Marriage and Mental Illness: For Better or Worse?

For Better of Worse? Yes, that’s the vow. But when the symptoms of mental illness seem to change the personality – the very soul - of your husband or wife, how do you keep going? How do you hold the family together?

Partners for Life

When faced with mental illness, family members have two sets of challenges, it seems:

  1. the emotions we all face (like grief, confusion, guilt, loss, anger) and,
  2. the more practical issues in the role of any family caregiver - a role we all have to play at least some of the time in this situation.

My most personal experience, as a family member of someone diagnosed with mental illness, is as a Mom. In fact, I’d venture to say that a majority of the people who take NAMI’s Family-to-Family course are parents. A typical class of 20-25 usually includes a handful of siblings, spouses, and/or children (that is, adults who grew up and may be caring for a parent with mental illness) – but the biggest group always seems to consist of parents.

Many of the issues, emotions, and challenges we face as family members certainly are universal to all of these roles – however, there are also additional feelings and obstacles that are unique to each “relative group.”

Yes, I am a mother – but I also watched my daughter suffer through

I Do...

the loss of the “big brother” she knew,  and adjust to her new role with a “little brother”, whose growth and accomplishments now trail behind.  I also was married to an alcoholic for seven years (Ben and Ali’s father, William) and though I now struggle to determine if he’d had a co-occurring mental illness, I know that I did live with some of the uncertainties that spouses face when mental illness changes the partner they thought they’d married.

Challenges Facing Spouses with Mentally Ill Partners

Here are 5 things I learned from spouses of those with mental illness about their particular “objective” challenges, in addition to the ones we seem to all have in common (financial worries, staying alert to relapse symptoms, coping with family conflict etc.):

Spouses also face:

  1. Feeling like you’ve lost the partnership of marriage. If you always turned to your spouse in times of need, where can you turn now? (I know, in our house, my friends’ sympathy for my Williams’ alcoholic episodes wore thin very fast)
  2. Financial burdens. Coping with the loss of a wage-worker in the household,  if mental illness has led to job loss. (I began to lose count of the number of jobs William lost, or the number of customer complaints when he started his own business, due to unreliability)
  3. Resentment – and sexual distance – that can accompany the change in roles when one spouse takes on the “caretaker” role.
  4. Single-parenting coupled with being primary caretaker of your spouse. (One Mom I met told me about walking down the stairs dressed in her husband’s Santa suit to greet their three young kids, after he’d been hospitalized on Xmas Eve. That may the tip of the iceberg, but it still broke her heart). Worrying about your children’s emotional state as well as your own.
  5. Stigma, social isolation, loss of the “couple friends” group. Invitations dwindle when your spouse’s actions are unpredictable and sometimes embarrassing.

What helps spouses? What helps all family members? In my next post I’ll talk about life balance, and some concrete steps like learning all you can, reaching out for support in new places, and self-care.

Are you a spouse of someone with a diagnosed mental illness? Does this ring true for you? What helps you?

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155 Responses to Marriage and Mental Illness: For Better or Worse?

  1. Fred B says:

    I think my wife may have a slight mental illness. She certainly has a ferocious temper. She functions fine outside the family environment, at work, or with friends, but not at home. We have two very young girls (3 and 5) and I worry about how it affects them. She’s got worse over the last few years, as has our marriage. Whenever I’ve suggested anything like marriage councelling or therapy she reacts badly. To my family and friends, who know she is difficult, I play it down, act like things are OK. I worry they would start to really dislike her if they knew the detail – and it would end up making things worse. I really don’t know what to do- it’s basically impossible to help someone who dosen’t want help. Any suggestions would be welcome.

  2. Marie says:

    My husband has stage 4 cancer with a surgery on the near horizon and was recently (3 months ago) diagnosed Type 1 bipolar with paranoia. We have been together for 3 years and were recently married since last year. Since his diagnosis his mental illness became harder to manage and that’s when he finally decided to get some help. He is on medicine now and that has helped somewhat but with all the stress from cancer he will and we will never quite be the same as we were. My social circle has completely dwindled to a few true friends that I am grateful for. Most people cannot understand what I am dealing with and want me to leave him and they scold me for staying. They don’t see the pain he’s dealing with and his health struggles like I do. I have been the sole caregiver for a year now as well as the parent that makes all decisions for our child. This has been the hardest year of our lives… It is comforting to read these entries, in regards to everyone standing by their partners. I feel very alone with all this. I need people around me that will understand. I definitely think a support group would be helpful but I am never sure where to start.

  3. mellowmtm says:

    I was adopted at a very young age into a mentally ill family; my foster mom & her daughter had suicidal & homicidal ideation. They would have violent outbursts. Thank god I am out of that environment. I suffered physical, emotional abuse. My foster mother tried to sexually molest me. Thankfully I fought the lunatic off me. I vowed to never be like that. I couldn’t imagine if they had been alcoholics on top of that.

    I work as a Paramedic & I am studying to be an ED RN. I deal with mentally ill daily basis. Thank goodness I don’t have to come home to someone with that. I’m single & all the better off!

    DO NOT start a relationship with a mentally ill man or woman. If you notice the red flags when you are dating, CUT OFF THE RELATIONSHIP ASAP.

    Violent outbursts should never be taken lightly. Suicidal ideations should never be taken lightly.

    “Temper tantrums” should not be taken lightly. A grown ass man or woman who throws temper tantrums should be questioned when it comes to sanity.

    Things will not get better with a mentally ill partner. You will spend all of your free time devoting your energy to fit their energy needs when you should be restoring your energy.

    THINK LOGICALLY & RATIONALLY before starting a relationship!

    DO NOT jump into sexual relations. DO NOT jump into the “falling madly in love” BS theory & move in together. Yet, so many people do it only to regret it later on down the road.

    Ask yourself “How well do I know this individual? Would I want to raise children with this man or woman? What would happen if he or she has violent outbursts with the children, like he/she does with me? What if he or she verbally, physically & sexually abuses the children as she/he does with me?”

    All it takes is one swing, one hit, one punch, one threat of violence to end a relationship. Don’t let them trick you into staying. They are desperate & they will say anything(manipulation) to get you to stay!

    What if it gets so bad, a divorce is the only choice?

    Can you be certain the more mentally stable individual will get custody?

    Can you be certain the more mentally stable individual will get the house & car?

    Good luck everyone for getting out of the hellish environment.

  4. Zoe says:

    I am a married woman of almost 28 years. Last spring my husband had a serious manic episode and it turns out he has bipolar 1 and paranoid delusions. We separated in august, i left the family home (actually was forced out by my husband due to his delusions of us trying to hurt him) with our adult kids and started a new life. Our two kids went thre litteral hell with what he put them and myself threw…it was like a horro movie, but i still loved him and resently we got back together in my home after selling the family home he bought me out of due to the fact he couldnt afford it anymore due to not being able to work. I helped him seel the home, took him in, take him to his doc visits for his shots and recently he has changed his shot med and now is back to hating on me. I am heart broken again…so are our kids, and i fear he is going back to hating on us all and we will lose each other again. How much do i endure for him? I can not bear losimg him over and over but i can’t forget the thirty years i have spent with my soul mate…i don’t have any kind of future with or without him, i am tired of waiting for him to pull the rug out from under me again.

  5. Shannon says:


    Thank you for your reply. How are things for you? For me, about the same.

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