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TheRelationshipCafe 04/08/08

Mental Illness and Your Marriage

To enter into the holy covenant of marriage is one of the ways we are allowed to glimpse our relationship to the Lord. We are told that we are now “flesh of my flesh and bone of my bone.” (Genesis 2: 23) United together, we are to cleave to one another.

What are we to do if we discover our mate has emotional problems, or worse a mental illness? What if their disorder is of such magnitude that it—the illness—causes havoc and chaos in the relationship?

There is, of course, no simple answer to the question. I can´t imagine walking in a young womans´shoes who finds that she is married to a schizophrenic, or perhaps a man finds he is married to a woman struggling with Borderline Personality Disorder. Platitudes won´t help this man or woman. Simple instruction to pray and hope will likely be met with anger and resentment. 

Consider this recent note from a woman who is struggling to maintain hope in her marriage.

Dear Dr. David. I have been married for over fifteen years to a man who has severe depressive episodes. It is not just that he is moody at times. He goes into serious slumps when he doesn´t want to go to work, pays little attention to me, won´t attend church and has even mentioned suicide. He won´t see a doctor, and I´m at my wits end. What can you tell me that might help with a spouse who doesn´t want help, but who´s mental illness is ruining our marriage?

Your letter reminds me, and all of us, that mental health issues are serious, and it is time we talked openly about them. Depression is one of many disorders striking many lives and has very debilitating effects.

Your note is particularly concerning in that your husband won´t seek help. Depression, which strikes at least one in ten adults, is not only very common, but very treatable. Your husband can be helped but he must reach out for it. Here are some things to consider.


First, we must be careful about the use of labels. Even calling your husband´s depression a mental illness is questionable, and probably not helpful. What is helpful is to describe the symptoms, determine if it fits a particular diagnosis, and then get on with the effective treatment.

Second, you can help your husband by not being in denial about his depression. That means that you must talk openly about it Pretending it doesn´t exist, that he doesn´t have mood swings and times of suicidal thoughts, only makes matters worse. Educate yourself about depression. Understand that men are particularly vulnerable to denying their depression and refusing to seek help for it. I discuss this issue at length in my book, Does Your Man Have the Blues?

Share with him some of the symptoms of depression, such as:

• Constant low mood
• Loss of appetite and outside interests
• Change in sleeping habits
• Loss of energy
• Loss of libido
• Mood swings
• Thoughts of suicide

Third, he must be evaluated and diagnosis is critical. There are many possible origins for his depression, including, but not limited to, nutrition, alcohol use, grief, adjustment to stress, spiritual issues and likely biochemical changes. He must see a physician to rule out physiological issues, and then, if appropriate, seek counseling.

Fourth, you may need to set some difficult boundaries. While love certainly means bearing with your husband’s weaknesses, this must not be confused with enabling them. Depression is a very serious issue—and treatable. But he must seek help and you must calmly, consistently confront him.

Fifth, it is very likely, given the length of time he has been depressed, that he may need medications. Consultation with a qualified physician is needed. Invite your husband to go to your family doctor to discuss the matter further.

Finally, depression is treatable. Through the combined use of nutrition, spiritual counsel, psychotherapy and medication, depression can be effectively treated. You must take action. Depression is a serious threat to your husband´s life, certainly to your marriage, as well as to the quality of life for both of you. And---it is unnecessary.

How have others handled their mate´s emotional and mental illnesses? What has worked and what hasn´t? We want to hear from you.

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