How to Love a Spouse Who Has Psychological Problems
Updated August 18, 2026
If your spouse has psychological problems, you have to have a balance between taking care of your spouse and taking care of yourself.
If your spouse has an ongoing psychological problem, such as anxiety, depression, severe ADHD, or OCD, it’s easy to change from being a partner to being a caregiver. And that caring may be far more than your spouse gives you. This can leave you feeling like you sacrifice too much and it can contribute to your putting up with behaviors that make your spouse a difficult spouse.
For sure, this doesn’t happen just with spouses. It can happen with children, with aging parents, and even on your job. Being in relationships for which others benefit from you, but from which you don’t benefit, makes you a martyr.
Burning out will not help your spouse or your marriage
If you are in this situation of caretaking for a spouse you love, you may burn out. Even if you don’t, you may feel that your life is totally unenjoyable, that you are stuck, and that there is nothing you can do. And, you may have resigned yourself just to stay stuck in what you believe is a hopeless situation.
In my opinion, being resigned to bad situation is not only unnecessary, it presents a real danger to your relationship. Most of the time, when people feel stuck, it’s not because they don’t have better options. It’s just because they are ignorant of what those options are. A lot more relationships could be reconciled if people used better methods. Being a martyr seems noble, but most of the time this route has a sad ending that could have been prevented with more loving and secure methods.
If you are a martyr, while I admire your dedication to your cause, I would like to help you to have more meaning and joy in your life. I would like to do that while helping you to make your relationship with your spouse better. The two go hand in hand. Too many people are needlessly struggling between the ideas of sacrificing their happiness and leaving their spouse.
Many people are are able to find meaning and happiness without leaving their marriage
Ask yourself what is likely to happen one year, five years, and ten years from now if you continue as you are. Be honest about it. If the answer is that your marriage will end, then the sooner you make changes, the brighter your future can be. If you know for sure you will be divorced then you can either work on your marriage now or divorce now. Either way will save you a lot of aggravation and future regret.
Not working on a bad marriage, and staying in a bad marriage too long, are both bad ideas. Life is too short for that.
Beware excessive caretaking and codependency
Love, patience, and selflessness are good virtues, but taken to an extreme they are not virtues at all. At an extreme, love becomes neediness, patience becomes hopelessness, and selflessness becomes codependency.
We must be patient, but also proactive in setting the right conditions for growth. We must be selfless, but not when it leads to ongoing problems. God is an excellent example of this kind of balance. He cares for us, but doesn’t give us everything we want. He is more concerned about having a good relationship with us than He is about pleasing us. And He will not help us with things that He knows are damaging for us. These qualities of God are part of the reason we know He loves us.
Let me say this another way. For a good relationship, you must:
- Care without giving your spouse everything he or she wants,
- Be more concerned about your relationship than pleasing your spouse,
- Not help your spouse continue to do things that are harmful to him or her.
Using your spouse’s mental health problems as an excuse not to have good boundaries is not admirable. It hurts both of you.
Three impacts of a spouse with psychological problems
In deciding when to be accepting and when to use boundaries, it is important to consider three areas. You need to think about how your boundaries are likely to affect:
- your spouse’s well-being,
- your relationship, and
- your own well-being.
For a relationship to be healthy, all three of these things need to be match.
Boundaries
Boundaries are used to stop behaviors when they are damaging. They feel mean, but are actually healthy. If you are doing something that makes your spouse feel better, while damaging your relationship or yourself, you must stop. That seems nice, but is actually unhealthy.
For example, allowing a hoarder to accumulate more and more stuff may make him or her feel less anxious, but is not good for your spouse or you. Taking on all work responsibilities for your depressed spouse would also not be good for either of you. Letting someone with impulse control problems or addictions be verbally or emotionally abusive is also bad for both of you.
Simply doing too much for your spouse can also be harmful. Good caregivers (including doctors, nurses, and spouses) take care of themselves first, so that they are in better shape for taking care of others. If you gradually allow yourself to become burned out, you will reach the point of no longer caring.
Do not use caring for or not upsetting your spouse to be your excuse for not enjoying your own life and taking care of yourself.
Short-term vs. long-term caring
Overextending yourself for a short period of time is not really a big problem as far as relationships go. It can even be helpful. If your spouse has had a shock due to a traumatic experience, you may need to carry the weight of the relationship and household chores while your spouse gets help. You may need your spouse to do the same for you at some point.
If the problem starts to appear to be a chronic, ongoing condition, you will need to find a way to restore balance to your relationship. This can be done by getting extra help for any part of your load. You may need to hire someone to clean your house or watch your kids, even if you are at home anyway.
