Mental Illness and Polyamory Recap

This blog series is already one of the longest I’ve written, and I’m about to add a bunch more information. So before we dive back in I decided it would be good to do a quick recap of the key points of the series so far.

Educate Yourself

If one of your poly partners suffers from mental illness, take the time to learn about their illness and how it affects them. This includes both reading up on the general information about the illness and learning about how your partner experiences their illness.

There is No Quick Cure

Mental illness is not something people can just “get over” and there is no fast treatment or cure. Medication can help manage mental illness but is NOT a cure or fix. And just finding the right treatment approach can take months, if not years.

Mental Illness Can Mimic Relationship Problems

Mental illness can mimic jealousy, abuse, loss of interest, and a number of other relationship problems and red flags. Treating mental illness like relationship problems just compounds the problem. Treat mental illness like mental illness and relationship problems like relationship problems.

The Big Book of Poly Doesn’t Always Apply

There’s a lot of great advice for folks in poly relationships. However, some of that advice doesn’t work when combined with mental illness. Following the standard polyamory advice may not work or may even make things worse. If this happens it doesn’t mean you/your partner are bad at poly. It just means advice formulated by and for mentally healthy people doesn’t always apply when dealing with mental illness.

Sometimes Mental Illness Isn’t

Michon Neal shared a horrific experience of being misdiagnosed and having physical illness dismissed as “all in zir head” and mental illness. In Michon’s case the problem was compounded by the way doctors tend to overlook or dismiss all black women’s problems as mental illness.

For Michon this meant, ze was not only NOT getting the treatment ze needed, but was put on unnecessary medications with severe adverse effects. Nearly as harmful is when the wrong mental illness is diagnosed. Depression and bipolar may seem similar from the outside, but the respond very differently to treatment. Bipolar and schizophrenia are often mistaken for each other.

Irrational Feelings Are Still Feelings

Mental illness makes people feel things that have no basis in reality. Telling someone feeling abandoned because of depression “You are wrong to feel that way!” or “how dare you say I don’t do enough!” or anything like this doesn’t help anyone. That doesn’t mean you should try to fix problems that don’t exist. But understanding and empathy go a long way. “I’m sorry you feel that way. I hope you know that I love you and would never abandon you. Would cuddling for a bit help?”

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

Help Support Polyamory on Purpose.

Depressive Disorders and Polyamory

Apologies for the late post. I had this typed up and ready to go yesterday, and then the internet gremlins ate it. Took me until this morning to be able to rewrite it.

This post and others discussing specific mental disorders will reference the Diagnostic and Statistical Manuel of Psychiatry and Psychology, Edition Five (DSM-V). Apologies to my international readers, I’m just not familiar enough with the ICD to use it as a reference.

Please note: everyone’s experience of depression is different. This is general information meant to give you an idea of what to expect. Nothing in this blog is intended to diagnose or treat. Please see a psych professional if you or someone you love is suffering from depression.

The Depressive Disorders

The DSM-V recognize four main depressive disorders:

  • Disruptive Mood Dysregulation Disorder (DMDD)
  • Major Depressive Disorder (MDD)
  • Single and Recurrent Episodes Persistent Depressive Disorder (Dysthymia)
  • Premenstrual Dysphoric Disorder (PMDD)

Other depressive disorders are depression caused by medication or substance abuse, depression caused by another medical condition and two varieties of “other” depressive disorders (specified and unspecified).

Of the four main disorders, three are recognizably “depression”: major depressive disorder (MDD), Single and Recurrent Episodes Persistent Depressive Disorder (Dysthymia), and Premenstrual Dysphoric Disorder (PMDD). While there are some symptom differences, the main distinction between these three disorders is the depth and duration of the depressive episodes.

These are the three disorders this post will focus on.

Disruptive Mood Dysregulation Disorder (DMDD) is only diagnosed among children and adolescents, and on the surface looks more like an anger/attitude problem than depression. However DMDD is usually a precursor to MDD or dysthymia, so it is included as a depressive disorder.

Symptoms of Depression

Given responses I’ve gotten, my post last week seems to be a very good description of many people’s experiences of a major depressive episode. (Diagnostically a major depressive episode (layman’s term) might fall under either MDD or dysthymia depending on how long it lasts). If you haven’t read it yet, take the time to check it out now.

