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Marriage and Mental Illness: For Better or Worse?

What happens when mental illness changes your spouse? Having a husband or wife with mental illness changes the marriage and bring challenges.

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?

When faced with mental illness, family members have two sets of challenges. They seem to be

  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 throughΒ 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,Β  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 the 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 Christmas 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?

154 thoughts on “Marriage and Mental Illness: For Better or Worse?”

  1. It helps to know your not the only one going thru similar problems. I have been married for 21 years and recognized quickly that my husbands behavior wasnt normal. I was glad he agreed to get counseling but found out this wasnt going to work for him, if he was told something hedidnt want to hear he walked out. It has been a rollercoaster life that i wouldnt wish on anyone. The worst part is looking back and thinking why me and having friends and family tell me I was smart enough to know better, which only makes my self esteem worse.

    1. Oh, Jeanne –
      one of the most helpful things I learned at NAMI (National Alliance on Mental Illness) is this “You can’t know what no one has told you.” In this world of marriage counseling, “superwomen”, and self-help books, there just hasn’t been enough support and information out there that would help us see that we are dealing with an illness. Of course you are “smart enough”! – but who thinks mental illness is the issue, when we are constantly told that if we work hard enough, we can “fix” it?
      I’m so glad you found this site. NAMI may be of help to you too. This is not your fault – or even your husband’s fault. It is an illness, and there are things – as you well know – that just don’t work.
      If you get a chance to take NAMI’s Family-to-Family course, it may be of great help too.
      Readers of my book know how long it took to even consider that my son’s problems were illness-related, not behavioral.
      It’s the last explanation we want to think about.
      hang in there. You are NOT alone, and you are NOT to blame.

  2. The five challenges noted above are absolutely correct. My wife has suffered a severe form of bipolar and related issues all of her life, finally diagnosed 18 years ago (we’ve been married 23).

    The wreckage includes suicide attempts, endangering our children, hocking her wedding rings (twice!), beating my wedding ring to smithereens with a hammer, not to mention a general inability to cope with the simplest matters in life. Hospitalizations are routine.

    I long ago decided I’m not really married. I am the caretaker to a person who swings from being an obstreperous child to a sick old woman. Outside of her need to be cared for, and my responsibility to do it, we have virtually no relationship and no common interests or activities. I maintain an active social, philanthropic, and cultural life virtually independent of her. People frequently ask if I’m really married because of the absence of my spouse at most activities.

    She is not at fault for much of this, I’m aware. She’s trapped in a world of loneliness and often confusion and deserves a great deal of pity and nurture.

    Yet I’m so worn down at every level that I now feel I have no choice but to end the marriage. I do not wish to abandon her, and quite likely would not be allowed to by the courts, due to the fact that she’s been wholly dependent on me for our entire married life.

    That being said, I’m interested in finding resources that will allow me to initiate divorce proceedings while also ensuring her ongoing care. Thank you for any thoughts on how to arrive at the best outcome.

    1. Hi Jim –
      Thanks for writing to share your story. I know it must be so difficult – and while you are trying your best to have empathy, it must be so frustrating and heartbreaking.

      I am not qualified to suggest legal actions – but others are. While my book is a memoir with applicable resources in sidebars, there are two books that have many more practical steps in them. One is called “Defying Mental Illness”, the other “When Someone You Love Has a Mental Illness” also “Loving-Someone-with -Bipolar-Disorder” – search the index for practical tips.
      I also highly suggest you reach out to your local NAMI chapter, if you haven’t already done so. Family-to-Family is what saved our family by helping me know when I could help my son and when I could not. Whether you do this, or attend a support meeting (sometimes there are speaker meetings as well, with experts in the field) , your chances of meeting others who truly understand – and who may have local info to share – are good here. They may even know a lawyer who can answer your legal questions.

      Hang in there, and I hope you find a solution that makes the situation better. It will never, as you know, be perfect…

  3. All these stories sound so familiar. I’ve been married 34 years, lots of ups and downs, five sons and one daughter? We still have our daughter at home, she will graduate in June, but we are now raising our grandsons 6 & 9. I feel so stuck and not able to be in the house with him and of course he will not leave the house. I just can’t figure it out.


    1. Hi Susan – Yes, I agree – is is so hard to figure this all out: the emotions, the system, the places to go for help, the symptoms of the illness, the ways to treat, the ways to relate to a relative with a mental illness. Have you joined NAMI? Although no one has easy answers, the information and support available there can be a way to begin.

      You are not alone.

  4. Thank you to the others who shared their experiences as it offered a tinge of comfort in a time of anguish. I am the 15 year spouse of a man whos soul has been robbed by mental illness. I am in a constant state of grief trying to mourn the loss of the man I once knew and loved yet look at him everyday. It has been the most twisted fate imaginable. I know our 8year old son struggles as a result of his fathers illness and the guilt I feel knowing that is undescribable. I have sacraficed my life to continuing caring for this man with nothing in return but anger ,manipulation, and lies. I have considered trying to start anew but do not care to spend the rest of my life looking over my shoulder. May my strength continue to outway my sorrow..best wishes to those in similar prediciments.

