Navigating the dating scene is tricky for anyone — but how is it different when you have a mental condition like bipolar or schizophrenia? (Illustration: Erik Mace for Yahoo Health)
Christina Bruni seems to have it all. She owns her own co-op, has a gym-toned body and striking good looks, and a career as a librarian. She’s fit and active.
And 22 years ago, she was diagnosed with schizophrenia.
“I don’t have time to waste with fearful, ignorant guys,” she tells Yahoo Health. “Rejection is a two-way street, and I rejected plenty of guys online and in person, too.”
Bruni, 50, is just one of the 42.5 million Americans (about one in five people in this country) with mental illness, including depression, anxiety, bipolar disorder, and schizophrenia. And while dating is a minefield already, doing so with a mental condition requires a serious dedication to honesty, communication, and — like Bruni says — an open mind. After all, some stats reveal that in marriages where one person is depressed, the divorce rate is nine times higher. And if one person is bipolar, the divorce rate can be 90 percent, Stephanie Buehler, PsyD, a psychologist and sex therapist, tells Yahoo Health.
But Bruni, who wrote Left of the Dial: A Memoir of Schizophrenia, Recovery, and Hope, emphasizes that like a physical disease or a personality trait, mental illness is only a part of someone.
Indeed, “a mental illness shouldn’t be someone’s identity,” agrees Hilary Bye, a social worker at McLean Hospital’s OnTrack program, which treats 18-to-30-year-olds going through a first episode of a psychotic disorder. “There are so many attributes that someone has. This is just one part.”
There are a multitude of factors at play when it comes to making a perfect romantic match that have nothing to do with mental illness. (As Bruni says, “The lack of a guy in my life has nothing to do with my schizophrenia diagnosis.”) But for many people with mental illness, the stigma is very real — and can have an impact when it comes to finding a partner.
“People bring in all sorts of biases and challenges they face into relationships,” Karen Swartz, MD, the director of Johns Hopkins’ mood disorders clinic, tells Yahoo Health. “But when people are deciding things about bipolar disorder or schizophrenia, for example, based off of a few very inaccurate portrayals, that leads to stigma.”
Bruni says she doesn’t expect others to truly understand what she’s been through, so she accepts the stigma. “I’m not scared of anyone who would stigmatize me,” she says. “But if a guy’s not compassionate, he’s not in my target market. The truth is, I’m more successful in life than narrow-minded people will ever be. Open minds are open doors.”
And experts agree. “Most people with mental health conditions have the potential of having very happy relationships,” Swartz says. “You can have a family and a partner — it’s not that you have this experience and you’re doomed forever.”
(Illustration: Erik Mace for Yahoo Health)
But first someone has to address certain unavoidable factors — like when and how to tell your partner about a mental condition, and how treatment (including medication) can impact sex life. Issues like these directly impact the relationships of people with a mental health disorder — even more so than the average person.
To Tell or Not to Tell — and When?
For people with a mental condition, when meeting a potential romantic partner, the first words out of their mouths are likely not “Hey, I’m depressed/bipolar/schizophrenic.” But that leads to the question: When is the right time to reveal illness?
Of course, it depends on a multitude of factors: Some people are more open than others, every relationship is different, and some conditions are more serious than others. “Some people can have a mental health condition that intrudes very little into their day-to-day,” notes Swartz, while “some people have more serious conditions.”
But no matter the situation, one thing is for sure: “This is your story to tell — and how much you tell and when you tell it is in your control,” Bye says. For people with a mental condition, just remember to be honest — with yourself and any future partner. A good rule of thumb? “I think if someone has a diagnosis and is treating a condition, they should tell a partner about that before any intimacy occurs,” says Buehler.
Online dating websites dedicated to people with mental health conditions may make the reveal easier. (Sites like nolongerlonely.com, an online dating website for individuals with mental illnesses, target this population.)
Bruni used to have a profile on one such site. “I’m a creative, quirky gal who’s an artist and a writer, and I feel most at home among my own tribe. I think someone with a mental illness would be more understanding of what I’ve been through, though I am open to dating people without mental conditions,” she says. “And even though I have been in remission for 23 years, I still think a lot of people might have a hard time learning that.”
On the other hand, she agrees that speaking up about a mental health condition is uber-important. “Someone with a mental illness where they still have symptoms needs someone to understand what it’s like to live every day with that extra challenge,” Bruni says.
Even though Bruni has not yet had to disclose her schizophrenia diagnosis to a partner without mental illness, she says she would disclose her diagnosis sometime between the fifth date and the 10th date, and that it’s important to do it in a straight-forward and honest way. “Ideally, you’ll disclose in your own apartment or in your partner’s apartment and ideally before you decide you want to have sex with him or her,” she says.
Let’s Talk About Sex
By now you probably know that something as “small” as a little bit of stress, lack of sleep, or even an antibiotic can affect your sex life — mental health condition or not. But certain aspects of illness — whether it’s the condition itself, or the treatment — can affect sex in ways you may not realize.
