My Final Paper!

Once again, I do not know how to post this as an attachment...so here is my final paper....enjoy!



Michele Gross
HONR218e
16 December 2004

Psychiatric Disorders and Love:
A Study on How "Crazy" Love Really Is

The terms "crazy" and "love" seem to occur together quite often, although not in the context that this paper will approach them. As youngsters, many people one day dream of having the perfect relationship and growing old with their significant other whether they be a male or a female. However, what happens when this is not the case? What aspects of a relationship are affected when one of the people involved has a psychiatric disorder? The following paper examines the ability to pursue and maintain relationships through five different psychological disorders. Many of these affected people have trouble with one or more important features of having and developing a lasting romantic relationship. A deficit in lasting love is not a symptom that is commonly diagnosed in these individuals, but it is a sad and realistic part of having such a disorder. From schizophrenia to obsessive compulsive disorder, these illnesses make romantic relationships difficult to maintain, although they can be successful with the right partners and elements.

Schizophrenia:
Schizophrenia is the most costly disease to society today. Individuals with schizophrenia occupy about fifty percent of beds in all hospitals in addition to fifty percent of the beds in psychiatric hospitals. Schizophrenia is characterized by a disruption of normal perceptual and thought processes. It is a young person’s disorder, with the peak age of onset being 18-25 for males and 25-30 for females and is characterized by a number of both positive and negative symptoms. These include delusions, hallucinations, thought disorder, anhedonia, avolition, alogia, and catatonia. This disorder makes it difficult for the affected individual to form and maintain romantic relationships and to give and receive feelings of love (Raulin).
Fifty percent of male schizophrenics never get married. The statistic for female schizophrenics is better. However, the divorce rate of sufferers is very much higher than the general population. Conclusion, schizophrenia wreaks havoc on relationships (Rogalla).
Unrequited love is a very common thing indeed. We tend to fall in love with people who do not fall in love with us. This is quite natural. Counselors often advise "There are plenty more fish in the sea," or "Don't put all your eggs in one basket". If you suffer from unrequited love you have to learn to let go. This is a natural process of bereavement. It is well worth while to stay away and never socialize with the target of your unrequited affection if it doesn't go further, as the constant pining can cause a schizophrenic to relapse. The sufferer could even undergo a depressive breakdown. But how do you let go?
It has been scientifically researched that when humans fall in love their biochemistry changes. There is a type of addictive process that goes on. If you are separated from your lover you undergo a withdrawal process which is felt as pining. This is totally natural even between healthy humans and depression may result if this goes on. On the other hand when we meet our lovers again we experience euphoria. This usually happens at the passionate beginnings of a relationship. It is scientifically recognized that biochemistry, especially hormones, play a part in the process of "Falling in love". It is also thought to be a form of temporary madness. One women described her new relationship with her boyfriend like this: "Love is a form of madness between two complete fools." This is totally natural, even to healthy humans.
However, if you do not cause a biochemical change in the target of your affection, through a great deal of pampering, they may not fall in love with you. This can be very frustrating and exceptionally hard to come to terms with. People who suffer a lot may be given tranquillizers or they may be given antidepressants or indeed both. It is important to stay away from the target of your affection if it is not reciprocated (Rogalla). Give them a fair chance, talk about it and if the answer is "no" then do your darn hardest to stay out of their social contact circle as this may provoke pining and jealous feelings.
There may be reasonable evidence to believe that when a person with a genetic potential for schizophrenia falls in love and undergoes a change in biochemistry, he or she may develop full blown schizophrenia. Often it is around the time of mid to late teens that someone develops schizophrenia, which may be hormonal in origin and it may be a genetic defect in people who can't handle the first passionate part of falling in love. People may suffer temporary insanity even if they have no genetic potential to develop schizophrenia. Either way this can be traumatic indeed. Relationships do not have to be negative for schizophrenics. Having a partner is to be desired. Often a partner will counsel the schizophrenic and love them for who they are and help them through ups and downs.

