. I’m here to say, nope. Go on through the next couple of phases of grieving what you wish were true but isn’t, and look for your next love.
posted by Sublimity at 9:52 PM on April 17, 2018 [51 favorites]

From an anonymous commenter
In my case, I had to take desperate measures. My partner's anxiety revolved mainly around money, or rather the lack of i, and they refused to see a psychiatrist for fear of being labelled with a mental illness. I did convince them that their problem might be medical - I pointed to a relative whose personality changed after a stroke. But my partner still wouldn't see a doctor because money. So I finally snapped and asked them how much they thought it would take to see a doctor, and then I started crowdfunding to get that money. I didn't even get anywhere close to the amount they demanded, but it was enough to convince them for a first visit. Luckily the medication had an almost immediate effect, and my partner's all right now.

So I would say find out why your boyfriend won't seek help. Is it because he's afraid of the stigma of mental illness? Then try to convince him that he needs a checkup to rule out any other physical illness that might manifest in anxiety. But when you make the appointment for him, make sure it's with someone who has at least some background in mental health. Anything just to get him into the doctor's office.

I know it seems awfully coldblooded and manipulative right now, but I felt then exactly the way you do now and I was willing to do whatever it took to save our relationship. Thankfully it worked out, and if anyone else here has a better and less manipulative way to convince him, please follow their advice. But for now, this is what worked for me, and I'm grateful.

Best of luck to you and your boyfriend, I'll be thinking of you.
posted by restless_nomad at 10:07 PM on April 17, 2018 [7 favorites]

Basically, how should I have this question, and what can I/we hope to get out of it?

I think you sit down and say something along the lines of “your anxiety seems to be getting worse, increasingly all-consuming. My heart goes out to you because it’s a really tough way to live, and I hate to see you suffer so much all the time. It’s also very difficult for me, because your anxiety makes you emotionally absent from our relationship and leaves me feeling lonely and unloved. If you want to get treatment, I’ll help you research doctors and medications, I can even go to appointments with you. I'll help however I can. But if you’re not prepared to get treatment, I’m afraid I can’t continue to be in this relationship.”

I also think you should be prepared for this conversation to go very poorly and end in you guys breaking up.

It’s not just that he isn’t making an effort to manage his illness, it’s that he’s totally oblivious to how it might be affecting you. In the heat of the moment, sure, I can see him being oblivious to everybody else, including you.

But it sounds like he never says, after the fact “hey, I’m sorry for how I lost it back there” or “hey, I bet my anxiety can be tough to deal with sometimes, thanks for being supportive” or anything along those lines.

So my guess is that if you bring this up he will be hurt and defensive. It could well trigger another anxiety spiral for him, and you’ll end up comforting him because he freaks out.

But anything short of him saying, right off the bat, “You’re right, this is a terrible way to live, I want to get better for myself and not subject you to this any more” realistically means that you’re going to spend at least another several months in a relationship that makes you feel lonely and unloved, devoting a lot of mental and emotional bandwidth to a person who may or may not ever be healthy enough to participate in a mutually supportive relationship.

I hope I’m not coming off as unsympathetic to him — I struggle with anxiety myself and it has definitely affected my romantic relationships.

But you can’t make him help himself, and if you’re 7 months in, none of your friends and family like him, and you’re already unhappy in the relationship, you should save yourself, not drown with him. There's a really high chance that if he's reluctant to get treatment but you stick with him anyway, you'll still break up in the end, and you'll regret not breaking up sooner -- not just for the sunk time, but for the cumulative damage to your self-esteem from being in a relationship with someone who isn't there for you and frequently rejects you.

Good luck, I hope he's ready to make a change.
posted by mrmurbles at 10:44 PM on April 17, 2018 [44 favorites]

You’re only 7 months in, and you’re already dreading his anxiety and the way he behaves toward you, the disturbing things you have to tolerate in order to spend any time with him, and the multiple ways you still have to manage even simple tasks and interactions that he turns into ordeals. All of this sounds exhausting.

