Supporting a Spouse Through Mental Health Challenges
Sunday, February 23, 2025.
Supporting a spouse through mental health struggles is one of the most profound yet challenging roles in a relationship. Mental health conditions like depression, anxiety, PTSD, and bipolar disorder don’t just affect individual partners—they impact relationships in deeply personal ways.
Many partners feel lost, unsure how to help without losing themselves in the process.
The good news?
Research shows that with the right approach, couples can strengthen their bond, even in the face of mental health challenges. This modest post explores what works, what doesn’t, and how to strike a healthy balance between support and self-preservation.
The Emotional Toll: How Mental Health Struggles Affect Both Partners
When one spouse is struggling with mental health issues, the other often experiences heightened stress, emotional exhaustion, and even symptoms of anxiety or depression (Benazon, 2000). However, not all research points to inevitable distress.
A study by Revenson et al. (2016) found that some partners develop resilience, greater empathy, and a stronger emotional connection through these struggles. The key difference? The presence of healthy coping mechanisms, such as:
Open communication about mental health struggles
Seeking external support, including therapy
Avoiding the trap of over-functioning for their spouse
On the flip side, when partners take on too much responsibility—such as managing all household tasks or making every emotional decision—their own well-being declines. This imbalance, known as over-functioning vs. under-functioning, can quickly lead to resentment and burnout (Levine, 2010).
The challenge is being supportive without losing your own mental and emotional health.
Support vs. Codependency: Where to Draw the Line
Many spouses fall into the “rescuer” mindset, believing that their love alone can “fix” their partner’s mental health. Unfortunately, research contradicts this belief.
Over-involvement can worsen symptoms: A study by Knudson & Terrell (2012) found that when a partner micromanages their spouse’s mental health—by constantly checking in or shielding them from stress—it often reinforces learned helplessness. Instead of helping, it can increase dependency.
Encouraging autonomy is key: Research on self-determination theory (Deci & Ryan, 2012) suggests that partners who support independence—such as encouraging self-care and seeking professional help—see better long-term mental health outcomes.
So what does this mean in practice? Instead of:
“I have to fix this for you.” → “I love you, and I’m on your side. Let’s find support together.”
“You’re struggling, so I’ll handle everything.” → “I can help, but I also need to take care of myself.”
Healthy support means being present without over-functioning.
How to Communicate Without Frustration or Burnout
One of the biggest struggles for partners is knowing what to say. Many fall into the “fix-it” trap, offering solutions when their spouse really needs validation and emotional support.
What Actually Works (According to Research)
Emotional Validation – A study by Shallcross et al. (2010) found that when partners simply acknowledge their spouse’s emotions without rushing to “fix” them, relationship satisfaction increases significantly.
Low-Pressure Encouragement – Instead of pushing therapy or medication in a way that feels forceful, research suggests collaborative conversations work better (Gottman, 2015). Example:
“I know you’re struggling. Would you be open to trying therapy together?”
Understanding Withdrawal Without Taking It Personally – Depression and PTSD often lead to emotional distancing. A study on expressed emotion found that low-pressure communication (e.g., “I’m here when you’re ready”) is more effective than criticism or over-involvement (Hooley & Teasdale, 1989).
The best way to support your spouse is by listening, validating, and being present—without forcing solutions.
How to Handle Crisis Situations
Mental health struggles sometimes escalate into crises, such as:
Suicidal thoughts
Substance abuse
Emotional shutdown or extreme withdrawal
When this happens, boundaries must change. While everyday struggles benefit from patience and low-pressure communication, crisis situations require immediate action.
Take Concerns Seriously – Research by SAMHSA (2020) confirms that direct intervention—such as contacting a crisis hotline or a mental health professional—saves lives.
Involve Professionals – You are your partner’s spouse, not their therapist. If your partner refuses help and their condition worsens, seeking external support is necessary.
Set Boundaries Without Guilt – If a spouse refuses treatment for severe mental health challenges that harm the relationship, protecting your own well-being is also essential.
You cannot force someone to get better, but you can set boundaries, seek professional help, and protect your own mental health.
How Couples Therapy Can Help
Many assume that mental health struggles should be addressed in individual therapy alone, but research suggests that couples therapy can be a game-changer.
Emotionally Focused Therapy (EFT) – Developed by Sue Johnson, this approach helps couples create secure emotional bonds and is particularly effective for partners dealing with depression or anxiety (Johnson, 2004).
Gottman Method Couples Therapy – This approach integrates cognitive-behavioral techniques into a relationship framework, helping couples challenge negative thought patterns and improve communication (Gottman, 2015).
When couples learn coping strategies together, they are more likely to build a supportive, resilient relationship.
Final Thoughts: Balancing Love and Self-Care
Loving someone through mental health struggles is both a gift and a challenge. The journey requires compassion, patience, and resilience—not just for your spouse, but for yourself.
While research offers valuable insights, every relationship is unique. There is no single roadmap, but these principles can help:
Prioritize Self-Care – You cannot support your spouse if you are emotionally drained.
Encourage Professional Help – Therapy and medication can be life-changing, but they must be willingly pursued.
Communicate with Patience – Validation over solutions, presence over pressure.
Establish Boundaries – Support should not come at the cost of your own mental health.
Seek External Support – Therapy, support groups, and trusted friends can make a difference.
If your partner is struggling, know that you are not alone. There is help. There is hope. And with the right tools, love can not only endure but grow stronger in the face of adversity.
Be Well, Stay Kind, and Godspeed.
REFERENCES:
Baucom, D. H., Epstein, N., Kirby, J. S., & LaTaillade, J. J. (2012). Cognitive-behavioral couple therapy. In Alan S. Gurman (Ed.), Clinical handbook of couple therapy (5th ed., pp. 23–60). The Guilford Press.
Benazon, N. R. (2000). Predicting burden and depression in caregivers of individuals with schizophrenia: A path analytic approach. Schizophrenia Research, 45(1-2), 67-73.
Deci, E. L., & Ryan, R. M. (2012). Self-determination theory: Basic psychological needs in motivation, development, and wellness. Guilford Publications.
Epstein, N. B., & Baucom, D. H. (2002). Enhanced cognitive-behavioral therapy for couples: A contextual approach. American Psychological Association.
Gottman, J. M. (2015). The seven principles for making marriage work. Harmony Books.
Hooley, J. M., & Teasdale, J. D. (1989). Predictors of relapse in unipolar depressives: Expressed emotion, marital distress, and perceived criticism. Journal of Abnormal Psychology, 98(3), 229-235.
Johnson, S. M. (2004). The practice of emotionally focused couple therapy: Creating connection. Routledge.
Shallcross, A. J., Spruill, T. M., & Wiltshire, J. (2010). The power of validation in romantic relationships. Journal of Social and Clinical Psychology, 29(5), 579-605.