How to Love a Spouse with Psychological Problems

If your spouse has psychological problems, you have to have a balance between taking care of your spouse and taking care of yourself

Help where needed. Use boundaries where appropriate.

If your spouse has an ongoing psychological problem, such as anxiety, depression, 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. The result is that you can become a martyr for your relationship.

For sure this doesn’t happen just with spouses. It can happen with children, with ageing parents, and even for your job.   You know if you are a martyr because if you are, you will be in your relationship entirely for the benefit of others. While it may earn you the sympathy or admiration of others, none of them would want to be in your shoes and most would downright refuse.

If you are in this situation of care taking 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.  You may have resigned yourself just to stay stuck in a hopeless situation.

In my opinion, that is not only unnecessary, but presents a real danger to your relationship. Most of the time 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. The vast majority of relationships could be reconciled if only people knew how. And, it is rarely the case that being a martyr will truly benefit the people they want to help, whether it is a mother, a spouse, or a patient or a client.

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.

You can find meaning and happiness without leaving your relationship

Too much of a good thing is a bad thing

Love, patience, and selflessness are good virtues, but taken to an extreme are not virtues at all. At an extreme, love becomes neediness, patience becomes hopelessness, and selflessness becomes codependency.  They must be balanced. We must love, but we must not be all accepting.

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 is damaging for us. These qualities of God are part of the reason we know He loves us.

Let me say these the other way. For a good relationship, you must:

  1. Care without giving your spouse everything he or she wants,
  2. Be more concerned about your relationship than pleasing your spouse,
  3. Not help your spouse continue to do things that are harmful to him or her.

Using your spouse’s psychological 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:

  1. your spouse’s well being,
  2. your relationship, and
  3. your own well being.  

For a relationship to be healthy, all three of these things need to be in line.

Boundaries are used to stop behaviors when they are damaging. If you are doing something that seems to make your spouse feel better, while damaging your relationship or yourself, you must stop.

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.

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.

Beware the belligerent spouse

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 of 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. There is no diagnosis that prevents someone from being a loving spouse, except those that cause major brain impairment requiring custodial care or hospitalization.  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.


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.

Love requires sacrifice, but not all sacrifices are loving

The sad thing is that the sacrifices of the healthy spouse in the 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. Depression does not cause abusiveness, so should not be an excuse for it.

You can work with a psychologist or a psychologist coach. Many of my clients have transitioned from helping too much to loving with healthy limits.

But, my spouse doesn’t feel like going out…

With depression and panic disorder it is true that people will not feel like making an effort to go out.  That is one of the symptoms of these disorders.  People with OCD may have difficulty with changes and people with ADHD may be irritated by too much stimulation.

But rudeness, inconsideration, and emotional abusiveness are not symptoms of either depression, panic disorder, OCD, or ADHD.

Is your kindness hurting your spouse?

Sometimes, this kind of behavior happens 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.

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.

When to be nice and when to use a boundary

My opinion is, that if someone is dying, be as patient as you can, but stay 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 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 from our overanxious spouse, or tolerate verbal or physical abuse from our explosive spouse.  To do so wouldn’t be doing them any favors.

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 friend, 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 relationship.  Here is an example of the spouse in the previous example, after learning to apply a healthy boundary:


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.”

Healthy Spouse:  “I’m not going to argue with you.”

Spouse:  “Go then.  I don’t care!”

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 manipulate 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.

A special note on borderline personality disorder

If your spouse happens to have borderline personality disorder, then he or she may make a suicide attempt when you first set boundaries.  But, the healthiest thing for the person with borderline personality disorder is to realize is that such control tactics don’t work with you.  Otherwise, he or she will become more extreme in order to control you. It is important for you to have professional help to set and maintain boundaries, one hundred percent consistently.

More normal reactions to boundaries

People with mood and anxiety disorders are not likely to make suicide attempts when you set boundaries.  For sure, they won’t like your boundaries, but what will happen is that after a while, they will adjust.  If you are going out without them, their desire to go out with you will increase.  That will help them to overcome the symptoms of their disorder.  Paying someone who doesn’t work will not motivate them top get a job. Likewise, if you always sit home and take care of someone, they may not be able to be persuaded to get out of the house.  Going out without them, while maintaining a good relationship, may be the healthy push they need.

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.

  1. 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.
  2. 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.
  3. 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 for you 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.
  4. Lastly, get help.  A psychologically trained relationship coach can help you to improve your relationship, get to work on your happiness, and still have proper consideration for your spouse’s psychological problems. Your spouse’s psychological disorder does not need to be your reason for a bad relationship. Many people successfully have good relationships with spouses with psychological conditions and, with a little learning, you can too.

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