How to Manage Mental Illness in a Marriage

Whether it’s you or your spouse who suffers, mental illness can take a toll on a marriage. Both partners can help manage the mental illness by supporting one another, communicating effectively, and taking care of themselves. Don’t be afraid to work with a therapist to improve your marriage and your understanding of mental illness. When spouses commit to working together to help manage the mental illness, it can have positive benefits for both partners and the marriage.

Part 1

Part 1 of 3:

Helping Your Spouse Cope

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Educate yourself. If your spouse has a mental health diagnosis, spend some time reading up on it. Learn to recognize the triggers and behaviors associated with the diagnosis.^{[1]XResearch source} For example, if your spouse suffers from depression, they might appear hopeless, helpless, have a depressed mood, socially isolate, feel agitated, or have changes in sleeping or eating habits.^{[2]XResearch source}
- For example, you might feel frustrated that your spouse is appearing lazy, distracted, moody, or irritable. These, in fact, may be symptoms of mental illness.^{[3]XResearch source}
- Learn more about how to interact with someone with anxiety, depression, OCD, and bipolar.
- Talk with your spouse about their specific struggles as well. Your spouse’s experience with a mental illness might be quite different from what other people have experienced.
2
Prioritize your own well-being.^{[4]XResearch source} You may have eagerly taken care of your partner in earlier times, yet may now feel like you are tired, exhausted, or resenting your role as a caretaker for your spouse. This can lead to slowly backing away from taking a caretaker role or can result in angry outbursts.^{[5]XResearch source} If you notice these signs in yourself, re-evaluate your situation.
- Set time aside every day to take care of yourself. Do things that are important to you and that help you feel good. This might include meditation, doing the laundry, or keeping a garden.
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3
Avoid taking responsibility for your spouse’s diagnosis. It’s not your role to be your partner’s therapist or to tell them what is best for them. Stay away from making excuses for your spouse or enabling your spouse. It can be difficult to stand back while your spouse refuses to get help, but it’s not your job to make decisions for your partner or to control their outcome. ^{[6]XResearch source}
- Take a role that is supportive, but not controlling. It’s up to your spouse to manage their mental illness.
- If your partner refuses to see a therapist but causes lots of problems with friends and family, you may want to gently encourage them to see a therapist. It’s not your role to repair relationships in the family or with friends that your spouse hurts.
- Likewise, you don’t have to make excuses for their behavior or lie on their behalf. Say, “My spouse has a drinking problem” or, “My partner is working on balancing their moods.”
- However, in some situations you may need to take some responsibility for helping to keep your spouse and yourself safe, such as by ensuring that your spouse takes their medications, taking your spouse to doctor and therapist appointments, and having an emergency plan if your spouse becomes suicidal.
4
Find the best ways to help. Ask a mental health professional and your spouse about the best ways to contribute.^{[7]XResearch source} You may want to take over treatment, but your therapist may suggest you let your spouse tell you what would be most helpful. There may be times you may need to be more responsible for home chores or childcare so that your spouse can handle their mental illness. Be willing to give a little and help out as needed and remember that it’s not permanent.
- Have a discussion with your spouse. You can say, “When you start to feel anxious, what can I do to help you? Are there things you’d like me to do or say?” Acknowledge their feelings without judging or criticizing them.^{[8]XExpert SourceLiana Georgoulis, PsyD
  Licensed Clinical PsychologistExpert Interview. 6 September 2018.}
5
Remember that some things are not personal. You might feel offended or put off by your spouse’s behaviors, but take a step back and ask yourself whether your partner is behaving this way on purpose or whether they are experiencing symptoms of mental illness. For example, your spouse may suddenly start spending more time sleeping and less time with you. While you may feel hurt or that your spouse is being distant, recognize that this can be a sign of depression and that treatment may be needed.^{[9]XResearch source}
- Begin to recognize the signs and symptoms of your spouse’s mental illness and find ways to address the problems right away. For example, if your spouse begins to have OCD symptoms, say, “ I’ve noticed your OCD has started up again. I’m here to help. Should we call your therapist?”
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Part 2

Part 2 of 3:

Managing Your Own Mental Illness

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Be honest about your struggles. Don’t hide your struggles with mental illness in your marriage.^{[10]XResearch source} You might fear feeling stigmatized by your spouse or ashamed to express your struggles. Be truthful about your challenges and don’t feel the need to hide yourself.
- Speak truthfully about what’s difficult for you and how it affects your life. For example, you can say, “There are times I feel stressed and overwhelmed and begin to experience OCD. It starts to take over my life in big ways, and I struggle to feel in control.”
2
Attend regular therapy. Therapy is an important part of treating mental illness.^{[11]XTrustworthy SourceNational Institute of Mental HealthInformational website from U.S. government focused on the understanding and treatment of mental illness.Go to source} While medications can be helpful, they do not treat the main cause of mental illness and often have side-effects. Engage in regular therapy with a therapist you trust and feel comfortable talking to. Talk to your therapist about how your mental illness affects your marriage and what you can do to improve it.
- Even if you’re coping well with your mental illness, have a therapist you know you can reach out to in times of trouble. For more information, check out How to Find a Good Psychologist.
3
Say what you need. Honest communication is important to any marriage, and especially important if you have certain needs related to your well-being. If you have a need related to your mental illness, share it with your spouse. For example, if you’re feeling depressed, ask your spouse to encourage you to engage socially or go exercise.
- Mental illness is nothing to be ashamed about. Everyone struggles with painful emotions, doubts, worries, and fears at some point in their lives.^{[12]XExpert SourceLiana Georgoulis, PsyD
  Licensed Clinical PsychologistExpert Interview. 6 September 2018.} It’s likely your spouse wants to help you, and telling them how to help you can make them feel better.
- For example, if you struggle with mood swings, say, “When you notice my moods changing, please give me space. I don’t want to say something I don’t mean and I need time to sort things out on my own. It’s not personal.”
- If you’re feeling anxious, tell your spouse, “This situation makes me feel anxious. I know you’re trying to help, but I don’t want to talk about it right now. I need a moment to cope with my feelings first.”
4
Talk about your sex life. Mental health problems can affect sex, especially if you take medications. If medications are interfering with sex, talk to your partner and your physician. Do not take yourself off medications without your prescriber’s knowledge, as this can lead to severe withdrawal symptoms.^{[13]XTrustworthy SourceNational Alliance on Mental IllnessGrassroots mental health-focused organization providing resources, support, and education for those affected by mental illnessGo to source}
- Be honest with your spouse. Say, “I love you, but medications make sex difficult right now. I want to be affectionate and loving toward you. I want to sort this out and will talk to my doctor about adjusting my medication.”
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Part 3

Part 3 of 3:

Working Together with Your Partner

1
Notice if the relationship is becoming distant. If one spouse is burnt out from caretaking or the other spouse feels guilty or ashamed of needing caretaking, it can take a toll on the relationship. Often, this leads to partners becoming distant, avoiding one another, or resorting to surface-level interactions.^{[14]XResearch source} If you notice these dynamics occurring in your marriage, figure out how you can break this pattern.
- Say to your spouse, “I’ve noticed us becoming distant, and I don’t ever want to feel far from you. Let’s find a way to work through this together and not put any more holes in our marriage.”
2
Attend family therapy.^{[15]XTrustworthy SourceAmerican Psychological AssociationLeading scientific and professional organization of licensed psychologistsGo to source} Work with a couples or family therapist can help you and spouse communicate effectively around issues of mental illness. You may need to find strategies that help each of you function better in the marriage. Both of you may need to improve communicating your needs, thoughts, and feelings. Family therapy can help each of you function better.
- Family therapists are trained to work on improving relationships. Work with someone who specializes in mental illness in relationships and how to relate better together.
3
Communicate positively. Maintain your marriage just like any other marriage: check in with each other, say “I love you” regularly, and go on dates together regularly. There’s no reason for mental illness to run your marriage.^{[16]XResearch source} Maintain a normal marriage as much as possible and do things that other couples do in healthy marriages.
- Set aside one night each month to enjoy a date together. Go to a concert, enjoy a movie, or try out a new restaurant. Focus on spending quality time together and avoid sticky topics like finances.
4
Practice relaxation. Find some healthy outlets for stress and do them together. Healthy coping strategies can help both partners manage stress and deal with problems before they get out of hand. Do relaxation exercises each day for 30 minutes to help you stabilize your moods and address daily stress.^{[17]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source}
- Find relaxation methods that appeal to both of you and that you see yourselves doing daily. Try daily yoga, qi gong, or meditation. You can also walk the dog together, enjoy tea each morning, or read together.
5
Avoid turning to alcohol or drugs. Many couples who experience peak marital stress turn to alcohol or drugs.^{[18]XResearch source} You may try to numb your pain or escape your emotions, however, substances often make this worse and can quickly dissolve your marriage. If you’ve struggled with substance use or abuse in the past, stay clear of substances if your marriage is experiencing stress.
- If you’re having a hard time coping, try new coping skills such as deep breathing, going for a walk, or journaling.
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