The main symptoms of depression are depressed mood (sad or empty) and loss of interest in activities. One of these two symptoms need to be present for a doctor to diagnose depression. Other common symptoms are:

  • changes in sleep or eating patterns
  • restlessness and/or moving very slowly (sometimes both will be present at the same time)
  • exhaustion or fatigue
  • feelings of worthlessness or guilt
  • loss of focus, inability to concentrate, or indecisiveness
  • suicidal ideation (thinking about dying without making actual plans or attempts)

Dysthymia is often (though not always) a subtle disorder with symptoms seeming to just be part of a person’s personality. Low energy, lack of interest in activities and low self-esteem are easy to see as “part of who you are” when they don’t reach the point of interfering in life’s basic necessities. PMDD is, as the name implies, a form of depression that strikes during pre-menstrual periods. It can range from mild to extreme, and some researchers believe it is triggered by hormonal changes. MDD is a major depressive episode that lasts at least two weeks. If the episode lasts for or recurs regularly for two or more years, it is an extreme case of dysthymia.

Treatments for Depression

The most common treatments for depressive disorders are medication and therapy.


Medication is said to have around a 50% success rate in treating depression, though it often takes several tries to find the right medication. SSRI (selective serotonin re-uptake inhibitors) are the first line medication for depression. The idea is that depression is often accompanied by low levels of serotonin, so increasing the levels of serotonin in the brain should make the depression better. Personally I think it’s a bit of a chicken-and-the-egg problem–which came first the low serotonin or the depression? Regardless, many people do benefit significantly from medications–once they find the right one.


The most effective form of therapy is cognitive behavioral therapy (CBT). Cognitive behavioral therapy focuses on identifying the recurring thoughts and mental patterns that form an individual’s experience of depression and re-training the mind to stop those thoughts and patterns, and develop healthy thoughts and patterns instead. It sounds strange, but many people I’ve spoken with have commented on how helpful CBT was–and my own experience agrees.

Other forms of “talk” therapy are more familiar: “let’s talk about what’s bothering” or “how is your relationship with your mother” type stuff. Family system’s therapy is very difficult to find, but focuses on the family as an interacting unit, and can be very helpful when depression is part of a long-standing unhealthy life pattern within a family.

Talk therapy (CBT or other forms) combined with medication are usually more effective than either alone, but this will vary from person to person.

Outside of talk therapy there are “fringe” treatments such as art therapy, music therapy, animal therapy, and group therapy. These treatments are fringe only in not having been studied enough to assess their treatment value for depression, they are largely recognized and supported by the APA for some, though not all, mental illnesses.

“Alternative” Treatments

Some studies suggest 2 ounces of dark chocolate a day is as effective in treating depression as SSRIs. As dark chocolate has been shown to increase the serotonin levels of the brain (explaining why it is so many people’s go-to for when they are stressed) this fits fairly well with the current theories of depression.

Getting sun, exercise, interacting with people in a healthy environment, meditation, and spending time with animals have all been shown to increase serotonin levels and be effective in fighting depression.

People with severe and lasting depression may qualify to receive a trained service animal (yes, there are service animals for mental illness. I’m most familiar with them in treating PTSD, but they can be “prescribed” for depression.)

When Depression and Polyamory Collide

Put a few of the common symptoms together–depressed mood, lack of interest in activities, low energy, low self-esteem–and it’s easy to understand how and why depression affects a poly relationship.

Dates and activities will be cancelled frequently as the depressed partner is unable to generate the interest or energy in going. Low libido will become a problem as low-self esteem, lack of interest and low energy combine to kill your sex life. Weepiness and other signs of a depressed mood can be off-putting to poly partners who don’t want to be “brought down” by hanging around someone who is never happy.

Perhaps most damagingly, for people who don’t know their partner is suffering from depression, or don’t understand depression, the limited sex life and frequently cancelled/turned down date nights and activities can seem like the depressed partner is no longer interested in them. In fact, depression does not affect how we feel about the people in our lives. It does curtail, severely, the ways we are able to express our feelings. And in a culture where “actions speak louder than words” it is very easy for a depressed person’s actions (or inability to act) to seem like a reality and their words of love an (at best) self-delusion.

