Mental illness is very hard on marriage. I know. I’ve been there. My first husband had a diagnosis of atypical psychosis, and our final years of marriage were filled with escalating abuse.

The stress can and does reach crisis levels. This includes the practical burdens of day-to-day problems as well as the emotional consequences of the illness. Some couples fall into pattern where managing the illness is the central part of the relationship. You become primarily patient and caregiver, not husband and wife.

The core of the emotional burden is an ongoing grieving process: mourning for the individual who has the illness and for the family life … present and future … that has changed.

Despite this, some do maintain healthy relationships.

Impact on a Marriage

Note: The following information came from verywellmind.com and “Stop Walking on Eggshells” by Paul T. Mason, MS, and Randi Kreger. The research study referenced is “Love and Mental Illness: A Survey of Psychological Well-Being and Intimate Partnerships,” published in PsychGuides.com (from American Addiction Centers) in January 2019. I also include my own thoughts from my experience.

It starts with finding out what is happening. The 2019 study by PsychGuides.com found that men tend to wait longer to disclose their mental illness diagnosis than women do. It found that 73.5% of woman tell their partners about the diagnosis, while only 52% of men do.

A new diagnosis of mental illness can be devastating, embarrassing and even frightening. Due to the problems of stigma, sufferers worry that you may not love or desire them anymore. They fear divorce. And, in situations of violence, separation and divorce may be the best answer. (This happened to me in my first marriage, and the church agreed it was best under the circumstances.) This is a decision that takes much prayer, and we’ll go over some questions to ponder below.

In meantime, understand that a negative reaction from you can potentially exacerbate symptoms of the mental illness and bring on additional feelings of hopelessness. So, if you can, let your spouse know that you are there for and love them “in sickness and in health.”

Steps to Take When Your Spouse Is Diagnosed

Educate yourself.

• Seek out high-quality psychological and medical professionals. Find literature and online information about the particular diagnosis from legitimate sources only. Websites that you rely on should have good reputations or come recommended by your psychotherapist or physician.
• Understand that issues that you think of as “character flaws” might be symptoms.
• Effective treatment combining therapy and medication is crucial. Mental health professionals can also educate you about what role you can and should play in your spouse’s treatment plan.

Do not become their therapist or enabler.

• Let the professionals outside your marriage do their jobs with your spouse. Your role is to provide love, support, and sympathy for your partner during their recovery efforts.
• You don’t want to do things for your spouse that they can do for themselves. How involved you should be depends on how ill your spouse is.

Seek individual and couples counseling.

• Spouses of people with a mental health condition can feel hate, frustration and anger. Emotional exhaustion is not unusual. Individual counseling can help you.
  • It’s normal to be angry if your spouse is not trying to manage their illness. You may feel yourself acting as a parent/caregiver in the situation. This can damage you and your relationship.
  • Your own therapist can help you talk through decisions about boundaries issues. Your spouse’s ability to take care of themselves will change along the continuum of care. Your therapist can help you to be strong, yet flexible.
  • If your spouse continues to refuse treatment, you can work with your own therapist to decide key issues, such as:
    • Should I use our marriage and the children as leverage to get my spouse to get help?  (As in:  You get treatment or we’re leaving you.)
    • Is this situation dangerous? Should I leave with the children?
  • Mental illness also changes the relationship with your in-laws. A counselor can help you with this.
• Couples counseling can prevent the two of you from falling further into an unhealthy relationship. (For example, it’s easy to blame everything that’s wrong in the relationship on the mental illness.)
  • Couples counseling can help with sexual intimacy issues as well, which are common when a spouse has a mental illness.
  • Financial stresses are common when one spouse has a mental illness. Couples counseling is a good place to discuss the situation.
  • This setting is also a good place to discuss specifics about child care.  Should you leave your children with your spouse while you work?
• Stay active in a support group.
  • You get to hear lived experience from others who have been in your situation.
  • You can talk through issues.
  • You can also help others as they help you.

Practice self-care regularly.

• Self-care is necessary if you have a spouse with mental health problems. If you don’t focus on your own health, you may be sucked into the vortex of the mental illness, putting your marriage at risk.
• Go back to the basics: Get enough sleep. Do some regular physical activity. Eat well. Spend time with friends or loved ones. Engage in activities or hobbies that you enjoy.
• Watch out for compassion fatigue and burn-out. This is a common scenario when dealing with an ill or disabled partner.
• Ask yourself if you are responding well to this new scenario, and to other challenges in your life. Are you stepping up in a way you that you are proud of or are you avoiding doing your part to help your spouse, your family, your marriage, and yourself?

Deciding to Stay or Go

This is a tough decision. Sometimes your family, especially your parents, may see things more clearly than you do. I remember when my husband’s therapist told me “I think you need help to become strong enough to leave this marriage.” It was a shock to me, but not to my father.

Here are some questions to consider:

• Am I in physical danger?  Are the children in danger?
• Have I accepted the fact that my spouse is the one who decides about treatment?
• How would a separation impact the children?
• How does this marriage affect me?
• If a friend were in my place, what would I say to them?

Having a spouse with a mental illness can be a heavy cross to carry. But, remember, with treatment 60% to 80% of people with mental illness improve their behaviors. You can have hope, but may have to be practical in the moment.