Skip to main content

Verified by Psychology Today


When Your Spouse Is Mentally Ill

How do you know? What do you do?

Everyone has personal issues that we collectively describe as our insecurities that may affect our marital relationships. Most of us can learn to manage such insecurities, often with help, so that we lessen their impact on our marriages. However, self-management of personal insecurities is not the way to deal with significant emotional and/or mental impairments that a partner may have, such as bipolar disorder, debilitating anxiety, clinical depression, obsessive-compulsive disorder, schizophrenia, alcoholism, drug addiction, and serious personality disorders such as narcissism, paranoia, and borderline personality.

If your spouse is engaging in actions and behaviors that are detrimental to establishing a successful marriage beyond the general insecurities, it’s important to recognize that—and to respond to it appropriately. You may choose to stay in the marriage. You may find it necessary to think about how and when to divorce your mentally ill spouse. Either way, it’s important to have some idea of what to do if you believe your partner is suffering from a mental/emotional illness.

How Do You Know?

How do you know and what do you do when your wife or husband suffers from mental illness?[1] How can you tell the difference between a series of bad days and a real problem? When repetitious arguments, unfounded accusations, lengthy withdrawals from the relationship, unwillingness or inability to discuss important issues, and/or standoffs between the two of you persist despite your efforts to engage your spouse, you must consider the possibility that serious problems are occurring.

Excesses in behaviors can also be warning signs—being obsessed with ritual cleanliness, withdrawing completely from sexual contact, staying up all night and not being able to function the next day, and excessive drinking or drugging are examples of problematic behavior. When problems like this continue to occur in your marriage despite repeated attempts to identify and discuss issues that bother your spouse, it may be that something other than marital disagreement is occurring.

Taking the First Step

So, what can you do if you think your husband or wife may be suffering from mental illness or serious psychological problems? You can take a page from what we have learned about confronting the problem of alcoholism or drug addiction. Here are the suggested steps you can take:

  • Do not confront your spouse during an argument. Choose a good time to initiate a conversation with your spouse about his/her actions that you are concerned about and/or are having a negative impact on you and your marriage.
  • Express your concerns. Talk about your worries, trying not to lecture. Give the clearest examples you can about the problems you are experiencing, e.g., “When you get angry, you are not able/willing to tell me what you are angry about”; “We no longer have sex; I miss our intimacy”; “When you drink, you get sullen and won’t talk to me.”
  • These kinds of clear statements directly state the problem and its negative results. Find out what your spouse thinks in a non-critical manner. Ask him/her if these actions are a problem for him/her too. Wait for him/her to answer.
  • If he/she agrees that he/she is having a problem, you may want to ask questions like, “Why do you think you are having a problem with ___________?”; “What do you think you can do about ____________?” If your spouse can acknowledge that he/ she is having difficulties, you can begin to negotiate the next steps (e.g., seeking help).
  • If your spouse denies that he/she has a problem, continue to express your concerns and address his/her excuses from a place of compassion rather than judgment.
  • If your spouse continues to refuse to get help and continues to exhibit problematic behaviors despite your efforts, you may need to set clear boundaries on your relationship. For example, tell him/her that you cannot spend time with her/him when they act in the problematic way you have described. It may come to telling him/ her you need a break until they’re willing to seek help.
  • Ask your spouse to see a physician, psychiatrist, or psychologist with you. If your spouse will not cooperate, go on your own to get further help and guidance on how to proceed.

You can be helpful and supportive to a mentally ill spouse if he/she recognizes the illness and seeks ongoing treatment. You’ll also find you can be more sympathetic to your spouse if you understand what is happening to him/her, and if he/she is willing to take major responsibility for managing the illness. Don’t forget about getting help for yourself as well; maintaining your own emotional well-being is crucial!

How to Live with a Mentally Ill Spouse

Living with a spouse who is mentally ill will be challenging. The condition from which your spouse is suffering will determine what steps you’ll need to take in order to live with and to help him/her. You will find a list of articles on dealing with spouses with specific illnesses at the end of this article. It is important to learn as much as you can about the particular condition you are dealing with to know how to help your spouse manage his/her illness and how to take care of yourself in the process.

If your spouse neither recognizes his/her illness nor is willing to seek individual or marital therapy, the situation for you is difficult. You must seek professional help for yourself in this situation, work hard to maintain your own work and social life, stay informed about your spouse’s illness, and seek out personal support from friends and family. If your spouse continues to refuse to own their illness, however, it is likely that at some point, you will consider divorce.

When to Consider Divorce

Deciding to divorce a spouse who has a mental illness is a painful and complex decision. There will be enormous social pressure and guilt in deciding to end your marriage to someone who is mentally ill. You took those wedding vows to be married “in sickness and in health,” after all. Here are some suggestions for you to consider if you ever find yourself in this situation.[2]

  • Give yourself the time you need to make the decision to end your marriage; talk with trusted others and professionals.
  • A legal separation may address concerns you have with breaking your marriage vows.
  • Recognize the process of divorcing a mentally ill spouse will take time.
  • Consider how to help your spouse to be self-sufficient.
  • Create a parenting plan for your children that keeps your spouse involved in a way that is safe and feasible.
  • Don't hold your spouse’s condition against him/her to penalize him/her.
  • Leave without anger or resentment.

Everyone has personal issues they bring with them into their marriages; we collectively describe them as our insecurities. I addressed how to consciously consider and analyze the personal issues you bring to your marriage in my book, A Marriage of Equals. Using the methods described in this book and/or other resources you have access to, you can learn to manage such insecurities and lessen their impact on your marriage. The ways we deal with the usual emotional insecurities we all experience—insecurities that can be managed through reflection—will not work with a spouse who is mentally ill.


1. Sandy Malone, “Mental Health in Marriage,” HUFFPOST Blog, November 23, 2012, mental-health-in-a-mar1904140.html. riage_b_1904140.html.

2. Mandy Walker, “Deciding to Divorce When Your Spouse Has a Mental Illness,” Since My Divorce Blog, February 19, 2014, http://

Additional Resources

Alcoholism: “Guide to Living with an Alcoholic,”

Anxiety: Steve Whyley. P.S. I Love You. “Married to Someone with Anxiety”

Bipolar Disorder: Sue Sanders and Francesca Castagnoli, “I Lost My Husband to Bipolar Disorder"

Depression:. Sari Harrar, “How to Deal with a Depressed Spouse"

Paranoia: Carrie Barron, “7 Tips for Coping with a Paranoid Partner”

Psychosis: Mark Lukach, “My Lovely Wife in the Psych Ward,” Pacific Standard. (This is a truly remarkable story about a husband’s love for his ill wife.)

PTSD (Post-Traumatic Stress Disorder) and TBI (Traumatic Brain Injury): “To the Spouses Who Are Enduring Hell"

More from Catherine Aponte Psy.D.
More from Psychology Today