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One-in-four people experience a mental health problem in any given year and of these, a lot of couples will find that mental health problems become an unwelcome addition to their relationship. When looking through their distorting lens you can start to feel that there is a problem with the relationship - or with one person within it. So, how do you manage?

Between us, my husband and I have both anxiety and depression. At least we can start to understand what it feels like for each other and over the past seven years we’ve both needed, and given, support. Recently I have been more vulnerable, as I’ve been struggling with SSRI withdrawal symptoms as I have come off my anti-depressants after 15 years of use.

I have surges of anger that pretend to be to reactions to things happening day-to-day; negative comments, slamming doors and frustrated tears. He recognises these as symptoms. He knows that they’re not my fault. Although incredibly difficult, he does his best not to react to them as if they are, which is perhaps the most supportive thing he can do for me right now.

Here are some of the other things that we’ve found work for us.

We make sure we see the difference between our relationship and our mental health problems. It’s something external to us both

Viewing mental health problems and their symptoms as external to us both stops it being associated purely with one of us - or becoming too intertwined with the rest of the relationship. It isn't physically separate in the same way as a tricky landlord or demanding colleague – but trying to deal with it in the same way seems to help. We’re a team, facing it together.

Helping each other understand by finding our own language to talk about it

The better we understand what is going on, the easier it is to help. If your partner hasn't had depression (for example) they might not understand why you can't just pull yourself out of it. Or they might worry that it’s something they have done. It helps to try and find a way to describe it in a way that you’ll both understand.

Metaphors help. It uses the language of shared experience to transfer and talk about some pretty intangible feelings.

I describe a negative fog in my mind that magnifies and bounces every thought back at me. Saying 'I feel foggy tonight, I think I'm going to go to bed' helps him understand my needs better than if I say 'I feel rubbish, I'm going to bed, don't talk to me'. This is more likely to make him worry that it's something he’s done.

We also find it helpful to think about some of the symptoms of anxiety as a tape playing in our minds – blasting out unanswerable questions and worries at top volume. I can say ‘the ‘I’m not good enough tape’ is playing loudly today’ and we know this means I need some help distracting myself until the batteries run down.

We work out (as best we can) how our mental health problems affect how we feel and behave. Then we try and recognise these as symptoms and not ‘reality’

My depression makes me feel needy and over-dependent. But these are negative experiences you might have in a relationship anyway. So it really helps to remember that they are a result of the depression.

Saying 'When I'm low, I feel really needy, so I might be a bit dependent and irrational today', helps us manage much better than if I let the current feeling of neediness do the talking; 'Why are you going out today, I really want you to stay in, do you even love me?’

Whatever works – use it!

At some point in our lives we’ve probably all felt as though a relationship with the right person should be perfect. If it’s difficult we worry that there’s something wrong. But that isn’t true, relationships take management. We can all find ways to make it work. Some of the ways you find might be unique to your relationship – and that’s fine.

We’re both writers so it’s not surprising that we find it helpful to write difficult things down. It sometimes feels odd to write an email from the kitchen or a letter from the lounge - but writing gives us more time to work out how we feel and capture it exactly. It also gives the other person more time to take it in and make sense of it. Sometimes the process of writing helps us clarify things too.

Use whatever works for you. Don’t feel weird if you think your tools are different to other peoples – if they strengthen your couple 'team' then that’s always valuable.

Enlist each other’s help - and don't disregard it

When I feel depressed it's hard to imagine I’ll ever feel better. I need help to remember what feeling better feels like. I do my best to have faith in my husband’s reminders - even if in the moment I genuinely can’t believe him. But I know he knows me. I know he wants the best for me. This helps me to trust him when he is encouraging me to go for a run or attend an appointment.

It can really help to talk about each other’s warning signs, as it’s often easier to recognise the beginning of a relapse in someone else. And if you do, you can start to gently encourage them to look after themselves.

Reading up on it and asking about it

Get to know your enemy. There’s lots of useful information and stories online that help us to understand the issues and how we can help each other. Share things that make sense or capture how you feel. Sometimes other people can put things into words better than we can.

It definitely isn’t easy. There have been times when it is desperate, exhausting and miserable. Mental health problems have a way of sneaking into the most precious places and sucking out the joy. But overall I think our honesty, resilience, understanding and love is much stronger as a result of standing shoulder-to-shoulder against the enemy when things are hard.

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