  5. The role of caregiver to a spouse with a major mental illness is sometimes a very difficult role to navigate. My husband has panic disorder with agoraphobia and was home bound for 4 years. He also has a phobia of medication and for a period of time was fearful of being alone, so not only was he stuck at home, but anytime I had to be away from home for more than a few hours became a major, dramatic, event. He is no longer home bound, but his world is still pretty small. My feelings range from guilt (how much am I enabling his illness??) to resentment for our lives being dictated by his illness, to grief for the type of relationship I so yearn for, to anger for the difficulty we’ve had in getting adequate treatment, to love, because despite his illness, he is an amazing soul and after 19 years together, I can’t imagine my life without him in it (though I can imagine my life without his illness!). We persevere because we have hope that things will get better. To all the other spouses out there…hang in there. You are not alone!!

    1. Thank you so much for your comment, Lori – I love your words, “he is an amazing soul and after 19 years together, I can’t imagine my life without him in it (though I can imagine my life without his illness!). We persevere because we have hope that things will get better” – these are the thoughts that have often kept me going when my son’s symptoms seemed unbearable.
      Thanks for writing – and you hang in there too.

  6. Hi Randye, It is quite interesting that this subject has come up at this time … My Wife, Best Friend and Soul Mate suffers from Schizo-Affective Disorder, Obsessive Compulsive Disorder,Anxiety,Panic and post Traumatic Stress Disorder … We have been Married for 13 year and are in the middle of a “Major Episode” at this time and she is temporarily not at home … To top it of I am going in tomorrow for further evaluation For Major Depressive Disorder and possible medication among other Things … My point I think is that Love And Faithfulness trumps all … We are constantly in a state of flux yet one thing remains, Our Love and Commitment to each other … Thank You,


    1. Hi Dave – I’m so sorry that you are both facing this challenge – and yet I can feel your commitment to each other even in your e-mail. I’m glad my post may have provided some words of comfort or perhaps a helpful idea. Thanks for writing, and remember to take care of yourself as well πŸ™‚ (healthyplace, NAMI, your own hobbies,etc.)

  7. I’ve been with my husband 38 years and we have 1 child (a daughter, now 34). Life has had it’s ups & downs with his MDD diagnoses 11 years into our marriage. I think the most difficult aspect to deal with, for me, is the anger and the “..it’s all about ME, and MY illness” attitude which I perceive almost everyday of my life. He seems always to be angry & suspicious of family, & our very few friends – thinks everyone is out to “use” him, sigh… I must say there are times I wish I would have ended the marriage & tried for a “normal” life but then again – what’s normal? Presently, he’s retired & I am 4 years away – looking forward to retirement and traveling the US in our 40′ motor coach!

    1. Hi Barb –
      You make so many excellent, heartfelt points. Thanks for taking the time to comment, andf share your experience. “what’s normal?” a really good question… best. Randye

  8. Marriage as intimate emotional relationship between two person of different sex exhibits many psychosocial obligations and demands. However,this coexistence is useful and healthy for spouses and their heirs. When it is about matrimony with mental disorder member in the family, the matter becomes more intrigued. Firstly, every person with mental illness makes a mess in family bosom, beginning from sorrowful emotional influences to deteriorate psychosocial performances of a respective familiar community as whole. On the other side, cohabitation of person with mental illness supply many benefits for itself person. Thus, family as a foundation community offers support and security for its members, as well as mentally ill ones. These prerequisites indicates the main life necessity for mentally ill person. besides other, family life is the best way to manage mentally illness, because it present the natural psychosocial circumstance, where the psychiatric patient recover all its life skills, that was wasted during attack of concrete mental disease.

  9. I am the long time spouse of a husband with a mental illness – depression. We have been together for almost 32 years, married for 28. Your five points are definitely feelings I have experienced over the years. While I suppose I had to act like a single parent, I never let him off the hook and said I was. I always tried to engage him in the children’s care or issues even in his deepest depressions. The financial burdens were not caused by job loss – luckily that was one thing he could always hold on to – but things like, for example, when he sold a car and threw away the money. Or threw away his paycheck. Things like that. I did not discuss his depressive episodes with too many people, only my parents and a few close friends. I made my decision to stay with him and so I do not complain about him. As time has gone on, his episodes are less frequent. I have learned to have boundaries. My biggest feelings of guilt are in relation to our children. They are all adults and have good relationships with their father, but I wonder if things would have been better for them to not have had to deal with the episodes a few times a year as they did. Should I have divorced him and had him out of the house? I never lied for him, they were told it was dad’s illness not them, but it is still something I worry about. My oldest dd has anxiety issues which is why I think that mental illness can be genetic. However, even after everything, he is still my best friend. I cannot imagine my life without him to be honest. We always say that, if nothing else, life has not been boring.

    1. Of ,yes, I agree -Definitely not a boring life with these challenges! Michele, thank you SO much for your first-hand account, and for sharing how you choose to handle this in your marriage – and especially for the positive attitude, when all is said and done, that your husband is your best friend. Wow.
      best to all your family,

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