Self-care advice in a time of someone-else's crisis
March 12, 2022 8:46 AM Subscribe
Further to my previous question, I'm glad to say that my spouse (they/them) is starting to get the help they need.
Whilst that is going on, I need to focus on supporting both them and myself. I'm working on finding myself a therapist (the last couple of potentials have been a bust, sadly), and in the meantime I'm looking for advice from people who have been in the position of caring for the SO through a mental illness, whilst remaining a functional, productive member of society.
First, an update for those who expressed concerns in the previous answers: my spouse has now started therapy, and has, after a particularly concerning 24 hours during this week, been prescribed Sertraline, having been diagnosed with severe GAD and moderate-to-severe depression.
Currently, the symptoms of their illness are:
I've tried to stop them asking my opinion on the news, to no avail. Right now I try and deflect by saying "I don't know," or simply "okay" whenever they read something out to me and ask an opinion, or just announce a news headline, expecting a reaction.
I don't mind being there for them, holding them together when they break down — that's what I'm for for Christ's sake — but it has started to affect my work enough that people I'm working with have noticed (either because I'm very quiet on a call, because my mental energy is sapped, or because my output during a day is lower than they'd become accustomed to). I can make some excuses to deflect for this, but not forever. Were I an employee, I'd take sick leave to look after my spouse, but I can't do that.
The doomscrolling is also causing problems at night, because they simply won't stop looking at their phone all evening, no matter any entreaties from me, their therapist, or their doctor. This means that though we aim to go to bed between 10pm and 11pm, we're often not in bed before midnight, and they're usually not asleep before 1am. For a variety of reasons I have to wake around 6am most mornings, and the lack of sleep is taking its toll. Again, I can work around it with some naps during the day, but then that affects my work again.
At particularly low "what is the point of anything" points, they've tried to encourage me to quit my job, and reacted angrily when I refused, saying that I was choosing work over time with them during my last days. The things is that work, right now, is something that I can actually do and feel useful at, and whilst I may take a couple of days off, I simply can't stop working altogether (the rent still needs paying after all).
Finally, the separation anxiety: I'm starting to feel like, absenting short trips to the store, I can't leave the house on my own. As someone who has grown up valuing private space and time to myself, that's really hard to cope with. A walk on my own has been one of my self care routines for a long time, and I feel like I can't do that so easily now. Exercise is my other self-care routine, and I can still do that — though because our gym space adjoins our living room, that's often interrupted by doomscrolling now, too. So I don't know how to make space for myself, unless I get up very early in the morning and go for a walk whilst my spouse is still asleep — which has its own perils.
The other concern here is what will happen when I need to visit a client on-site for a day. Some of my clients are local, some of them are a few hours' travel away, and I don't know that I can risk taking those trips right now, or whether, if I do take them, my spouse is going to find it too hard and need me to come home.
Has anyone been in a similar position of looking after someone going through a mental health crisis whilst trying to look after oneself? Any advice, as ever, is appreciated.
First, an update for those who expressed concerns in the previous answers: my spouse has now started therapy, and has, after a particularly concerning 24 hours during this week, been prescribed Sertraline, having been diagnosed with severe GAD and moderate-to-severe depression.
Currently, the symptoms of their illness are:
- General hopelessness and thinking that everything is pointless, to the point of not being able to get out of bed
- Extreme anxiety, particularly centred around the war in Ukraine (every night this past week they have been convinced that we would be killed in a nuclear strike before morning)
- A conviction that I and our pets would be better off if my spouse packed a bag and disappeared
- An inability to stop doomscrolling through the news, with no discernment about news sources (they will read twitter, then switch to BBC news, then NYTimes, WaPo, Sky News… then they will hit Google and read any news source they can find, regardless of its reliability). Whilst they acknowledge that this isn't healthy, they cannot be without their phone or laptop for more than ten minutes before they need to check again.
- Separation anxiety when I need to leave the house without them.
- An inability to focus on work, or indeed most tasks, due to the above doomscrolling
- A conviction that they (and only they) know the truth about what's going to happen: that Putin is going to start a nuclear war and that he doesn't care about the rest of the world. Also, that everyone else is naïve, stupid, or possibly just pretending not to know what's going to happen
I've tried to stop them asking my opinion on the news, to no avail. Right now I try and deflect by saying "I don't know," or simply "okay" whenever they read something out to me and ask an opinion, or just announce a news headline, expecting a reaction.
I don't mind being there for them, holding them together when they break down — that's what I'm for for Christ's sake — but it has started to affect my work enough that people I'm working with have noticed (either because I'm very quiet on a call, because my mental energy is sapped, or because my output during a day is lower than they'd become accustomed to). I can make some excuses to deflect for this, but not forever. Were I an employee, I'd take sick leave to look after my spouse, but I can't do that.
The doomscrolling is also causing problems at night, because they simply won't stop looking at their phone all evening, no matter any entreaties from me, their therapist, or their doctor. This means that though we aim to go to bed between 10pm and 11pm, we're often not in bed before midnight, and they're usually not asleep before 1am. For a variety of reasons I have to wake around 6am most mornings, and the lack of sleep is taking its toll. Again, I can work around it with some naps during the day, but then that affects my work again.
At particularly low "what is the point of anything" points, they've tried to encourage me to quit my job, and reacted angrily when I refused, saying that I was choosing work over time with them during my last days. The things is that work, right now, is something that I can actually do and feel useful at, and whilst I may take a couple of days off, I simply can't stop working altogether (the rent still needs paying after all).
Finally, the separation anxiety: I'm starting to feel like, absenting short trips to the store, I can't leave the house on my own. As someone who has grown up valuing private space and time to myself, that's really hard to cope with. A walk on my own has been one of my self care routines for a long time, and I feel like I can't do that so easily now. Exercise is my other self-care routine, and I can still do that — though because our gym space adjoins our living room, that's often interrupted by doomscrolling now, too. So I don't know how to make space for myself, unless I get up very early in the morning and go for a walk whilst my spouse is still asleep — which has its own perils.
