How to Help a Spouse with Mental Illness: Support, Communication, and Treatment

Diane delays her homecomings. Rather than rushing home after work, she languishes, stopping by the cemetery to eat in her car, stealing a moment of silence before she has to go back to what awaits her. Because what awaits is this: her husband snooping through her drawers and reading her emails, hovering over her, standing ready with Lysol to disinfect anything she touches.

Diane’s husband is depressed. It is not fleeting or even situational. It is a depression that has lasted for years, one accompanied by psychosis, paranoia, and germ obsession. Although he has tried medication in the past, the side effects were too much to bear and his disorder now goes untreated. “I get overwhelmed thinking about how untangle it all,” says Diane. “When you live with someone who is mentally ill, the whole environment becomes a bit ill but because you’re so ‘in’ the situation you don’t realize how unhealthy it is.” Indeed, the glimpses of normality Diane used to get from her friends have largely disappeared. “That’s the hardest part,” she explains. “The danger of living with a mentally ill spouse is that you lose sight of normalcy and get sucked into the chaos.”

Having a spouse with mental illness is uniquely painful. You are at once witness to and, typically, the primary support for a person in profound distress, distress that affects you both emotionally and practically. For many, the burden can feel unbearable as you struggle to negotiate your role in your spouse’s illness and in your family as a whole. But by learning how to support a spouse with mental illness while also supporting yourself, you can create a strategy to care for both you and your marriage even in the presence of psychological disturbance.

Mental health disorders are complex illnesses that can affect thoughts, beliefs, and behaviors in myriad ways. By educating yourself and coming to understand your partner’s mental illness, you can gain deeper insight into what they are experiencing. In doing so, you can not only come to develop a clearer picture of what your spouse is going through and help them feel seen, heard, and validated, you can also begin to understand your own experience of their illness. This can be a powerful start to the healing process, as you learn exactly what you are dealing with and can begin the search for recovery.

An essential part of educating yourself is learning that you are not to blame for your loved one’s illness. When you are married to someone, it is natural to take on certain emotional responsibilities and want to ensure that your spouse is fulfilled. After all, when we love someone we want them to be happy and marriage itself is primarily a work of emotional labor. But mental illness isn’t your fault. It does not arise due to discontent within a marriage and you could not have prevented it by being a better husband or a more attentive wife.

Being married to someone with an untreated mental health disorder typically means that you give more than you get back due to the emotional and practical limitations imposed on your partner by their illness. From the emotional support you provide to the extra chores you perform, it is easy to deplete your inner resources and you need your own support to replenish yourself.

Unfortunately, the stigma mental illness carries can prevent you from reaching out even to those you trust most. Dennis, a facilitator with the Depression Bipolar Support Alliance of Boston, says, “It was difficult for me to talk about my partner’s illness because it wasn’t my own. I felt like I was violating her confidentiality.” Others feel that their own suffering pales in comparison to that of their spouse. “In the beginning, I felt like it was [my wife’s] life, her story to tell, her pain,” says Sabrina Holley-Williams, a 38-year-old woman whose wife struggles with depression. “I didn’t like to think about it like I was also dealing with it.”

It is common to feel guilty about reaching out for support when your partner’s needs appear to outstrip your own. However, mental illness affects both of you and it is vital that you find a safe space in which you can express your own thoughts and feelings about your spouse’s illness and the impact it has on your own life. Some of the best places to find and build this support include:

• Individual therapy. For many, individual therapy is an ideal place to find meaningful support as you navigate life with a mentally ill spouse. It offers a confidential, nonjudgmental space in which to voice concerns and ask important questions.
• Peer support groups. A more social option than individual therapy, peer support groups and group therapy can be invaluable to breaking the silence that too often surrounds mental illness and learning from others who understand what you are going through.
• “Me” time. Aside from formal sources of support, it’s also important to take time for yourself. Do things that bring you joy. Nourish your relationships with friends and family to ensure you are not isolated. If you need more practical support, hire a nanny or a housekeeper to take some of the pressure off.

If you do begin to feel guilty about your efforts to take better care of yourself, just remember: not only is self-care essential for your own well-being, it also helps you help your spouse more effectively.

When you have a spouse with mental illness, it can be easy to feel as if you are walking on eggshells, fearful that you will say or do the wrong thing or that your own concerns are not worth bringing up. It can be common for both of you to attribute legitimate relationship issues with symptoms of mental illness, keeping you from dealing with them as real conflicts. You may also both resent the “patient-caretaker” dynamic that so often emerges when a partner has a mental health disorder. Talking to your spouse about what both of you are experiencing can be essential to understanding each other and learning how to effectively nurture your relationship in troubled times.

“The hard part has been the unspoken expectations and resentments that can pile up between us when we’re navigating an illness episode,” says Mark Lukach, whose wife struggles with bipolar disorder. “After the first one, we have had to have some really hard talks. Talking through our experiences let us share our pain, resentment, and tension—and realize that we’re in this together and have an unshakeable bond.”

Steve Austin, whose wife was hospitalized with postpartum depression, agrees. “There is great power in being able to tell our stories. Being able to name our pain, our struggles and frustrations, and even our greatest hopes is a catalyst toward true change.” Indeed, maintaining your connection in the midst of mental illness helps ensure that it does not become the center of your relationship and enables you to keep nourishing all aspects of your marriage despite the presence of the illness.

You can be an invaluable source of support for your spouse, but you cannot cure them of their mental illness. Encouraging them to seek professional mental health treatment is the best way to ensure that they receive the care they need to heal. For many, residential mental health treatment offers an ideal way to begin the recovery process, particularly if your spouse has not achieved remission of symptoms in outpatient care.

High-quality residential mental health treatment programs provide a safe, supportive space in which your spouse can engage in a broad-spectrum curriculum of individual, group, and holistic therapies designed for their unique needs. These therapies seek to give your partner the insight and skills they need to break through distress and find psychological tranquility. Simultaneously, judicious use of medications may be used to support the healing process; the residential nature of these programs allows for continuous monitoring of efficacy and side effects to perfect the pharmacological regimen.

The best residential mental health treatment programs recognize that mental illness doesn’t just affect your spouse, but profoundly impacts your family as a whole. As such, they offer family and couples therapy in order to give each family member the support they need while nourishing your marriage. With the guidance of highly trained professionals, you have the opportunity to explore and express your feelings about your loved one’s mental illness and its role in your life while also identifying unhealthy dynamics, resolving residual conflicts, learning how you can better support each other. This can be instrumental in forging deeper bonds and creating a healthier, more fulfilling relationship for both of you. It also allows you to lay a strong foundation for participation in your partner’s continuing care plan following residential treatment to ensure the gains made in care are preserved. Together, you can start a transformative journey toward healing and create a stronger, healthier relationship.

Our Treatment Program

Bridges to Recovery offers comprehensive residential treatment for people struggling with mental health disorders as well as co-occurring substance abuse and eating disorders. Contact us to learn more about our renowned Los Angeles programs and how we can help you or your loved one start on the path to lasting wellness.