Take bipolar disorder. “If you’re bipolar, your libido may be very high and then may drop at times — especially if you’re not on medication,” says Buehler.
And SSRIs, the most commonly prescribed antidepressants, can cause sexual side effects like decreased sexual desire for both sexes, erectile dysfunction or delayed ejaculation in men, and trouble with orgasm in women. In fact, up to 50 percent of people on SSRIs can have a decrease in sexual desire, studies have shown.
A partner without mental illness may not easily grasp all this. (And it doesn’t help that sex is often a tricky topic to talk about for most couples.) “If one person says, ‘Look, I’m having some difficulties because of a medication’, the other person might understand that, but also take it personally,” Swartz says. “They could take it as a reflection on the relationship.” Therapy — specifically, sex therapy — can help.
Communication: Hard in Any Relationship
But the biggest struggle of all may be not having the appropriate support, says Buehler. For those with mental health conditions, it can be difficult to communicate experiences, feelings, and needs. That’s not only the nature of conditions like depression or bipolar, but also a day-to-day struggle in dating.
Take Erica*, an 18-year-old with bipolar disorder. She met her boyfriend, who is also bipolar, in treatment. And even though both have the condition, communication can still be difficult. “Sometimes people ask me to elaborate on how I felt when I was depressed while I am in the more upward swing of my moods. What they don’t realize is I really can’t tell them,” she tells Yahoo Health. “For my boyfriend and I, being bipolar is a lot like having split personality disorder — you don’t remember how your other personality felt. We both agree our calm personalities only get into fights with each other when we are unstable. It’s great because our ability to relate has prevented either of us from hiding our mood swings, which can be a huge key to our recovery when we go off the rails.”
(Illustration: Erik Mace for Yahoo Health)
Another important aspect? “No matter how irrational my bipolar brain was at the moment, he could differentiate between me and the illness,” says Erica. “I think that is the key to our communication.”
Buehler says that for people with mental illness, being able to develop self-awareness and communicate directly are key. This could be as simple as learning how to say “I need some time alone to think about things” or “I need to cuddle” (instead of walking away or not saying anything at all). “I think everybody who has mental illness could benefit from some sort of therapy to understand how to manage and better communicate needs,” Buehler adds.
The Trials and Tribulations of the Dating Scene
Being in a relationship is one thing. Finding the right person to be in a relationship with is entirely another. For many people with a mental condition, sometimes the perfect romantic partner is someone who truly understands what it’s like to live with an illness.
“People do bond over that powerful experience — and sometimes it can be helpful to bring people together with similar struggles,” says Bye. (Many organizations like the National Alliance on Mental Health, or NAMI, do just that.)
Of her boyfriend, Erica says: “It’s good that I met him in the hospital. He understands that part of me. When I said I was going to inpatient, he understood. He knew I’d only be able to call him at certain times from random numbers. He got it.”
And because he has the same mental condition as Erica, he’s more understanding of symptoms. “If I flip out or am unstable, I can call him and he understands. He isn’t like, ‘Whoa, are you OK?’” she says. “If one of us has a bad day, we can talk about what could have triggered it and stuff like that.”
But people with mental health conditions shouldn’t feel like they have to seek out others who struggle, too. As Erica puts it: “Even though my boyfriend and I are both bipolar and we met because of that, that’s not the main thing we connect on.”
Bye adds that the most important thing is for people — regardless of if they date someone else with a mental condition or not — to get back to their life and relationships as quickly as possible. Research shows that returning to your regular life and participating in activities you love is most helpful for recovery long-term, she says.
That can also help with the stigmatization, Swartz says. “People — especially in younger generations — are accepting of mental illness, but the way it can be de-stigmatized is if people with mental illness are out there living their lives.”
As for Bruni? She expects to update her online dating profile in June.
As a Partner…
If you’re in a relationship with someone with a mental health condition, you may not know what to do, how to help, or what role you should be playing in your relationship. But Buehler says that that is no reason to turn and run the other way. With the right communication skills and a little education, you can have a thriving, successful relationship:
- Don’t become a micro-manager. “Sometimes people feel like they have to be in a caretaker role,” says Bye. And while it’s certainly nice to be taken care of, it’s easy to veer more into “parent” territory than “partner” territory, especially with comments like “Take your meds!” or “How much did you sleep?”
- But know that it’s fair to ask questions. Ask your partner what he or she is doing to manage the condition — and what kind of support he or she may need. “You don’t need to police someone, but you want to know that they are taking responsibility and helping you help them,” Buehler says.
- Don’t attribute everything to the mental illness. If one person feels identified as a patient, that can be very damaging. “It has to feel like an equal partnership,” Bye says.
- Have a communication plan. Ask, “How can I talk to you about this?” After all, the person you’re with didn’t choose to have a mental health condition. Make sure to listen and ask how you can help. And remember: “Empathy and pity are very different,” Bye says.
*Name has been changed
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