Sex and mental health...

INTRODUCTION

Sex is one of life’s great pleasures. But also a cause of some of life’s greatest pains.

It is an expression of our love. In fact, we now use the term “making love” for sex – although originally this term described dating up to marriage, literally “making love”.

Sex can be incredibly beneficial for us physically and emotionally. It reduces stress, boosts immune and enhances our mood.

Obviously it’s burning up energy, just as exercise does. But it also releases some of our natural feel-good chemicals such as oxytocin, dopamine, serotonin and endorphins.

So sex, including masturbation, has been shown to ease stress, depression and anxiety. Sex can be a very spiritual thing in that when two people have sex they start to become one with each other.

However, there is a shadow side to sex. It is one that can cause extremely distressing pain that is damaging to our emotional and mental well-being.

“Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.

For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”

1. Infidelity

Around 15 to 20 percent of married couples cheat on their partner. The figure may well be higher as it’s not something some people will admit to, even as part of an anonymous survey.

Dating apps such as Tinder have enabled people to look for quick-fix sexual encounters too. So cheating on a partner is easier than ever.

Cheating is of course dishonesty. In a marriage it’s the ultimate form of betrayal.

Anyone who cheats will know how devastated their partner would be if they found out. If there are children in the relationship, the cheating person will know that the consequences of their dishonest behavior will likely affect those children for the rest of their lives.

So why does anyone do it? Especially when they often create for themselves feelings of anxiety, stress, depression, guilt and shame.

Some literature in the Twelve Stepsprogram describes it perfectly. This is from the Step Four explanation in the .Twelve Steps And Twelve Traditions book

Creation gave us instincts for a purpose. Without them we wouldn’t be complete human beings… So these desires – for the sex relation, for material and emotional security, and for companionship – are perfectly necessary and right, and surely God-given

Yet these instincts, so necessary for our existence, often far exceed their proper functions. Powerfully, blindly, many times subtly, they drive us, dominate us, and insist upon ruling our lives…

When thus out of joint, man’s natural desires cause him great trouble, practically all the trouble there is. No human being, however good, is exempt from these troubles.

Nearly every serious emotional problem can be seen as a case of misdirected instinct. When that happens, our great natural assets, the instincts, have turned into physical and mental liabilities…

So it’s a natural instinct that is out of control. From a mental health point of view it might be necessary to look at why someone is cheating on their partner.

Could it be that they are trying to deal with a past hurt by doing it? Can it be a way of attempting to feel full inside where they are empty?

They may justify it by saying there was not enough sex with their partner or for some other reason. But if someone has committed adultery and really wants to change they will be willing to look back at and into their life to pinpoint anything that has led to their cheating.

Some mental health conditions mean someone is more likely to cheat, including bipolar disorder. This can affect someone’s sex life by increasing their libido during mania episodes.

Then, some people with BPD (borderline personality disorder)are impulsive. They may be promiscuous and hypersexual.

Both conditions can be treated to help with this.

2. Selfishness

A dictionary definition of selfishness is: “lacking consideration for other people; concerned chiefly with one’s own personal profit or pleasure.”

This is the difference between healthy sexual desire for someone and what is known as lust. Lust is seeing someone else solely as a sexual object for selfish objectives.

When it comes to sex, many people are clearly only thinking about themselves. There is no consideration for their partner’s desires, wishes and wants.

There may be constant demands for their partner to do sexual things that they don’t want to do. This could be certain sexual practices or having a threesome.

Not only is it damaging the relationship and hurting their partner, they are causing themselves emotional problems. A selfish insistence can lead to continual frustration, self-pity and/or anger.

Of course, any successful relationship involves some compromise in all matters. But if this is an issue, the help of a therapist trained to help relationships should be sought.

3. Using pornography

If someone doesn’t like the way they feel, they can get addicted to anything that changes their feelings. This is one of the reasons for all addictions, including to pornography.

But many people look at pornography because they’re lonely and because they’re dissatisfied with their sex lives. But all that most often does is make them even more dissatisfied and more lonely.

As most people only view porn secretly it means they will be carrying that inside. As the recovery slogan says: you’re only as sick as your secrets.

This will increasingly isolate them. They will struggle with feelings of shame, remorse, guilt, anxiety, stress and depression.

As with any addiction, they will at some point want more. What used to “work” for changing the way they felt stops working.

So they end up looking at images or videos they are even more ashamed about.

Frequently they will spend more time looking at pornography too.