Honestly, I would tell him exactly what you’ve posted. It has concrete examples of specific behavior and how it affected you. And simply tell him that this can’t continue, and that he needs to seek professional help for his anxiety. If he actually takes that declaration as a wake-up call and makes an appointment, then maybe consider continuing the relationship based on that contingency. If he balks and won’t make an appointment because reasons, then break up. It’s not your job to manage his mental health for him so he doesn’t have to work on himself. And no, I would not make the appointment for him. If this were a long-term relationship and a fairly recent onset of illness, then that might be appropriate, but for a new relationship with someone who knows he has this condition and chooses to not treat it...nope.

If you think it’s bad now, imagine being 5 years in and having kids while he behaves this way. And I know how it feels, I dated a dude who, while not suffering from anxiety, had issues that also took up all the space in the relationship, so that both of our energy was constantly focused on his latest crisis, and there was just no emotional room for me at all. After 8 months I was just completely drained and peaced out. Relationships are not where one person is the constant live-in nursemaid for the other. Especially not when you want to have a family (and thus children who do actually need live-in nursemaiding), or if you might need care yourself, and need a partner who can step up and shoulder the extra weight sometimes. Early 30s is old enough to recognize things one needs to work on and to take steps to get that done, and if someone is not doing that, they either cannot be or won’t be a full partner. It is not your job to be the Florence Nightingale who rehabs this guy and makes him fit for marriage.
posted by Autumnheart at 11:01 PM on April 17, 2018 [26 favorites]

"I can feel my leg bone" seems like something other than straight anxiety (if there even is such a thing).
posted by rhizome at 11:03 PM on April 17, 2018 [24 favorites]

^^ I agree that this sounds a bit different than anxiety- some of what you describe sounds like OCD. At any rate, he needs therapy and medication, and you're right to be concerned and to bring it up and to insist on change. 7 months in is SO SOON for you to be dealing with this much dysfunction- it honestly sounds horrible.
posted by pseudostrabismus at 11:22 PM on April 17, 2018 [19 favorites]

The unplugging all the stuff because of fear of the landlord also seemed like something more on the OCD spectrum. I have anxiety and a partner who doesn't love it (which is fine!) and not only do I work on it but I also think it's my job (mostly) to work on it and his job to just be supportive of me. So this especially:

But it sounds like he never says, after the fact “hey, I’m sorry for how I lost it back there” or “hey, I bet my anxiety can be tough to deal with sometimes, thanks for being supportive” or anything along those lines.

If, when he's not freaking out, he doesn't recognize what he was doing as freaking out, that's going to make this a little challenging. Because that seems to indicate, to me, that he feels like it's your job to put up with whatever his anxiety makes him do, which is not a great way of taking agency for your own shit.

So I'd wait until a calm time and tell him, in short, that you sympathize with what is up, that this seems tough, but that also it's not okay for him to get so wrapped up in his issues that he can't deal, or becomes a bad boyfriend. Because it's okay for you to say "This is making you a bad boyfriend. I would like to not have to also be dating your anxiety. How can we work to make this go better for us?" And if he's not ready with some sort of ideas, I think it's okay to make this sort of thing a dealbreaker. Anxiety is hard because often anxious people wind up with somewhat-enabling partners which can prevent them from getting the help that they need.
posted by jessamyn at 11:55 PM on April 17, 2018 [21 favorites]

You are not his caretaker. It is not your job to fix him; it is not your job to stay at his side, loving and supportive and quiet, while he refuses to get any treatment for a condition that's driving you to despair and restricting your life. (It's doing bad things to him, too, but he gets to choose if he wants to put up with that.) You don't need to bonsai yourself for him.

If he recognizes that his anxiety, which may be of the OCD variety rather than the social/worries variety, is a serious problem and that he needs to put some real effort toward mitigating its effects on him and the people around him, you can discuss those options with him.