The other concern here is what will happen when I need to visit a client on-site for a day. Some of my clients are local, some of them are a few hours' travel away, and I don't know that I can risk taking those trips right now, or whether, if I do take them, my spouse is going to find it too hard and need me to come home.
Has anyone been in a similar position of looking after someone going through a mental health crisis whilst trying to look after oneself? Any advice, as ever, is appreciated.
I don't say this lightly but seeing as this has been going on for 2 weeks now with no sign of improvement, is inpatient care an option? This seems like more than just depression--your spouse's anxiety is putting them in an alternate reality, and you just don't have the resources to deal with that on your own.
This is an alternative to simply leaving in exhaustion (which, as a caring human being, you don't want to do) or staying in a situation which doesn't seem to be improving and which is creating conditions in which your spouse can't improve.
I wish you all the best--dealing with mental illness can be incredibly difficult.
posted by kingdead at 10:14 AM on March 12, 2022 [24 favorites]
This is an alternative to simply leaving in exhaustion (which, as a caring human being, you don't want to do) or staying in a situation which doesn't seem to be improving and which is creating conditions in which your spouse can't improve.
I wish you all the best--dealing with mental illness can be incredibly difficult.
posted by kingdead at 10:14 AM on March 12, 2022 [24 favorites]
Is your partner's therapist aware of what you've written here? I'm with kingdead that this really sounds like it's at an inpatient status.
posted by cooker girl at 10:28 AM on March 12, 2022 [2 favorites]
posted by cooker girl at 10:28 AM on March 12, 2022 [2 favorites]
Just a note that, for me, starting Sertraline caused a severe exacerbation of the symptoms it was prescribed to treat for a good 7-10 days before I adjusted to it and it began to work. I'm not saying this to scare you or anything, but to suggest that you hash out an emergency plan in your mind in case your partner has a really bad reaction while adjusting to the drugs. In the UK I know it feels like there aren't really emergency options that would do any good, but I have always been advised that calling 999 for an acute mental health crisis is absolutely the correct thing and is what the NHS encourages you to do. Your area may even have a specialist emergency mental health unit attached to the ambulance service.
I agree that you need to find ways to be able to have space and time and breathing room for yourself away from your spouse. From the way you've phrased these two questions, you are trying so so hard to normalise what you're going through, but this is a really bad situation. I know your spouse is super private but could a friend of theirs come to sit with them while you get out for an afternoon? Could you plan such a visit for the days you have to go out to meet clients? It is really concerning that your partner's crisis is putting your work in jeopardy.
Could your spouse stop attempting to work at the same time as you while they're in this state? Like they could just as easily doomscroll and be sad on the sofa while you're at your desk instead of you being cheek by jowl with the insanity all day long.
posted by Balthamos at 10:42 AM on March 12, 2022 [6 favorites]
I agree that you need to find ways to be able to have space and time and breathing room for yourself away from your spouse. From the way you've phrased these two questions, you are trying so so hard to normalise what you're going through, but this is a really bad situation. I know your spouse is super private but could a friend of theirs come to sit with them while you get out for an afternoon? Could you plan such a visit for the days you have to go out to meet clients? It is really concerning that your partner's crisis is putting your work in jeopardy.
Could your spouse stop attempting to work at the same time as you while they're in this state? Like they could just as easily doomscroll and be sad on the sofa while you're at your desk instead of you being cheek by jowl with the insanity all day long.
posted by Balthamos at 10:42 AM on March 12, 2022 [6 favorites]
I never had a partner like this but I had a parent who would go into not-dissimilar states. The first thing I want to strongly recommend to you is that you shore up your own support system. Reach out to your close friends and family, and see if someone can find you a therapist, too. It is terribly isolating to be in the middle of another person’s breakdown, it can feel like it’s going to eat you alive, and you have to put your own mask on first.
Second, if inpatient care is available to you I would nth the recommendation for it. This breakdown merits it.
Third, I want to gently push back on “it’s what you’re for,” not because I don’t admire your loving heart, but this may be well outside your pay grade. I also fear that taking too much psychic responsibility for your partner might be leading you to not draw boundaries where necessary.
I’m so sorry this is happening and my heart goes out to both of you.
posted by hungrytiger at 10:45 AM on March 12, 2022 [8 favorites]
Second, if inpatient care is available to you I would nth the recommendation for it. This breakdown merits it.
Third, I want to gently push back on “it’s what you’re for,” not because I don’t admire your loving heart, but this may be well outside your pay grade. I also fear that taking too much psychic responsibility for your partner might be leading you to not draw boundaries where necessary.
I’m so sorry this is happening and my heart goes out to both of you.
posted by hungrytiger at 10:45 AM on March 12, 2022 [8 favorites]
Realistically, your partner who appears to be in active psychosis should be under 24/7 care and supervision of professionals. That is the first line of support you should be receiving right now.
Are you FULLY disclosing the severity of this to their therapist and prescriber (if that's two different people)? If not would you please leave messages with them TODAY, NOW? Because once a person is the Only One Who Knows The Truth, we've departed from reality, and a lot of people know to hide that from mental health care professionals at least until their grandeur becomes so immense that they can't not brag about it. I can guess why Sertraline was the choice made - it's sometimes part of the treatment plan for obsessive-compulsive behaviors - but it does not feel like a great choice to start someone with delusions or a really high suicide (or murder-suicide, which is a significant risk here) risk on it without inpatient supervision. Also to send someone home like that with no benzos or beta blockers or some kind of rescue med is really shitty, but possibly is because of the harm risk.
I understand that because of finances, where you live, transphobia, and probably substandard professional care options, you may rightfully feel that inpatient care is too dangerous or unobtainable. In any case, but especially so if those are the reasons, it's time for you to tell the friends and family you mentioned in the last post the real truth about what is going on here, and ask some of them to come stay with you. That will put them in the danger along with yourself but will at least average down the possibility that your partner can harm all of you, your pets, and themself without being stopped. You need the safety of numbers, and you need people there to intervene so you can work. It's either that or one of you needs to leave, and I know why you're not considering that option.