Abusive or demanding behavior from a spouse with mental health conditions
Through your patience, it is quite possible to train your spouse to expect you to wait on him or her hand and foot. Your spouse may also use his or her psychological problems as an excuse to be abusive and demanding. Letting this pass, out of guilt or sympathy, is not helpful. It will only make things worse.
It is not your spouse’s job to make sure that you take care of him or her. It is his or her job to love you and to take care of the relationship. If your spouse cannot or will not be loving, you need to use boundaries just as you would if your spouse did not have a psychological problem.
Example of caretaking spouse without boundaries::
Caretaking spouse: “Let’s go out and do something together.”
Spouse with Disorder: “I can’t go out with you. Don’t you get it? I am depressed. That means I don’t feel like doing anything. So get off my back about going out with you!”
Caretaking Spouse: “I’m sorry. I didn’t mean to upset you.”
Spouse with Disorder: “I would think by now you would have learned. Just don’t bug me anymore.”
Caretaking Spouse: “Okay, okay. I will stay home and take care of you.“
Spouse with Disorder: “I should hope so. I didn’t ask to have this problem, you know.”
In this example, the disorder is depression, but you could easily substitute any other disorder. I don’t know about you, but my level of saintliness is very low. I could put up with this kind of behavior for about a day…maybe.
Yet, incredibly, there are many people who are replaying this scenario over and over and blaming themselves if they become impatient. The caretaking spouse in this example has actually trained the spouse with the disorder to be this way, just as a parent could spoil a child. Even if this behavior was learned in a previous relationship, the current spouse would be the one maintaining it.
If your spouse threatens to leave in order to be with someone who will put up with abuse, happily be willing to sign the divorce papers.
Love requires sacrifice, but not all sacrifices are loving
The sad thing is that the sacrifices of the healthy spouse in the previous example do not actually aid his or her spouse in recovery. If anything, it may add extra incentive for the spouse with the disorder not to recover. This can happen if the healthy spouse fails to distinguish between the psychological symptoms and the willful behavior.
A psychological disorder is not a license to treat other people badly.
You can work with a psychologist or a psychologically trained relationship coach. Many of my clients have used my Difficult Partner Coaching Package to transition from helping too much to loving with healthy limits.
But, my spouse doesn’t feel like going out…
Let’s get back to the example about getting a spouse to go out.
With depression and panic disorder, it is true that people will not feel like going out. That is one of the symptoms of these disorders. Most disorders are partially self-maintaining by creating resistance to healthy behavior change. If people with these disorders felt like doing healthy things, they might not have the disorder to begin with.
The path to good behavior change, whether it is you with your marriage, or your spouse with his or her disorder, is never one that feels natural or easy. Change will not feel natural until we get used to it. Doing what is right, rather than what feels good, is what creates maturity and success.
No matter how unnatural boundaries may feel, you won’t have a successful marriage without them. And, no matter how unnatural it may feel to love someone who is treating you badly, you won’t be able to fix your marriage without being loving.
Loving behavior and boundaries go hand-in-hand to create and maintain good relationships.
Is your kindness hurting your spouse?
Sometimes, people are too kind. This can happen with well-meaning parents who feel sorry for their child. When I worked with the Association for Retarded Citizens (ARC), I got to see many developmentally delayed children and adults who had been allowed to have all sorts of bad behaviors. That made it more difficult for them to be able to be in public and to be liked by others.
They needed to be trained, and their parents needed to be trained in how to set limits and stop behaviors which were interfering with socializing their children. To allow your spouse to do with you what would never work with others makes your spouse less functional and contributes to his or her problems.
When to be nice and when to use a boundary
Sometimes we must lean toward being nice and other times toward having boundaries, but how do we decide?
My opinion is, that if someone is dying, be as patient as you can, while staying safe. However, if someone is not dying, then do whatever you can to help them to live better. Sometimes that may mean that you are nice, but it often means that you set healthy boundaries and make sure you are not codependent for their problems.
Just as we don’t buy alcohol for an alcoholic, we don’t sit at home with our depressed spouse, rush to remove all dangers for our overanxious spouse, or tolerate verbal, physical, or emotional abuse from our explosive spouse. To do so wouldn’t be doing them any favors. On the contrary–we would be harming them more.
To effectively use boundaries, you must overcome the idea that your spouse getting angry is the same thing as your spouse being injured. If your spouse is angry because you are having a few hours out with your friends, you are not harming your spouse.
