DEAR DR. NERDLOVE: I am writing to you about my husband, who is dealing with some serious mental health challenges. I don’t really feel like I have anyone else to talk to about this, because everyone I know is going through equally stressful problems.
Some background, my husband and I have been married for 3 years. When I first met him, he was starting to get seriously ill, and his worsening health was a constant backdrop during our initial friendship and then our dating relationship. After months of terrifying and agonizing symptoms, he almost died and was hospitalized. While in the hospital, he was diagnosed with a lifelong debilitating disease. He started treatment, his health stabilized, and we later married.
During our first year of marriage, we lived with his mom. I was in school, and his disease is disabling enough that he cannot work, so this living situation was our only option. Unfortunately, he grew up in a severely dysfunctional and abusive home, and I experienced some of this during that year. It is what pressured me to get a higher paying job and insist that we move out. I also insisted that my husband start therapy, because he was showing symptoms of mental illness, even then.
While moving out of the dysfunctional home was great for me, it has been very hard for my husband. It has been a shock for him to live in a place where there isn’t daily yelling, fighting, child abuse, drug abuse, and hoarding… All that was normal in his daily existence. He was the person in the family who was expected to “fix” the results of everyone else’s dysfunction, and he surrendered all his aspirations and dreams to do so.
Now that he doesn’t have to be the fixer anymore, he feels worthless. He hates himself and tries to punish himself by refusing medicine and food. He says he knows this is illogical, but he feels like resources should not be “wasted” on a worthless person like him. His therapist says he has depression, anxiety, and PTSD. Sometimes, he is even afraid to leave our bedroom and be seen by our roommates (who love him and would never hurt him), because he spent most of his childhood locked in his room, and would be beaten if he came out. His self esteem problems are worsened because, on top of all this, his physical illness is a disability that keeps him from working. He calls himself a “bum” because I bring in the money, and he calls himself “lazy”, “weak”, and “worthless” when he can’t help around the house on days his illness flares up.
My husband is a smart, funny, enjoyable, and worthwhile person, but he cannot see it. He is an incredible spouse who treats me wonderfully, but whenever I tell him so he doesn’t believe me. I thought he would be happier, once we moved away from the dysfunction, but he has only gotten more unhappy. Without the constant distraction of his family’s drama, he is having to unpack years and years of suppressed trauma and abuse… and it’s causing him to fall apart.
He is still going to therapy, but it is clear this will be a years-long battle for him.
In the meantime, I’m struggling a lot. I am afraid and I don’t feel like I have many outlets for those fears. It is awful to watch my husband have panic attacks and say horrible things about himself. I hate not being able to have a quick solution to make him feel better. I suppose this letter is more of a vent session then a question but, if you have any advise, I would appreciate it.
Feeling Helpless and Worried
DEAR FEELING HELPLESS AND WORRIED: My heart sincerely aches for you FHW; you and your husband are in an incredibly rough place and one that sounds incredibly painful for the both of you. It’s made all the worse because — in a real way — you and your husband have similar worries: you’re both feeling lost and helpless because you’re facing situations where you feel like you both have little to no control.
That’s a really hard thing for people to deal with in general. When we feel like we have no agency and no influence, it’s very easy to fall into despair. When that happens, we often turn inward. Your husband, for example, feels worthless because he can’t “fix” things. That family dynamic was toxic as hell, but it gave him a perverse sense of purpose. He felt like he could do something — be the “fixer” — even though on some level he knew this was hopeless. What’s worse is that there’s likely a part of him that associates “being the fixer” with “here’s how I justify being deserving of love”. I suspect that part of why he’s having this crisis is because he’s coming to the realization of just how f--ked up that whole situation was. When feeling like his “job” was tied to being the fixer, then he could at least rationalize any mistreatment as not being good at his job. It’s an incredibly irrational and harmful belief but it makes a twisted sort of sense because it means that his parents love and care for him and this is his fault. As long as the reason for their mistreatment of him was tied to his “failure”, then it was still possible to say his parents loved him. Realizing that no, what his parents did to him was horrific and abusive can be incredibly hard to accept. Parents are supposed to love and care for their children. Harming them like this is an incredible betrayal and facing that realization is the sort of pain that can shake people to their very core.
If that’s the case — and to be sure, this is just my read on things based on what you’ve written here — then it’s not surprising that he’s feeling worthless and that he’s punishing himself. Not only does it keep up the idea that he “failed” his parents, but it gives the illusion of control. He can’t make his parents’ abuse go away, nor can he make them love him. That’s out of his sphere of influence. He can, however, affect himself. It’s perverse, it’s masochistic and it’s harming him and you… but it may well be something that brings a strange sort of comfort.