People who use porn can often get the wrong concept of sexuality. None of this is healthy for the person or any of their relationships, especially with their partner.

We live in a modern world now where access to pornography and sex chat websites is much more available than it ever was. So it’s a burgeoning problem.

4. Paying for sex

There’s a connection in reasons for visiting prostitutes and looking at pornography. Much of this is to do with seeking external validation.

This comes from not feeling whole or complete inside. There can be many reasons for this, a lot to do with childhood. It can also be a way to numb or mask inner pain.

Negative mental health consequences can be the same as from viewing pornography. These are feelings of shame, guilt, remorse, anxiety, stress and depression.

As with some pornography use too, someone paying for sex knows they are spending money that ought to go on such as their partner or children. Also in connection with pornography, many people know that those involved in these industries are there against their own will or have a history of sexual abuse.

All of this only increases negative feelings. Most likely their paying for sex is a secret too – and secrets make us sick.

According to The Society for the Advancement of Sexual Health, three to five percent of the population suffer from sex addiction. Sex addiction describes any sexual behavior that feels “out of control”.

It can mean someone acting in an irrational and self-sabotaging way. This is sometimes behind someone paying for sex.

Sex Addicts Anonymous (SAA) has some self-assessment question sthat ask such as: Do you keep secrets about your sexual behavior or romantic fantasies from those important to you? Do you lead a double life?

Have your desires driven you to have sex in places or with people you would not normally choose?

A sex addict who feels overpowered with negative feelings of such as shame, remorse and guilt may try to escape by again using compulsive sexual activity. As with all addictions, it’s a vicious cycle.

Thankfully, there are proven successful treatments for addiction.

5. Anxiety & depression

Any of those previously mentioned here can and most likely will cause anxiety and depression. The longer any unhealthy behavior goes on, the more anxiety and depression it will cause.

But even “normal” sex in a loving healthy relationship can lead to anxiety and depression. This could be for instance for men if they have erection problems or physical issues for women as they get older.

If someone was sexually abused it is clearly a trauma that can often affect their sex life. It could be that understandably they don’t want sex.

This might be even though they madly love their partner. This can cause significant anxiety.

At times some people with OCD (obsessive-compulsive disorder), a chronic anxiety disorder, say they feel besieged by unwanted sexual thoughts and sexual obsessions. This can lead to anxiety and depression.

Then someone who is suffering from anxiety and/or depression may not feel as if they want to have sex. These mental health conditions can affect everything that someone once previously enjoyed in this way.

Thankfully there are various treatments that are proven to help with anxiety and depression. This includes.

SAFER SEX

Using condoms for penetrative sex is the best way to protect yourself and your partners from Sexually Transmitted Infections, including HIV. Condoms also offer good protection from unwanted pregnancy. In the text of this booklet, we have chosen not to refer constantly to the use of condoms. Instead, we encourage you to make your own decisions about protecting yourself and others in each instance of sexual activity you undertake.

GENERAL SUGGESTIONS

It’s important to remember that resolving any difficulties or dissatisfactions with sex involves:

l having sex only when you want to, and only the kinds of sex that you want;

l meeting your own conditions for good sex (for example having privacy, not feeling rushed or pressured, feeling able to trust your partner);

l recognising when you are tense and learning how to relax; l getting the kind of stimulation you like and focusing on this stimulation; and l being able to enjoy having sex rather than worrying about your performance.

The exercises in the following sections offer a starting point for becoming more in tune with your body and improving your enjoyment of sex.

EXERCISES YOU CAN DO ON YOUR OWN

EXERCISE a few minutes a day

KEGEL EXERCISES

One way of enhancing your sexual experience is to strengthen the pelvic muscles that run from the pubic bone to the base of the spine like an ‘elasticated hammock’ underneath the pelvis. The contractions of these muscles produce the feelings at orgasm. The ageing process or lack of exercise can contribute to a weakening of these muscles and men who practise these exercises report stronger and more pleasurable orgasms.

You can feel these muscles by contracting your anus as though you’re trying to hold back a bowel movement, or by stopping and starting the flow of urine when you’re peeing. At first you might find you’re contracting your stomach or thigh muscles as well, but with practice you can squeeze just the pelvic muscles. Begin by squeezing and releasing these muscles fifteen times, a couple of times a day. You can do this without anyone noticing, for example while driving, watching TV or reading. Continue doing the Kegel exercises every day, gradually increasing the number until you can do about 50. At this point, instead of releasing the muscles immediately, you can hold the contractions for a few seconds. You can do both the long and short Kegels a couple of times a day, or alternate between them. Most people don’t notice results until after about a month or six weeks, but if you practise them consistently you will feel the difference.