Bipolar disorder:
Bipolar disorder is generally characterized by a pattern of mood fluctuations in which the mood is sometimes depressed and sometimes manic. The depressive phases are defined as a "mood that is characterized by sadness and a loss of energy and enjoyment in life", while the contrasting manic phases are "characterized by excessive energy, extreme confidence, euphoria, and irritability. The periods of depression and/or mania may last anywhere from a few days to months. It is an emotional roller coaster for both the people with this disorder and their families and friends. As a result of these frequent changes in mood, romantic relationships with others become very hard to develop and maintain (Raulin). The affected’s partner must be fully understanding of the illness and must be willing to put up with a lot of change and fluctuation in their spouses everyday mannerisms.
There are many aspects of the disorder, than make it hard to form adequate relationships. Hypersexuality, which involves an excessive interest or involvement in sexual activity, is a real problem for the manic bipolar (Raulin). Because it feels very good, and very powerful, it can be a driving force that propels all thought, all feeling, and all motive. Hypersexuality, a common problem while experiencing phases of mania, often causes the individual to engage in flirtatious, seductive behavior that they would never otherwise consider. Hypersexuality also often causes them to abandon real relationships and can lead to dangerous sexual situations. Worst of all, it often causes irreparable damage to integrity, dignity, and reputation (Host).
Sufferers of bipolar disorder also often wrongly interpret subtle nuances in voice and body language when having a physical conversation. This is a problem in interpreting how to pursue a relationship with a possible partner. They also exhibit poor impulse control and tend to enjoy the desire to "live in the moment" without consideration of future consequences. This can be a real problem, especially during periods of mania and depression. Long term relationships do not generally conform to this attitude and their partners suffer in the process.
Another characteristic of bipolars that affects their relationships is their common trait of poor self-esteem. Bipolars often have a desperate need for attention, friendship, and validation from other human beings. These feelings make them very vulnerable to manipulation and deceit in relationships and make them cautious towards new partners and activities. On the opposite end, they also often suffer from feelings of grandiosity when they are in their manic stages. When afflicted with this, they feel that they have absolute clarity and that they can do no wrong. All of their decisions, even the terrible ones, "feel right" and they make perfect sense to the afflicted partner, even though their significant other may think otherwise (Host).

