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How to connect when there’s a mood or anxiety disorder in the family

“You’ve been lying on the couch all day. I don’t see why you don’t just get up and do something,” said Hannah to her husband, Mark.

Mark, who recently began treatment for his depression, hasn’t had much energy lately. He hasn’t been sleeping and he’s been feeling sad and worthless. Hannah doesn’t understand why everything is so hard for him.

When someone is living with a mood or anxiety disorder, friends and family members may become frustrated and impatient.

“Part of the reason it’s hard for others to be empathetic,” says Dr. Simon Rego, Director of Clinical Training, American Institute for Cognitive Therapy in New York City, “is that we can’t actually see the symptoms of a psychiatric disorder the way we see a physical injury– there’s no cast or crutches.”

How can Mark help Hannah understand?

“It’s hard to be assertive when you’re feeling depressed,” says Dr. Rego, “but it’s important that Mark speaks up and explains what he’s feeling and what he wants from Hannah.”

“When you talk to me that way, I feel worse,” Mark could say. “I feel wiped out because of my depression. If you’ll try to understand that I’m going to get tired easily, I’d be willing to take a walk with you.”

Jennie, who takes medications for bipolar disorder, still sometimes has mood swings and can be irritable with her husband, Max. He knows she doesn’t mean to be that way, but it’s hard for him not to take it personally.

It could help, says Dr. Rego, if the two of them talked it over when they’re both calm. Jennie tells Max she doesn’t recognize her behavior when it’s happening. Max could tell Jennie that he’s going to start giving her a signal that she’s in that state. So next time, Max said:

“Jennie, remember last weekend when you told me that you don’t always realize that you’re being irritable? Well, this is one of those times.” Jennie was able to step back and say, “Oh. You’re right.” And she was able to turn her behavior around.

“Jennie’s irritability can be related to thoughts she’s having about what others are doing or thinking,” says Dr. Rego, and she may need to challenge those thoughts. It’s also important that Jennie remembers that, while she may be feeling irritable, her feelings don’t have to drive her behavior. She can feel that way and still act respectively to people around her. It’s a choice.”

An anxiety disorder can cause sudden and terrifying panic attacks. When it happens to Susan, she feels safe only in her home.  It’s been hard for her husband, John, to understand her fear. He knows she’s not to blame, but it’s frustrating and takes a toll on their lifestyle.

Susan can help John understand by describing what she’s feeling and by letting him know that she’s taking small steps to challenge herself to face her fear, but not to the point of becoming overwhelmed.

John can help by not dismissing her fears. He can ask, “What can I do to help you?” and offer encouragement and support. He’ll need to be willing to compromise.

“Susan and John can work together as a team – the two of them fighting against the illness, rather than one against the other,” says Dr. Rego.

“A mood or anxiety disorder in the family can be a challenge,” says Dr. Rego. “But, by working with a mental health professional, it’s possible to learn new ways to collaborate and be supportive of each other.”

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