It's difficult to help someone with a mental illness. But it's an extreme challenge to have a mentally ill spouse and remain in love.
Deeply in love, Sara and I married 17 years ago. Three years later, Sara was diagnosed with mild depression, and over the next few years she was re-diagnosed several times with ever more serious conditions.
Pieces of Sara’s life slipped away from her. She became suicidal and was hospitalized for three months. She was finally diagnosed as having drug-sensitive, lithium-intolerant, rapid-cycling, atypical type one bipolar disorder (manic depression).
Sara was told she would never work again and was prescribed various cocktails of potent pills–many of which made things worse. Not quite what I had in mind when I vowed to take Sara in sickness and in health. I was thinking of the occasional flu, not chronic, incurable, and difficult-to-treat mental illness.
Managing Many Hats
Being married to a mentally ill spouse is extremely challenging, and divorce rates are sky-high. So how, you ask, have Sara and I managed to remain in love for nearly two decades?
First, I had to acknowledge that Sara was in no way to blame for having this genetic defect. Second, I had to realize that my actions affected Sara’s well-being profoundly, for good and ill, so I had to carefully juggle the roles that I played in our marriage. I have divided these into eight distinct roles.
There will be times when your spouse won’t be able to do anything for themselves, for you, or for your family. You have to care for everyone. But never play the role of doctor. Doctors diagnose, treat, and prescribe; nurses care for, observe, monitor, and report on the patient’s progress.
A broken arm or a failing heart doesn’t define a person, but a brain that is chemically out of balance seems to. A mentally ill person has to deal with sceptical relatives, narrow-minded neighbours, disappearing friends, insensitive doctors, and callous insurance companies. You have to help your spouse deal with them all.
A mentally ill person has had their confidence shattered and their self-esteem crushed. They believe that they aren’t normal, can’t do anything, and are a burden. They feel that they can’t cope with the smallest of problems. Life simply overwhelms them. Your role as your spouse’s biggest fan is to encourage and praise them in whatever they can achieve, no matter how small.
Physical exercise improves your spouse’s health and releases certain chemicals into their brain that make them feel happier. We aren’t talking about marathons or body-building, but just going for walks or attending fitness classes. Your role is to cajole, nag, and beg them to get dressed and out the door. They’ll thank you afterwards, but don’t look for gratitude before–at least that’s my experience.
At times, your spouse’s mind will be murky, thought processes confused, and emotions running wild. You must listen to them with sympathy and without making judgements. Listen for key words which might indicate trouble. Much of what a mentally ill person worries about has no basis in reality. Let them talk and they might see that for themselves; if they don’t, a few carefully chosen words from you may help.
Mentally ill people often have negative and distorted ideas of their appearance, and they become disinterested in having a love life. This is often exacerbated by medications that cause rapid weight changes and loss of sex drive. (I’m puzzled about how an antidepressant that makes you fat and kills your sex drive is supposed to make you happy, but that is for another article.)
I find that planning a romantic event can often improve Sara’s mood for days before, and improve my love-life during. A long cuddle or a bath for two also works wonders. Nevertheless there will be times when your spouse won’t be fully participating and both of you will have to accept that.
Laughter is an excellent antidepressant for your spouse and a great stress-reliever for you. If you don’t have a good sense of humour, develop one–or else you’re doomed!
Despite all this, don’t forget that you are an individual with your own needs and occasionally your own bad days. Don’t become a martyr–that role will inevitably lead to bitterness and resentment. If you’re having a bad day or have a need to be fulfilled, let your spouse help you. Not only will it make you happy, it will also improve your spouse’s feelings of self-worth and importance.
Many mentally ill spouses believe they aren’t worthy of your love and feel immense guilt at what they have burdened you with. In the depths of her depression, Sara has twice offered me a divorce–not because she doesn’t love me, but because she loves me very much and wants to set me free. By letting your spouse help you, they understand that they can contribute not only to your problems but also to your happiness.
Juggling Pays Off
And the reward for playing all these roles? Behind the mask of mental illness, the person you married is still there. The illness will never go away, but by carefully balancing these eight roles, the mask will fall away more often and for longer periods.
I must stop writing now. Sara is making me breakfast, so it must be a good day. I’m off to take advantage of it.