Generalized Anxiety Disorder (GAD):
For some people it becomes very difficult to control their worries even when their life is going relatively well. The frequency and intensity of worry thoughts and images is high, and the person worries about a variety of different areas rather than just one thing. Often the excessive worrying is associated with other disruptive and uncomfortable symptoms including sleep disturbance, muscle tension, restlessness/being on edge, being easily fatigued, irritability, and difficulty concentrating. Mental health professionals refer to excessive uncontrollable worry that interferes with daily functioning and is associated with these types of symptoms as Generalized Anxiety Disorder (GAD). Some individuals with GAD experience panic attacks due to extreme anxiety associated with excessive worry or worry triggers. Other individuals complain of feeling shaky or twitchy, muscle soreness, cold clammy hands, sweating, dry mouth, nausea, diarrhea, urinary frequency, an exaggerated startle response, trouble swallowing or a "lump in the throat" (Raulin).
In general, people with GAD worry about the same things as people with normal worry. Common areas of worry include relationships, work or school, family or friends, pets, health issues, finances, community or world affairs, and daily hassles (e.g., being late for appointments, getting tasks completed, car breaking down, losing personal possessions). Examples of some of the specific worries that have been reported by people with GAD include "Is my husband late home from work because he has been in a terrible car accident?" "What if my work this week wasn’t good enough and my boss gets angry with me tomorrow?" "What if everyone hates the meal I make at my dinner party? What if I’ve lost something important?". For people with GAD one worry can often spiral downwards into other worries that are increasingly frightening. For example, "what if I have made my boss angry? what if he fires me? what if I can’t pay the mortgage? what if my family ends up homeless? what if my wife and children leave me and I end up alone?" This excessive worrying can often lead one’s romantic partner to become equally stressed as well and can lead to the breaking up of relationships. By adding these additional stressors to a relationship, something that already may be a stressful situation, there becomes more of a chance of instability in the relationship (Long).
As a result of excessive and extreme worrying most people with GAD feel high levels of anxiety (sometimes chronically). In an attempt to reduce their anxiety some individuals with GAD begin to engage in a variety of behaviors such as excessive checking, excessive reassurance seeking, distraction or self-medicating. These behaviors can create further problems and they don’t tend to be very effective ways of managing worry. Some people with GAD have positive beliefs about their worrying which make it difficult to give up. Some people with GAD have negative beliefs about their worry (e.g., worrying could give me cancer, worrying could make me lose my mind, my worrying may cause the bad thing to happen). Relationships can be fully maintained between people with GAD, as it does not severely limit their functioning and may not be detected during the beginning of a relationship (Long). However, dealing with a loved one who suffers from GAD can be a difficult task and does lead to problems in some relationships. The anxiety that the affected experiences can rub off and cause the individual’s significant other to be stresses as well.
Most people with GAD report that their worrying led to significant problems during their late teens or early twenties. However many people with GAD also say they have been a "worrier" as long as they can remember, including their childhood. Approximately 3 to 4 out of every 100 people meet criteria for GAD, which makes it just as common as other anxiety disorders such as panic disorder. We also know that GAD seems to affect more women than men. Studies have shown that people with lower socioeconomic status (e.g., lower incomes, poor housing, etc.) are more likely to have GAD, possibly due to a higher rate of life stressors that can make a person more vulnerable to uncontrollable worry (Gliatto). Researchers are focusing upon these different patterns to learn more about GAD and why certain individuals seem more vulnerable than others. Researchers have found that as many as 75 to 90% of individuals with GAD have at least one other disorder such as social phobia, major depression (or symptoms of depression), panic disorder or substance abuse disorder (Long). Some people with GAD also have physical conditions associated with stress such as recurrent headaches or irritable bowel syndrome while others struggle with substance use problems as they try to reduce the excessive worrying and related symptoms with alcohol and/or drugs. These physical traits, along with the wholly mental ones, can lead to rockiness in relationships, but they can still be maintained as the capacity for love and romance is still present in these people, not matter how much anxiety they experience.

Obsessive Compulsive Disorder (OCD):
Obsessive compulsive disorder is characterized by "strong, unwanted thoughts that create significant anxiety. These thoughts and the anxiety they produce often drive repetitive behavior that is excessive, is utterly unnecessary, and sometimes seems foolish to the person" (Raulin). The unwanted thoughts that the individual cannot control are called obsessions, while the behaviors that the individual feels compelled to perform are called compulsions. The compulsions are often described as rituals because they must be performed repeatedly and usually in a very specific manner. Common obsessions and compulsions include "washers", people who wash their hands fifty or more times in a single day, and "checkers", people who will check their locks repeatedly in fear of a break-in or something else (Raulin).
It is horrible to have obsessive compulsive disorder, but the disorder is made especially worse when it causes problems in a relationship. The "normal" partner is often put in an awkward position, trying to understand and often accommodate behaviors which are bizarre. From their perspective, many compromises and sacrifices are often made. This sometimes causes resentment and friction within the relationship. On the other hand, the person with the OCD desperately needs the help of someone that they can confide in and trust. They may feel helpless in knowing that the non-OCDer cannot truly understand how much the illness controls their actions (Steketee).
An OCDer can feel betrayed when some "personal rule" is accidentally broken/ignored by their partner or when the disorder is used as the focal point of daily conflicts within the relationship. Very often the non-OCDer will be unsure of the best way to deal with things. It can be extremely upsetting to see a loved one trying to cope with the illness and being tormented by their obsessions. The non-OCDer can feel as if they are placed in an impossible position. On the one hand, they might feel compelled to help their partner by accommodating their bizarre and irrational fears and rituals - whilst on the other hand they may be reluctant to do anything that might make the illness worse. This can push the theory known as "tough love" to it's limits.
After years of living with this illness, a tremendous amount of strain is put on the relationship. Both partners may have several feelings and emotions regarding the other. The non-OCDer may well feel so absorbed in the bizarre world of their OCD partner that it feels like they share the disorder with them. Of course, there may also be feelings of resentment, especially if they have been restricted in their life and their enjoyment of certain things has been affected. They may well have been prevented from doing certain things or going to certain places due to their partner's fears (Steketee).
The partner with the disorder needs the assistance, support and co-operation of the other, especially when dealing with the compulsions, but this may result in them feeling guilty for disrupting their loved one's lives in such a way. There is no doubt that OCD does put a great deal of strain on any relationship, and there are many couples that do break up, with OCD being used as a real/imagined excuse (Raulin). However, there are also many people who rise up to the challenges of OCD and become closer and better people despite it. It isn't easy coping with the symptoms of OCD or sharing the pain, embarrassment or hopelessness that it brings and OCD definitely makes it difficult to maintain a romantic relationship for an extended period of time.

