Supporting Your Spouse With Severe Mental Illness: A Guide to Stability and Care
Unfortunately, there’s still a lot of stigma surrounding serious mental illness, potentially making it harder for you or your spouse to seek support. You may worry that your friends and family may judge or view your partner as a “failure.” Or, you might feel emotionally burned out if you perceive that you don’t have a stable network of support.1
On this page, we explore how to support a spouse with serious mental illness through an empathetic, evidence-based approach. Focusing on actionable areas that help reduce stress within your and your spouse’s control can empower you both in achieving healing and recovery.2
This article discusses:
How to understand your partner’s condition- Conditions that are considered to be serious mental illnesses
- How to communicate with a mentally ill partner
- Tips on how to speak to a partner with mental illness
- How to help a partner with mental illness
- Support options available to family members of people with mental health conditions
- How to find support
Understanding Your Partner’s Condition
Education is key to helping you understand how mental health conditions affect how you think, feel, and act. Having a serious mental illness may affect someone’s well-being and ability to carry out day-to-day tasks, including those at home and at work. Also, poor mental health could cause your spouse to neglect their self-care and become withdrawn, removing themselves from any social contact.
Education on mental illness is key for the following reasons:1
Education helps reduce stigma and promote increased understanding in families. With increased awareness, you can encourage your spouse to feel empowered to seek mental health treatment.- Greater understanding may help you to be able to offer empathy and be as actively involved in your spouse’s care as possible.
- By understanding the signs of mental illness, you can promote and be involved in early intervention and prevention.
Which Conditions Fall Under the Subset of Serious Mental Illness (SMI)?
- Severe bipolar disorder (bipolar 1): In its severe form, bipolar disorder is a condition of extreme mood instability and can include psychosis. Psychosis is when someone hears voices or has visual hallucinations that can lead them towards self-harm, or thoughts of harming themselves. Someone with severe bipolar disorder can fluctuate in mood from depression to mania, either rapidly or across a period of time. Family members may see psychosis more commonly occurring during a period of mania.
- Major depression with psychotic features: Sometimes, major depression can occur with periods of psychosis. Major depression, otherwise known as clinical depression, is when someone has a persistently low mood or sadness without any identifiable cause.
- Schizophrenia spectrum disorder: Schizophrenia spectrum disorder is a range of conditions that all have elements of psychosis. Psychosis can present differently in different people. Some people might experience extreme paranoia and start hearing voices. They may also have delusions and or visual hallucinations.
How to Communicate With a Mentally Ill Partner
Communication can be the first thing that starts to break down when someone is mentally unwell. It may be hard to know what to say, but opening lines of communication with your spouse can help reduce stress and make your spouse feel heard – strengthening your relationship. You could do so by gently bringing awareness to how you’ve noticed your spouse’s struggles. For instance, you might say, “I’ve noticed you seem to be having a really hard time lately. How can I help you?”
We cover some further tips on how to speak to a partner with mental illness below.
Tips on How to Speak to a Partner With Mental Illness
1. Listen First
It is hard to sit alongside someone you love who is distressed and not jump in and fill the space by talking too much or trying to “fix” the problem. Reflective listening is a way to build trust in your relationship and requires you to pause to take in what someone is saying, before paraphrasing it back to them. There is an attitude of openness to reflective listening, and you could say something like:
“You seem to be saying that you have little energy and are feeling a sense of hopelessness. Have I got any of this right?”
2. Ask Open-Ended Questions About Their Mental Health
Asking open-ended questions avoids a closed-down “yes” or “no” response and, instead, invites more detailed responses. The following examples of open-ended questions may give you an idea about what you could ask.
- “How would you describe your mood today?”
- “How can I help you to organize your appointments?”
- “What would it take for you to feel less anxious?”
3. Avoid Shaming, Blaming, or Judgment
Therefore, avoid shaming your partner when communicating with them. Try to remember the bigger picture and what your long-term goals are for the relationship. In other words, pick your battles and try not to get defensive. For instance, you could express yourself in nonjudgmental ways and by using “I” statements, like, “I am concerned because you seem really distant as if it’s hard for you to hear me?”
How to Help a Partner With Severe Mental Illness
Below are some practical, daily habits for improving your own emotions. This way, you can feel more balanced in your moods and emotional responses to stress.
Exercise: Exercise, in any form, can promote emotion regulation and improve mood.7- Journaling: Expressing emotions through journaling can help you tune in to what you’re feeling. It works as an act of self-care by reducing stress and providing an outlet for your feelings.
- Mindfulness: Learning to be present in the moment can help you become less reactive to stress. Mindfulness can be practiced through daily yoga, meditation, and breathwork.
How to Help a Partner With Depression
The more you can understand the symptoms of depression, the more you can be aware of the signs of when your spouse is struggling with their mental health. Also, this allows you to promote earlier identification and mental health support.
If your partner is struggling with a recent diagnosis, or with a long-term chronic depression, it may be important for you to build a network of support around them. You can do so by…
- Listening to them, showing empathy and concern
- Asking how you can support them
- Offering to be an advocate for them, for example, by attending any mental health appointments when you can
- Being involved and engaged in their treatment plan
- Encouraging them to join support groups
- Recognizing that you can’t be their therapist. You can be there for them and support them while still keeping your own boundaries.
Supporting a Partner With Anxiety
Depending on their symptoms, your spouse might be advised to undergo cognitive behavioral therapy (CBT) or mindfulness therapy to improve symptoms of anxiety. If they choose to see a therapist, you can support them in the following ways:
Validate their feelings.- Let them know that you are there for them.
- Understand that certain behaviors, such as lack of eye contact, are part of their condition.