Yes, it will be embarrassing to tell the truth. It will be awkward to reveal you've been downplaying the situation. But get yourself a big glass of water to wash that pill down and do it.
You are actively being traumatized, ongoing, and self-care isn't really going to fix that. It's certainly not even feasible if you can't ever be alone. Get your people around you now, start yelling at some professionals, maybe also reach out to whatever trustworthy queer organization in your vicinity might be able to help direct you to the safest possible inpatient situation or maybe just some volunteer help or better therapists or something.
If you happen to be in Los Angeles (for some reason I have assumed you're in the UK or Europe), please memail me and I will figure out some kind of support to offer you, there are probably other mefites who would do the same (or have information that you may not even realize would help you) if you want to vaguely disclose where in the world you are, but the number one thing here is you cannot tackle all this alone. Please let people help you, and also maybe lean harder on the people who are supposed to be helping them.
posted by Lyn Never at 10:51 AM on March 12, 2022 [12 favorites]
Are you FULLY disclosing the severity of this to their therapist and prescriber (if that's two different people)? If not would you please leave messages with them TODAY, NOW? Because once a person is the Only One Who Knows The Truth, we've departed from reality, and a lot of people know to hide that from mental health care professionals at least until their grandeur becomes so immense that they can't not brag about it. I can guess why Sertraline was the choice made - it's sometimes part of the treatment plan for obsessive-compulsive behaviors - but it does not feel like a great choice to start someone with delusions or a really high suicide (or murder-suicide, which is a significant risk here) risk on it without inpatient supervision. Also to send someone home like that with no benzos or beta blockers or some kind of rescue med is really shitty, but possibly is because of the harm risk.
I understand that because of finances, where you live, transphobia, and probably substandard professional care options, you may rightfully feel that inpatient care is too dangerous or unobtainable. In any case, but especially so if those are the reasons, it's time for you to tell the friends and family you mentioned in the last post the real truth about what is going on here, and ask some of them to come stay with you. That will put them in the danger along with yourself but will at least average down the possibility that your partner can harm all of you, your pets, and themself without being stopped. You need the safety of numbers, and you need people there to intervene so you can work. It's either that or one of you needs to leave, and I know why you're not considering that option.
Yes, it will be embarrassing to tell the truth. It will be awkward to reveal you've been downplaying the situation. But get yourself a big glass of water to wash that pill down and do it.
You are actively being traumatized, ongoing, and self-care isn't really going to fix that. It's certainly not even feasible if you can't ever be alone. Get your people around you now, start yelling at some professionals, maybe also reach out to whatever trustworthy queer organization in your vicinity might be able to help direct you to the safest possible inpatient situation or maybe just some volunteer help or better therapists or something.
If you happen to be in Los Angeles (for some reason I have assumed you're in the UK or Europe), please memail me and I will figure out some kind of support to offer you, there are probably other mefites who would do the same (or have information that you may not even realize would help you) if you want to vaguely disclose where in the world you are, but the number one thing here is you cannot tackle all this alone. Please let people help you, and also maybe lean harder on the people who are supposed to be helping them.
posted by Lyn Never at 10:51 AM on March 12, 2022 [12 favorites]
From my experience, people like that are often able to pull it together a little bit more when non-family enter the situation (which may also involve masking symptoms to their doctors and therapists). If you don't feel safe leaving your partner even for an hour without a good reason, maybe get someone to visit, Covid permitting? Just talking about something else, like your BFF's ongoing home renovation, might be enough to give you a mental break. And if your spouse can't mask their symptoms for an hour, you'll have a ready-made sounding board who now knows the situation.
(And honestly, this is what acute inpatient care is for. You don't have to drive yourself into a breakdown just because your spouse needs more care than any single person is able to give.)
posted by I claim sanctuary at 11:06 AM on March 12, 2022
(And honestly, this is what acute inpatient care is for. You don't have to drive yourself into a breakdown just because your spouse needs more care than any single person is able to give.)
posted by I claim sanctuary at 11:06 AM on March 12, 2022
Purely on this point:
Were I an employee, I'd take sick leave to look after my spouse, but I can't do that.
Are any of the projects you're working on potentially postponable, and any of your clients potentially willing to let you postpone them in order to care for your spouse's medical emergency? Sometimes it's surprising who ends up willing to accommodate you.
It sounds like you're trying to take care of everything alone. I agree with the suggestions above to try whatever you can to get some help, whether from friends and family or from the medical care system. It seems like you're both pretty isolated where you are.
posted by trig at 11:46 AM on March 12, 2022 [1 favorite]
Were I an employee, I'd take sick leave to look after my spouse, but I can't do that.
Are any of the projects you're working on potentially postponable, and any of your clients potentially willing to let you postpone them in order to care for your spouse's medical emergency? Sometimes it's surprising who ends up willing to accommodate you.
It sounds like you're trying to take care of everything alone. I agree with the suggestions above to try whatever you can to get some help, whether from friends and family or from the medical care system. It seems like you're both pretty isolated where you are.
posted by trig at 11:46 AM on March 12, 2022 [1 favorite]
I agree that sertraline can cause side effects, particularly in the early going while the body adjusts.
When I took it, the adjustment period involved manic 2 am rage cleaning, followed by wracking sobs at 3 am.
Would it help to tell your spouse that if this is The End, you would want your final days to be like your other days? Work, marriage, home, pets, friends, family etc. Or would that make things worse?
As for self-care, my mother had a lot of mental health challenges. I learned that I could not love her out of them. It's ok not to be able to rescue people.
posted by champers at 11:59 AM on March 12, 2022 [3 favorites]
When I took it, the adjustment period involved manic 2 am rage cleaning, followed by wracking sobs at 3 am.
