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The short answer, of course, is: love someone who is mentally ill as you would love anyone else—unconditionally, with all your heart—but don't expect that love to be reciprocated, and don't expect everything to just "get better" one day, because it probably won't.

Mental illness can come in all shapes and sizes; trying to maintain a relationship with someone who suffers from mild depression is a walk in the park compared to trying to work things out with an individual with schizophrenia or bipolar disorder. So there is no silver bullet, no panacea...each relationship has its own parameters and its own rules—the most important being that those parameters and rules are subject to change at almost any time.

Back in grad school, I dated a young woman who, as it turns out, suffered from bipolar disorder. I won't get into the gory details of the relationship, but suffice it to say that bipolar disorder can manifest itself in a billion different terrible ways, the most frequent of which being a pendulum that swings back and forth between "I love you, I can't imagine my life without you" and "I hate you, I can't stand you, get the hell away from me."

I don't want to generalize about people who have this particular disorder (because it does indeed manifest itself in different ways depending on severity), but it's not uncommon for bipolar individuals to have trouble with impulse control, to have trouble maintaining stable relationships, to fear commitment, and to intentionally sabotage relationships even when they're (miraculously) going quite well.

Loving an individual with a mental illness is tricky; it takes patience and a degree of self confidence lacking in most of us (including, apparently, your humble author). It's difficult not to get angry when your boyfriend or girlfriend tells you, "I love you," one minute and "I never should have left my last boyfriend/girlfriend" the next. It's difficult not to be crushed when you realize that you really care for someone and, meanwhile, they're doing fairly awful things behind your back.

The situation actually seems to be worsened if you understand the underpinnings of the disorder involved. I stayed in the relationship mentioned above way too long, despite all the lies and deceitfulness, despite the fact that I only felt she genuinely cared for me about half of the time. I stayed in the relationship because the excuse—you know I'm sick, honey...I didn't mean what I said—rang true with me. I spent a good deal of time in my undergrad years taking courses in psychology and the philosophy of psychopathology and I agree with the materialist point of view: we are very much the sum of our genetic code and our environment, and we have very little (if any) free will.

So who am I to judge? How can I really condemn a person for acting in a way that is very much a part of her nature, a part of her illness? Should she really be held accountable for things she can't control?

So when she apologized, it seemed genuine. And hell, I have no doubt that it was genuine. But what took me so long to realize was that apologies didn't matter, best intentions didn't matter, and, in this case, love didn't matter, either. Because every apology was followed by more thoughtless actions...because despite best intentions, we are who we are, and some mentally ill individuals (even when medicated) simply lack the capacity to see their own actions with any type of perspective or introspection. They don't mean to hurt people, but they do—and, often, they will continue to do so, because that's the nature of the disease.

Looking back on that relationship, I often ask myself: Why did I put myself through so much hell, just so she could hurt me, apologize, and then proceed to hurt me again and again, over and over? It seems like a stupid question. What, was I a glutton for punishment or something? Why did I hang around when I knew that any love she felt for me was fleeting at best—why did I hang around when I knew that she was never going to "get well?"

Ah, but therein lies the rub. Implicit in any relationship with any mentally ill person is often the belief that "one day s/he will get better, and everything will be okay." It's a stupid thing to believe, but we believe it nonetheless because it's human nature to believe perseverance pays off...that if you try hard enough, things will work out. This may indeed sometimes be the case, but with individuals who are mentally ill, it often just leads to heartache.

Put simply, the mentally ill often play by a different set of rules. We try to interact with them, to work things out with them, to maintain our relationships with them; but in the end, we're often inadequately prepared.

Sadly, my understanding of this subject runs deeper than memories of some failed relationship from years past. Mental illness has taken a toll on my own family, and loving a family member who is sick in this way can often seem like an impossible task.

I've written about my sister before. Life with a family member who suffers from mental illness (in this case, Borderline Personality Disorder) is stressful as hell, to say the least. With some Borderlines, you can trigger an episode just by saying something seemingly innocuous; life becomes an exercise in walking on eggshells. You can't treat the person you love the way you used to for fear of hurting that person's feelings, driving them away, or otherwise wrecking the relationship.

My sister and I used to be best friends. Now I view my relationship with her differently, in a way that is difficult to explain. I still love my little sis, and I'm sure I always will—but loving her has taken a back seat to making sure I'm prepared for whatever might happen next. I've lived through her drug abuse, her attempts at suicide, and her subsequent involuntary commitment to a mental institution.

