WHEN YOUR SPOUSE IS MENTALLY ILL

 

spouse-mental-illnessThis post is about how to recognize when your spouse seems to be showing actions and behaviors that are detrimental to establishing a successful marriage that are more than the general “insecurities” we all have and are responsible for managing.  I will also talk about what to do when you begin to think that your partner may be suffering from a mental/emotional illness, and how to be married to someone who is mentally ill.   There are links to sites addressing bi-ploar disorder, debilitating anxiety, clinical depression, schizophrenia, alcoholism, drug addiction, and serious personality disorders such as narcissism, paranoie, and borderline personality in the context of marriage.  I will provide an introduction to deciding when and how to divorce a mentally ill spouse.

How Do You Know?

An article in the Huffington Post in 2012 written by Sandy Malone, a former journalist turned wedding planner, was right on target when she asked:

“How do you know and what do you do when your wife or husband starts suffering from a psychological condition?  How can you tell the difference between a series of bad days and a real problem.  How is a husband or wife to know when their occasionally moody spouse has gone from having a ‘glass is half-full as attitude’ to actually suffering from clinical depression?”

While Malone says it’s really hard to know, she notes that mental illness may manifest itself in your marriage as big and nasty fights, sustained silent standoffs, and/or withdrawing from sexual contact.  When fights or standoffs persist despite your efforts to look at yourself first, making repeated attempts to identify issues that bother your spouse, and making repeated attempts to negotiate issues.  When nothing works, it may be time to start thinking that something different than just marital conflict is occurring.

Often people are battling depression, anxiety, or other devastating mental disorders without understanding what is happening.  As Malone notes a young mother may fall apart and be labeled “overwhelmID-100277147ed”, under “stress”, or getting the “baby blues” when it is really post-partum depression.  Your husband having a panic attack may look just fine while inside he thinks he is dying.  He may not share this with you because of embarrassment and fear of being seen as “crazy”.  A mother suffering from bi-polar disorder may stay up of all night working on a work-project and then just barely be up to get the kids to school and home on her day to take care of the children.

Malone notes that you may get through specific episodes of mental illness.  You may say nothing to each other or you may have a fight.  Neither of you wants to remember the turmoil and the things you may have said to each other.  Not dealing with the rising fears about what is happening only serves to undermine further your marriage.   As the less impaired, less stressed spouse it is likely you will hold back worries and concerns so as to not overload your spouse.  Holding back like this only increases the difficulties for your spouse even if he/she does not fully understand what is happening.

Taking the First Step

So what can you do if you think your husband or wife may be suffering from mental illness or psychological problems? You can take a page from what we have learned about confronting the problem of alcoholism or alcohol/drug addiction.  Here are several suggested steps.

  1. Do not confront you spouse in the midst of an argument, etc. Choose a good time to initiate a conversation with your spouse about his/her behaviors/actions that you are concerned about and that have a negative impact on you and the marriage.
  2. Express your concerns. Talk about your worries, trying not to lecture.  You may have to work to imagine yourself in his/her shoes in order to be gentle and kind.  Give as clear examples as you can about the problems you are experiencing, e.g. “When you get angry, you are not able/willing to tell me what you are angry about.”  “We no longer have sex; I miss our intimacy.”  “When you drink too much, you get sullen and won’t talk to me.”  These kinds of clear statements directly state the problem and the negative results that happen.
  3. Find you what your spouse thinks in a neutral way. Next, ask him/her if these actions are a problem for him/her too.  Wait for him/her to answer. If he/she agrees that he is having a problem, you may want to ask questions like, “Why do you think you are having a problem with ___________?”  “What do you think you can do about ____________________?”  If your spouse can acknowledge that he/she is having difficulties, you can begin to negotiate the next steps to seeking help.
  4. Chip away at their refusal to address the problem. If you spouse denies that they have a problem, don’t expect to overcome their denial with the “blunt hammer” of rationality.  Instead, continue to try to express your concerns and addressing their excuses from a place of compassion, rather than judgment.
  5. You can put limits on your relationship. If your spouse is continually unwilling to get help and continues to show the problematic behaviors and actions despite your efforts, you may need to set clear boundaries on your relationship. For example, tell him/her that you cannot spend time with her/him when they act in the problematic way you have described.   It may come to telling him/her you need a break until they’re willing to seek help.  Explain that you care and want to help, but that his/her actions are having too big of a negative impact on your life.  In the short term, this will likely lead to resentment, but in the long term it may lead to your spouse beginning to recognize the impact of his/her behavior on those around them.
  6. Consider getting professional help.   If your spouse won’t cooperate, make an appointment with a physician, psychiatrist, or psychologist to go to together so that you can discuss the concerns you have about your spouse.  If you spouse will not cooperate, go on your own to get further help and guidance on how to proceed.