Ways to Manage Depression in a Poly Relationship

Dates and activities are more likely to actually happen if they are low energy and low key. Needing to pick out a coordinated outfit, review possible restaurants, and take three busses to get to your meeting point are all major hurdles for someone with depression. Think of it this way: Getting done up for a night on the town is the depressed person’s equivalent of walking 500 miles to prove their love. It’s not something that can be done every night, or even every week[1].

Good dates or activities:

  • At home movie night curled up on the couch with popcorn
  • Sitting on the porch blowing bubbles or other sit-down outdoor activity
  • Eating out at a casual restaurant
  • Going for a walk

The closer you can bring a date to “throw clothes on, you are good to go” the less likely it is that your depressed partner will need to cancel due to their depression.


Don’t cancel a group date because a depressed poly partner doesn’t feel up to going. This can be one of the hardest situations for everyone. But canceling the entire date because your depressed partner can’t go will often just leave your depressed partner feeling worse due to guilt at ruining the fun for everyone. On the other hand, if everyone is going anyway, the group energy of people getting ready to go may help your depressed partner get motivated enough to come anyway–and in my experience we usually end up having fun after all. If they still can’t come, that’s okay. “We’d love for you to come, but we understand if you can’t” is often the best approach all around. No guilt, no pressure, and always welcome. If your depressed partner is always being left behind on group activities, work on coming up with group activities that are low-key enough they can join in, whether it’s a family picnic in the park or a night binge watching the latest Netflix release.

That said, the above does not apply if your depressed partner says “I need you to stay with me.” “I need you to stay” is very different from “I just don’t feel up to going out.” However much your partner needs you, only you can decide if the right thing to do is stay–there were times I asked my partners not to go to work because I needed them. I did, really and truly need them, but the bills needed to get paid too. Was I damaged when they went to work anyway? Yes. Was going to work the best decision they could make? Probably. The judgement call has to be yours.


Depression has a way of making you feel completely cut off from the world. Anything which bridges that gap–a hug, cuddling on the couch, reading to each other, playing a video game, holding hands, cooking a favorite meal–can make a big difference to a person battling depression. Incorporating small but regular interactions into your relationship can strengthen your relationship against the influence of depression, and help your depressed partner in their journey back to health.


How has depression influenced your poly relationships? What ways have you found to take care of your relationships in the face of depression?

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

Living with Depression

I hadn’t meant to start introducing the different mental illnesses yet. I hadn’t meant to write this post this week. But for reasons that will hopefully be obvious it is the only post I could write. Here then is a look at depression from the inside.

Depression is hell. Depression is a different hell for everyone. My hell is icy. I sit in 80 degree weather shivering, cold down to the marrow of me with no way to get warm. The cold goes so deep it locks me up. I can’t move, I can’t think. My brain is a clouded fog. Focus is a faint memory. One of the torments of hell is remembering being able to move, to think, to get off your ass and fucking do stuff, knowing that once upon a time that was only yesterday you were capable and functional and goddamn useful and today you are a frozen lump, unable to think beyond the constant mental ravaging of how you should be doing this, or you could be doing that, if only you weren’t such a useless pile of shit.

Depression, the first shrink to ever help me said, is anger turned inward. It’s when all the hateful, horrible things you would never dream of saying—of even thinking—about anyone else become the unshakeable truth of who you are. It’s sabotaging everything you are, everything you believe in, everything you try to do, not because you mean to sabotage yourself but because you hate yourself so much you can’t do anything else.

Everyone’s hell is different. But this is my hell. This is my depression.

You can’t live like that. You can’t live hating yourself that way, destroying yourself that way. So you stop living. Your mind shuts down, your body slows and freezes, and all the hatred and horror and self destruction get buried under the ice of nothingness. Because being nothing, doing nothing, reducing yourself to a frozen lump on the couch that can never get warm is the only way you can protect yourself from the way you are trying to destroy yourself.

You know you could feel better. If you go out with friends, if you get out in the sun, if you exercise, if you go see your boyfriend, if you do anything other than playing endless games of solitaire until you’re ready to set fire to every pack of playing cards in the world. But you can’t. The ice numbs you, makes it impossible to think of warmth, of happiness, of friends, and fun, and loved ones. If you can melt the ice you can manage to get moving—but if you melt the ice you find the self-hatred underneath, saying you don’t deserve to be happy, you don’t deserve the wonderful people in your life, you don’t deserve anything.