If he claims it's not really a problem, or not a big one, he "just" needs everyone else to stop doing things that bother him, then you've hit the dealbreaker point: he's declared that he's more interested in shaping his life around his illness than sharing a life with you.
posted by ErisLordFreedom at 12:03 AM on April 18, 2018 [7 favorites]

This is not anxiety -- or it's not just anxiety. The leg bone thing in particular is way over into some other mental illness that's comorbid with his anxiety, and he needs hands-on help, pronto. I speak from personal experience as well as observational experience; he needs a professional diagnosis followed by medication and intensive therapy. What you need is for him to accept the help of professionals because you are way out of your depth. If he won't get on board with all of that, I'm sorry, but this goes nowhere good, and if you're on a clock for settling down, you need to start looking for someone else.
posted by tzikeh at 12:03 AM on April 18, 2018 [36 favorites]

He or people he is close to may have had bad experiences either trying to get or receiving treatment that for whatever reason he just hasn't told you about yet, and that may be a factor holding him back. For example, has he or anyone he is close to had their trust in the therapeutic process damaged by a bad therapist? Has he tried SSRIs but they didn't work for him and/or had lots of negative side effects? Has he tried to find a therapist but had problems finding one that would take his insurance? Did he find a therapist that he liked but the out of pocket costs were too high? What are his experiences trying mindfulness meditation practices for anxiety? Was he raised in an environment that highly stigmatized mental illness and made him believe things like he needed to be able to "snap out of it" or "solve his own problems"?
posted by jazzbaby at 5:38 AM on April 18, 2018 [3 favorites]

This sounds exhausting, and you're only seven months in. You say you love him and that he's a lovely person, but his anxiety and other issues mean the moments when you can enjoy these qualities are outmatched by the times you have to deal with the drama his anxiety and other issues are creating. It may be worth asking yourself how much of the time you spend together is actually enjoyable, and even if he agrees to seek help how long it might take to get to the point where the good parts outweigh the bad.

If you really want to try to get him to seek help, I might actually recommend having him read this question. You've taken the time and energy to detail the situation as you see it, and received supportive feedback, which may help to convince him that this isn't just your own skewed opinion and that others recognise there is an issue, and from there may be able to work toward getting him to consider treatment of some kind.

But this is a lot of work to put into a young relationship. If he's made it to his early thirties without recognising that this is a problem both for his own life and for those around him, you may have an uphill battle convincing him to pursue help in dealing with it. And just getting him to seek help/treatment isn't a solution, this is an ongoing condition that, even if managed, will be with him for the rest of his life and may well flare up and cause additional problems in the future -- quite likely compounding other stressful issues. If he can't handle watching a film, how will he deal with a financial crisis/child's illness/similarly difficult issue, a situation where you would likely want to have a supportive spouse? It's rather trite to say 'there are a lot of fish in the sea' or DTMFA, but it may be worth considering how much of energy you're willing to pour into this, how long it could take to reach a point where you're happy with things, and when the effort starts to become detrimental to you.
posted by myotahapea at 5:53 AM on April 18, 2018 [3 favorites]

Is he getting treatment? He should. Has her been assessed for possible Aspergers? Some of his behavior points me in that direction.

I would recommend you develop boundaries. He can order his own coffee or not. He is responsible if he is rude or uncomfortable. Read about ways to address his behavior. The library will have books. If he is over -focused on his leg bone, maybe music would be a good distraction. If he can't order coffee, there will be another place with coffee down the road. You cannot manage his feelings, you may be able to manage a free components of his behavior towards you.
posted by theora55 at 6:29 AM on April 18, 2018

When I'm in a relationship I find it useful to check in on the size of my life from time to time. Has your life expanded or contracted with this partner? It sounds like it has contracted and continues to shrink. That doesn't seem particularly healthy or fun (and at seven months in I expect the relationship to still be fun!) It sounds like a lot of your mental and physical energy is being directed toward your partner and his mental health. That is a LOT for seven months. A good relationship expands your life and does not consume it. Best of luck.
posted by sockermom at 6:30 AM on April 18, 2018 [23 favorites]

