Mental illness is tough on couples. “The stress level often stretches into a crisis mode, in which managing the illness becomes, for all intents and purposes, the sole function of the relationship,” said John Duffy, Ph.D, a clinical psychologist who works with couples and author of the upcoming The Available Parent: Radical Optimism in Raising Teens and Tweens.
“The mental illness has a way of wanting to direct the movement of the relationship, rather than the individual partners,” said Jeffrey Sumber, MA, LCPC, Chicago psychotherapist and relationship coach. But remember that couples have the ultimate control.
“It is not true that a mental illness can destroy a relationship. People destroy a relationship,” Sumber said.
Here’s what you can do to maintain a healthy relationship rather than a relationship overwhelmed and steered by mental illness.
- Know the illness and treatment options. Mental illness is confusing for everyone involved. You might think your spouse is being lazy, irritable, distant or distracted. But these supposed character flaws might really be symptoms of the mental illness. Also, make sure your partner is receiving effective treatment.
- Find out how to help. “Learn from a mental health professional what role you might be able to play in the treatment plan,” Duffy said. Not knowing how you can help can be frustrating for both partners. Find out how you can best support your spouse during his or her treatment.
- View the diagnosis as another challenge. “Healthy couples don’t allow mental illness to run their relationship but encounter diagnoses as just other challenges to the relationship,” Sumber said. Challenges can be overcome.
- Work on your marriage as you would without the mental illness intruding. “Honor and care for your marriage as you would without the presence of the mental illness,” Duffy said. He often sees “couples fail to attend to their marriage through dating, talking and sharing, creating feelings of isolation, which compounds the stress of the illness itself.”
He recommended carving out time when “you both can fully enjoy one another, at least for a few hours.” This also helps couples become more resilient during tough times.
- Maintain positive communication. “In my experience, couples who continue to say ‘I love you,’ or to check in during the day via phone calls or texts, tend to fare much, much better in terms of relationship longevity,” Duffy said.
- Admire each other. Stress is a common and overwhelming challenge for couples coping with mental illness. According to Duffy, “there’s some very good research that suggests that, regardless of the level of stress, couples that sustain a sense of admiration for one another co-create relationships that tend to survive.”
- Check in with each other. Every week, sit together for 15 minutes and talk about your “needs and intentions for the coming week,” Sumber said. Start with “appreciations and affirmations from the preceding week,” he said. Healthy couples “spend a large amount of their focus on appreciating their partners for even the smallest things.” This helps keep couples accountable for their relationship’s wellbeing, he added.
- Practice self-care regularly. Many people see self-care as selfish but “you need to have a lot of energy to help your partner manage such an illness, and taking care of yourself is critical,” Duffy said. Not focusing on your own health increases the risk “the disease will pull both people in” and jeopardize the marriage, Sumber said.
Be sure to get enough sleep, eat well, participate in physical activity, spend quality time with loved ones and engage in enjoyable activities. “For the best self-care plans,” Duffy suggested Cheryl Richardson’s books, especially Take Time for Your Life and The Art of Extreme Self-Care.
- Don’t expect your partner to meet all your needs. In fact, this is normal. “Couples that split up are typically stuck in the paradigm that their spouse is here to make them happy and meet all their needs. These couples distort personal needs into projected expectations and then become resentful and angry when the other person doesn’t meet their needs,” according to Sumber.
- Avoid blaming. Both experts often see blaming on both sides, which can go beyond the mental illness. “The ‘healthy’ spouse runs the risk of blaming everything that goes wrong in the relationship on the other person, which is also typically not the case,” Sumber said.
This becomes an “unhealthy dynamic for a relationship,” Duffy said. His suggestion is to cultivate understanding. “Express curiosity over judgment.”
“Ask open-ended questions about the illness, and really listen to the answers,” he said. You may not like the responses, but understanding is better than ignoring the reality. Not knowing how your spouse is truly doing can be detrimental. “You want to understand them, even this difficult side.”
For instance, if your spouse struggles with bipolar disorder and tends to act out, try to “communicate your concerns, feelings or anxieties in a non-blaming way so that communication is the process that keeps the relationship flowing,” Sumber said.
Also, remember that “both people need to be responsible for themselves, their healthy responses to situations rather than unhealthy reactions, and their intentions and picture for the marriage,” he said.
- Seek individual counseling. If you can’t “communicate your feelings in a nonjudgmental or blaming manner,” voice them in individual counseling, Sumber said. This way, you can process them in a healthy way when you’re with your partner.
- Seek couples counseling. “Counseling provides perspective, balance and guidance in a situation that can easily become imbalanced under the wrong circumstances,” Sumber said. Because the mental illness can drive your relationship, couples counseling can be a tremendous help.
Many people say that counseling isn’t in their budget. But, as Sumber said, “just as we require gas and electric to make our daily existence run smoothly, a good therapist is a nonnegotiable expense for both people.”
- Learn from the struggles. Ask yourself what lessons you are being offered in the situation and if you are learning them well, Sumber said. Specifically, consider: “How are you responding to the challenges of your life? Are there ways you can do it better or different?” Think about “the person you truly desire to be.” “We choose partners that will challenge us to grow and this is no exception,” he said.
Remember that every relationship has brief periods of drama, and it’s easy to let these hurtful moments overshadow your entire marriage. “The truth is that if two people love one another and are willing to make things work, they can with good process and impeccable communication,” Sumber said.