- Come up with a plan together for when they feel anxious.
- Encourage them to engage in regular exercise.
Living With a Spouse With Schizophrenia
Schizophrenia is a complex mental health condition where a person can have episodes of psychosis.9 Psychosis is when someone loses contact with reality, and they may not be able to differentiate between what’s real and what’s fantasy.
Taking medication regularly can help your partner feel more in control of their symptoms. However, if you have any concerns about medication, it’s important to speak to a doctor, as they can talk you and your partner through any possible side effects.
Alongside coping with psychosis in the form of delusions or hallucinations, someone with schizophrenia may change their behavior towards others. For instance, they may express emotions inappropriately or show a lack of awareness of personal boundaries. They may also neglect self-care, such as sleep, diet, and hygiene. In severe cases, it may be possible that someone with schizophrenia and psychosis cannot live independently.
To reduce distress, worries, or stress around helping a spouse with schizophrenia:
- Create a safety plan to turn to during times of concern10
- Keep suicide and crisis helpline numbers on hand in case of emergencies
If you ever feel afraid, or concerned for your own safety or your partner’s, contacting crisis intervention for advice and support is important.
Supporting a Partner With Bipolar Disorder
Bipolar disorder is a mental health condition associated with extreme disturbances in mood. Someone with bipolar disorder may experience periods (or episodes) of mania. During a manic episode, it is possible to feel elated, meaning they may not sleep much, experience hallucinations, or have an increased sexual drive. A manic period is then typically followed by a severe low mood.
Symptoms of bipolar disorder can be managed with medication, therapy, and support to maintain a healthy lifestyle. However, you can also help a partner by…
- Encouraging them to follow their treatment plan
- Helping them remember to take their medication
- Prompting them to engage in regular exercise
- Supporting them through meditation or taking part in activities they find calming
- Trying to find moments where you can have fun together
- Reminding them that by taking these steps, it is possible to get better
What Support Is Available for Family Members of Loved Ones Who Have a Mental Health Condition?
There are many different forms of support that family members can access. Such as:
1. Mental Health Support Group
Attending a support group can be helpful, as there is mutual understanding from other members experiencing similar challenges. Support groups can be offered either in person or online.
2. Couple's Mental Health Support
Recovery from mental illness often relies on the support of family. Couples therapy addresses any conflict in a relationship, as well as offers ways for partners to communicate effectively.
3. Interpersonal Therapy
This form of therapy explores the dynamics of family relationships. We all have blind spots when it comes to our own dynamics in how we relate with others. Interpersonal therapy helps you to problem solve and improve the quality of your relationships so that symptoms are improved.
4. Trauma-Focused Therapy
This is a form of therapy to process trauma, emotionally and psychologically, and it promotes healing from trauma-related symptoms.
5. Cognitive Behavioral Therapy (CBT)
This is a structured, short-term therapy to help change negative thought processes and behaviors.
Find Support for You and Your Partner Today
Families are uniquely placed to recognize the signs and symptoms of mental ill health.
Having family members who are empathetic and actively involved creates trust, which, in turn, promotes healing and recovery.
This is why, at Mission Connection, we support both those struggling with mental health and their loved ones. If your spouse, or someone you know is struggling with mental health, contact us today to find out about the range of treatment options that we offer.
References
- Struening, E. L., Perlick, D. A., Link, B. G., Hellman, F., Herman, D., & Sirey, J. A. (2001). Stigma as a barrier to recovery: The extent to which caregivers believe most people devalue consumers and their families. Psychiatric Services, 52(12), 1633–1638. https://doi.org/10.1176/appi.ps.52.12.1633
- Brun, C., & Rapp, R. C. (2001). Strengths-based case management: Individuals’ perspectives on strengths and the case manager relationship. Social Work, 46(3), 278–288. https://doi.org/10.1093/sw/46.3.278
- National Institute of Mental Health. (n.d.). Mental illness. https://www.nimh.nih.gov/health/statistics/mental-illness
- National Alliance on Mental Illness. (2024, December 3). Mental Health Conditions | NAMI. https://www.nami.org/about-mental-illness/mental-health-conditions/
- De Hert, M., Correll, C. U., Bobes, J., Cetkovich‐bakmas, M., Cohen, D., Asai, I., Detraux, J., Gautam, S., Möller, H., Ndetei, D. M., Newcomer, J. W., Uwakwe, R., & Leucht, S. (2011). Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry, 10(1), 52–77. https://doi.org/10.1002/j.2051-5545.2011.tb00014.x
- Oexle, N., Müller, M., Kawohl, W., Xu, Z., Viering, S., Wyss, C., Vetter, S., & Rüsch, N. (2018). Self-stigma as a barrier to recovery: a longitudinal study. European archives of psychiatry and clinical neuroscience, 268(2), 209–212. https://doi.org/10.1007/s00406-017-0773-2
- Zhang, Y., Fu, R., Sun, L., Gong, Y., & Tang, D. (2019). How does exercise improve implicit emotion regulation ability: Preliminary evidence of Mind-Body Exercise intervention combined with aerobic jogging and Mindfulness-Based Yoga. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.01888
- National Institute of Mental Health. (n.d.). Any anxiety disorder. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
- Harvey, P. D., & Strassing, M. (2012). Predicting the severity of everyday functional disability in people with schizophrenia: Cognitive deficits, functional capacity, symptoms, and health status. World Psychiatry, 11(2), 73–79. https://doi.org/10.1016/j.wpsyc.2012.05.004
- Michail, M. (2021). How can we work together to keep you safe? A simple and effective intervention that can save lives. British Journal of General Practice, 71(710), 409. https://doi.org/10.3399/bjgp21x716909