I agree with myotahapea that this is really early in the relationship to be pouring this much energy into this. That said, he sounds like he’s probably not in a headspace where he can manage the process of seeking mental health care expediently. Thus, you should consider that an ultimatum talk that goes as best as you might imagine - still a shitshow, probably, but he eventually agrees to seek care - could still put you back in the same situation two or three months from now. I don’t want to counsel you to do a whole bunch more work, but regardless of whether you stay together it might be a kindness to find ONE mental health care provider who has an appointment time available the week after this conversation- and maybe even book the appointment. Then you come into the conversation with a specific ultimatum: that you need him to seek treatment by X date, with this person or someone else he finds on his own. Otherwise I fear you’ll just have a repeat of “can’t watch a movie or TV show without doing extensive research beforehand,” only on a much larger scale. From what you’ve written, it sounds like he should probably see a psychiatrist (either directly or through a GP referral) and then be referred out to regular therapy sessions, which will work better of he can get his anxiety somewhat more under control to start with via medication. I wish him and you luck, however it shakes out.
posted by deludingmyself at 6:35 AM on April 18, 2018

This sucks, but kudos to you for recognizing this as the deal breaker that it definitely is so early in the relationship. My first LTR involved a similar dynamic, particularly around the "brilliant and funny but with social skills that magically evaporate around friends and family" part. It just didn't hit me early enough that there wasn't anything I could do externally to help him fix something he didn't really see as a problem and I ended up staying in that relationship WAY longer than I should have as a result.

Long term, I didn't realize what a toll that constantly feeling like I had to make apologies to my friends and family on behalf of my surly/pedantic/too drunk too fast at parties/socially disengaged boyfriend was taking on my psyche. When we broke up, it was like a weight had lifted. And, of course, a lot of friends and family came out of the woodwork to (tactfully) congratulate me on this very wise course of action.

I'm nthing the "it's too early to be dealing with this ish" chorus. If he doesn't seem willing to acknowledge and address his illness in some kind of meaningful way, there's really nothing else you can do but remove yourself from the situation.

I hear what you're saying about ultimatums, but in your case, saying "this is not what a partnership looks like to me, I cannot be in charge of managing your illness for you, and it is causing me pain" is more about drawing a personal boundary than throwing down a gauntlet. I feel like if his response to this perfectly reasonable declaration is something like "that sucks, but even though I know it's hurting you, I'm still not willing to put in the work to try to fix this," then that would REALLY be an ultimatum.
posted by helloimjennsco at 7:47 AM on April 18, 2018 [7 favorites]

I don't want to make an ultimatum, because I think that they poison relationships, but the truth is that this IS a deal-breaker for me.

Sometimes it happens that all life gives you is a choice between poison and worse poison.
posted by flabdablet at 8:31 AM on April 18, 2018 [13 favorites]

I was... not quite this bad, but full of anxiety when I first entered a new relationship. For awhile I didn't address it because I didn't need to. He reassured me and tiptoed around it and ran errands for me because I'd panic in the grocery store. Eventually he got to a point where he was sick of enabling me and told me I needed to deal with it. I went to therapy because I was less scared of that than losing him. I got on medication and improved nearly immediately.

Make sure you're not doing things that prevent him from needing to get help. Look up some info on codependency and see if that fits your situation. His behavior and illness is absolutely not your fault but your behavior can reinforce an unhealthy dynamic that inhibits change.
posted by AFABulous at 10:07 AM on April 18, 2018 [3 favorites]

I feel ready to settle down

Do not reproduce with this man. He's hard going now, and it would be far, far worse with a kid in the picture.
posted by zadcat at 10:34 AM on April 18, 2018 [16 favorites]

Are you totally sure you can make a distinction between his anxiety and his personality and behaviour when it comes to the anti-social, impatient, rude, unsociable part that makes you feel lonely and unloved?

