A Guide for Spouses of Partners with Complex Mental Illnesses

Complex mental illness in a spouse is a major challenge for many families. Illnesses like schizophrenia or bipolar disorder, concurrent substance abuse, and other serious mental health conditions make life for the individual difficult. For the spouse, with care resting mostly on their shoulders, the responsibility and burden can be overwhelming. With good treatment and other important actions, it is possible to maintain a healthy, satisfying relationship and home life with complex mental illness.

There are several things you must do as the spouse of someone living with complex mental illness. Treatment is first and foremost, and it is most effective and useful for both of you with your involvement. Take time to address your own mental and physical health to avoid burnout, enlist support and assistance from others, manage your finances and make sure the children feel safe, and your family can manage and live well with complex mental illness.

The term complex mental illness refers to any serious or severe mental illness, or combination of conditions, that limits normal functioning and causes significant distress. Schizophrenia, bipolar disorder, severe depression, or a substance use disorder concurrent with any mental illness fit into this category.

As the spouse of someone in this state, it falls on you to take charge of care. The most important thing you can do for your spouse and family is to get them into treatment. Mental illness treatment that is effective is available. It won’t cure your spouse, but it will help them learn to manage and cope with symptoms and reduce the frequency and intensity of episodes.

Treatment generally involves psychotherapy, behavioral therapies, medical care and medications when appropriate, group support and therapy, family and relationship therapy, life skills training, and alternative, creative, and holistic strategies. Above all, good treatment is individualized to each patient’s needs.

Get Involved and Educated

While your spouse is in care, it’s time to do your own homework. Talk to the treatment facility to find out how you can get involved in your spouse’s treatment. A family psychoeducation program will teach you about specific mental illnesses, symptoms, treatments, and the best ways to provide support.

Relationship and family therapy during treatment will help you and your spouse communicate better and learn together how to cope with mental illness. By being a part of treatment you not only show your spouse you are there for support, you also learn the best ways to be supportive and to take care of your own needs.

Understand and Overcome Shame and Other Negative Feelings

Living with a loved one with a serious mental illness can stir up all kinds of bad feelings. Shame is a big one, but you may also experience guilt, embarrassment, and a strong sense of burden and even despair. It may feel unfair to have to live with this, while other families are healthy and functioning.

First, know that these feelings are normal. Having them does not make you a bad person or uncaring. You need to accept and move through the bad emotions. Allow yourself to feel them and then move on, with the understanding that, while natural and expected, they are not productive or helpful. If you continue to struggle with these feelings, find a therapist to work with and a local support group to join.

Practice Positive Coping Strategies

A major part of living with mental illness in the family is how you react and respond. There will always be challenges, and you have a choice to respond with negativity, despair, and stress or to meet those problems with positive, healthy coping strategies. Use these for yourself, but also together with your spouse and children to help everyone learn and practice productive ways of reacting to and coping with difficulties:

  • Try mindfulness meditation
  • Exercise regularly
  • Practice yoga
  • Take breaks and timeouts, or walk away when needed in times of conflict
  • Practice deep breathing, visualization, and other immediate relaxation strategies

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Make Your Own Self-Care a Priority

Caregiver burnout is a real thing. If you are largely responsible for your spouse’s care and have little social support or practical help, you are more likely to experience burnout. Early signs of distress, including anxiety or depression, difficulty sleeping, fatigue, feeling resentful, or turning to food or substances to cope, are warning signs. The symptoms of burnout are similar and more severe:

  • Significant drops in energy and constant fatigue
  • Increased physical health problems, like getting sick more often
  • Neglecting your own needs
  • Feeling as if your life revolves around caregiving and not getting much pleasure out of life
  • Getting more and more irritable or impatient with your spouse
  • No longer being able to empathize with your spouse
  • Feeling hopeless

These are signs that your own self-care is lacking. It’s important to take time away from caregiving in order to prevent burnout and to preserve your own mental health. Don’t think of this as selfish because it is not. It is necessary. Let someone take over care for a period of time; keep up with social activities and hobbies; find time to just relax at home and do something you enjoy.

Self-care also includes your physical health. Prioritize exercise or other physical activities you enjoy and that bring you mental peace and relaxation. This could include yoga, walks alone, or meditation. Make sleep a priority as well, and mind your diet, eating healthfully as often as possible.

Seek Out Support and Ask for Help

An essential strategy for managing stress and avoiding burnout is social support. This can take any number of forms. For instance, making time to go out with friends and get out of the house is enough to release a good deal of stress.

More strategic and specific ways to benefit from a social network include joining a support group. Look for a group in your community or online that is designed for family members of people with mental illness or substance use disorders. Also rely on close friends and family to provide direct support. They can relieve your burden by helping directly with your spouse’s care or by taking care of your other responsibilities: household chores, cleaning, picking up the kids, grocery shopping, and more. Even one or more of these small tasks give you the gift of time to focus on your spouse or your self-care.

Managing Finances

Serious mental illness requires ongoing treatment, which costs money. And, if your spouse cannot work you may be operating on a single or limited income. It is important to stay on top of finances in this situation. Getting overwhelmed by money will only add to your stress and burden.

Before starting treatment for your spouse, check with your insurance plan to find out what will be covered. Make sure you can afford any additional costs and that you select a program that is within your plan or financial means. This will save a lot of stress down the road.

At home, you can manage finances by creating a budget. List your expenses and match it up with your income. If there are discrepancies, look for places to cut back on costs, like eating out or buying expensive coffee drinks. Small savings add up, and sticking with a budget will help keep this one part of your life in order when other aspects feel out of control.

What About the Children?

Mental illness in parents can be a major burden for children, causing lasting negative effects if not addressed immediately. Studies show that children of parents with mental illness are more likely to also have mental health issues. This is partly because of genetics but also because mental illness disrupts a healthy child-parent relationship. There may also be traumatic experiences living with a mentally ill parent.

Your children will benefit when you take all of the above actions. Treatment for your spouse and family psychoeducation will provide them with a healthier home environment and a framework to understand their mother’s or father’s mental illness. Engage them in appropriate ways, depending on age. For instance, older children may be able to get involved in direct care, and those of all ages will benefit from practicing relaxation and coping strategies with you.

Watch your children for signs they are struggling: behavior changes or problems, lashing out and other emotional outbursts, problems at school, social isolation, and mental health symptoms. Being proactive in getting their own mental health treatment will make a positive difference. Whether they seem to be coping well or not, your children need extra love, time, and assurance. Make time for one-on-one activities regularly with each child so they feel safe and loved.

Life with complex mental illness is challenging for families, but there is every reason to be hopeful. If you can get your spouse high-quality treatment, support your children, and take time for your self-care, your family can live a better, more satisfying life together.

If you’re concerned about a loved one and believe they may need residential care, we can help. BrightQuest offers long-term treatment for people struggling with schizoaffective disorders, schizophrenia, and severe bipolar as well as co-occurring substance use disorders and process addictions. Contact us to learn more about our renowned program and how we can help you or your loved one start the journey toward recovery.