Upset married couple sitting on the sofa after a disagreement

Emotional Problems and Disorders in Relationships

Is It a Relationship Problem or Is It Your Partner’s ‘Issue’?

By Richard J. Loebl, LCSW, BCD

Suzanne is taking medication for depression, but her husband still complains that she doesn’t do anything, and there is little affection or sex in their marriage. Rob’s girlfriend believes he has an addiction to marijuana and pornography – she broke up with him several times but keeps coming back when his behavior improves, and they continue to have loud arguments and fights. Julie is fed up with her narcissistic husband (narcissism is one of the personality disorders). She’s tired of complaining about his arrogant attitude, his demanding behavior and his lack of empathy or interest in meeting her needs. He says that Julie exaggerates and distorts the truth.

Are these examples of relationship distress caused solely by one partner who has depression, addiction, or personality disorders? Or is there more to the story? Is the relationship distress due to one individual’s emotional and behavioral problems, or could there be other relationship dynamics created by both partners? In other words, is it one person’s “issue” or is it about the relationship dance?

It’s a complicated picture to be sure. But as a general rule, when there are problems like depression, addiction and personality disorders, there will also be relationship distress. Emotional problems and disorders can trigger relationship distress, but it’s not always a simple cause-effect situation. This article will describe some typical examples, with suggestions for coping with these difficulties.

How These Problems and Disorders Impact Relationships

When there is relationship distress, the most commonly reported emotional problems and disorders are depression, addiction, and personality disorders. Anxiety, OCD, and bipolar disorders are also quite common, and are frequently associated with relationship distress. Three of the most common problems, and the way they manifest in relationships are described below:

* Depression can range from quite mild (dysthymia) to major depressive episodes and bipolar depression. And the impact of depression on marriage and other relationships can range from minimal (such as a general relationship lethargy or dissatisfaction) to severe relationship distress (anger, fighting, distance and affairs). A depressed partner may be unmotivated, isolative, moody, irritable, and disinterested in sex and other pleasurable activities. Anti-depressant medication can also result in lowered libido and lack of sexual response.

And relationship problems can contribute to depression. Some partners may become depressed due to severe and chronic relationship distress. For example, it’s quite common for the spouse of an alcoholic or addict to become depressed. Victims of spousal abuse are often depressed. And to complicate matters even further, depression, addiction and personality disorders may be present in the same person or couple.

Suzanne has felt controlled and demeaned by her husband for over 20 years. She started taking anti-depressant medication about 6 years ago, and she’s been able to return to her part-time job. With the help of couples therapy her husband Tom has become less demanding and critical, but he’s still very concerned. Suzanne tends to withdraw and isolate when she’s depressed, and Tom feels lonely and rejected. Suzanne’s medication may contribute to her low libido, along with her negative self-image and body-image. And when Tom complains about the lack of sex Suzanne feels guilty, inadequate and frustrated. She reacts defensively with more distance, Tom becomes more frustrated, and the cycle repeats itself.

* Addiction is often the primary concern when couples seek therapy. At other times there are other types of relationship distress and addiction is a complicating factor. The most common addictions we see with couples are alcoholism, prescription drug abuse, marijuana dependency, sex and pornography addiction. Addiction problems in relationships are usually very destructive, and couples will not benefit from therapy until there is a period of stable sobriety.

Relationship distress can also contribute to the development of addictive behavior or exacerbate an existing addiction. For example, when Rob quits smoking marijuana he is less tolerant of his girlfriend’s insecurities and demands for attention (he had been “self-medicating” to deal with their relationship problems). He becomes more defensive, and she reacts to the perceived abandonment with clingy and complaining behaviors. When things escalate between them and they start fighting again, Rob may “take refuge” in smoking marijuana again or using pornography. And the cycle repeats itself.

* Personality Disorders, such as narcissism and borderline personality disorder, may be a complicating factor in relationship distress.

Julie believes her husband is narcissistic, and she’s right. David is selfish, and rarely considers Julie’s feelings or needs when he makes decisions. Many narcissistic men, like David, feel entitled, special or unique, and take advantage of their spouse (and others). David can’t seem to understand Julie’s hurt and angry feelings – or he doesn’t seem to care. The more she complains, the more he says that she doesn’t understand or appreciate him – and he expects a great deal of attention and admiration from Julie.

Personality disorders can be very difficult to deal with, and partners or spouses are usually frustrated, angry, and baffled. They can’t win. Another example is borderline personality traits or the disorder itself (generally more common in women). This type of personality is emotionally unstable, and relationships are like roller-coasters. Borderline characteristics include excessive feelings of insecurity and fears of abandonment, impulsivity (addictions are common), self-harm or threats of self-harm, irrational anger and mood swings. The emotionally reactive cycle of relationship distress usually centers around abandonment issues. The borderline partner feels abandoned or unloved, and when she complains, interrogates, or is demanding, the exhausted partner reacts defensively, with anger and/or avoidance, which then fuels more reactivity by the borderline partner. And the cycle repeats itself.

Relationship Coping Skills

There are several tried and true coping skills for dealing with emotional problems and disorders when there is relationship distress – but it’s not always easy, and most couples will need professional guidance and support.

* Acceptance – 12 Step programs offer some of the best advice. Accept the things you cannot change, and remember the “3 C’s” (you didn’t Cause it; you can’t Control it; you can’t Cure it) – this is especially useful with addictions and depression.

* Emotional Detachment – Emotionally detach from the problem, not the person, with love. Know that it’s really not about you – don’t personalize. Especially useful with personality disorders.

* Don’t React – It helps to start with the one deep, centering breath (in through your nose, out through your mouth). Do not react to the drama, the incident, or any provocation. Take that breath, and use your highest self (your most adult or even spiritual self) to determine the best response.

* Use Empathy & Compassion – It’s actually one of the easiest ways to respond. Let your spouse or partner know that you’re really there, and that you do care. Ask them what they need from you right now – is there anything you can do for them (like “How about a hug?”).

* Practice Self-Care – Beware of co-dependent traps like enabling behavior. Remember to take care of yourself. Use a support system (support groups are available for co-dependency, Al-Anon for addictions, and depression support groups). Exercise, meditate or pray, and practice self-love (inner child work is recommended).

* Boundaries – Know what your limits are, and clearly, firmly indicate to your partner where that line is. Boundaries are best expressed in a positive, even caring manner. For example, “Please don’t ask me that or do that behavior. I love you, but that is not okay with me. We can talk about this some time, but for now, please respect my wishes.”

* Forgiveness – Practice letting go by forgiving your partner as an internal process. Do not tell your partner that you forgive them – that will simply provoke an emotional reaction. Tell yourself (journaling is also helpful) that you are forgiving and letting go.

* Know when to stay and when to leave – What is the deal breaker for you? Only you can decide. For more suggestions, see my article “Separation & Divorce – Should I Stay or Should I Go?

* Seek Professional Help from a qualified, licensed counselor or therapist.

The counselors, therapists, and couples therapists at our Center have many years of experience and training in helping individuals and couples. We can help you navigate the troubled waters of depression, addiction, and personality disorders. Contact us today to make an appointment, or to ask any questions.