I’m very glad to hear that he’s still going to therapy; this is something that’s going to require a lot of love, support and the dedication of the work of trained mental health professionals. And it’s going to take a lot of work and a lot of strength to heal. It sounds like his depression is particularly stubborn and resistant to treatment. If that’s the case, there are potential therapy options that he could discuss with his therapist and see what they think, whether they would be a good match for him or whether they’re even available as an option. These can include more experimental therapies like MDMA or psilocybin, transcranial magnetic stimulation or ketamine infusion; if he qualifies for these studies, they may provide relief that would make it easier for him to deal with his trauma and PTSD. And to be 100% clear: these are therapies that are still under study, performed under specific guidelines and standards, and they have varying levels of success. Initial studies are promising, but they aren’t a miracle cure and they’re sure as s--t not something that you can do yourselves. But looking into them and talking them over with his therapist (who, unlike Dr. NerdLove, IS a trained medical professional) may provide options that could make a difference for his recovery.
Here’s the thing you need to understand: as hard as this is, you can’t fix him. I know that you know this on an intellectual level, but on an emotional level, when we see our loved ones in pain, we want to do something. We want to believe that we can make things better, no matter what, because they’re hurting and damn it we love them and we should be able to fix this. And the fact that we can’t, being forced to admit that we’re not gods, is very, very hard because it feels like the worst practical joke in the world. What the f--k good is it when we love someone that much and we can’t take that love and make them better if only through sheer willpower alone?
But the fact that you can’t fix him doesn’t mean that you are powerless to do anything. In fact, I don’t know if you give yourself enough credit for the fact that you have gotten him to this point in the first place. The fact that you pulled him out of the nightmare that was his f--ked up family situation is huge. I know it feels (illogically) like you’ve made things worse because of the way he’s been spiraling, but the truth is that I think you saved his life. I think that if you hadn’t busted ass and gotten yourselves out of there, you wouldn’t have a husband. Yes, he’s dealing with a lot of pain right now, but the reason why he’s in the position to do so is that you pulled him out of hell. He’s only in the position to face this damage and begin the healing process because you got rid of the thing that was harming him. So I think you need to take a moment to realize that you are, without exaggeration, a goddamn superhero.
Just as importantly though… you also need to pay attention to your own mental and emotional health too. He’s not the only person dealing with trauma right now, you are as well. I realize that it can sound absurd or even self-indulgent to say “I’m hurt by this situation too”, but it’s the truth. Secondary trauma is a very real thing. Caretakers get post-traumatic stress disorder too. It’s all too easy to dismiss your own pain as lesser, that calling what you’re experiencing trauma somehow diminishes what your husband has gone through, but the fact is that you’ve been harmed by this as well. It’s just as important that you take care of yourself as it is to take care of your husband. It doesn’t do him any good if you break yourself to pieces trying to help him. Frankly, I don’t think there’s any way he wouldn’t want you to be hurt like this, so in a very real way, taking care of yourself means that you’re taking care of him, too.
You need a support system of your own. That means friends who can give you love and support when you need it and provide you with breaks so that life isn’t just about how hard you both are fighting to heal. It also means finding an outlet where you can express these feelings without worrying about judgement. If you aren’t already, I think that it’s very important to find a therapist of your own who can help you process these very real, very valid feelings of pain, stress and despair. They’re going to be a very important part of taking care of your own mental and emotional health, so that you can help your husband take care of his. As the saying goes: be sure to put your own oxygen mask on first before helping others with theirs.
And while it certainly isn’t going to change his feelings of worth or undo the f--ked up dynamic his parents had forced him into, one thing that might help your husband is to make it clear that right now the way he can be of use is to get better. It’s time for him to focus on fixing himself. If he needs to believe he’s fixing someone then by taking care of himself and focusing on healing, he’s helping you too. The better care he takes of himself, the more it helps the both of you. That’s the best way he can be of use right now, the best way he can give back for all that you’ve done. His love for you can be the motivation to learn to love himself enough to heal.
Of course, that goes both ways:
This s--t is hard. It’s grueling and it’s left you both with scars. You’ve dragged yourselves out of the fires of hell and you’ve got the ashes to prove it. Take care of yourself so that you can help your husband take care of himself.
You’re both incredibly strong to have survived this. You both clearly care about each other more than words can say. Be strong for each other and for yourselves.
You’ve got this.
All will be well.
Please send your questions to Dr. NerdLove at his website (www.doctornerdlove.com/contact); or to his email, firstname.lastname@example.org