Would it help to tell your spouse that if this is The End, you would want your final days to be like your other days? Work, marriage, home, pets, friends, family etc. Or would that make things worse?
As for self-care, my mother had a lot of mental health challenges. I learned that I could not love her out of them. It's ok not to be able to rescue people.
posted by champers at 11:59 AM on March 12, 2022 [3 favorites]
Best answer: Yes, I have been in a similar position. What I did was to carry on as best I could, for as long as I could, until my loved one completely snapped, put themself and their pets in danger, and ended up inpatient against their will partly because at that point I myself was so traumatized and fucked up that I couldn't find any other way out that ended with them alive at the end of the day, and I decided alive-but-hating-me-forever was better than the alternative. (They did not hate me forever; in the aftermath, they agreed I had done what needed to be done.) So I am sending you all the sympathy in the world and also telling you, from a place of absolutely knowing it to be true, that your current situation is not sustainable for either of you and does not end anywhere good.
If I had it to do again, in that crisis mode, I would have worked much harder to convince my loved one to either voluntarily sign into inpatient care, or to work with their care team on something intermediate like an intensive outpatient program. I didn't even know at that time that IOP existed. So that's my first, most immediate suggestion: escalate your professional help. Make sure your partner's care team knows how bad it is, and knows if it gets worse; they can't talk to you without her permission but they may be willing to listen to you, or your partner might be willing to do a joint session if you press on her how critical you think it is.
Meanwhile, on to taking care of yourself:
* You need to sleep. Maybe that means sleeping in a different room, maybe it means earplugs and an eye mask. It definitely means you go to bed at the time you need to go to bed, even if your spouse is staying up, even if she's doomscrolling. You have to just go to bed and let her do what she's going to do.
* If there is anything you can give yourself some slack on right now, do it. If you need to slack off on housecleaning, order delivery instead of cooking, drop a personal obligation you don't like that much, reschedule an appointment, deliver a simply fine work performance without going above and beyond - do any or all of those things that you can afford to do. (That said, maybe for you, exercising is self-care and your weekly D&D game is a lifeline and you'll be more depressed than ever if your house is a mess - do what makes the most sense for you. But at least consider whether there are some things that you can let go of for a little while that would be helpful in freeing up some of your energy.)
* You need support. The place I've come to with my loved one is that they trust I will not just go around telling tales out of school for fun, but that if I need support, I need it, and I can tell our mutual friends whatever I need about their mental health to get the support I need. I'd like it for you if you could reach a similar place with your partner. But meanwhile, if you can't, do you have a friend who's not also your partner's friend that could be your sounding board? Can you find a support group, in person or online? (NAMI might be a place to start.) Hell, can you go back to one of the not-ideal therapists for now while you keep looking, just to have a safe place to cry for an hour a week if you need to?
* Can you set any boundaries around your work in a useful way - would working in a different room, or even going out and working in a coffee shop, be less difficult than what you have going on now? Can your partner agree to give you even two or three quiet hours in a row at some point during the day to really focus, even if she's not currently able to keep it together on her own for a full workday?
* You have to be able to leave the house for work and for personal things. You and your partner can practice it in very small increments - if that means you go outside and sit on the porch for fifteen minutes where she can peek out the window and see if you if you need to, or you walk around the block three times and wave to her every time, then that's where you start and you can work up from there to being gone longer or being out of her sight longer. But you have got to be able to remember that the world is carrying on around you and to take some little part of the self-care you need.
All of that said, a new med is a major adjustment period and if you can get through another week or two on what you're doing now, and you think that would be less painful than trying to renegotiate sleep and work and walks - then sure. Hang on for two weeks, get through the initial medication adjustment, and then re-assess. But don't let it go any longer than that.
I used to roll my eyes at the cheery "you have to put your own oxygen mask on first!" people but now I cling to that with my life. If I had taken better care of myself, I would have been better able to take care of my loved one. Take care of yourself in whatever way you can now so that you can continue to support your spouse, as well as because you deserve it.
posted by Stacey at 12:10 PM on March 12, 2022 [6 favorites]
If I had it to do again, in that crisis mode, I would have worked much harder to convince my loved one to either voluntarily sign into inpatient care, or to work with their care team on something intermediate like an intensive outpatient program. I didn't even know at that time that IOP existed. So that's my first, most immediate suggestion: escalate your professional help. Make sure your partner's care team knows how bad it is, and knows if it gets worse; they can't talk to you without her permission but they may be willing to listen to you, or your partner might be willing to do a joint session if you press on her how critical you think it is.
Meanwhile, on to taking care of yourself:
* You need to sleep. Maybe that means sleeping in a different room, maybe it means earplugs and an eye mask. It definitely means you go to bed at the time you need to go to bed, even if your spouse is staying up, even if she's doomscrolling. You have to just go to bed and let her do what she's going to do.
* If there is anything you can give yourself some slack on right now, do it. If you need to slack off on housecleaning, order delivery instead of cooking, drop a personal obligation you don't like that much, reschedule an appointment, deliver a simply fine work performance without going above and beyond - do any or all of those things that you can afford to do. (That said, maybe for you, exercising is self-care and your weekly D&D game is a lifeline and you'll be more depressed than ever if your house is a mess - do what makes the most sense for you. But at least consider whether there are some things that you can let go of for a little while that would be helpful in freeing up some of your energy.)
* You need support. The place I've come to with my loved one is that they trust I will not just go around telling tales out of school for fun, but that if I need support, I need it, and I can tell our mutual friends whatever I need about their mental health to get the support I need. I'd like it for you if you could reach a similar place with your partner. But meanwhile, if you can't, do you have a friend who's not also your partner's friend that could be your sounding board? Can you find a support group, in person or online? (NAMI might be a place to start.) Hell, can you go back to one of the not-ideal therapists for now while you keep looking, just to have a safe place to cry for an hour a week if you need to?
