Marriage isn’t always easy, and neither is managing mental health. When things like anxiety, mood, impulse and substance abuse disorders are present in a relationship, it can be incredibly challenging. But, if we can navigate these things correctly, they can also bring about an even deeper connection and understanding of ourselves and each other. A mental health condition within a marriage can be managed if both partners have the skills and awareness to cope and communicate through challenges.

Let’s talk about it.
Just starting the conversation about mental health can often be the hardest part, so it’s no surprise that some people tend to hide that part of themselves from the people they love. While this may be sustainable for a while, it will inevitably negatively impact the relationship in the long run. By sharing our health history, we’re sharing insight into not just our challenges but also our strengths.

These tools can be used to start the conversation for those suffering or for those concerned that their partner may be suffering with a mental health condition.

• Talk when there are no active symptoms of mania, anxiety, or psychosis present.
• Initiate with a text, email or letter if it feels uncomfortable to speak face-to-face.
• Use “process talk” to introduce a difficult conversation. (“I want to tell you something important that I’ve been worrying about. This is difficult for me to say, though. I hope you can listen and understand.”)
• Find important information online that might help explain symptoms, concerns and feelings.
• Expect to be asked questions. Expect to not have all the answers.
• Be prepared for them to have mixed reactions and emotions.
• Listen.
• Be honest with each other.

It won’t always be easy.
Because many of the symptoms of mental health conditions express themselves through social behavior, it’s natural to feel hurt by the symptoms. We tend to assume behavior is conscious and deliberate, but with mental health conditions, things are not always so black and white. It’s important to embrace the gray in these situations. According to licensed marriage and family therapist, April Eldemire, the following issues are commonly present in relationships that involve mental health conditions.

1. Shame, guilt, embarrassment. The stigma associated with mental health can add an extra layer of stress for both partners. The person with a mental health condition may feel shame, embarrassment, or guilt about their condition, and may try to hide symptoms or fail to seek help. Meanwhile, their partner may feel confused or frustrated by their inability to help. In some cases, a person with depression or anxiety may find it hard to complete household tasks, have limited emotional availability, struggle to maintain employment, and lack the desire to socialize. For their partner, these behaviors and challenges can put a strain on the relationship which may lead to feelings of disappointment or even disconnect.
2. Intimacy problems. Having a mental health condition can make a person disinterested in sex–either as a result of the condition itself and/or as a result of the treatment. Many people with mental health issues may feel inadequate and have performance anxiety and low self-esteem. For both partners, this can lead to a decreased opportunity for bonding and result in unmet needs.
3. The risk of codependent behaviors. Codependency is an unhealthy relationship pattern that manifests as one partner enabling another person’s poor mental health, addiction and/or coping strategies. The partner of a person with a mental health condition may start to derive their self-worth from the degree to which they are “needed” or how much they are able to “take care of” their loved one. In extreme cases, codependency can increase the risk of abusive behaviors, including manipulation, name-calling and other unhealthy dynamics.

But it is manageable.
While conversation is the first step, it shouldn’t be the only step. Seeking professional help both individually and as a couple can help with managing expectations and fears, setting boundaries, and with developing the tools to cope when symptoms arise.  

No two people struggling with mental health issues are the same, which is why a trained professional will be vital to providing valuable insight into navigating the challenges that come with living with a mental health condition. 

In relationships, challenges often come when we try to hide a piece of ourselves from those we love. Dealing with mental health is no different. The more open, honest and understanding partners are with each other, the easier it will be. 

Finally, it’s important to remember that a good relationship should always provide valuable social support during difficult times. A bad relationship will inevitably worsen the person’s mental health symptoms. However, if a relationship is not conducive to safety and growth, then it may be time to reevaluate the partnership. ■