Advice on how to live with a mentally ill person 

There is a very good article “Along for the Ride” on the blog BrainPhsics.com written by a woman about a husband with Obsessive-Compulsive Disorder (OCD) describing her excruciating tale of what they both went through before identifying the problem and getting treatment.   Here are several important things this wife has to share about how to manage living with a mentally ill person.

  1. Know your enemy. The more she learned about William’s (her husband) illnesses, the more she was able to understand his behavior.  This allowed her to be more empathetic toward William and to be more positive about his treatment.  Obsessive-compulsive disorder is characterized by intrusive thoughts followed by rituals aimed at warding off the anxiety-provoking obsessions. This explained the bizarre sexual thoughts and William’s subsequent, drastic actions.   In her words, “Although much of the time it felt like my husband was the enemy, the illness is the true enemy. If your spouse has a mental illness, arm yourself with as much information as possible. A full psychological evaluation is critical. Read books, talk to the doctors, and even take a class if you have time. The more you know, the easier it will be to sort out the illness from the one you love.”
  2. Get the right kind of treatment It may take a while to find the right treatment for the particular illness your spouse has. You can read the individual stories I have provide in this post that make suggestions about different approaches for different illnesses.  For example, it took several years for William to settle on a combination of Cognitive-Behavior Therapy (CBT) and the judicious use of the antidepressant Zoloft.
  3. Do not participate in your spouse’s illness.William’s wife thought she was being supportive by offering continued reassurances and listening to William’s confessions, which turned out not to be so helpful.  She heard of cases where spouses enabled an ill spouse with his or her irrational OCD rituals.  Talk to your spouse’s clinician about what your role in the treatment should be. You can affect your spouse’s recovery for better or for worse.  However, don’t fall into the trap of thinking you can cure your mate. The illness is his responsibility.
  4. Remember, you are the healthy one! When your spouse is not thinking clearly, which can happen in any illness, he or she may try to convince you that you are the one with the problem. You may start to question your own judgment at times. Do not allow your partner’s disordered thinking to affect your self-esteem; trust your own judgment.
  5. Get family counseling/therapy. It is likely that keeping your marriage intact will require couples and/or family therapy.  In addition, this is one of the best ways to learn how to be helpful to your ill spouse.  Make sure you find someone who has a good understanding of your partner’s disorder.
  6. Get support. As William’s wife says, you can’t do it alone.  You impaired spouse cannot be your only source of emotional support.  Maintain as many friendships as possible. Find a support group for yourself and go to meetings for family members with the illness your spouse has.  This is a great source of education and coping strategies.
  7. Keep going with your own work and social activities. It’s important for you to continue with your own life activities; continue the things you do without you spouse.  You need to have a life of your own, which can sustain you if/when the next bout of the illness occurs.
  8. Have realistic expectations. Even when your spouse is being successfully treated, he/she may still act in ways that surprise you.  William’s wife, for example, asked him to take her to the doctor when she began to miscarry a pregnancy.  William suggested she go alone, because he had so much work to do, even though he had taken a leave of absence from work.  After the fact, she realized that his anxiety impaired his ability to respond appropriately.
  9. Help others. William’s wife found that after several months of attending her family support group she had something to offer others who were just beginning on the road to recovery.  This felt good to her and she later joined other relevant associations.  She felt helping others gave some meaning to what was the worst experience she had ever endured.
  10. Expect setbacks.  Remember, a relapse can happen even with excellent treatment.   With most mental disorders there is no cure; there can be effective ongoing management of the condition.  It is important to understand that there will be setbacks; knowing this may make it easier to handle when they occur.
  11. Recognize progress.  During times of difficulties or setbacks, it is important to recall the progress in treatment that your spouse has made.   The more you know about the illness and the better your relationship, the more likely that you can manage this.

William’s wife ends her comments with:                “

 “Though I’m grateful that we’ve made progress and found

some good treatments, I reflect soberly on the losses and

many unknowns. I lost my husband for over a year and still

don’t know who he is much of the time. I’ve lost many of my

‘friends,’ our church, my sanity at times, and even our unborn

child. I realize that life has no guarantees, that my husband

or children might wrestle with the same demon on another day.

I hate the struggle, but I know I’ve come out stronger. Though

I don’t have any satisfying answers yet, I turn to God for strength.”

A list of references

Here is a list of articles by spouses dealing with specific illnesses.  Hearing someone else’s story is a great way to get a handle on what may be happening in your life.

