ALONE TOGETHER: LONELINESS IN RELATIONSHIPS

“You know, Dr.D., everyone is just making relationships work for the sake of it. Very few are happy in the real sense if you ask me.”

His words stayed with me long after our session was over. Krish (name changed) had been seeing me to tackle the unhappiness stemming from his relationship with his wife.

While those words were his, I’ve heard them from several other individuals and couples who have expressed their angst, dissatisfaction, frustration, displeasure, and in more extreme cases, apathy over what they call “failed/failing relationships.”

But the one thing that commonly crops up in relationships that leads to these reactions is loneliness. When you’re single, loneliness is often perceived  as a given, something to be expected. “Of course you’re going to be lonely when you lack companionship” is a refrain you commonly hear.

But loneliness in a relationship? Ouch but true phenomenon. After all, a relationship is supposed to provide you with a sense of belonging, comfort, care, connection, meaning, and a better tomorrow. So it hits even harder if you end up lonely while being in a relationship.

Let me make an important distinction here first. Partners can seek and prefer to be in solitude as a way to recharge while being together, and find those silences together to be comforting and healing. It’s part of how they remain kindred, connected spirits and anything but lonely.

But getting back to loneliness, what is resulting in this increasing occurrence and outward expression of loneliness in relationships? It’s important to understand this because its effect is often first on the individuals in the relationship, before affecting the relationship and making it spiral down further.

When I have asked people what they mean by loneliness in relationships, I hear them talking about how they feel disconnected from their partner, feeling unloved, unheard, uncared for, dismissed, not a priority, often expressed simply as “we just don’t talk anymore and are so distant.”

A couple I have been working with spoke about how the same things that she used to say to her spouse 15 years ago and were accepted then and never became an “issue,” are now a huge trigger in their relationship which makes her feel alienated. “What changed, why can’t I reach him,” she asked?    

What changed: “Life” and what it threw at them: Increased responsibilities, especially when kids were born; tenuous relationships with extended families which become sources of conflict between the couple; kids growing up and moving away; stress in personal lives due to work or other reasons; not enough time or an inclination to even communicate, and the ineffectiveness of communication even when it happens; or when the resentments and conflicts pile up so much that they disengaged from each other, often completely.

But the more serious threats are when there is an internal shift within ourselves: how we perceive ourselves, the people we once loved and now feel differently towards, how we relate to our world; and we then begin to question the role of those relationships in our lives.

Let me elaborate on this by pointing out the effect of the specific language we use in talking about relationships.

 “What does your better half do?”
“You complete me.”
“Without you, I am lost.”
“You are supposed to  make me happy.”
“You have to fulfill all my needs. That’s what a relationship is about.”

How often have we been fed these beliefs about romantic relationships? And we grow up with all these notions that this is how it’s meant to be. It’s always about the other person, and what they do or don’t that bounces off us and that’s how we are supposed to evaluate our relationship.

There are other variations to this theme too.

“He doesn’t have time for me and the kids.”
“She always nags.”
“We don’t even show that we care about each other.”
“He/she doesn’t give me any appreciation for all that I do for the family.”
“He just keeps things to himself. We barely talk!”

And it constantly becomes about “you” vs. “me.”

The disgruntlement results from the onus always being on the other person and never on our own internal worlds and how we think. And this belief system becomes a self-fulfilling prophecy with such conviction that the relationship is soon seen as a burden. We change as people, our wants from our partners change, the “old” just doesn’t work anymore. The isolation, alienation, and emotional disconnect is further deepened and perpetuated. Loneliness creeps up insidiously.

Then there are couples where the partner does everything the other is wanting him/her to do but the loneliness and rifts continue. What’s happening here is that the dissatisfied partner looks to have the void in his / her life to be filled by the partner, and that may not always be possible. Because relationships are not a cure-all prescription that can fulfill all needs or fill all voids. Commonly experienced voids are those of “insecurities,” “feelings of emptiness, ” “feeling unloved,” where every effort of the partner to assuage those gaps is failing to make any difference. Because one is attempting to treat back pain with an anti-diarrheal medication (pardon that weird example, but you get the point). Those perceived gaps are internal processes and mind states that need to be worked on at an individual level, not via the relationship. The partner can help, but as a support system, not the panacea.

I also hear this a lot: “We just don’t have heart-to-heart talks anymore. There seems to be a wall between us.”

I have talked many times about how we often equate sharing our vulnerabilities as a sign of weakness, because we run the risk of being judged, or just don’t feel that our partner is available or interested enough to listen. Can it further create a dent in the communication between two people and perpetuate the cycle of estrangement when you don’t get to share personal stories, experiences, and lives anymore? Absolutely.

“We just grew apart,” say many couples who were married for as many as 30 years, and, at a minimum, for 22 years, and then got divorced. They just didn’t feel emotionally invested enough anymore to want to make things work.

