Mind of the marriage

Mental illness has wrecked many marriages and families. If one of the partners has symptoms of a mental illness, not only does it disturb the normal functioning of an individual, but it also impedes his abilities of sustaining lasting and meaningful relationships

unhappy couple in an argumentMental illness has wrecked many marriages and families. If one of the partners has symptoms of a mental illness, not only does it disturb the normal functioning of an individual, but it also impedes his abilities of sustaining lasting and meaningful relationships.

If there is a clear diagnosis of psychosis, neurosis, a psychopathic personality [a morally-challenged individual], or any other mental illness that requires psychiatric intervention, seek urgent professional help. Unfortunately, many fail to recognise the signs of mental illness in their partner until it is too late.

An understanding perspective

It is important to realise, though, that mentally disturbed individuals are not to blame. It is incorrect to insensitively label them as 'mad', 'crazy' or 'loony'. Instead of labelling, we need to recognise and acknowledge mental illness as an illness, which is understood and treated just like a physical illness.

What the person needs is a humane, empathetic, responsible and dedicated psychiatrist, who gives the right prescription of medication, and monitors it constantly to modify the medication when necessary. However, along with this, supportive psychotherapy may also be needed to sustain the gains made by medication to help in behavioural modification, and management of the disorder.

At times, a deeper healing is initiated by the psychotherapist to deal with early childhood traumas, after which, the individual gets liberated from the hold of the disorder, and is able to be fully functional.

Like in Sudesh's case.

Sudesh suffered from an anxiety disorder, and there were times when he just declared to his family that he would not earn for them as he was unwell. At such times, his wife would dig into her savings and make trips to psychiatrists with him. He would be on medication, get back to work and get off his medication till anxiety struck again. His wife reacted to this by getting into depressive spells with extreme physical fatigue, and chronic asthma.

The couple came in for marriage counselling. The wife was taught coping strategies, and through intensive psychotherapy, Sudesh was helped to trace the roots of his anxiety, which lay in his early childhood experiences. He was gradually helped to help himself, and became functional at work and in the family. Family therapy healed the wounds of the past, and slowly the family limped back on track.

Let's consider a few other examples of how mental illness in one partner affects the marriage.

Cases in point

Tarini suffered from a bi-polar disorder, which was undiagnosed till she had her second child. She strangulated her infant baby and sought to take her own life. Her husband could not even grieve the death of their child with her because of the mixed emotions he felt towards his wife. Later, in the midst of a manic phase, she engaged in an extra-marital affair, got pregnant and aborted her boyfriend's child.

Then she went into a depressive phase, again wanting to end her life. Her swings devastated her husband and shook the marriage to the core. They subsequently divorced. Her husband took the custody of their child, who was visibly affected and distraught with his mother's mood swings and erratic behaviour.

Dipti suffered from obsessive-compulsive disorder [OCD]. She would engage in an elaborate ritual of cleaning doors, window knobs and other furniture with an anti-bacterial and antiseptic solution if it was touched by anyone other than her husband and child. Her husband and child had to have a bath every time they came from outside, even if they just went to the elevator, to the neighbour's home, or to the car to get something.

The husband's friends too were required to wash their hands with an antiseptic before entering the main house. Once inside, they were to sit on a particular sofa. Even their child's friends had restricted entry. The family was faced with embarrassing questions from guests.

Finally, they stopped inviting people over. No hired help stayed for over a week because of the elaborate cleaning rituals and restrictions. Cut off from people, Dipti was preoccupied cleaning all the time, and her husband and child were helpless and depressed.

Fortunately, in marriage counselling, she was helped to see her behaviour as a 'disorder' that needed to be treated, and how it was disrupting life for herself and her family, and resulting in poor self-esteem in her child. She is currently on medication and is in supportive psychotherapy, and is more functional than before.

More examples

Sunil suspected his wife with other men; he suffered from Othello's syndrome. He controlled the way she dressed, the people she spoke to, the places she visited. She even had to keep her eyes glued to the ground when she was outside. He would threaten to kill her if she waited a second more on a magazine page that had a picture of a man. He would accuse her of infidelity in her mind and said that she was just waiting for an opportune moment to be with another man.

His wife was emotionally agonised with this behaviour, and the breaking point for her was when he accused her of eyeing their own son. She gave him the ultimatum of psychiatric treatment or divorce. When he didn't agree to psychiatric care, she chose to live away from him.

Sulabha suffered from visual hallucinations and was diagnosed as a schizophrenic after the delivery of her child. Her parents later revealed that she had suffered a similar mental state as a student and had even been on medication for a few months, a fact which they had concealed from her husband.