* Can you set any boundaries around your work in a useful way - would working in a different room, or even going out and working in a coffee shop, be less difficult than what you have going on now? Can your partner agree to give you even two or three quiet hours in a row at some point during the day to really focus, even if she's not currently able to keep it together on her own for a full workday?
* You have to be able to leave the house for work and for personal things. You and your partner can practice it in very small increments - if that means you go outside and sit on the porch for fifteen minutes where she can peek out the window and see if you if you need to, or you walk around the block three times and wave to her every time, then that's where you start and you can work up from there to being gone longer or being out of her sight longer. But you have got to be able to remember that the world is carrying on around you and to take some little part of the self-care you need.
All of that said, a new med is a major adjustment period and if you can get through another week or two on what you're doing now, and you think that would be less painful than trying to renegotiate sleep and work and walks - then sure. Hang on for two weeks, get through the initial medication adjustment, and then re-assess. But don't let it go any longer than that.
I used to roll my eyes at the cheery "you have to put your own oxygen mask on first!" people but now I cling to that with my life. If I had taken better care of myself, I would have been better able to take care of my loved one. Take care of yourself in whatever way you can now so that you can continue to support your spouse, as well as because you deserve it.
posted by Stacey at 12:10 PM on March 12, 2022 [6 favorites]
I was in a situation somewhat similar a year ago, only the person concerned was my then 12 year old son, suffering from anxiety disorder and severe depression/ suicidal ideation as a co-morbidity of ASD.
I strongly encourage you to find out how they can be admitted as an inpatient. I assume it will be difficult, but please do for your own sake.
My son refused to leave the house at first and then to stay alone, went into spiralling anxiety episodes if i left the house even briefly for fear Something will happen to me. We have a garden, he demanded i stay inside with him in bed. He had suicidal ideation and was convinced we would all die of covid.
He needed inpatient care but i was reluctant and kept telling myself and my therapist and my psychiatrist and also his psychiatrist that i was able to cope and that it was the least i could as a parent was to keep him home and care for him.
We ended up spending our days in my bed 24/7, and both detoriated to a point hard to describe.
Anyway, after several months of this my psychiatrist finally said that there were only two choices: she could find an inpatient bed for me. My son would go into care. Or i would commit him to the pediatric psychiatric ward and continue my own treatment with her and the therapist.
I chose to admit him to the pediatric psychiatric ward. It was the hardest thing i ever did and initially i had many misgivings. He pleaded and begged to come home.
The logistics for an adult will be different, but i assume still not easy.
As others have said, be honest with his psychatrist and hopefully soon you find someone for yourself.
My son's symptoms receded once he was an inpatient, and received therapy and took the medication. He is now not cured but no longer imprisoned in his mind and in constant spiralling fear.
posted by 15L06 at 12:18 PM on March 12, 2022 [7 favorites]
I strongly encourage you to find out how they can be admitted as an inpatient. I assume it will be difficult, but please do for your own sake.
My son refused to leave the house at first and then to stay alone, went into spiralling anxiety episodes if i left the house even briefly for fear Something will happen to me. We have a garden, he demanded i stay inside with him in bed. He had suicidal ideation and was convinced we would all die of covid.
He needed inpatient care but i was reluctant and kept telling myself and my therapist and my psychiatrist and also his psychiatrist that i was able to cope and that it was the least i could as a parent was to keep him home and care for him.
We ended up spending our days in my bed 24/7, and both detoriated to a point hard to describe.
Anyway, after several months of this my psychiatrist finally said that there were only two choices: she could find an inpatient bed for me. My son would go into care. Or i would commit him to the pediatric psychiatric ward and continue my own treatment with her and the therapist.
I chose to admit him to the pediatric psychiatric ward. It was the hardest thing i ever did and initially i had many misgivings. He pleaded and begged to come home.
The logistics for an adult will be different, but i assume still not easy.
As others have said, be honest with his psychatrist and hopefully soon you find someone for yourself.
My son's symptoms receded once he was an inpatient, and received therapy and took the medication. He is now not cured but no longer imprisoned in his mind and in constant spiralling fear.
posted by 15L06 at 12:18 PM on March 12, 2022 [7 favorites]
Apologies for using wrong pronoun. Should have been: be honest with their psychatrist. I am sorry, was thinking of my son.
posted by 15L06 at 12:46 PM on March 12, 2022 [5 favorites]
posted by 15L06 at 12:46 PM on March 12, 2022 [5 favorites]
Sorry to be blunt, but:
People who say the kinds of things your partner is saying sometimes kill themselves, and/or their entire families. This is serious. This is not a home-DIY project. I strongly suggest inpatient care as well.
>I don't mind being there for them, holding them together when they break down — that's what I'm for for Christ's sake
This is actually NOT what you're for.
You are a full and worthy person and you deserve a safe place to live, enough sleep, to be allowed to come and go as you please, and not to be someone's emotional punching bag.
You deserve 100% space.
You are not meant to squeeze and tiptoe around someone who is infringing on your right to sleep and sincerely discussing killing your pets as if that's normal. It is CONCERNINGLY NOT NORMAL.
It's a nice trait to be loving and loyal, and gaps in their mental health are not your spouse's fault, but they are also not your birthright.
It would be ok to
Definitively refuse to discuss the war. "I can't have this conversation, so I'm going to leave the room for 15 minutes."
Shut down all distraction while working. "I can't concentrate while you read headlines. Please don't talk to me for the next 4 hours while I work. If that's challenging for you, one of us has to sit in the living room."
Leave the house. "I am going to the grocery store. I will be back at 2pm. While I'm gone I will text you every 30 minutes to help you feel more comfortable (only promise a duration / frequency you can actually manage without resentment, and do make sure to be back on time or communicate adequately if not).
Impose very strict boundaries around medication and therapy. A boundary is something YOU do, and it might look like saying, "I love you and I am afraid of you when you are unmedicated, so if you skip a single day of medication or therapy, I will take the pets to make sure they're safe, and I will move out until you are committed to your mental health enough that I can feel me and the pets are safe."