At some point it’s not fair to your or even to him to attribute everything about his behaviour to his mental health condition, especially in view of the fact he refused treatment so far.

And also, I’d be very worried about this condition being downplayed - see what tzikeh wrote - this sounds a lot more complicated than what can be described with the term "anxiety" alone, in any case it sounds very serious and not something anyone can or should handle by themselves, much less expect their loved ones to put with.

I know it must be very difficult for you and you have all my solidarity, but it doesn’t sound like there will be a painless way to have that talk to get him to get help, if he’s become so used to living like this, obviously his resistance is stronger than his discomfort, which in itself is troubling given the details you provided here. Getting help at this stage is not even a decision or a choice, it’s just a thing to be done, he has postponed it far too long and that can be very dangerous. An ultimatum, expressed with the same compassion and honesty and clarity with which you wrote your question, would be the kindest most loving most helpful thing you can do for him, as well as for yourself. I wish you the best and make sure you get some sort of help yourself for dealing with this.
posted by bitteschoen at 10:51 AM on April 18, 2018 [2 favorites]

Seven months is still in the test driving phase of a relationship. This is a great time to discover the issues that will be ongoing heavy lifts for the relationship and decide whether they're a good fit for you and your resources (mental, emotional, financial, logistical, interpersonal).

Don't stay with him because you feel time is wasting; stay with him because he's awesome and the right fit for the life you want to build with a partner. He's not the right fit? Now is a VERY GOOD time to say, "Thanks, but no, thanks, I want to partner up with someone who's more proactive about dealing with their stuff."

Myself, I'm done picking up romantic partners who want me to be their emotional project manager, life logistician, or issues handler. And if I found myself backed into that role, I would drop it ASAP. From what you've said here, I think you should do that in this case, too.
posted by spindrifter at 11:07 AM on April 18, 2018 [8 favorites]

nthing the idea that you're only seven months in, and this is highly likely to only get worse, not better. These are not small problems. Anxiety is no excuse for treating you badly. The more comfortable he gets with you, and the more he takes your commitment for granted, the easier it will be for him to dump all his frustrations on you.

What you need to see right now is a clear sign that he will, without denial or prevarication, take full and complete responsibility for dealing with his issues. Do not suggest solutions to him, like take medication or see a therapist or do yoga or whatever. Do not print out a list of potential therapists for him. Do not remind him when his appointments are, do not remind him to take his meds. Do not take any responsibility for his process or his healing. You don't have to be unsupportive... just 100% clear that all of this is his job and not yours.

Further, do not sugarcoat your feelings about this. He needs to hear your feelings and pay attention to them. Going forward, if he slips up, do not minimize the incident or swallow it without mention. You don't have to be unkind... just fully honest and unapologetic about his impact on you.

In my opinion, if there is whining or denial or blaming you or making you feel bad for any of this? That's your signal to dump him. It's not worth it. Don't waste your life.
posted by MiraK at 11:32 AM on April 18, 2018 [3 favorites]

Do not reproduce with this man. He's hard going now, and it would be far, far worse with a kid in the picture.

Yeah, I'm kinda living this unbelievable shitshow right now, and it is with utmost concern and sympathy that I say - RUN DO NOT WALK.

Your guy sounds A LOT like mine, and mine has been diagnosed with OCD and generalized anxiety disorder. He has very few executive functioning skills because of this (I think). He is a NIGHTMARE to live with and a nightmare to communicate with, and it's taken it's toll on me and our kid. I just kicked him out after 6 years of hell. I mean, seriously painful hell.