So how does loneliness manifest in relationships? Some common observations are:

There is increased annoyance and irritability with the partner. Communication breakdowns happen frequently which create further misunderstandings because one tends to interpret the other based on assumptions. An increased emptiness seeps in especially when one is in the company of the partner and feels no joy in their presence. They each have their own lives which often don’t even meet at a crossroad. There’s indifference which often transforms into hostility; attraction and intimacy diminish, and the chasm deepens.

How and where does one even begin to tackle this issue?

In, perhaps, the most obvious place: oneself. It’s important to reflect on ourselves as individuals and on the relationship we are an integral part of and do some soul searching. We may not have or find all the answers all at once. But asking ourselves the tough questions would be a good place to start figuring out the answers.

Did I feel lonely before I entered this relationship? Do I feel more lonely in the presence of my partner because that is just how the relationship feels to me? Did I ever feel fulfilled and content in my relationship prior to these feelings surfacing? What changed? But most importantly, am I happy and content as an individual, keeping the context of the relationship out of this equation? How do I relate to myself? Do I have feelings of insecurities, fears of rejection & abandonment, beliefs about myself as a person that pull me away from myself? Because come to think of it, your relationship with yourself is what you see in your relationships. However difficult our partner makes it for us, it’s up to us on how we deal with the relationship with whatever it brings our way, and maintain our sense of equanimity.

We each have our own wellness and happiness quotient and I wish it to be high for all of us. While our partners may add to that and have our well of joy overflow (how lovely that would be 😊), we can help by not feeding into the age-old belief that we need someone else to “complete” us or to be our “better half,” or to make us happy.

We create a lacuna within us this way, creating a dependence on the other person to “complete” us. And when that doesn’t happen, we feel left behind and unhappy.

The Japanese (my favourite life philosophers!) may or may not have a pithy phrase for it (like ikigai or wabi-sabi), but perhaps we need to reflect more on the idea of what completes us as individuals. And whether incompleteness is such a bad thing in the first place. After all, we are all different and complete in our own individual ways.

I paused after I wrote the previous line, and had an image of a kaleidoscope pop up in my mind. In its simplest form, a kaleidoscope is a cardboard tube with a view-hole at one end and mirrors inside to reflect light from the outside on broken bits and pieces of colored glass. Our lives are touched by moments of happiness and joy, good times and bad, moments of despair, disappointment, success, failure, pain, loss, and countless other experiences. And just like with a kaleidoscope, you can take these moments, shuffle the bits together, and create a magnificently beautiful image, so in sync, well patterned and formed, with just the slightest shift in our viewing lens.

The pieces of the puzzle are with us. Loneliness and togetherness are both parts of us. How we use our understanding of our ourselves and each other is what can lead to completeness. A completeness of our own selves, however broken, yet shining, resplendent, resilient and inside us at all times is a wonderful place to start.

“I Don’t Want to Talk About it”: Depression in Men

He held his face in his hands and sobbed. “I wish I had sought help sooner.”

I looked across at his frail frame, as he sat in his wheelchair.

Akash (name changed) had been clinically depressed for months, and the pressure of work and the demands of family overwhelmed him to such an extent that he decided to end his life. Except that the jump from the 5th floor of his office building only landed him with a spinal cord injury, which meant complete and irreversible paralysis below his neck.

“This life is worse than the one I had previously. I am dying a million deaths every day.”
He sobbed uncontrollably for a few minutes and then we went on further, into our session.

In separate incidents that made it to the news this past week, two ostensibly (and highly) successful men committed suicide. There are several more such cases that happen every day that go unreported, and it made me reflect on the issue of depression in men that we just don’t talk about. I am not even going to use a euphemism such as “stress” instead of depression, because that would mean downplaying a serious issue. Using euphemisms tend to become a nice way to shove things under the carpet, hoping they would magically disappear. But the reality is much starker.  

“Boys don’t cry.”

How many times have we said this to our boys or heard it ourselves? From when we are young we are told to behave in certain ways, which in turn become ingrained behaviors. We condition boys from a very young age  to not express emotion, equating emotions with weakness.

Men are told to be strong, to be in control of themselves, and consequently perceive expressing their innermost feelings as a threat to their masculinity. Where it gets far more troubling is when you couple it with fear of failure, a constant striving to be successful, to never take your eyes off of ambition, on top of the expectation to ascribe to beliefs such as “Mard ko dard nahin hota” (“Men don’t feel pain”).

Here’s the inevitable reality though. Men will experience moments of despair, feelings of being overwhelmed, the stresses and strains of daily living, and they will – unless addressed appropriately and in time – spiral into hopelessness and helplessness.