Take a break and move out for a while - without giving an ultimatum or conversation or second chances first. Maybe sneaking out at night. That is OK.
End the relationship in any way.
Any of those things are OK, AT ANY TIME, whether the person is in crisis or not. Just as they are feeling entitled to destroy your quality of life by not taking care of their brain, you are equally entitled to take care of yourself even if it feels bad to them.
Looking after yourself might mean leaving, for a while or forever. You are not a bad person if that's what you need to do.
posted by nouvelle-personne at 1:05 PM on March 12, 2022 [18 favorites]
People who say the kinds of things your partner is saying sometimes kill themselves, and/or their entire families. This is serious. This is not a home-DIY project. I strongly suggest inpatient care as well.
>I don't mind being there for them, holding them together when they break down — that's what I'm for for Christ's sake
This is actually NOT what you're for.
You are a full and worthy person and you deserve a safe place to live, enough sleep, to be allowed to come and go as you please, and not to be someone's emotional punching bag.
You deserve 100% space.
You are not meant to squeeze and tiptoe around someone who is infringing on your right to sleep and sincerely discussing killing your pets as if that's normal. It is CONCERNINGLY NOT NORMAL.
It's a nice trait to be loving and loyal, and gaps in their mental health are not your spouse's fault, but they are also not your birthright.
It would be ok to
Definitively refuse to discuss the war. "I can't have this conversation, so I'm going to leave the room for 15 minutes."
Shut down all distraction while working. "I can't concentrate while you read headlines. Please don't talk to me for the next 4 hours while I work. If that's challenging for you, one of us has to sit in the living room."
Leave the house. "I am going to the grocery store. I will be back at 2pm. While I'm gone I will text you every 30 minutes to help you feel more comfortable (only promise a duration / frequency you can actually manage without resentment, and do make sure to be back on time or communicate adequately if not).
Impose very strict boundaries around medication and therapy. A boundary is something YOU do, and it might look like saying, "I love you and I am afraid of you when you are unmedicated, so if you skip a single day of medication or therapy, I will take the pets to make sure they're safe, and I will move out until you are committed to your mental health enough that I can feel me and the pets are safe."
Take a break and move out for a while - without giving an ultimatum or conversation or second chances first. Maybe sneaking out at night. That is OK.
End the relationship in any way.
Any of those things are OK, AT ANY TIME, whether the person is in crisis or not. Just as they are feeling entitled to destroy your quality of life by not taking care of their brain, you are equally entitled to take care of yourself even if it feels bad to them.
Looking after yourself might mean leaving, for a while or forever. You are not a bad person if that's what you need to do.
posted by nouvelle-personne at 1:05 PM on March 12, 2022 [18 favorites]
Best answer: My concern is that you may not actually be helping. If you spend an hour with them and they are no better after you spend that hour with them, then you are not helping, even if they beg you not to go. If you can't see definite signs that what you are doing is making them better, then anything they say about needing you to stay is probably only a symptom of their anxiety.
Is there any chance that you are staying to keep them company basically because your anxiety makes you too scared to leave them alone unsupervised?
The thing about a suicide watch is that one person can't do it. You need to sleep, eat, work and use the bathroom. You can't isolate them from every single thing they could use to self harm such as bed sheets and the knives in the kitchen and you can't over ride them if they don't disclose their intentions. If your partner wants to go outside, you can't make them stay at home even if you suspect them of going out to look for pills or to throw themself under a truck.
Making consoling noises is kind and supportive but it doesn't help someone struggling with a psychotic break any more than it helps someone who is bleeding from an artery.
You will help your spouse more by earning an income than you will by allowing them to make you lose your clients. You'll help your spouse more by going out and getting exercise than you will by staying and agonizing with them. If your spouse is so fragile that you going out for exercise puts them at risk, then it also puts them at risk if you fall asleep or if you leave them alone long enough to take a shower. Either they need to be an in-patient or it is okay for you to leave them unsupervised long enough to work. There isn't an in between.
Their behaviour isn't acceptable - certainly they can't control it and they don't deserve to be punished for it, but not letting you sleep or do work for a period of over forty eight hours means that you are not in a crisis, you are in an on going dysfunctional situation. Could you keep this up for six weeks or six years? Trying to endure and to sustain the situation is counter productive. It doesn't help them and it harms you and them. The more tired you get the worse your judgement will be.
I think you seriously need to get at least five good nights sleep a week and at least four uninterrupted work days a week, and do whatever is necessary to ensure it - whether that means leaving them alone and going somewhere else to sleep and work, returning only for a few hours each day, or getting them admitted.
Do you have any friends or family who would let you work from their home or crash on their couch? Is there any public location you can work in, like a mall or a library?
You are on an airplane fighting to put an oxygen mask on a shrieking, kicking, struggling two year old. But your own mask isn't on yet.
Please take care of yourself.
posted by Jane the Brown at 4:16 PM on March 12, 2022 [13 favorites]
Is there any chance that you are staying to keep them company basically because your anxiety makes you too scared to leave them alone unsupervised?
The thing about a suicide watch is that one person can't do it. You need to sleep, eat, work and use the bathroom. You can't isolate them from every single thing they could use to self harm such as bed sheets and the knives in the kitchen and you can't over ride them if they don't disclose their intentions. If your partner wants to go outside, you can't make them stay at home even if you suspect them of going out to look for pills or to throw themself under a truck.
Making consoling noises is kind and supportive but it doesn't help someone struggling with a psychotic break any more than it helps someone who is bleeding from an artery.
You will help your spouse more by earning an income than you will by allowing them to make you lose your clients. You'll help your spouse more by going out and getting exercise than you will by staying and agonizing with them. If your spouse is so fragile that you going out for exercise puts them at risk, then it also puts them at risk if you fall asleep or if you leave them alone long enough to take a shower. Either they need to be an in-patient or it is okay for you to leave them unsupervised long enough to work. There isn't an in between.