EXERCISE 15 minutes

GETTING COMFORTABLE WITH YOUR BODY

Sensual or sexual pleasure results from the interactions between physical sensations and thoughts and feelings. Knowing how to both give pleasure to your body and accept pleasure from it can help you get what you want sexually with a partner or on your own.

Reserve 30 minutes for yourself and relax in a way that you enjoy — perhaps by having a bath or by doing some relaxation exercises. Create an atmosphere that you find pleasing, for example using lighting, temperature and sound. When you’re naked and comfortable, warm some body oil or lotion in your hands and then smooth it on your body. You could start with your arms and

hands and move down to the rest of your body. Or, if you prefer, start with your feet and legs. Try to focus your attention on the feel of your hands on your body.

Experiment with touching yourself in different ways, and try to make your body feel good rather than turned on. Be gentle with yourself. Remember that the point of the exercise is simply to enjoy the pleasure that your touch on your body is giving you.

Try to practise this exercise as many times per week as you can fit in without feeling pressured. It won’t be easy to relax and enjoy these feelings if the exercise feels like a chore.

EXERCISE 20 minutes

ENJOYING MORE INTIMATE TOUCH

The aim of this exercise is to discover the kinds of touch you find most pleasurable, and to practise

focusing on the sensations you feel when you touch yourself in these ways.

Ensure that you have complete privacy, and explore your genitals, using a hand mirror to look at yourself if you like. Try touching your scrotum gently, and then run your hand up and down your penis. Explore the sensations you like best. If you are uncircumcised, try drawing back the foreskin very slightly and then pull it up again to cover the head of your penis. The head can be very sensitive. If you are circumcised, move the skin covering your penis, squeezing and releasing.

Vary the pressure of your touch – try grasping yourself firmly as well as stroking various areas of

your penis very gently. You can also vary the speed of your movements. Some men like slow downward movements and a rapid upwards movement, others the other way around. Some men like the feeling of a vibrator around their genitals and you might like to try this too.

POSSIBLE PROBLEMS

l What if my mind keeps wandering and that makes it hard to relax and focus on the sensations?

This is natural. Just keep trying to bring your attention back to the exercise. It’s important that you aren’t tense, in a hurry, or very preoccupied with something else. If you are, or if you don’t really have enough time to do the exercise, leave it for another time. You may be feeling nervous or

self-conscious if this is the first time you have explored enjoying your sexuality in this way. Or perhaps you’re putting lots of pressure on yourself to feel turned on or to have an orgasm. Try to just relax and enjoy the sensations and not worry about how turned on you are.

Developing fantasies in your mind can help you to enjoy masturbation more, because it can help you feel more turned on and also help keep your mind focused. You might like to experiment — imagining different scenarios with different fantasy partners in different settings.

Give yourself permission to not judge yourself on these fantasies. Fantasies are not facts! You can

experiment with scenarios and activities that you may never wish to try in real life. If you find fantasising difficult, you could experiment with erotic writing or images to stimulate your imagination.

NEXT STEPS

The next step involves doing some exercises with a partner. If you’re in a relationship and have stopped having physical contact because of sexual problems, then it is important to re-establish that contact before you carry on. If this applies to you and your partner, read the section on re-estabishing physical affection on page 18 and follow the suggestions there before continuing with the following exercises.

EXERCISES YOU CAN DO WITH A PARTNER

Before starting any of these exercises, both you and your partner should read and discuss them. Talk about your feelings about doing the programme and sort out any issues that are raised. It’s common for couples to have some disagreements, but if you sort them out as soon as they appear, you’ll get more benefit from the programme.

These exercises are like a training programme. You won’t need to do them forever, but how long you need to do them depends mainly on how often you do them, so you need to work out an agreement about frequency. However, don’t do more than one exercise a day—twice a week is a good starting point. You also need to agree that neither of you will push the other faster than they want to go. It’s important not to rush through the programme, as this just puts pressure on you both. The point of this is to allow yourselves to enjoy taking things at a pace that feels

right for you, not what you think someone else expects. It may feel a little strange to begin with,

because you’re doing things differently than before. Only stop if you feel uncomfortable, and, if this happens, do something else before going back to the activity. You could agree with your partner beforehand what you will do together to relax before starting again — such as cuddling, holding hands or talking. Don’t make these exercises the only physical contact you have with your partner, either physically or emotionally. Make sure you also have mutually satisfying time, unrestricted by the programme, and that you have ways of expressing affection physically

without needing to end up having sex. You might want to do the exercises both ways round so that it feels fair, or you might prefer to focus on the partner who would benefit most from them — it’s up to you to decide together how you use them. The minutes given for each exercise are just suggestions.

