Question

My husband has a mental illness diagnosed and under the care of a psychiatrist. The doctor avoids giving me a diagnosis, as he feels like it labels someone. He takes several medications for his multiple mood disorders. Unfortunately, he is absolutely unwilling to have any psychotherapy. His doctor says he is not a good candidate because of his unwillingness to talk about himself. He was not always this way. The mental illness started somewhere between our 15th and 20th anniversary with anxiety attacks. We have been married almost 40 years. Because of the medications he takes, intimacy has not been part of our marriage, for at least the last 10 years. He has attempted suicide twice and that is a daily worry for me, frequently telling me that he is near the end of his rope. I feel manipulated often by his words and behaviors, but I don’t think he’s aware he does it. I’ve thought about leaving many times, but I do still love him and know that the “real” guy I married is somewhere inside of that broken mind. How do I continue to care for him? How do I cope with the mood swings? How do I find happiness in our relationship again? Any good counsel you can give would be appreciated.

Answer

When you’re married to someone who has a serious mental illness, you will completely drain your emotional, relational, and physical resources if you don’t set realistic expectations and find adequate support for yourself. These are your biggest priorities if you’re going to choose to stay in the relationship. Let’s talk about how you can reinforce yourself to continue forward in this marriage.

If there aren’t ongoing abuse, addiction, or affair concerns, then it makes it more likely that you can experience a more stable relationship. Even though the reality of a mental illness creates relationship instability, it’s much more chaotic when you introduce these other types of traumatic betrayals.

It’s critical to have realistic expectations of what is possible in a relationship like this. Acceptance doesn’t mean that you love what you’re experiencing, but it does mean that you don’t spend your time fighting your reality. I can tell that you’re working to distinguish between what is the illness and what is your husband. Sometimes the two are impossible to separate. However, this is an essential practice if you’re going to hold onto the truth of who he is underneath the affliction of mental illness.

Elder Jeffrey R. Holland gave this sound counsel to caregivers of those who struggle with mental illness:

Try not to be overwhelmed with the size of your task. Don’t assume you can fix everything, but fix what you can. If those are only small victories, be grateful for them and be patient. Dozens of times in the scriptures, the Lord commands someone to ‘stand still’ or ‘be still’—and wait. Patiently enduring some things is part of our mortal education. For caregivers, in your devoted effort to assist with another’s health, do not destroy your own. In all these things be wise. Do not run faster than you have strength. Whatever else you may or may not be able to provide, you can offer your prayers and you can give “love unfeigned.”[i]

If your husband becomes too emotionally volatile or irresponsible with his behavior, then it will be important for you to set healthy limits. This could mean that you legally protect your finances, give yourself permission to leave the home, or other safeguards to respond to the unpredictability that comes with mental illness. Even though you work to understand and have compassion for his condition, you can’t let the reality of mental illness put your own financial, physical, and emotional security at risk.

Getting support for you can take many forms. For example, you can seek education and support through a local NAMI (National Alliance on Mental Illness) chapter.[ii] You can open up to close friends and family who love both of you and can offer a listening ear when you need to talk. You can set up your own separate bedroom to have time to study and ponder. You can ask his doctor or other health providers to be in charge of caring for him so that burden doesn’t fall on you. This might include the services of a case manager, which is a Para-professional who coordinates his care. You can get your own personal therapy to help you problem solve and establish healthy limits so you’re not enabling him.

Make sure you can work closely with his doctor to understand what you can realistically expect from your husband. It sounds like his doctor is still trying to figure out how to help him. Some cases are complex and take time to diagnose. However, if you feel his doctor isn’t getting it right, then don’t hesitate to get a second opinion.

Even though you are his wife and have a responsibility to care for him as your spouse, it doesn’t mean that you are responsible for him if he harms himself or takes his life. Many caregivers have difficulty knowing where their responsibility begins and ends when it comes to a loved one’s mental illness. Some caregivers will experience burnout trying to keep someone alive. If he becomes suicidal or physically dangerous, then please do not hesitate to call law enforcement or other emergency services to get the appropriate level of help. Your support is only support when your husband is willing to work with you to one degree or another. Otherwise, it’s going to be one-sided and you will become depleted trying to keep him stable.

Stay close to others who can help you stay in reality. Even though mental illness isn’t something your husband created, living with someone with a serious mental illness can cause you to distort reality. This means you might allow unhealthy behaviors to happen, ignore your own mental and physical health, or miss important danger cues. Keep getting support and speaking openly and honestly with your support network, including his doctor, so you can stay healthy and grounded in reality.

Your relationship with your husband may not ever reach the level of closeness and intimacy you originally dreamed of, but it is possible to set up relationship that isn’t constantly full of chaos and pain. In fact, you may find times where you feel hopeful, connected, and genuinely happy in this relationship. People living in the presence of mental illness, chronic physical illness, and other long-term struggles can still have moments of joy. I hope you can find a way to stay balanced, safe, and have some measure of joy as you continue forward with your husband.

Geoff will answer a new family and relationship question every Friday. You can email your question to him at [email protected]

About the Author

Geoff Steurer is a licensed marriage and family therapist in St. George, UT. He is the owner of Alliant Counseling and Education (www.alliantcounseling.com) and the founding director of LifeStar of St. George, an outpatient treatment program for couples and individuals impacted by pornography and sexual addiction (www.lifestarstgeorge.com). He is the co-author of “Love You, Hate the Porn: Healing a Relationship Damaged by Virtual Infidelity”, available at Deseret Book, and the audio series “Strengthening Recovery Through Strengthening Marriage”, available at www.geoffsteurer.com. He also writes a weekly relationship column for the St. George News (www.stgnews.com). He holds a bachelors degree from BYU in communications studies and a master’s degree in marriage and family therapy from Auburn University. He served a full-time mission to the Dominican Republic. He is married to Jody Young Steurer and they are the parents of four children.

You can connect with him at:
Website: www.lovingmarriage.com
Twitter: @geoffsteurer
Facebook: www.facebook.com/GeoffSteurerMFT

[i] https://www.lds.org/general-conference/2013/10/like-a-broken-vessel?lang=eng

[ii] https://www.nami.org/