Please, please, PLEASE - you are not going to change this. Even with treatment he MIGHT NOT GET BETTER. He will possibly get worse as he ages. Ruuuun, Forrest, run!
posted by clseace at 11:40 AM on April 18, 2018 [6 favorites]

calling it clinical anxiety as if it's a settled fact is probably giving him some cover to keep denying/ignoring it, because as difficult and dangerous as anxiety and depression can be, they are among the less scary-sounding ailments one can have. he is mentally ill and is having episodes of...something. that's all you know. please do not take to heart any of the random and contradictory diagnostic suggestions thrown out in the thread, but do take their diversity to mean that something is wrong that you have miscategorized (and it is not your responsibility to categorize it correctly, you're not his psychiatrist.) if it's really just "anxiety" he still needs intensive ongoing therapy or/and regular medication, an emergency benzo and ER visit now and then won't manage this. he doesn't have just one trigger or phobia, it's a huge part of his whole personality now. if he is avoidant because of fear of drugs, he doesn't have to take drugs. but a disorder that can be mostly corrected with drugs is pretty much the best case scenario, considering the other possibilities. be prepared for it to be something beyond the reach of a daily SSRI.

How do I say this in a respectful, supportive way? I don't want to make an ultimatum, because I think that they poison relationships, but the truth is that this IS a deal-breaker for me.

telling the truth is respectful.

his behavior has already poisoned the relationship but, more importantly, it has severely degraded his quality of life and he sounds on the way to genuinely nonfunctional. I think that you should not tell him to get his anxiety treated, as if his condition is already known and classified. instead, tell him (in as formal a sit-down discussion as you want to have) that you cannot watch his mental illness continue to progress undiagnosed and untreated, and that while you can't/won't dictate or micromanage his treatment, you can't stay if he won't consult a professional. I don't think it'll go well. but honesty requires letting him know that he doesn't seem "anxious" as people usually mean that; he seems frightening unwell in a way impossible to ignore.

you don't have to stay just because he goes to a doctor, but you can't stay if he won't. tell him just the second part.

I don't think it'll work because you don't know what his problem is and neither does he, but it's getting worse. and that is probably part of the resistance to see someone, like his refusal to watch a show without knowing how it ends. so an absolute shutdown when you try to talk about it is likely. but do try. and then leave.
posted by queenofbithynia at 11:48 AM on April 18, 2018 [9 favorites]

This is a tricky one for me because my husband is also like this. I want to be able to tell you you can work this out. The truth is it's a big ask to get someone to take their mental health seriously when they don't see it as a problem. I've been with my now husband for almost 13 years and it's a lot. We started couples counseling and things are getting better, but he is always going to have anxiety. My husband has OCD and one of the big ways this manifested was him compulsively calling me out for things that's caused him distress. It took a LONG time for him to recognize that that was what he was doing and that it wasn't just "my fault". At every stage it had been on me to beg him to take care of himself. For me it was worth it because I adore him and his good qualities make this something I can be patient about. But honestly? This is never not going to be a problem in your relationship and if it's already this bad, it's going to be a long road for both of you. It's hard because on the one hand, I love my life with my husband and I feel like telling you to consider leaving is like me saying my relationship isn't worth it, when I think it is. I guess I just want you to know it will probably always be on you to prod him to do what's right for him and I don't think that's healthy and I think it will make you miserable. It's a bad pattern to set up. I think depending on how he responds you might want to leave.
posted by Bistyfrass at 12:04 PM on April 18, 2018 [3 favorites]

I need to know that he is making a real, concerted effort to solve this

You already know that he is not doing this. Is it possible that you can plead, bargain, and threaten him into making the effort? Maybe. How much of yourself do you want to sacrifice on the altar of struggling to try to make this become a functional relationship someday?
posted by prize bull octorok at 1:01 PM on April 18, 2018 [4 favorites]

I am not your therapist (or your boyfriend's) -- but his symptoms seem to be what's called "ego syntonic" - meaning that, even though he's uncomfortable, he takes them literally rather than understanding that they ARE symptoms of a disorder. I'm saying that because you've said nothing to indicate that he regards his symptoms as "outside of himself" or "weird" or things that need to be changed, or things that represent a disorder (if he did, his symptoms would be called "ego dystonic") --

Before you can get treatment, you have to be able to regard what's going on as a problem, and he doesn't seem to be seeing that. The problem is how you ordered the coffee, or other people, or those damned movies that you have to watch in order to find out how they end.