But men most commonly react to this inevitable reality by denying it, trying to cover it up, or camouflage their symptoms and address only the ones that take a physical manifestation, such as diffuse pains, headaches, sleeping disturbances, or sexual problems. And as a result depression in men often gets overlooked and untreated, leading to significant consequences such as impacting close relationships, productivity at work, proclivity to substance use, emotional regulation, decline in overall enjoyment of life, eventually spiraling so deep that it pushes men to commit suicide.

If that sounds extreme, here’s some data.

In 2016, the last year that global data is available from the World Health Organization (WHO), there were an estimated 793,000 suicide deaths worldwide. Most were men. Suicide is still the single biggest killer of men under the age of 45. Forty percent of countries have more than 15 suicide deaths per 100,000 men; only 1.5% of the countries in the study show a rate that high for women.

But wait, don’t women tend to have higher rates of depression diagnoses? So how does that add up?

There’s a simple but unsurprising reason for it.

Men seek help for mental health less often.

Think about that for a minute.

It’s not that they aren’t struggling with the same issues as women, but the denial of mental health problems, or simply not knowing that they have significant mental health issues may be putting them at greater risk for suicide. And that becomes a reason for the reduced frequency with which they seek assistance from professionals.

A UK British Medical Journal study found general primary care consultation rates were 32% lower in men than women; and consultation rates for depression were 8% lower in men than women. And in a country like India, a further double whammy comes in the form of the stigma associated with seeking mental health services because of the labels, unsolicited advice, unwanted judgments, and differential treatment we as recipients of mental health services beget.

I particularly wanted to talk about depression in men for just these above mentioned reasons. Men may be less tuned to recognizing the signs and symptoms of depression. They may not want to talk about it, may deny the presence of tell-tale signs of depression, or may mask it with other behaviors.

How do we recognize those signs and symptoms?

Men may typically show the classic signs of clinical depression such as: persistent sadness, anxiety, or feelings of “emptiness,” trouble concentrating, remembering details, and making decisions; feelings of guilt, worthlessness, and helplessness; pessimism and hopelessness; fatigue; insomnia or hypersomnia (sleeping too much); irritability; restlessness; loss of interest in things once pleasurable; reduced interest in sex; appetite loss or overeating; and suicidal thoughts or attempts.

However, men are also more likely than women to experience symptoms of depression that may just sneak up and masquerade as behavioral disruptions, such as the following.

· Physical pain: Frequent headaches, backaches, cramps, sleep disturbances, digestive disorders that don’t respond to conventional treatment.

· Anger: From being mildly irritable, to being sensitive to criticism, to road rage, short spurts of temper, and in severe cases violence and hostility particularly towards others. Some men may become abusive and controlling to hide their insecurities or their fear of rejection and abandonment.

·  Impulsive, reckless behavior: Engaging in dangerous sports, excessive gambling, substance abuse (in an attempt to self-medicate), and engaging in unsafe sex.

The triggers for the downward spiral could be many, and of course personalized to each individual, but the common ones for men tend to be financial difficulties, unemployment, failure to prove self-worth through success at work, and lately what I think is a rising concern: existential crises.

Social isolation and feeling disconnected from friends and family when one is at the topmost rung of the career ladder often serves as a push at the precipice too. We just don’t invest enough in nurturing our relationships outside of work, so when the pressures mount, how do we destress when we find ourselves alone?

In my clinical practice, I see women who seek help for the couple when the relationship is threatened. That’s right, she’s not seeking help just for herself, it’s for both of them.

Because “I don’t have a problem, it’s her,” is the most common reason their spouses give for not being the ones to seek help in the first place.

As sessions progress and men decide to give relationship therapy a shot, mental health issues in men, be it anxiety, mood, personality disorders or any other, seem to be one of the common wedges causing dents in the relationship. Women often tend to internalize and will ruminate over their feelings and find answers or solace by talking to friends or a counselor. Men, on the other hand, will externalize and often become irritable, hostile, or in extreme cases show rage, and that starts causing rifts between the two people.

It all comes down to what is still perceived as alien to and by men. That it’s okay for men to cry, to talk about how they feel when they are down in the dumps. That tears are not a sign of weakness, and neither is vulnerability. To accept that our strength lies in the fact that we learn from failures, that we bounce back from adversity, with our knees bloodied and hearts broken. That our self-worth should not be defined by our net worth, or what we are seen as in the eyes of our peers, competitors, or others we work with.

Ultimately, it’s the quality of our minds, our hearts, our sense of meaning and purpose in life, our inner world, and how we choose to script our stories that matter. It’s having that friend or family member you could talk to when you are struggling, just so that you know you are not alone.

The bottom line is, we all need a safe, accepting, non-judgmental space to share our feelings. And yes, the “we” here especially applies to men. Together, we can decide to bring that shift in our scripts we create of masculinity and femininity. We can decide to change our attitudes about mental health issues and seeking counseling.

Let’s open up our eyes, ears and hearts to the fact that the best of us (men included) may need a shoulder at one point or another. And let’s embrace those who need us.

Because boys can cry too.