EXERCISE 20-30 minutes

SENSUAL TOUCH WITHOUT TOUCHING GENITALS

This exercise is designed to help you feel more comfortable being touched more intimately when you have been feeling anxious about sex, or when you and your partner want to get ‘reacquainted’ with each other’s bodies to improve your sex life. Talk to each other before you start the exercise about what you both feel more or less comfortable with, so you can ensure that you make the experience as positive as possible.

Have your partner arouse you by touching your body, not including your genitals, using their hands, mouth, hair or anything else — they can be as creative as they like! Focus on the sensations and feelings you get from different kinds of touch — these may include feeling sexually aroused as well as other sensations, such as ticklishness. Give feedback and suggestions, without being critical. If you find your mind wandering, bring it back to focusing on the sensations. Your

partner’s job is to check out with you what you like (and don’t like) and to respond to your suggestions. You can take it in turns to be the ‘giver’ or the ‘receiver’. Use this exercise to develop communication between you and your partner about what touch feels best to eachof you. Focusing on the sensations in your genitals during these activities will keep your mind where it belongs during sex and away from negative thoughts and performance worries. This exercise should not include genital touching, sex or orgasm. It is important that both you and your partner understand this rule and stick to it, as it helps to take away anxiety, especially if one of you has been finding sex difficult recently. If either you or your partner try and bend the rules, you may undo the progress you have made, and make it harder to trust each other in these exercises in the future.

“ Sex is more like dancing

than digestion.”

Dr Leonore Tiefer

POSSIBLE PROBLEMS

l Help! I feel embarrassed being naked in front ofmy partner! Try at first to do the exercise clothed or partly clothed, then gradually aim to do the exercises naked when you feel more comfortable. Some couples find it relaxing to take a warm bath or a shower together first. Talk to your partner about your worries. It may be that they have similar worries and together you can find a solution. After you have practised this exercise for a couple of weeks and feel comfortable, talk together about your feelings about moving on to the next exercise.

EXERCISE 30 minutes

SENSUAL TOUCH INCLUDING GENITALS

Now you’ve explored the kinds of non-sexual touching you both enjoy, use the same turn-taking format to explore more intimate touch.

Get yourselves relaxed and comfortable, enjoying touching each other without genital contact. Whoever is the ‘giver’ first can gradually move to more intimate exploration from the touch that they will be used to giving by now.

Having done the previous exercise, you will have a lot of experience of giving each other feedback about touch that feels good and touch that feels less good. You may have also done the exercises on your own, and so will be more aware of the kind of touch that you like.

Keep your attention on the sensations you feel and what it feels like to be touched in this way. Remember that the point of this exercise is not to produce

orgasms, but rather to learn (or re-learn) how to be intimate and make each other feel good. If an orgasm happens as a by-product of this, that’s fine, but do not make it a focus.

Do this exercise once or twice a week for a couple of weeks, or until you feel completely comfortable being touched. As you and your partner become more in tune with each other’s bodies, you should find that your anxiety about sex decreases and your enjoyment increases. Use what you have learned both alone and together in conversations about your sex life and how you would like it to develop in the future.

POSSIBLE PROBLEMS

l What if I can’t stay relaxed and enjoy the sensations during this exercise?

It may be that you can’t get your partner to stimulate you in ways you like, in which case you

need to talk about what’s going wrong. Perhaps you need to go back to one of the solo exercises

and focus on finding the kinds of touch you enjoy. If you can enjoy this touch when you’re on your

own, but not when you are with your partner, then it could be something in your relationship that’s

getting in the way. If you want to explore this further, you might want to contact one of the

organisations listed below.

You won’t always feel like you want sensual touch or sex. If this happens, let your partner know. You could say something like, “I guess I just don’t feel like it today.” Then discuss what you’d both like to do instead. They might want you to sexually stimulate them, or you might want to talk about what’s happening, or to go and do something elsetogether.

l What if one or both of us gets turned on during the exercise, but we’ve agreed not to have sex?

Sticking to the rules is important, as it allows you both to relax and not focus on penetration or

orgasms. Agree beforehand what to do if this happens. For example, you could masturbate

together or separately, or you could cuddle until these feelings subside.