Did you know that people who are put on anti-depressants are at an increased risk for suicide? That’s why. The anti-depressants, when they work, take the ice away. They leave you able to move, and think and feel, and with no retreat, no defense, against just how angry you are with yourself, just how worthless and hopeless and useless you think you are. And there’s a knife, or a rope, or a gun. Or a car to drive off a cliff. You can think now, you can act now, you can end it. That’s why anti-depressants kill. That’s why you aren’t supposed to go on anti-depressants without medical supervision, preferably psychological supervision, able to help you navigate the self-hatred and catch you if you are in danger of leaving the ice while holding onto the self-hatred.

The scary fucking thing is knowing it’s all a lie. I am a good person, I’m not useless or worthless. I’ve touched a lot of lives and kept my family going through some impossible times. I may not be Mother Fucking Teresa, but I don’t deserve the thoughts and nastiness I’m directing at myself. I know that. I just can’t stop it.

I’m pregnant. Big news, wonderful news, happy news. But the hormones trigger my depression. It’s why I schedule myself five days off of work every month when I get my period. I know that when the hormones kick in, so will the depression and anxiety, and for a few days I’ll be a wreck. The human body is a wonderful thing. [sarcasm] I know for those few days my hormones make my mind lie to me, I know that I just need to wait it out, indulge in some comfort food, and the lies will pass.

But this isn’t just a few days. This is past 2 months now, with no sign of stopping. My work is suffering, my friendships are suffering. My relationships? Well thankfully Michael’s been down this road with me already. He holds me tight and tells me it’ll be okay, and the evil thoughts in my head are lies, and we’ll get through this together. Hunter I haven’t seen much of the past few months, but we’re supposed to get together tomorrow. Hopefully I’ll be able to go see him. Hopefully.

I’ve learned to use the anger. Dig down through the ice with meditation or long walks, or by letting stupid irritations build up and build up, and build up until real feeling bursts through. Take the anger I feel at myself and redirect it. Turn the anger into an adrenaline rush which is how I got up off the couch to sit down and write this. Still can’t think clearly enough to put together one of my usual posts, but with the energy I can at least pour out my thoughts and feelings and fears.

Fears. I am scared. I’m scared because I know this isn’t going to end in a few days. My relationships will survive—I know my relationship with Michael is solid and I believe my relationship with Hunter will weather this. My friendships will either survive or they aren’t the right friends for me. My work? God my work. My clients are waiting for me, my writing is completely halted, my social media…well, at this point it’s more “What social media?”

My family needs me able to work. Able to bring in money, and build my business because until Michael is medically fit for work (for the first time in 5 years I can say that in time he WILL be fit for work, huge, huge, fucking deal, but he’s not there yet), until then I’m the only income my family has. We can’t afford for me to fall apart like this—which of course becomes one more log on the self hatred everyday that I don’t manage to keep up with my work.

Grateful. I am so insanely fucking grateful that I know what is causing this. That I know it is temporary. That in 7 months or so, the baby will be born and this will pass (assuming I don’t miscarry, but hell, gotta think positive, right?). I remember what it was like when depression was an unending hell with no rhyme or reason. When I had no idea why I was in hell and no hope of escape. I am so goddamn lucky to be able to point to the calendar and say “Then. I’ll be better (mostly) then.”

I am lucky beyond words to have Michael, who has stood with me through 6 years and one other pregnancy, who knows both the depths of the ice and the horror of the self-hatred and holds fast through all of it. Who will believe in me when I can’t believe in myself, and give me an anchor to cling to, a connection to the world, when I’m lost to everything else.

The adrenaline is gone now. The tears still trickle slowly down to fall on the keyboard. For a few minutes, I can think enough to recognize just how much of my mind is closed of to me, terra incognita so I can be protected from myself. It hurts now, with the ice and adrenaline both gone and the feeling is like a knife in my guts that is so horribly familiar and yet never the same twice.

The ice will close in soon. I’ll struggle through it, using numbed and weakened hands to fumble through my days, using what spoons I have to do the absolute necessities first, so that at least when the ice becomes to much to fight, my family will have been fed, and I’ve done a bit to take care of myself, and maybe gotten half an hour of work done. And try not to hate myself too much for all the things I am failing to do.

This is my hell. This is my depression. For the next 7 months, this is my life.

Hell is different for everyone. So is depression. This is mine.

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