Dear Dr. Wes and Julia: I have always suffered with anxiety-driven depression. My boyfriend hasn't. He doesn't understand how to cope with this. How can I make him understand?
Julia: Being frustrated with your boyfriend is understandable; it seems insensitive or lazy not to make an effort to understand a loved one's issues. However, your frustration mixed with his confusion only weakens your relationship and causes a rift in communication. Instead, try to calmly teach him about your depression. You might mention how your depression comes about, what it causes you specifically to feel, how it might affect family members or loved ones and maybe a reference to someone else who has it. If you keep the conversation positive and in favor of his being informed, he may see that your relationship can benefit from his understanding your condition.
Try to be forgiving if your boyfriend doesn't fully get it at first. In a relationship, it is biologically typical that girls want an emotional connection and guys want a physical connection. Each has to understand this about the other in order that the two should ever be together. Make sure he knows how much his caring and understanding would mean to both of you and that your relationship means enough to you to try and work things out.
If you try this sort of nonaggressive approach and he still doesn't get it, you might reconsider your relationship. You don't benefit from the extra anxiety caused by him, and he doesn't benefit from having an unsatisfactory relationship.
Wes: Glad you asked. As parents and even professionals, I think we haven't fully realized the importance of processing and understanding romantic relationships in adolescence, or see them as worthy of intervention. While I consider teen romance a kind of practice for later adult relationships, that doesn't make it unimportant - quite the opposite. I believe most therapy with adolescents naturally includes advice on how to make those relationships work their best, which will in turn helps develop skills and ways of thinking that can extend to new relationships down the road. Too often teens get into bad habits in dating, including failing to learn how to manage differences, conflicts or, in your case, personality characteristics. Those habits may get harder to break once they're begun.
Unfortunately, few relationship issues are as difficult to process as one (or both) partners' mental health. At this age most boyfriends or girlfriends simply aren't emotionally equipped to handle someone else's anxiety or depression. It may seem unfair or disingenuous, but the advice a therapist will offer you will be different than that offered to your boyfriend if he's seeking counsel, and I think it's worth addressing both sides of that issue to do justice to your question.
As Julia notes, the basic advice to YOU is to help your boyfriend understand your illness and how it may impact your behavior, emotional display, what you say and how you interact. It may impact your ability to trust, your need for reassurance, and your tendency to over-respond to certain situations. He may need to recognize how your displays of anger are actually anxiety-driven. For you, anxiety apparently leads to depression, and this may leave your boyfriend feeling as though he's always moving from one emotional incident to another, seeming unrelated one. Based on all this new information, your boyfriend has to learn with great precision what to take personally and what to accept as reflective of your anxiety and depression. None of this sounds any easier than it is - especially for a teenager - regardless of how devoted he may be to you.
For this reason and unfortunately for you, the standard advice to your boyfriend will be to think very carefully about how involved he wants to get with you. Our culture deeply cherishes the "love conquers all" philosophy despite a lot of scientific research to the contrary. Instead, what you have to do to maintain this or any relationship is also serious and difficult. By working with a therapist and perhaps a prescriber, you have to begin to understand how your anxiety affects the way you approach relationships, how you define and understand reality and how you assign meaning to things others (including your b.f.) do. This issue of meaning is really at the heart of coping with anxiety and depression because it guides the way in which you respond to whatever is before you. A big part of this will be how you let yourself trust and how you attempt to enforce trust in the partner. This is where the anxious folks tend to struggle the most in relationships, and they can at times become rather controlling. So it's not really enough to want to cope with your illness. You have to be really on top of it, too, and until you are it's probably too much to expect any romantic partner to be.
If all the parents are OK with it, I'd suggest bringing your b.f. to your therapy session and seeing if the therapist can help you educate him. If he's still not able to be helpful, I agree with Julia - you really have to question the value of the relationship at this point in your life. I realize that is itself an unnerving proposition, but it is also necessary. The path to love is a long one, and rarely simple and straightforward especially when you are struggling with your own psychology along the way. I wish you the best of luck.
Next week: My child has an IEP, but he can't play sports because of grades.
- Dr. Wes Crenshaw is a board-certified family psychologist and director of the Family Therapy Institute Midwest. Julia Davidson is a Bishop Seabury Academy junior. Opinions and advice given here are not meant as a substitute for psychological evaluation or therapy services. Send your questions about adolescent issues (limited to 200 words) to firstname.lastname@example.org. All correspondence is strictly confidential.