Sometimes, relationships can reduce our anxieties. And other times, they can vamp them up.

A new report by Crisis Text Line, a national not-for-profit organization that provides free 24/7 text-based mental health support to people in the United States, found in 2022 that for the first time, relationship anxieties were a top issue among those seeking help.

Crisis Text Line. United in Empathy Report. 2022.

 

The results can be seen in Crisis Text Line’s United Empathy Report, which is published on their website. The report is an analysis of over the 1.3 million conversations conducted between Text Line workers and people of all ages—with the majority of texters under the age of 24—in 2022.

Crisis Text Line. United in Empathy Report. 2022.

 

Shairi Turner-Davis, MD, MPH, chief health officer at Crisis Text Line, says that while the 2022 results may seem surprising to some viewers, they may also mirror the social—and social media—structure of the peri-pandemic atmosphere and its influence on relationships. 

 

Connection between social media and reconnecting since pandemic

 

One explanation for the increase in relationship anxiety could be the increased time and pressure to maintain relationships in the absence of pandemic restrictions like social distancing.

These connections aren’t always in-person. The pandemic inspired more virtual spaces for fostering relationships, too. Facetime, Zoom, Slack, social media apps, and more all serve as platforms for connection.

“When you look at relationships, people are reconnecting, trying to reconnect, dealing with interactions both in the home and the workplace,” says Turner-Davis.

 

How virtual relationships can increase stress

 

Our new ability to have relationships somewhat, mostly, or completely over virtual platforms can come with stressors. Especially when it comes to texting, written words and phrases leave room for interpretation—or misinterpretation—of the other person's feelings and emotions. In romantic relationships, in particular, texting may also feel less personal.

A 2015 survey by the Pew Research Center also found that a sizable number of then-teens reported breaking up with someone or having been broken up by someone over text, despite considering texting one of the least “socially acceptable” ways to conduct a breakup.

Lenhart A, Anderson M, Smith A. Teens, Technology, and Romantic Relationships. Chapter 5: After the Relationship: Technology and Breakups. Pew Research Center. October 1, 2015.

 

“We've become such a text-dependent and text-reliant society that, oftentimes, people are conducting the better part of their relationship by text,” says Turner-Davis. “When you think about having difficult conversations or breaking up with someone, it's far less personal to do that by text than it is to call and hear someone's voice.”

She adds that because texting can strain relationships, it is important to intervene and find ways to improve that platform, rather than abandon it and its users.

At Crisis Text Line, volunteers undergo a training in text literacy before chatting with patients. Many say that the training helps them in their personal relationships outside of the job as well, Turner-Davis says.

The training involves things like guidance for “establishing a rapport,” and how to empathetically repeat back to the “texter” what the volunteer is hearing, she adds. “We train them because it's so important to try to create that connection without a voice, without a phone, but purely by text.”

 

Advice for health professionals

 

There are limits to how much a doctor can help their patient through relationship anxieties, particularly in the field of primary care. Some doctors may face time constraints in a busy practice, while others may not have the mental health literacy to aid in all situations. Some may deal with both.

As a result, some doctors may need help helping patients through relationship anxieties, and that’s OK, Turner-Davis says.

“We really have to start arming our physicians with the resources and the training to screen their patients because a lot of mental health concerns will be manifested in physical conditions,” says Turner-Davis. “If the physician isn't inquiring about mental health or stressors or the psychology behind physical symptoms, then they're missing an opportunity to help someone who may be struggling.”

If conducting a mental health screening geared toward relationship anxiety, she suggests incorporating questions such as the following:

• Do you feel safe in your relationship?

• Do you feel supported in your relationship?

• Do you experience or have you experienced any physical abuse?

• At any point are you or have you been feeling physically threatened by your partner?

People who are interested in seeking help from Crisis Text Line can text “hello” or “hi” to 741741 to chat with a volunteer crisis counselor who is supervised by a mental health professional. They can text in English or Spanish, via text, web chat, and WhatsApp.