Their behaviour isn't acceptable - certainly they can't control it and they don't deserve to be punished for it, but not letting you sleep or do work for a period of over forty eight hours means that you are not in a crisis, you are in an on going dysfunctional situation. Could you keep this up for six weeks or six years? Trying to endure and to sustain the situation is counter productive. It doesn't help them and it harms you and them. The more tired you get the worse your judgement will be.
I think you seriously need to get at least five good nights sleep a week and at least four uninterrupted work days a week, and do whatever is necessary to ensure it - whether that means leaving them alone and going somewhere else to sleep and work, returning only for a few hours each day, or getting them admitted.
Do you have any friends or family who would let you work from their home or crash on their couch? Is there any public location you can work in, like a mall or a library?
You are on an airplane fighting to put an oxygen mask on a shrieking, kicking, struggling two year old. But your own mask isn't on yet.
Please take care of yourself.
posted by Jane the Brown at 4:16 PM on March 12, 2022 [13 favorites]
I read this here somewhere and have repeated it here before:
Don’t set yourself on fire to keep someone else warm.
I was married to man with untreated bipolar disorder many years ago and spent a long time trying to care for him and support him. It was only after I left, because I had to care for myself, that he sought the help he needed.
posted by hilaryjade at 6:17 PM on March 12, 2022 [4 favorites]
Don’t set yourself on fire to keep someone else warm.
I was married to man with untreated bipolar disorder many years ago and spent a long time trying to care for him and support him. It was only after I left, because I had to care for myself, that he sought the help he needed.
posted by hilaryjade at 6:17 PM on March 12, 2022 [4 favorites]
Hey, I have some of this kind of brain thing myself. My friends and family will absolutely say "no" if I am particularly off-kilter (my go to was "we will end up homeless if X"). After establishing the falsity of it, no further what if meandering was tolerated.
Your partner is trapped in their own mind and has no drive to not be there. Not doomscrolling will help them but they refuse to and more damaging, they insist you participate. You are not here to participate or support their psychosis. Because 'only I know' and so on? Really concerning.
I don't know if it's having had a shitload of therapy or what, but I am unsympathetic to the idea that giving in to anxiety helps. Because it doesn't. Listening to the doom wailing doesn't help them and harms you. Anxiety is a liar and a thief. It cannot be placated, not when it's so disjointed from reality.
You are allowed to and should say "no" to participating in the doomsaying. Yes it creates conflict, and your partner may become violent or abusive in response - it still isn't something you have to do.
The best thing my ex ever did for me way disengage from my anxiety. Sure it hurt but it helped so much more. Feeding into it only makes it stronger.
So disengage. Grey rock if necessary. Enforce your own boundaries for sleep and work and health. That's the only way to maintain enough reserve to get through to supporting them.
posted by geek anachronism at 6:40 PM on March 12, 2022 [8 favorites]
Your partner is trapped in their own mind and has no drive to not be there. Not doomscrolling will help them but they refuse to and more damaging, they insist you participate. You are not here to participate or support their psychosis. Because 'only I know' and so on? Really concerning.
I don't know if it's having had a shitload of therapy or what, but I am unsympathetic to the idea that giving in to anxiety helps. Because it doesn't. Listening to the doom wailing doesn't help them and harms you. Anxiety is a liar and a thief. It cannot be placated, not when it's so disjointed from reality.
You are allowed to and should say "no" to participating in the doomsaying. Yes it creates conflict, and your partner may become violent or abusive in response - it still isn't something you have to do.
The best thing my ex ever did for me way disengage from my anxiety. Sure it hurt but it helped so much more. Feeding into it only makes it stronger.
So disengage. Grey rock if necessary. Enforce your own boundaries for sleep and work and health. That's the only way to maintain enough reserve to get through to supporting them.
posted by geek anachronism at 6:40 PM on March 12, 2022 [8 favorites]
Best answer: I was once where you are now. The classic book, "Codependent No More" was a huge help to me in addressing self-care because I too found myself feeling like my job was to support and care for my partner, but I ended up being the person who set myself on fire to keep them warm. This book helped me to see the difference between the two and gave me specific strategies for changing that dynamic.
posted by eleslie at 5:08 AM on March 13, 2022
posted by eleslie at 5:08 AM on March 13, 2022
Best answer: If you are not entirely sure if spouse is displaying to the therapist just-how-bad things are, find a way to record them. Verbally at least, visually too if possible.
You're still in the danger zone, and given the previous comments about the pets, I worry about their safety. (And the resultant devastation that would impact BOTH of you in the long run.)
I fully agree you need more help than once - or even three times a week - therapy appointments. Spouse needs trained supervision until they stabilize... and it needs to be in a safe environment that doesn't make the condition worse. (Which means no access to news, in all likelihood.)
posted by stormyteal at 1:26 PM on March 13, 2022
You're still in the danger zone, and given the previous comments about the pets, I worry about their safety. (And the resultant devastation that would impact BOTH of you in the long run.)
I fully agree you need more help than once - or even three times a week - therapy appointments. Spouse needs trained supervision until they stabilize... and it needs to be in a safe environment that doesn't make the condition worse. (Which means no access to news, in all likelihood.)
posted by stormyteal at 1:26 PM on March 13, 2022
Response by poster: Thank you everyone.
I'll not deny that this has been a hard thread to read.
As things stand, my spouse is still at home; things have calmed down a little over the last couple of days, and although they are still doomscrolling regularly, they're no longer absolutely convinced that they know something that other people don't — they're mostly just confused about how it is that I and other people can be not massively scared about everything that's happening.
We've talked about inpatient care, and we've agreed a couple of bright lines which, if crossed, would lead to us going down that route (specifically around self harm / suicidal urges as well as a couple of other things).
