I am excited about this episode today. We all dread mental health issues but today you’ll find out that there is a lot of hope for marriages where one spouse has significant mental health problems.

Mental health is a huge problem that affects millions of people around the world. Disorders including depression, anxiety, bipolar and others impact many more people than you may think and can cause real pain and distress.

Living with a long term mental illness is hard, and so is being married to someone with such a disorder. So today we want to look at the reality of how mental health impacts marriages, and what you can do to support your spouse if you are in this situation.

How Mental Illness Impacts Marriage

We need to be realistic about the impact of mental illness on marriage. Mental illness in one spouse often has a negative impact on wellbeing and marital satisfaction for both the mentally ill spouse and the other[i]. This is normally stronger for the mentally ill spouse but both spouses to feel the effects.

What we’d like to share with you is that for both the ill spouse and the healthy spouse, there are specific mediating factors which can account for much of the marital distress, and therefore be used to help keep marital satisfaction high even when dealing with severe mental issues like mood disorders, anxiety disorders and substance abuse disorders.

Attributions

Mental health disorders (especially mood disorders like depression or bipolar) affect how you interpret your spouse's actions and what you attribute them to[ii]. This attribution effect is important to be aware of.

Mental health disorders cause people to attribute their spouse's actions more negatively. They can also cause people to attribute negative behaviors to being stable parts of their spouse's personality rather than being isolated one-off incidents. This tendency to attribute things negatively leads to lower marital satisfaction over time. Levels of depression themselves do not lead to lower marital satisfaction: all the changes are due to this attribution issue[iii].

Remember our recent episode on attribution and misinterpretations in marriage? We talked about how the way you interpret your spouse’s actions can either set you on an upward or a downward spiral. Mental illness can, if you aren’t careful, make you more likely to see everything as negative, which then alters the way you act and feel. So we really have to watch the attribution piece and thoughtfully counteract that.

Negative Thoughts and Views

People with mental illness will hold more negative views about themselves, and about their marriage. Mental illness can affect perception so that the mentally ill spouse pays more attention to negative events and disregards the good things that happen. Mental illness can also cause people to have more negative expectations about the future[iv]. All these negative beliefs and expectations can influence the way people act and cause them to withdraw and hide away.

Interpersonal Difficulties

Anxiety, depression and personality disorders can all lead to impaired social skills,[v] such as expressing more negative views, difficulty expressing emotion, reduced problem-solving ability, a high need for reassurance and difficulty accepting and believing the reassurances offered.

The cycle of repeatedly asking for reassurance or seeking comfort and the refusal or inability to accept comfort can eventually lead to rejection.

These issues can create interpersonal problems within marriage over time as the non-ill spouse has to constantly reassure and comfort their mentally ill partner without getting as much support in return. Also without getting appreciation for the effort required to support the ill spouse.

To help with this, training in communication and social skills can lead to improvements in symptoms of mental illness, and improve marital functioning at the same time[vi]. Once again the point here is that it isn’t the men...