He felt cheated, and was now left with the challenging task of looking after an infant and caring for Sulabha. Sulabha failed to experience maternal feelings and lived in a parallel world of her own creation. She would also have violent episodes, which scared and scarred the child. She had to be kept in the care of a full-time psychiatric nurse and caregiver in a different home, while her husband raised his child with the help of his own mother.

The family needs help too

It's evident from the above examples that along with the one with mental illness, the family suffers too. Therefore, in cases of mental illness, family therapy is imperative to help the family understand the illness, its various manifestations and the prognosis. The family also needs support and counselling to help them cope with the situation in a healthy manner and prevent themselves from getting depressed, anxious or angry.

Time for tough decisions

The children in the family need to be empowered to not hold themselves responsible for the erratic behaviour of a mentally ill parent in any way. Children of parents displaying behaviour detrimental to the psyche of the child should be shifted out of the house. If that's not possible, the children should be made to live in a hostel or with a guardian.

The spouse of a mentally ill individual needs to honestly evaluate whether the illness is something he wants to live with. A lot depends on the nature, severity, manifestation, and prognosis of the illness. A psychiatric evaluation and an honest, no holds barred opinion of a responsible and empathic psychiatrist, often helps in arriving at a decision.

The degree to which the ill person's behaviour affects the life and the psyche of the children plays a vital role in determining whether the spouse wants to live together. However, often, financial or social restrictions compel individuals to live together with the mentally ill person.

At such times, joining a support group of families ina similar situation can help them to overcome their feeling of helplessness and isolation.

Should you stay?

Ultimately, it's up to each person to decide whether to remain with the mentally ill partner or not. But the final call must be taken after gathering of information and careful deliberation. Seek an insight into your own inner and outer resources, as well as an honest acknowledgement of your cherished dreams and aspirations about your relationship and life in general.

As relationship counsellors, we try our very best to rescue all relationships and help them survive and thrive. But we need to categorically state, that in cases where the mind, body or spirit of the partner is in danger because of the mental illness of the spouse, we believe that the 'survival of human life' is more important, and sanity and life of the partner should be chosen.

Whatever the choice, acknowledge that with your choice comes the responsibility of the repercussions of your choice. Such mature decision-making should be encouraged and supported by a counsellor, friends and family, as ultimately it is the spouse whose life is most affected by the decision.

Before tying the knot

happy coupleTo prevent families and lives from being destroyed by mental illness, resort to as many preventive measures as humanly possible before marriage.

  • Request diagnostic psychological tests. These help create a personality profile and give you an inkling of what's to come.
  • Initiate a discussion on sensitive areas of life before marriage. It exposes the thinking and reactions of the partner in advance.
  • Inquire into the genetic history of the family. It helps to reveal whether a family member, living or dead, has suffered any mental illness.
  • Ask your partner, his/her family and friends about past instances [if any] of suicidal ideation or attempt, or violence on oneself or another.
  • The dating period is particularly telling; paying attention helps—frequent mood swings, irrational thinking or unreasonable conduct any display of violence, whether verbal or physical, even if it seems harmless like a pinch, or a push, or an outburst in public.
  • Take it as a warning if the partner displays extreme possessiveness or suspicion.
  • Ideally, a prolonged period of knowing each other as friends, knowing each other's families, and speaking honestly on all crucial areas of life after marriage, is recommended, along with a psychological profile.

This is the best prevention one can have in order to determine whether there are any predisposing factors that can make the individual more vulnerable and susceptible to mental illness under stress.

The decision of tying the knot, then can be based on such information. Of course, it goes without saying that if such an irregularities come to light only after marriage, and if a psychiatrist diagnoses them as a mental illness, it would only be wise to not have children till such time that the psychiatrist does not give a clean bill of health, which might be later, or even never.

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Minnu Bhonsle
Minnu R Bhonsle, PhD, is a Mumbai-based consulting psychotherapist and counsellor. She conducts training programmes in Personal Counselling [Client-centred Therapy] and Rational Emotive Behaviour Therapy, and also workshops in Stress Management, Art of Listening, Couple Therapy, and Communication Skills. Minnu has co-authored the book, The Ultimate Sex Education Guide along with Dr Rajan Bhonsle.
Rajan Bhonsle
Rajan Bhonsle, MD, is a consultant in sexual medicine and counsellor. Along with his wife Minnu R Bhonsle, PhD, who is a consulting psychotherapist and counsellor, he runs a unique therapy centre

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