Finally, I've set some strong boundaries around working time. That's a work in progress, and we'll see how it goes.
posted by six sided sock at 10:25 AM on March 14, 2022 [4 favorites]
I'll not deny that this has been a hard thread to read.
As things stand, my spouse is still at home; things have calmed down a little over the last couple of days, and although they are still doomscrolling regularly, they're no longer absolutely convinced that they know something that other people don't — they're mostly just confused about how it is that I and other people can be not massively scared about everything that's happening.
We've talked about inpatient care, and we've agreed a couple of bright lines which, if crossed, would lead to us going down that route (specifically around self harm / suicidal urges as well as a couple of other things).
Finally, I've set some strong boundaries around working time. That's a work in progress, and we'll see how it goes.
posted by six sided sock at 10:25 AM on March 14, 2022 [4 favorites]
It sounds like you're at least hearing some self-awareness, which is a great sign.
I'm in a couple of groups for people with family that have fallen down the Qhole, and for the ones who seem to have done it out of severe anxiety and maybe other unmanaged mental health challenges, the critical factors for the successfully un-rabbit-holed has been finding something else a) really compelling but way lower-stakes to get into (real life examples: k-pop, wordle and other puzzle games, video games (ideally less violence and more adventure/puzzle type), Geogessr) b) that literally keeps their hands busy, whether that's a craft or home repair or volunteering somewhere or whatever. 1000-piece puzzles, Lego, yoga, Rubik's cube. Learn to knit or crochet, if they want to learn a survival skill. (Check your local version of Craigslist/FB Marketplace/Buy Nothing to see if someone wants to unload basic tools and some yarn stash.) I have a bunch of friends who have gotten into painting miniatures lately, and these are apparently associated with various video games but they don't play the games they just paint the little figures? I don't know, but it seems to help. A lot of these are things they could quietly do in your vicinity, if being near you is reassuring to them, while you work.
In my partnership, if someone is unemployed or between freelance gigs, the rule is "if there's time to lean or mercilessly doomscroll, there's time to work on that closet full of crap or cook and freeze a bunch of chili or paint that room." They may not see the point in doing these things since we're all gonna die any minute, but I'm here from the 80s to tell you everybody still had to clean their rooms and do their homework. It was some mercy that we only got news 3-4 times a day, and that might be worth considering as a personal goal.
posted by Lyn Never at 11:03 AM on March 14, 2022 [6 favorites]
I'm in a couple of groups for people with family that have fallen down the Qhole, and for the ones who seem to have done it out of severe anxiety and maybe other unmanaged mental health challenges, the critical factors for the successfully un-rabbit-holed has been finding something else a) really compelling but way lower-stakes to get into (real life examples: k-pop, wordle and other puzzle games, video games (ideally less violence and more adventure/puzzle type), Geogessr) b) that literally keeps their hands busy, whether that's a craft or home repair or volunteering somewhere or whatever. 1000-piece puzzles, Lego, yoga, Rubik's cube. Learn to knit or crochet, if they want to learn a survival skill. (Check your local version of Craigslist/FB Marketplace/Buy Nothing to see if someone wants to unload basic tools and some yarn stash.) I have a bunch of friends who have gotten into painting miniatures lately, and these are apparently associated with various video games but they don't play the games they just paint the little figures? I don't know, but it seems to help. A lot of these are things they could quietly do in your vicinity, if being near you is reassuring to them, while you work.
In my partnership, if someone is unemployed or between freelance gigs, the rule is "if there's time to lean or mercilessly doomscroll, there's time to work on that closet full of crap or cook and freeze a bunch of chili or paint that room." They may not see the point in doing these things since we're all gonna die any minute, but I'm here from the 80s to tell you everybody still had to clean their rooms and do their homework. It was some mercy that we only got news 3-4 times a day, and that might be worth considering as a personal goal.
posted by Lyn Never at 11:03 AM on March 14, 2022 [6 favorites]
This thread is closed to new comments.
I mean... only to an extent? There's a limit to how much you can hold someone together who is seriously mentally ill and it sounds like you're a kid with your finger in the dyke, in the face of an overwhelming tide.
It sounds like there are some things that you need to do in order to preserve your own mental health, which are you resisting doing because you feel like you're responsible for holding your partner together. You absolutely have to put on your own mask first.
Some ideas off the top of my head:
* Work in a different room, even if it's less than optimal.
* Sleep in a different room, ditto.
* Wear earplugs during both activities so that you can't hear or respond to their doomscrolling-inspired questions - your reassurance is possibly not actually making that much of a difference.
* Get out on your own and walk around the block without them, twice a day, even if only for 5-10 minutes. Let them doomscroll while you're gone. If you come back and they're crying, that's OK, crying won't kill them.
* Really, really lean on your support network. IIRC, in your last post, your partner didn't want you talking about this to anyone else. They don't get to make that decision when the result is absolutely crushing you, which it appears to be. Get friends/family members/someone you barely know who really likes helping people/almost anyone, tbh, to come over and hang out for half a day once a week so you can get out and do something different. If there are any social or mental health charities in your area, contact them and see if they can offer this kind of support.
You need headspace as much as they need support. Inevitably when someone is ill, the balance tilts towards their needs, but right now it sounds like the balance is way, way, skewed towards them and their needs in a way that is going to make you ill if you don't right it. It's not sustainable.
And finally, this is out of left-field, and totally disregard it if you need to, but in case it's helpful for someone to say out loud to you something that seems unthinkable: If this is utterly unbearable and is threatening to sink you, you don't have to stay. There's 'in sickness and in health' and there's 'losing your own mental health and your job by trying to shore up someone who is so mentally ill that it's simply not manageable by a spouse no matter how much we love one another'. That might be unthinkable or impractical or whatever, but I just thought I'd throw it out there as the response of an outsider, in case you haven't dared think it yourself for fear it would make you a terrible person, or would make you to blame for their suffering. It wouldn't. You have needs too.
posted by penguin pie at 9:21 AM on March 12, 2022 [13 favorites]