You pledge to be together for better, for worse, in sickness, and in health. But what if this sickness affects the mind, so much that your spouse seems different than the person you married? What if there are hints of danger, making you fear for your spouse’s safety and that of your family? In most cases, mental illness comes when it’s least expected, and few people feel prepared for it.
“The greatest challenges I faced being a spouse to someone with mental health issues (mainly depression and anxiety) is that it created a lot of fear in me,” Hannah told me, “fear of our future, fear for his life, fear that nothing was predictable anymore. I had a few days where I wondered what I would do if I were a widow with three young boys and no job. Sometimes, there was the fear that if I were not around him, Charlie would question his worth in this world.”
It all started with what they thought was a heart attack. It turned out to be a panic attack, and it was just the first of many increasingly frequent ones, usually in public places. “One thing I learned is to get help sooner than later,” Hannah said. “If you or your spouse are not already under care with a psychiatrist it can be very hard to get seen when things get rough. We waited until Charlie had suicidal thoughts and was in deep depression. By the grace of God, we got a same day cancellation appointment. Had we not, I am not sure what our lives would be like today.”
For Megan’s husband Steve, the first signs of mental distress didn’t come to the surface until they had six kids and he had made the decision to pursue the pastoral ministry. “Three years into seminary,” she said, “and he was completely crushed. He kept pushing and pushing until his body wouldn’t budge any more. In fact, he could barely speak and was seeing things and having horrible nightmares. He was also suicidal. It was a very tough time. I did take over things for the sake of our family and him. I contacted doctors, our pastor. I tried to hold things together, but it was hard. I never saw him so broken; he would just lay in bed and sometimes cry.”
Both Hannah and Megan persevered through those initial, frightening months, and gradually learned to live with their new situations. The thought of leaving never crossed their minds.
Things were different for Donna. When her husband of two years committed adultery and announced that some voices were telling him to drive off a cliff, she had to think carefully about whether their marriage could still work. “My reaction was mostly to keep him safe and try to be supportive of his recovery, but inside I was screaming ‘Why?’ at the Lord, which isn’t a lovely place to be.” Donna called the sheriff and asked him to look out for their truck. Her husband was taken to a hospital and diagnosed with bipolar 1 depression (the most severe form). “I needed to have time to learn about the illness and also read Scripture about divorce, which was something I never wanted for my child,” she continued. “I also attended group/family outpatient therapy with Andrew. Later, when Andrew was hospitalized for both suicidal and homicidal ideation, we were separated for around six months. I think God saved our marriage through our second child. I found out I was pregnant while he was in the hospital. That was the turning point for Andrew as he decided to take medication seriously and has never stopped taking it since then, when he almost lost us.”
To Marry or Not to Marry
In spite of their challenges, if Hannah had known about Charlie’s illness before their marriage, the news would not have turned her away. She believes, however, that a couple contemplating marriage while one of them lives with mental illness should see a counselor or therapist to see if the mental health issues are managed well enough to withstand the good and hard times together. “I think it could be extremely troublesome to enter into a committed marriage with someone who did not have his illness under control with either medicine, therapy or both,” she said.
Donna agrees, adding that it’s also important to talk to your prospective spouse’s family and friends, find out the family’s health history, and attend pastoral counseling. Also, if a man shows, before marrying, that he is not willing to take instruction from others, including his wife, regarding his mental health, this is a red flag.
David Lee Chu Sarchet, Mental Health Advocate and founder of the Christ-Centered Mental Health ministry, concurs that these things should be discussed before marriage. “I believe that the person with mental illness should disclose their diagnoses and what it means to their significant other early on in the dating process. This will give the other person a chance to decide if he or she still wants to pursue a relationship. I told my wife about my schizoaffective disorder the first time we had a conversation over the phone because I needed to understand if she wanted to continue talking to me. I also think mental illness should be brought up in pre-marital and marriage counseling. It’s unfortunate that many pastors do not bring it up because they assume mentally ill people are not getting married.”
In reality, mental illness is not in itself a reason to avoid marriage. “I know my husband has grown in compassion as a result of his experience,” Megan said. “There are many men who seem godly but are very unkind toward others who are suffering. But mental illness causes many to become humble and more caring. Having a mental illness doesn’t mean that a man won’t be a wonderful husband.”
And yet, even being knowledgeable about an illness and knowing that it is under control is no guarantee of a trouble-free life. Nothing is. Everyone enters into a marital relationship with the awareness that everything could change overnight.
Liz understood this early in her relationship. She and Matthew had been together for one year when he told her he was suffering from depression. “I thought he was preparing to break up with me. He got really quiet before tears welled up in his eyes, and he said, ‘Honey, we have to talk.’ My heart jumped in my throat.” Matthew had no intention to leave, but what he shared was equally troubling. “He told me he was depressed and that he had been for a while. He said that he struggled to go to work, and that he had seen a doctor about an antidepressant. He also told me that he planned on going to therapy.”
