According to the National Alliance on Mental Illness roughly 1 in 5 people have a diagnosed mental illness. Despite its prevalence, we still don’t talk about mental health struggles enough. And the reason is well-known: stigma.
Stigma is real. And yet paradoxically stigma is perpetuated by not talking about mental health struggles, not sharing our stories about our mental health struggles with others. One important question related to mental health struggles and stigma that isn’t talked about enough is: should people in relationships disclose their mental health struggles to their partners?
It’s a generally accepted platitude that disclosure of mental health struggles is completely voluntary. That is, we’re under no obligation to disclose our mental health struggles to, for example, complete strangers, co-workers or even family or friends. Conventional thinking that flows from this platitude is that if it’s in my own best interest to disclose my mental health struggles to one of these people, I may. But even if disclosure benefits me, I sill have no obligation to disclose to others because my mental health struggles are my own. For example, I might go to therapy and discuss my mental health struggles with my therapist, but it’s my own business. And so on. All of this seems plausible.
Now let’s limit ourselves to people in romantic relationships. Romantic relationships come on a spectrum from less to more serious, which tend to be correlated with time and other things, for example, as being sexually exclusive, saying “I love you”, and having the so-called RDT (i.e., relationship defining talk), etc. Whatever the exact criteria, at some point, for some cluster of reasons, people eventually agree to be in a relationship. So, when people agree to be in a romantic relationship with each other, are we obligated to disclose our mental health struggles with our partner? Contrary to the conventional platitude and its general rationale laid out above, I think we are.
The first reason is practical: disclosing my mental health struggles to my partner will actually benefit me and my relationship. That is, disclosure will give my relationship the best chance of surviving and flourishing. Let’s use the example of childhood CPTSD developed from childhood abuse from a parent. Letting my partner know that I have childhood CPTSD will, among other things, help us resolve conflicts better when my CPTSD is triggered. Once I disclose my mental health struggles with my partner she does have a responsibility to research and become informed about my childhood CPTSD. However, unless my partner is well read in psychology, CPTSD, the affects of childhood CPTSD on adults, etc., simply disclosing my mental health struggles to my partner will be inadequate. Disclosure must also be informative, cannot discount or omit important information about my mental health struggles, etc. For example, I’ll likely need to walk my partner through what CPTSD is, it’s causes, how it affects me now (especially in romantic relationships), what my triggers are so my partner can try to avoid triggering me, what the best course of action is once I’ve been triggered, etc. Last, disclosure will be the beginning of an ongoing conversation with my partner that will evolve over the course of my healing process and the relationship.
All of the reasons considered so far — for or against disclosure — have been based on self-interest, directly or indirectly. That is, I’m not obligated to disclose my mental health struggles to anyone unless it benefits me or my relationship is some way. And this rationale dovetails with the original culturally accepted platitude about disclosing mental health struggles. But the second reason I’ll offer that we should disclose our mental health struggles to our romantic partner isn’t grounded in self-interest. It’s grounded in the moral relationship I have with my partner. My partner isn’t a stranger, a coworker or even a family member. My partner is someone I’ve agreed to have a relationship with and also the single person on whom my behavior has as great an affect as anyone in my life. Indeed, it’s plausible that the greater the affects of my mental health struggles on my partner, the stronger my obligation to disclose my mental health struggles with her. Mental health struggles can have significant affects on those with the mental health struggles that range from depression to suicidality. And my mental health struggles also have significant affects on my partner, which is compounded when my partner doesn’t know about my mental health struggles or doesn’t understand the full extent of my mental health struggles. Because my mental health struggles, e.g., childhood CPTSD, will have a significant affect on my romantic partner and her well-being, I have a moral obligation to disclose my mental health struggles to my partner. Again, from a practical perspective the unique potential harms that my mental struggles pose for my partner can be significantly reduced by disclosure. And from a moral perspective, without disclosure nor can my partner consent to the unique challenges that my own mental health struggles pose for her.