Once you’re comfortable with these exercises, you will be better able to enjoy sexual contact with

your partner and find it easier to communicate about sex. After doing this programme, many

couples find that the sex they have is less focused on orgasms, and that this takes the pressure off

and makes it more enjoyable, more creative and more satisfying.

l What if my partner wonders why I haven’t had an orgasm?

If it’s a regular partner, you may want to find a way of talking to them about it, and explain that you don’t always come, and that it isn’t their fault if you don’t. It’s also a good idea not to apologise — you haven’t done anything wrong and there’s nothing to be ashamed of. Perhaps tell them what’s happening, as honestly and directly as you

can — this is respectful to both yourself and your partner, and may help you to feel more

comfortable.

l What if I still have problems?

You might find it helpful to read other leaflets in this series — see the list on the back cover. You

can pick them up from the leaflet racks at the clinic, or ask a clinician for a copy. Or you could

ask your doctor about getting referred to a psychosexual counsellor or therapist, or contact

one of the organizations listed below.

RE-ESTABLISHING PHYSICAL AFFECTION

If you are in a relationship and have stopped having physical contact because of sexual problems, then it is important to re-establish that contact. If there are any relationship issues that are getting in the way, you may need to work these out first. If this is something you would like further help with, there is a list below of organisations that offer psychosexual/relationship therapy. You can begin to reconnect physically by holding hands, hugging, taking baths or showers together, doing light body-rubs, or anything else that both of you are comfortable with. You need to feel

comfortable being physical with your partner, and these kinds of activities are a good way to get there. If you feel tense or anxious about the physical contact, go back to something that feels more comfortable until you feel okay to try the contact again.

Make sure that the conditions you need for sexual activity are met. These may include a comfortable environment, privacy, knowing you have sufficient time or trusting your partner to stop if you want them to.

With casual partners, it can be helpful to read the partner exercises for ideas about how to deal with any possible problems. It’s up to you to decide whether you want to tell your partner that you want to do an exercise, whether you say you’d like to try such-andsuch, or whether you simply say you’d like to take things more slowly for a bit.

During any kind of physical contact with a partner, you should be focusing your attention on any

pleasurable sensations you feel, but also noticing whether you’re tense or relaxed. If you’re tense, do something to get more relaxed (take some deep breaths, consciously relax your muscles, talk about it, slow down the pace), even during non-sexual contact.

Try to focus on enjoying other sexual activities than penetration. You may even find that you enjoy other activities as much as, or more than, penetration. If this is the case, you may want to vary the activities you do with a partner. Not everyone has penetrative sex all of the time, and some couples choose not to have penetrative sex at all.

Sex as Relationship Maintenance; perfect remedy for mental illness.

Sex is a powerful way for couples to enhance their bond and promote the success and happiness of their relationship. Yet, maintaining sexual intimacy and passion is a challenging endeavor in romantic relationships, making it crucial to understand the role of sex in relationship maintenance. This part focuses on the role of sexuality in enabling couples to maintain satisfying relationships, focusing in particular on how couples can maintain sexual desire and satisfaction over time and as they navigate important relationship and life changes that may result in partners experiencing differences in their sexual interests, such as in the transition to parenthood. We begin the chapter by describing the ways that sex can benefit relationships, focusing on the roles of sexual frequency, physical affection, and sexual satisfaction in shaping the quality and maintenance of relationships. Then, we review research on how couples can prevent declines in sexual desire, or remain satisfied in spite of these declines, with a particular focus on sexual goals, sexual communal motivation, sexual communication, and sexual expectations. We conclude the part by highlighting several promising directions for future research on sex and relationship maintenance.

Love isn’t a cure-all for mental illness, but it is true that being in love and having a supportive spouse and a healthy intimate relationship promotes happiness. A happy, stable relationship, whether with a spouse or partner, is connected to better mental health, lower levels of stress, and less depression, according to research.

On the other hand, being in a bad relationship can worsen mental health. An unstable or unhealthy relationship with your partner can increase your stress, anxiety, and depression, and even thoughts of suicide. This fact further supports the benefits of a good relationship. Being in love and being happy in your relationship is automatically supportive of better mental health.

If one of you struggles with mental illness, know that your ongoing healthy relationship is helpful. It may not always seem that way, especially during a difficult episode, but maintaining a strong, loving relationship will aid and support healing and recovery from mental illness.