Using healthy boundaries with a spouse with psychological problems
Healthy boundaries protect you, your spouse, and your relationship. They are the opposite of allowing harm to come to you, your spouse, or your relationship. Here is an example of the spouse in the previous example, after learning to apply a healthy boundary:
Example of caretaking spouse with boundaries:
Caretaking spouse: “Let’s go out and do something together.”
Spouse with Disorder: “I can’t go out with you. Don’t you get it? I am depressed. That means I don’t feel like doing anything. So get off my back about going out with you!”
Healthy Spouse: “I get it. Thank you for being clear with me. It is helpful to know. I will just leave the invitation open, but not keep asking you. Instead, I will go out without you.”
Spouse: “What? You are going out without me? Don’t you think that it is a little selfish for you to go out and have a good time while I’m miserable, all alone, at home?”
Healthy Spouse: “Yes, I can see how it really feels that way to you. I wish you didn’t need to feel miserable or be alone.”
Spouse: “Then you will stay home.”
Healthy Spouse: “No, that would only make me burn out and that wouldn’t help you.”
Spouse: “Oh, that’s all bullshit and you know it. Did you read that in a book or something?”
Healthy Spouse: “I’m not going to argue with you.”
Spouse: “Go then. I don’t care!”
Caretaking spouse goes out with a friend.
Never expect people to like your boundaries, whether they are your friends, parents, children, or spouse. If you are sure that what you are doing is healthy, they will soon get used to your boundary and your relationship will improve. Their initial anger, sadness, or anxiety is their way to try to stop you from making this change.
Once they can clearly see that their feelings do not stop you, their bad feelings will become less intense. For this to happen, you need to be consistent and persistent, not in arguing, but in your boundaries.
When people fail with boundaries it is typically due to inconsistency.
If you can’t leave your spouse alone
What if you can’t leave your spouse alone?
In the case of children or adults who need supervisory care, you will need to arrange for that before going out. Be sure that you make a habit of doing that though, or things will get worse. Time does not stop passing just because you are taking care of your spouse. You may have personal goals that you won’t be able to catch up with later on.
You need to be a happy partner for your spouse. You do that not by painting on a smile and giving a cheery “good morning,” but by actually living and loving your life.
If you feel trapped and guilty
If you are feeling trapped in your relationship and guilty because you have to take care of your spouse but don’t want to, there are things you can do.
- First, learn as much as you can about the actual symptoms of your spouse’s disorder. You need to be able to distinguish the psychological disorder from the unacceptable behavior.
- Secondly, take yourself off the hook for making your spouse happy. That would not be your job even if your spouse did not have a psychological disorder.
- Thirdly, work on your relationship. Make sure you are still being an attractive spouse and not becoming like a parent for your spouse. You don’t have to wait for the disorder to miraculously go away to do that. Some disorders won’t go away, or will come and go. Waiting for your spouse to recover from a long-term condition is a waste of your time and your spouse’s time.
- Lastly, get help. A psychologically trained relationship coach can help you to improve your relationship, get to work on your own happiness, and still have proper consideration for your spouse’s mental illness. Your spouse’s psychological disorder does not need to be your reason for a bad relationship. Many people successfully have good relationships with spouses who have psychological conditions, and with a little learning, you can too.
I recommend you visit my Difficult Partner Coaching Package page on my website. It may be just what you need to improve your marriage–for both of you. Consultations are also available and are a good choice if you are unsure what options you have for your situation.
FAQ
My marriage is terrible, but I feel I can’t leave due to my spouse’s mental illness
I recommend setting aside for the moment whether you should leave or not and instead focus on aspects of your relationship that you may be able to change. Often we have all-or-none thinking that makes us feel overwhelmed or stuck. Working on improving your connection in some places and using boundaries in some places may make it easier to stay, or even make it easier to leave.
I am running out of patience with my spouse’s hurtful behaviors
Good! Patience is not a good way to respond to ongoing hurtful behaviors, whether they are a symptom of a mental illness or not. Just as parents who have children with psychological disorders must use boundaries so that their children can function in society, so you must use boundaries to help your spouse function within your marriage/family. God does no less to help us have a better relationship with Him.
I have already burned out and have no energy for improving my marriage
Burnout happens when we are using more energy than we have to give, which drains us until we have a deficit. You must reduce the demands you are putting on yourself, or your body will start to break down. Continuing to give your all in a burnout situation will not truly help your spouse, as you will not be able to maintain it. Don’t try to work on your marriage until you have recharged.
For further study:
Idstad, M., Ask, H., & Tambs, K. (2010). Mental disorder and caregiver burden in spouses: the Nord-Trøndelag health study. BMC public health, 10, 516. https://doi.org/10.1186/1471-2458-10-516