The charming and brilliant part of him is going to get very old very quickly, given the hell of this other stuff.

Also, diagnostically, OCD is an anxiety disorder, not separate from "anxiety." OCD symptoms are attempts to control anxiety (by controlling one's thoughts, feelings, and the environment). These behaviors don't work, of course, so the person still feels enormous anxiety, and there is also a tremendous, constant need to exert energy to maintain all of these symptoms, leaving little else for, e.g. -- YOU.

You've given a pretty dire description of this relationship, and so I agree with everyone who says that, after only eight months, it's not in your best interest to try to fix this person, who doesn't seem to think he needs fixing.
posted by DMelanogaster at 2:34 PM on April 18, 2018 [7 favorites]

Yes, it's the lack of insight that's particularly alarming. I struggle with anxiety, too, but relatively early on I came to at least recognize after the fact that I had acted it out in some hurtful or inappropriate way. I was remorseful. I tried to fix it. With the passage of years, I can often recognize it while it's happening and shut it down or at least minimize it. On especially advanced days, I can spot the danger signs and divert my brain away completely before I get started. I am no shining example, but my point is: even my modest progress would not have been possible without insight. If you can't recognize you're hurting someone, you can't stop doing it. Nor are you likely to seek treatment, which means you're unlikely to get better.

I think that's also what's especially concerning people here. Most anxious or depressed people I know may not recognize what's prompting their actions in the moment, but, afterwards, they at least recognize that they hurt or scared someone, and feel bad about that, and don't want to do it again. It doesn't sound from your description like he does, which suggests a more serious degree (or possibly kind) of illness.
posted by praemunire at 3:48 PM on April 18, 2018 [6 favorites]

Many answers above recommend you leaving this relationship, and I don't disagree - it sounds very hard on and for you.

That said, if a perspective on staying interests you:

Both my SO and I have mental disorders. This certainly adds some challenges to our relationship and life. We handle it by:

Knowing we are each ultimately responsible for our mental health, and doing what it takes to keep it up.
Supporting each other when we are struggling, knowing that we need to keep the tab balanced, as it were.
Picking up tasks that provoke the others issues, monitoring the effort the other person is putting in it, making sure it is fair (for lack of a better word), and thanking each other for it often.

All of this requires a LOT of self-awareness and constant, clear, kind communication. A LOT.

If he is capable of all of that - and it may take some difficult conversations, it may take medical intervention first - then it can work. The benefits can outweigh the challenges. It can be wonderful.

But if it's not possible, it's not going to work. And probably in a crash and burn and fire way.

You have every right to expect these things, and tell him bluntly about them, and expect him to take swift and serious action, and then judge whether that's working for you. You deserve this and so does he.

If he can't listen or take action, then I think you need to get out. And soon. I think you need a serious deadline on this.

Best of luck. Please feel welcome to memail me if you'd like to speak further.
posted by hapaxes.legomenon at 6:06 PM on April 18, 2018

I have serious anxiety and depression, which is now managed pretty well. Several years ago, my husband started experiencing new "flying of the handle" anxiety and rage (with waving arms and shouting), coupled with very severe anxiety in general. He tried therapy, but the only benefit was learning breathing methods that helped him calm down a little. One problem with therapy is that it doesn't work if a person is super anxious.

We had already gotten good at communicating with compassion, "I messages," and "active listening." But things had gotten way beyond our skills in that area. I emphasized that I loved him deeply, felt empathy for his pain, AND was affected in specific ways, which I explained briefly. I finished by saying again how much I loved him, and that I couldn't live with those behaviors.

He said he needed help, and needed me to help him. When you have a lot of anxiety, the idea of seeking help is very confusing and frightening. You don't know who to call, don't know how to tell if a psychiatrist is any good or if they're "a good fit." Very possibly, you can't imagine that you can be helped. I was willing to help him towards helping himself, but felt like I didn't want to be the one to take responsibility -- that was for him.

