I saw a great movie last night (courtesy of Netflix), Love and Other Drugs, with Anne Hathaway and Jake Gyllenhaal. I don’t know how I missed this at the theatre, but I did. It is based on the memoir of Jamie Reidy, Hard Sell: The Evolution of a Viagra Salesman. The story has two story lines: an inside look at Big Pharma Pfeizer’s drug push, and the relationship between the Viagra rep and a beautiful 26-year-old woman, Maggie (Hathaway) who is struggling with Stage I Parkinson’s Disease.

Although the story of becoming a Big Pharma Rep was fascinating, the movie was really about dealing with a chronic illness and trying to maintain a romantic relationship. Many of the people who I work with are struggling with chronic illness (I see a lot of patients with Fibromyalgia, RA, and other issues that cause chronic pain and fatigue). I liked the movie, but statistically speaking, the relationship was more likely to fail than succeed, strictly because of her Parkinson’s.

Let’s look at some statistics:

60% of people with chronic illness are between 18 and 64 years old.
The divorce rate among chronically ill is over 75% for first marriages.
Depression is approximately 20% higher than for an individual w/out an illness.
70% of individuals with chronic illness commit suicide because of the intense pain

Clearly what these statistics suggest is that Chronic Illness doesn’t just affect the patient, it goes after the partner and family as well. Despite the despair of the diagnosis, dealing with pain and other horrific symptoms, many women find that they can deal with almost all of that. What they are MOST afraid of is their husband’s reaction to the disease: how will their husbands deal with their changing body, fatigue, attitude, and behavior?

Well, if that 70% divorce figure suggests anything in a Country where first time divorces have a 50% failure rate, abandonment is one way that spouses of the chronically ill deal when “sickeness” over comes “health” in living those marriage vows. Abandonment is the pits no matter when it occurs, but if you are ill when you get the “I need space or This isn’t working out” speech, it is devastating. Your mind starts to flood: How will I deal with the kids all alone? What if he TAKES the kids? Can I get a job to support myself? What about health insurance?

So, with only a 30% chance that your marriage will survive your diagnosis, let’s look at some ways to help the two of you pull together as a team.

Often times chronic illness can put a lot of stress on communication. If you are sick, it gets harder to admit how bad you are really feeling. We all know that many people don’t really want to know the details of how you feel when you are sick. And especially when you hurt every day, and are feeling scared and depressed most of the time. Chronic Illness can be tricky – you can have a lot of bad days, and then out of the blue, one or two good days. If your partner doesn’t understand how sick and in pain you are, s/he often thinks you are faking it, avoiding them or chores, or are just plain lazy. And eventually, they may start pulling back, emotionally or physically. This leads to isolation (check the blog on Depression, Loneliness and Isolation) which exacerbates your depression about having an illness that probably will never go away, will affect how you take care of your children, and may cause you to file for disability.

Trying to keep communicating with your spouse is not easy, but it is definitely necessary if you are going to stay together. If this is an area of your relationship that has never been very strong, now is the time to find a good couples counselor that specializes in Chronic Illness. I realize this is not the easiest thing to find, so I suggest you look in one of the psychology reference sites for a good therapist: Psychology Today or Good Therapy, or ask your GP or Specialist for a name.

Therapy can not only get you talking about the elephant in the room (your Illness), but it can help you express your feelings to each other in a gentler fashion. A common statement some men make in a state of complete frenzy and frustration is: “I didn’t sign up for this.” Now they may not all say it exactly like this. But many men are suggesting it, or thinking it. This can feel very frustrating since YOU didn’t sign up for this either! A good couples therapist can help you learn to communicate empathetically.

One suggestion that I make to anyone in a relationship is to take them with you to see your specialist. Often spouses will think you are exaggerating but when they see your doctor, watch them examine you, they can ask the questions THEY have (ie: “why good days, and bad days?” “Isn’t there something you can do?” ). I would tell your physician before the appointment that you are bringing your spouse to the appointment. Tell your doc that you release HIPPA so they can answer anything your spouse asks. And tell them the problems that are going on at home – so the doctor can prepare some information to help diffuse the spouse’s belief that perhaps it is “all in your head.”

If your spouse is overwhelmed being a caregiver or with the changes going on in your body/behavior recommend they find an Individual therapist. Sometimes they need to leg go of feelings that if they shared with you would be painful. Sometimes the healthy spouse needs a safe place as well.

Another thing to do is take your partner to either a support meeting or a general informational meeting run by a doctor (call the organization connected with your disease: The Arthritis Foundation, The Diabetes Foundation , The MS Foundation, for example) and ask when they have support or informational meetings. Bring paper and a pen so you can both take notes. They might even have support materials for spouses or meetings for spouses of chronic illness. Another place for finding support groups is Meet Up. They have a lot of support groups for physical and mental illnesses.

If the healthy spouse is male, then use the male need to “fix things” to your advantage. Ask them to google experimental trials that are open for individuals with your illness. Often in that process they will start reading articles, finding professionals that are using cutting edge therapies that they might not have been interested in if you gave it to them.

Dealing with a Chronic Illness is a hard thing for the patient, and for his or her partner. Communication is vital for you to feel heard and supported.

Gentle Hugs, 

Dr Karen Hoving 

Psychotherapist in Colorado

www.drkarenphd.com     www.facebook.com/drkarenhoving