Borderline Personality Disorder (BPD):
The defining characteristic of borderline personality disorders is "a pervasive pattern of unstable or intense relationships" (Raulin). People with BPD often find themselves in intense, wonderful relationships that turn terrible sour at some point, often breaking up painfully and dramatically. The relationships may be with professional colleagues, friends, or lovers. Generally speaking, the more intense the relationship, the more likely it is to collapse. For example, a relationship with a lover is more likely to collapse than one with an acquaintance. These people also always place the blame for their failed relationships on the other person, never on themselves (Raulin).
This personality disorder is identified by tremendous instability, especially in relationships and in mood. There is an intense fear of abandonment, and the individual makes constant efforts to avoid abandonment. However, the intense mood swings, especially the expression of anger, actually encourage abandonment because it is difficult for others to tolerate a relationship with an individual with a borderline personality disorder (Franklin). One minute you are the most wonderful person on earth, the next minute you are compared to Attilla the Hun. These individuals often make many suicide gestures, and frequently engage in self-mutilation. They are extremely impulsive, and engage in many self-defeating behaviors.
Approximately 2 percent of the population may have borderline personality disorder. The essential feature is a history of long term unstable relationships and intense mood swings, especially anger. The relationship problems make it difficult to treat individuals with this problem, and treatment is usually long term, perhaps lifelong. These individuals sometimes mask their inability to have a stable intimate relationship with stable non-intimate relationships or relationships that are stable as long as full intimacy is not possible (Franklin). Another problem with these individuals ability to function in an intimate relationship is due to the fact that they either idealize or denigrate others, perhaps switching abruptly between these two polar opposites. They also have a problem with confusing intimacy and sexuality, which is something that must be clearly distinguished in a romantic relationship.

Throughout all of these disorders, it is easy to see how maintaining a meaningful and romantic relationship could turn out to be a difficult endeavor. However, with proper counseling and understanding partners, there should be no reason that these individuals cannot lead and keep up a relationship of this type. No, these types of relationships will never be completely "normal" and will never be as easy to experience as those which do not involve lovers with psychiatric illnesses, but these people still have the capacity to love and to be loved. Through perseverance and determination for the relationship to work, these people can live happily and healthily and can live in lasting and fulfilling relationships for the duration of their lives.


Works Cited:
Franklin, Donald. Personality Disorders. Psychology Today, March 2001.

Gliatto, Michael. Generalized Anxiety Disorder. American Academy of Family Psychologists, 2000.

Host, Paula. Bipolars and Romance. 2002 http://bipolar.about.com/cs/menu_chat/a/0302_online1.htm

Long, Phillip. Generalized Anxiety Disorder. Medical Post, Jan. 7, 1997.

Raulin, Michael. Abnormal Psychology. Allyn and Bacon: Boston, 2003.

Rogalla, Talmadge. Schizophrenia. New York: David and Charles Publishers, 1998.

Steketee, G.S. Overcoming Obsessive-compulsive Disorder. Oakland, CA: New Harbinger Publications, 1999.