First he went to his regular physician. Internists often prescribe SSRIs, which are a type of anti-depression, anti-anxiety medications. A given person have have drastically different experiences with different SSRI, so there's no reason to give up on them if the first one or two don't work. If it becomes time to try a different type of medication, psychiatrists have many drugs to choose from. I'm telling you this because if you're going to support your boyfriend's efforts, you might want to know that obstacles are not necessarily road blocks.
There is nothing wrong with talking with a few doctors to see how the interactions go. And it's always fine to switch doctors.

I know it seems like a fine line between an ultimatum and telling him what you need, but it sounds like you can tell the difference. Perhaps you can be by his side for the early small steps -- asking the therapist and internist to recommend psychiatrists, making phone calls, resisting cancelling the appointments. My person view is that going to the appointments with him is too much.
posted by wryly at 8:00 PM on April 18, 2018

I guess maybe the difference here is that you're comparing your single episode of depression, that you were able to adress and fix, to a lifelong condition that can be managed to some extent-sometimes better than others- but which is always present and likely always will be.
If you had dysthymia or chronic depression, or if he had a single environmental triggered anxiety related bout you might likely better understand your boyfriend, but it is not accurate at all to compare your mental health to his.
If your deal breaker is for him to fix a chronic condition asap, then I wouldn't even offer that ultimatum to him, as it is likely to make his anxiety worse. Just leave the relationship.
posted by OnefortheLast at 8:30 PM on April 18, 2018

You don't know what's going on with this guy-- he's seriously disturbed/impaired, but you don't know if it's general anxiety, OCD, depression, a psychosis prodrome, amphetamine abuse-- like people are saying upthread, there are so many possible explanations for what's going on with him, and all of them are long paths to recovery IF he decides to actually take responsibility for managing his mental health. It doesn't sound like there's room for two people in this relationship, you want to settle down, and you really haven't known him for very long-- seven months is nothing. Cut your losses and run. He is responsible for his life, you are responsible for yours.
posted by moonlight on vermont at 9:02 PM on April 18, 2018 [3 favorites]

regarding your question on expectations:

you are allowed to draw whatever boundaries you need for yourself to live a happy life. a good faith, due diligent effort on your part is any effort to get him into therapy and on his meds. this is what a good person would do. if you have done this and he has not responded to it, any more effort on your part rapidly approaches a romantic, idealistic, and self-destructive notion of abnormal, saintly obligation that is, of course, also steeped in the altogether too common notion that the emotional well-being of men in society is not their own to handle. at this point (which may already be the point you've reached), anything further should be seen as you intentionally sacrificing yourself for the benefit of someone else. if this is something you want to do, fine; but you are very much within your normative and ethical rights to not do this and to expect better of him and of all men in general

relationships work better when all parties are demonstrating good faith; anything at this point of inequity is only going to be destructive for you. don't be afraid of setting a higher bar both for your own expectations and, consequently, for him
posted by runt at 8:31 AM on April 19, 2018 [2 favorites]

We broke up last night. Originally, I thought that if only his anxious behaviors changed, that everything else would be good as it was. But after mulling it over for a couple weeks, I realized that there were other issues that were deal-breakers in their own right (such as his passivity, his lack of affection). My friends and family also advised me to break up with him, saying that this kind of behavior is something that would be a problem for anyone, that these other issues are untenable, too, and that I deserve better. They've been very supportive and welcoming to my boyfriends in the past, so that consensus was a reality check for me. To be completely frank, I think now the only reason that this relationship was working at all was because I was forcing it to work.

The actual break up was very quiet and measured. Almost eerily so. We didn't get in a fight. I said I wanted to break up, and he basically just said "OK." I don't think he wanted to break up, but I think he thinks it was inevitable. We'll exchange our things on Sunday, and then who knows if we'll ever even see each other again.

Thank you for all your advice, I really took it to heart and it was extremely helpful.
posted by static sock at 8:40 PM on May 1, 2018 [5 favorites]

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