Alcoholism:  Guide to Living with an Alcoholic.  DualDiagnosis.org.  (http://www.dualdiagnosis.org/alcohol-addiction/guide-living-alcoholic/).  The Secrets to Helping an Alcoholic Family Member or Friend.  Discover Place.  (https://www.discoveryplace.info/secrets-helping-alcoholic-family-member-or-friend

Asperger’s.  Dealing with an Asperger’s Husband: Tips for married couples.  (http://www.adultaspergerschat.com/2012/04/dealing-with-aspergers-husband-tips-for.html)

Bi-Polar Disorder.  I lost my husband to bipolar disorder.  Sue Sanders and Francesca Castagnoli.  (http://www.cnn.com/2013/07/24/health/change-mind-real-simple/)

Borderline Personality Disorder (BPD):  Living with and Loving Someon with Borderline Personality Disorder.  Linda Sapadin, Ph.D. PsychgCentral.  (http://psychcentral.com/blog/archives/2013/11/15/living-with-loving-someone-with-borderline-personality-disorder/) http://psychcentral.com/blog/archives/2013/11/15/living-with-loving-someone-with-borderline-personality-disorder/psychcentral.com/…/living-with-loving-someone-with-borderline-personality-disorder

Depression:  How to Deal with a Depressed Spouse.  Sari Harrar.  http://www.rd.com/health/wellness/how-to-cope-with-a-depressed-spouse/

Narcissism:  7 Strategies for Dealing with the Narcissist You Love.  Dr. Craig Malkin.  The Huffington Post. (http://www.huffingtonpost.com/dr-craig-malkin/7-strategies-for-dealing-_b_5192851.html)

Paranoid.  7 Tips for Coping with a Paranoid Partner.  Carrie Barron, M.D. Psychology Today. (https://www.psychologytoday.com/blog/the-creativity-cure/201601/7-tips-coping-paranoid-partner)

Psychosis:  My Lovely Wife in the Psych Ward.  Mark Lukach.  The Pacific Standard, January, 2015.  (https://psmag.com/my-lovely-wife-in-the-psych-ward-2edac99d046e#.rnmiloo9q)

PTSD (Post-Traumatic Stress Disorder) and TBI (Traumatic Brain Injury):  To the Spouses Who are Enduring Hell.  (http://armyreservistwife.blogspot.com/2010/06/to-spouses-who-are-enduring-hell.html)

When do you consider divorce?

Deciding to divorce a spouse who has a mental illness is painful and complex decision.  There will be enormous social pressure and guilt in deciding to end your marriage to someone who is mentally ill.  After all, you took those wedding vows to be married “in sickness and in health”.  You will need a lot of help to make such a decision.  I strongly recommend that you seek professional support advice in making this decision. As an introduction, I suggest taking a look at a blog by Mandy Walker who is a Divorce Coach and Mediator.  Her blog is called “Since My Divorce, Easing the Pain and Stress of Divorce”.  Take a look at “Deciding to Divorce when your Spouse has a Mental Illness” posted on February 19, 2014.

The post begins with a poignant story about a husband with a bi-polar wife and two young sons.  Here is an excerpt from Jeff.

“I’ve drawn a boundary for myself. No matter what she does,

I have that promise to myself. I’ve had to really try hard to

stick myself to that promise and she’s actually helped me keep

it by being worse. Now, she’s rebounding and going through

the good phase of the cycle, now, she’s medicated, it’s going

to be a lot for me to break that promise to myself and remain

with her.  I don’t feel guilty about wanting to divorce and I’m

not even angry with her.  I know she has a disorder and she’s not

choosing to behave this way, but I have to keep her at arm’s

length. If I was angry with her, it would just create more

opportunities for her mania and episodes.”

Here are a few of Walker’s suggestions as you consider leaving or divorcing a mentally ill spouse, which is a very complex decision to make.

  1. Separate the decision to end your marriage from taking the steps to end your marriage
  2. Deciding how will be easier to figure out once you believe divorce is the best option for you
  3. Learn as much as you can about your spouse’s condition (typical symptoms, treatment, on-going issues, long-term prognosis) so you can formulate a future picture and get a handle on the possibility for change
  4. A legal separation may address concerns you have with breaking your marriage vows
  5. Think in terms of a loving detachment that involves:
    • Recognizing the process will take time
    • Considering how to help you spouse to be self-sufficient
    • Creating a parenting plan that keeps your spouse involved in a way that I safe and feasible
    • Not holding your spouse’s condition against him/her in order to penalize her/him
    • Leaving without anger or resentment

 

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