Everyone should be able to find their own worth outside of relationships and other people. But, being loved does add to a sense of self-worth. Knowing that someone loves you means that you matter, that you have value, and that someone would be devastated if you were gone.

In the depths of a mental illness, it can be impossible to see your value, especially in the despair of depression or suicidal thoughts. In these terrible moments, having someone who loves you can be the lifeline you need. It may be what gets you into treatment when you otherwise would not bother.

The benefits of relationships are not restricted to romantic connections. Social support in any form has been proven over and over again to be good for mental health. Studies show that quality of social support is much more important than quantity. In other words, it’s better to have one or two strong social connections than a large network of acquaintances.

Research shows that a good social support network benefits mental health in several ways:

Increased resilience in the face of stress

Healthier lifestyle choices

Better lifelong mental health

Improved self-esteem

Fewer negative effects of stress

Most importantly for someone needing care for mental illness, a strong social support group improves adherence to treatment plans. You’re more likely to stick with treatment for mental illness if you have one or more healthy relationships backing you.

A healthy relationship and good support network correlate with adherence to mental health treatment, which indicates a bigger trend: a positive relationship with your partner supports all kinds of healthy habits.

If you are in a healthy and happy intimate relationship, you are more likely to adopt and stick with healthy lifestyle choices. These include eating well, exercising, and avoiding substance abuse. All of these physical health habits promote good mental health. Your relationship may even encourage you to engage in more positive mental health habits, like opening up about your feelings and engaging in productive conflict resolution.

Focus on encouraging healthy habits in each other for good mental health. Find areas in which you can both improve, such as drinking less or getting adequate sleep. Work on improving those habits together and you will see improvements in mental health as well.

The positive implications of sex for relationships and mental illness

Sexuality is a key factor that distinguishes and shapes romantic relationships. In this part, we present evidence demonstrating the importance of sexuality in romantic relationships with a particular focus on the ways in which sex can positively impact such relationships. To this end, we describe the role of both sexual frequency and sexual satisfaction in shaping relationship quality. We also review research that sheds light on how couples can stave off declines or changes in sexual desire over time, as well as maintain sexual satisfaction during times when they have conflicting sexual interests. To this end, we focus our attention on understanding the motivational and cognitive influences important to the maintenance of desire and sexual satisfaction over time, as well as the individual differences and relationship factors that contribute to satisfying sexual relationships. We then conclude the part by highlighting what we see as promising directions for future research on sex and how it's related to mental illness.

Mental illness is not a one-person issue. If you have a mental illness, it impacts the people close to you. Your relationships also impact your mental health. Everything is connected. This means that the people you love, particularly your spouse or partner, can and should be involved in treatment.

A good treatment facility involves loved ones for support of the resident and for support of the family as a whole. When your partner is involved in treatment, it strengthens your relationship and your mental health.

Being active in treatment doesn’t look the same for everyone. For some couples, it’s useful to engage in regular relationship therapy. For others, support groups or group therapy sessions are more helpful. Still others may benefit more from simply visiting on family days and showing their love and support by taking an interest in their partner’s treatment process.

It’s important to understand that all these benefits—these ways that a relationship can support mental health and treatment—only apply to healthy relationships. This may seem obvious, but when in a bad relationship it can be hard to see the issues. These are the signs of a healthy relationship:

You trust each other

You are both able to share your feelings and thoughts without fear of ridicule

You respect each other

Each partner in the relationship values it and makes time for each other

You listen to each other and are able to compromise when disagreements arise

Neither person is wholly dependent on the other

You have boundaries

You can argue or disagree without threats of violence

There is no abuse, physical, emotional, or otherwise

It’s almost a cliché to say that you cannot love anyone else until you love yourself, but there is a lot of truth in the statement. The healthiest relationships are between two people who rely on each other but are also independent. They love each other, but they also love and value themselves.

If you or your partner struggles with a mental illness, take time to focus on self-care as well as care for each other. Be kind and compassionate to yourself, just as you would to your partner. Forgive your flaws, but also work on self-improvement. Embrace your best traits and appreciate them.

One of the best things you can do for positive self-care is to get treatment for mental illness. Realize that it is not a flaw you have but a real health condition that requires treatment. Take time out of your life to try residential care. If your partner truly loves you, they will support the decision and get involved in any way that is useful.

Love is powerful and healing, but no relationship, no matter how great, can fully heal mental illness. If you are struggling, reach out for professional services. A residential facility can help both of you work together to become stronger, healthier, and happier.