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Mental illness does not have to ruin your relationship

Sherry Amatenstein, LCSW, is a clinical therapist, and the author of three books, among them, Love Lessons from Bad Breakups and The Complete Marriage Counsler. She gives love advice on programs including Today and HuffPost Live, conduct...

'My spouse has a mental illness and this is how we cope'

One in four Americans suffers from mental illness in a given year. But how do you cope when one of those sufferers is your spouse?

There remains such a stigma around mental illness that your spouse may try to hide it, and you might do your best to pretend to yourself that everything will be fine. Do this instead.

Get a proper diagnosis

When your partner is having an ‘episode,’ it’s all you can think about. When the episode is over and the person you married reappears, the temptation is often to pretend everything is fine. Resist that temptation.

Jerri (names in this article are changed), a New York-based graphic designer, recalls, “When Tina started having what turned out to be a manic episode she’d spend all night scrubbing the kitchen floor like a madwoman, then collapse in bouts of inconsolable tears. Or we’d have fights where she said horrible, unforgivable things. Then she’d apologize and we’d go back to our usual routine… until the next time.”

Luckily a caring friend who was familiar with mental illness convinced the couple it was in their best interest to visit a mood disorder specialist. Tina was diagnosed with bipolar disorder and is now on lithium — a medication that needs to be closely monitored and sometimes tweaked. But on the whole Tina is once again Tina.

If your spouse refuses to visit a psychiatrist, you can keep the appointment and ask for suggestions. If a loved one had physical symptoms, you would insist he or she seek treatment. The same standards should apply to mental disorders.

Be prepared for reverse psychology

When your spouse is in the throes of mental illness, he or she is likely not thinking clearly, and might make a convincing case that you are the one with the problem or other untruths.

Dana, 33, and a Maine artist, explains, “It was a long road to get the diagnosis that Andy has Obsessive Compulsive Disorder (OCD). But it explained so many things, such as his obsession with taking showers three times a day, and his insistence on repeating the same sexual routine each time we made love. Yet when I’d ask if we could vary things a little he’d recoil and act like I had a problem.”

The goal here is not to let this wayward thinking affect your sense of self and good judgment, Dana says, “Once Andy was properly diagnosed, on the correct meds and doing Cognitive Behavioral Therapy (CBT), he realized he was the one with the problem. A year later, he still apologizes effusively for the way he acted.”

The road to mental health is not a straight one — there will be setbacks — which is why it is imperative to do the research on your partner’s condition, consult experts, then proceed on the course you know is ultimately best for your partner’s health and your marriage.

Know that you are a spouse, not a caregiver

Say your partner has a broken leg. It’s likely you do his or her errands, run around fulfilling his or her every need and consider your needs less important. Then the cast comes off and it’s assumed your partner will pick up the slack.

However, mental illness lacks this kind of time frame or definitive signs of illness. Yet it is vital that at some point you take back your life — this means being supportive but setting and maintaining boundaries.

Tami, a 38-year-old Chicago lawyer, has learned the best way to handle her husband’s chronic anxiety disorder is to stop treating him like delicate china. “I’d hold everything in, feeling he couldn’t take another stressor, and eventually I’d explode. It wasn’t healthy. His illness is part of him, but doesn’t define him. Paul is still the man I married 20 years ago. He’s got a therapist, takes his meds, and is capable of sharing in domestic and childrearing responsibilities so I happily ‘retired’ as his ‘clinician’ and became his wife again.”

It’s difficult enough to maintain a healthy marriage when mental illness isn’t part of the equation. When it is, you need to stop squelching your needs and desires and set about fulfilling them via support groups for partners with mental illness, a therapist, educating yourself about the illness, talking honestly with your spouse on a regular basis about how the two of you are coping and practicing self-care methods ranging from yoga to socializing with friends.

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