As troubling as the news was, Liz thought that Matthew had found a way to manage it. But not for long. “Over the course of the next year, Matthew’s depression was crushing. He stopped taking his medication, stopped seeing his therapist, and eventually stopped going to work. He would stay at my apartment for days on end. It was like he became a different man… a comatose man. I would go to work and come home on my lunch break to check on him, and he would be sitting on the couch, absolutely zoned out. On more than one occasion, he expressed the desire to escape, or to no longer exist. There were times when he lied about going to work. He eventually lost his job. I wanted him admitted to a psychiatric hospital, but his parents (and Matthew) didn’t agree with me. And because I was just his girlfriend, I felt helpless.”
Since Liz and Matthew were not married, she could still walk out of his life. “In those moments when he was his lowest, I knew that choosing to love Matthew was not the easy choice. Many people in my life encouraged me to end the relationship. Matthew himself wondered why I stayed. But I just constantly remembered Jesus, and I kept praying, ‘How can I be Christ to Matthew?’ And sometimes that meant taking an Uber to pick up Thai food from our favorite place. And sometimes that meant demanding truth.”
The Head of the Family
For this article, I have chosen to interview mostly wives because, in their case, mental illness creates a new dilemma. If, according to the Bible, the husband is the head of the family, what happens when that head is not only unable to lead, but needs to be led? While, generally speaking, wives understand their need to take over the helm, some husbands feel uncomfortable in this new situation. “Matthew deeply struggled in his effort to be a good provider,” Liz said, “and hated himself from jumping from one entry level position to the next. We moved into a new townhouse because of my income, and I watched my husband continue to struggle with severe doubts about his ability to be a good husband, as well as doubts about his faith.”
For Hannah, some weeks were harder than others. “The hard ones left me feeling like I had another child to care for, but in a different way than my boys. I wanted to make sure my husband did not feel like he was my patient but at the same time wanted to ask the right questions to make sure he felt seen, heard, and loved. Often that meant the emotional stability of my entire family was on my shoulders.”
“I think a wife has to be careful,” Megan said. “I don’t think our roles are ever changed, but there are times when things look different. I put it all under the umbrella of respect to him. There have been times where I’ve gone behind my husband’s back to ask for help. This is really rare and in serious cases when his depression is so bad that I feel like he is not making decisions he would normally make.”
At times, Megan also hid from her husband some bit of news he would have found particularly stressful. “Sometimes, his depression comes on suddenly and unexpectedly. I have a lot of fear of being the thing that puts him over the edge. I manage our home and lives trying to keep the stress down, but of course that isn’t always possible. And when it doesn’t happen, it’s hard not to blame yourself. God reminds me to ‘look up’ and keep my eyes on Him, trust him even for my husband’s life. Overall, he has learned what he can handle. I also have learned a lot. Our marriage is stronger now than before.”
Many couples have found it easier to discuss these things ahead of time. “My wife and I believe that she is to submit to me as long as I am stable,” David Sarchet told me. “However, as soon as she notices that I am getting unstable, it would be unwise for her to do so for the time being. And, if for whatever reason my illness progresses to the point where I am no longer ever stable and medication is not working anymore, then she should take charge at that time because I cannot be trusted to make good decisions.”
Overall, the people I interviewed have come to see mental illness—as painful and difficult as it can be—as positive challenge in their marriage and a means of sanctification for both spouses. They all mentioned learning to be more patient, to listen to each other, and to trust God more than ever before.
“I’m not sure I have much wisdom to share with others,” Donna said, “other than keeping your focus on Christ, and remembering what he’s done for you on the cross and the grace and love you’ve been so freely given, and then realize this is the type of love our spouses need and this is one way in which Christ looks upon them. Also, I suggest putting aside all expectations. We all have them, but they pretty much go out the window with mental illness.”
“I’ve been thinking a lot about our wedding day,” Liz said, “how we didn’t know where the vows would lead us, but God did. The God who was there on our wedding day, uniting us by His covenant, is the same God who carried David through years of abuse. And He is the same God who was with us the night David was hospitalized, and through every gut-wrenching moment that we have encountered, or will endure. I think back on that wedding day, and I marvel that God knew. God knew the hardships that would come in our marriage, and yet He has used this marriage as a means to bind David and I stronger together and closer to Christ. He is a kind and faithful Father.”
Simonetta Carr is the author of numerous books, including Broken Pieces and the God Who Mends Them: Schizophrenia through a Mother’s Eyes, and the series Christian Biographies for Young Readers (Reformation Heritage Books).
Editor’s Note: Names in this article have been changed to protect privacy.