Mental Illness Treatment Intensity and the Impact on Polyamory

FYI, depression is once again trying to kick my ass. Posts may be delayed while I’m getting it back under control. Thankfully, so far I seem to be winning.

Last week I talked about the range of treatment from hospitalization to home care–ie the different levels of intensity of care that is available to people struggling with mental illness. This week we’re going to look at how those treatment options affect polyamorous relationships.

polyamory and mental illnessHospitalization and Polyamory

Let’s start with the obvious: it doesn’t matter why a member of your polycule ends up in the hospital. This is one area where mental illness or heart attack or emergency C-section doesn’t matter. If one of your polycule is in the hospital, you may need to deal with disruptions of your normal routine, financial challenges from loss of income, fears for their health and well-being, limitations on when and how long you can see them (visiting hours suck!) and other issues.

Shorter hospital stays have less of an impact than longer hospital stays.

The one way I am aware of that mental illness makes a difference, is for caregivers. Caregivers for your loved one during their mental illness can deal with everything from making sure they take care of their meds to helping them shower to cooking their meals, in addition to helping them through panic attacks and differentiate delusion from reality. For a caregiver, having your loved one enter the hospital can be a huge weight off your shoulders (their life is no longer literally in your hands). It can also be a source guilt (if only you’d done enough, been good enough, helped enough, etc…). If there has been friction between a caregiver and another member of the polycule, there may also be blame–in either direction.

Don’t go there. No the caregiver(s) blaming the rest of the polycule for not giving more support and help. No other members of the polycule blaming he caregiver for not doing enough. Just don’t fucking go there.

Partial Hospitalization and Polyamory

From a practical perspective, entering a partial hospitalization program is much like starting a new 9-5 job. Loss of income may be a problem if the person entering the program had a job. Otherwise, you are dealing with the same schedule changes etc that come with any commitment to be out of the house from morning til evening.

However, partial hospitalization can be mentally and emotionally draining far more so than most jobs. You are literally spending all day every day in various types of therapy. Someone in partial hospitalization will come home drained and needing significant self-care some days. Other days they’ll be hyped with plenty of energy and excitement. And this may have nothing to do with how good or bad the day was!

In some ways, this can strain relationships more than hospitalization. Your loved one is RIGHT THERE but doesn’t have the energy or focus to give to their poly partners. Patience and some adjustments are needed. It sucks if the one evening a week you have to spend together your poly partner wants to do nothing but watch YouTube and recover from the stress of their day. But sometimes that’s what they need. Try to be understanding–it really isn’t personal. If it happens every week, you might want to ask about their schedule, and what is happening on that day every week that is leaving them so drained. If art therapy, or that one group activity, or program outings to this or that local thing are hitting them particularly hard, you might want to reschedule your regular time to a day when that activity isn’t on their schedules.

Partial hospitalization is a mixed blessing for caregivers, on the one hand, you have time during the day that can actually be for you. Heavenly! On the other hand, you need to help your loved one get ready and out the door, when they may barely be able to get out of bed.

Outpatient Therapy and Polyamory

Outpatient therapy will not usually affect regular schedules, family incomes, or other “major” issues. For caregivers–as opposed to supportive friends and family–outpatient therapy has a lot of the same challenges as partial hospitalization. “I know you feel like shit, love. But you can’t afford to miss another appointment. Come on, I have your clothes here…” without the benefit of several hours a day you can take for yourself and your priorities without fear of interruption. On the plus side, outpatient therapy is usually once a week, at most 2 or 3 times a week, so it’s not an everyday struggle.

For all poly partners, the rest of the day after a therapy session can be the same emotional rollercoaster as evenings after partial hospitalization. You never know what state your partner will be in when they come out of a session. They may be happy and relaxed, stunned with a new realization, broken and weeping…. it can definitely be rough on all concerned.

Whenever possible, don’t schedule important shit–whether it’s a family discussion about a recurring problems, or a special date, or your kid’s birthday party–after a therapy session. No one–not the person in therapy and not their poly partners–needs the stress that can bring with it.

Medication Only and Polyamory

For someone who has found their equilibrium and just needs a bit of help to keep their mental illness under control, medication only therapy can be just what is needed. Medication only might mean medication that needs to be taken every day, like lithium for mood stabilization. Or it might mean medication that is only taken as needed–such as many anti-anxiety pills.

Medication only therapy should not have a direct impact on polyamory. However, it is generally a good idea to know your more entwined partner’s medications and possible side effects. If only so on the day they have the flu and are on doctor ordered bed rest, you know what you are doing when they ask you to get the Haldol for them.

Sometimes people miss their regular medication. They might be caught out of town unexpectedly, lose their meds and need to wait for a refill, or just forget. If your poly partner isn’t able to take their medication as scheduled, you may see some personality changes, mood swings, or withdrawal symptoms. Try to be patient and remember that this time is even harder on them than it is on you.

Home Care and Polyamory

Whether in combination with medication and/or outpatient therapy or on it’s own, home care is critical for most people with mental illness. Ideally, whatever home care is necessary–be it meditation, some time in the sun, or a cup of chamomile tea before bed–is just a part of your normal routine. Much like taking a shower or combing your hair when you get up in the morning. Sometimes, especially when mental illness is acting up, home care can be disruptive. For instance, needing to cancel a regular activity because of a bad anxiety day.

When home care is part of a routine, it usually won’t impact polyamory directly. It can be helpful for poly partners to take part in or at least support, parts of the routine. Join in the meditation, have a cup of tea together etc.

When home care needs to disrupt routines and expected activities it can definitely have an impact. Someone going through a bad patch may need to cancel dates, ask for additional support, ask for additional space, and a great deal more. These disruptions can range from a loved one calling you up randomly “I’m having obsessive thoughts about X, help distract me please.” to “I’m having a panic attack, I need to cancel our date. Can you just come over and spend time with me instead?” to “No, I can’t go on our planned weekend outing my mental health is too shakey, and I don’t want to risk being away from my support system,” right up to “the suicidal thoughts are back, can you please give me a ride to the hospital/clinic/therapists? I don’t trust myself to drive right now.”

That last is, thankfully, rare.

Mental illness tends to run in cycles. Depression is a mildly annoying problem until it swamps you out of nowhere. After a few weeks you manage to get back on your feet and depression is a mildly annoying problem again. Until the next wave. During a bad part of the cycle, home care will have more of an impact on polyamory, and your poly partner may need more help and support. During a good part of the cycle, you may not even be aware of the steps they take each day to take care of themselves.

How often and how extreme these cycles are vary, and some people find the cycle takes them from home care to hospitalization and back. For others, they can rely on home care as their primary treatment throughout the cycle, but some months they won’t take a single as-needed pill while other months they are taking the maximum allowed every day.

Standard disclaimer

This post is part of the Polyamory and Mental Illness blog series.



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