When I think of my sister, instead of thinking, "Gee, I sure love her," I find myself thinking, "Good god...what's next?"

The answer to that question came recently: she's moving to Dallas. After spending a few weeks with an ex-boyfriend of hers, she's decided to pick up her life and move in with him. No matter that this ex-boyfriend is diagnosed manic-depressive (and off his meds). No matter that this ex-boyfriend has been known to cut himself and abuse all kinds of drugs. No matter that their relationship already failed years ago. None of these things matter to the mind of a Borderline, who are notorious for having difficulty with impulse control.

She's moving hundreds (hell, maybe even thousands) of miles away, to a place where she knows no one (except the ex-boyfriend), to a place where she has no support structure to catch her if and when this latest scheme fails. The last time I wrote about my sister, I suggested that her killing herself was inevitable, that I was simply glad she hadn't done it yet. It would seem, however, that this eventuality is becoming more and more of a reality every day.

It won't be long now, I find myself thinking.

I'm usually not a fan of fatalism, but when you've exhausted all of your options (save calling her up and screaming at her and getting myself cut out of her life again), you suddenly realize that certain things are just going to happen in this world, and sometimes there's not a goddamned thing we can do about it.

A few weeks ago, karma debt and I had a very nice conversation via /msg regarding the similarities between my sister's situation and what happened with Hermetic. (I felt terrible, because at the time, I had no idea who Hermetic was, being a relative newbie to E2 and all.) karma debt was extremely supportive, giving me all kinds of advice and well-wishes, but one thing she said still echoes in my mind: No matter how prepared you think you are for it, when they actually do it, you're never ready. You're never prepared.

She's right, of course. I keep telling myself that I know my sister is probably going to succeed in offing herself one of these days; I know it's not my fault, and I say I'm not going to blame myself if and when it happens. But the truth is, I will. The truth is, no matter how much I've done to try to avoid this eventuality (and that's quite a bit), it'll never be enough...I'm always going to end up thinking that I could have done more, I should have done more, I should have been there for her in some greater capacity, I should have stopped her, somehow.

And yet here I am, present day, and nothing has even happened yet. Why am I not doing something now? Have I really exhausted all my options, or have I just exhausted myself? Have I given up on her prematurely? Is there some way I can (literally or figuratively) shake the bejesus out of her and get her to realize what she's doing to her family, to herself?

Enough explication. Enough backstory. Enough concern for things that haven't even happened yet. As the title suggests, this is supposed to be a how-to.

I wish I could just jot down "twelve easy steps for loving someone who is mentally ill," but it would all be tripe bullshit—and besides, as the anecdotes above suggest, I haven't quite yet mastered the skill myself. But I do have a few thoughts to share on the subject, thoughts that basically boil down to the following:

Don't withhold your love from someone just because s/he is mentally ill. First, there are varying degrees of mental illness, and certainly the kind of stuff I've been discussing in this writeup doesn't apply across the board to everyone who is sick. But even with the ones who aren't "mild" or "moderate," some of the most incredible people in this world are bipolar or borderline. Meet them, get to know them, and love them (if applicable). Not every relationship with a mentally ill person is doomed to fail.


Don't let your concern for someone else's mental illness be an excuse for ignoring your own mental health. In other words, if your friends or loved ones are sick, give them some leeway. Give them your understanding. Give them your love. But don't let them use their disease as an excuse to treat you horribly. Don't let them use "I'm sick" as an excuse to hurt you and your family. In short, treat it as you would any other relationship: Understanding goes a long way, but if a person (sick or not) is continuously hurting you, for your own sake, you must distance yourself from that person.

That last part may seem like a difficult pill to swallow, but sadly enough, those feelings will develop by themselves over time. Don't get me wrong, I still very much love my sister—but at some point in my life (not so very long ago), I had to make a conscious choice to stop worrying so much about what she's going to do to herself next. I had to make a conscious choice to accept the fact that I am not my sister's keeper. She must live her life and I must live mine—and whatever happens...well, I'll just have to deal with that when it comes to pass.

Because throughout this entire saga, I've learned one very important lesson: There's only thing worse than watching a friend or loved one destroy themselves, and that's allowing yourself to drown in their wake.

It sucks to watch someone you love spiral down the drain, and it's natural to offer them your hand to try to pull them out. But if they continuously try to pull you in with them, if they're more interested in bringing you down than allowing you to bring them up...at some point, you must stop offering them your hand.