What if I think my spouse has a mental health condition and he or she doesn’t think so or he or she doesn’t want to get help?

You can’t force someone to get help; however, you’re able to communicate your feelings and how the behaviors are affecting you. Communicate with care and in a nice tone what you’re concerned about and what symptoms or behaviors you’re seeing. Then share how these symptoms are affecting you and others. Then ask if he or she would be willing to go to the doctors to understand if there’s something more there.  Be willing to go with him or her to the doctor’s if your spouse would like for you to join. Then share with the doctor what’s going on both physically and mentally. It’s important to share examples. If your spouse is unwilling to go, you may need to set up a boundary like “I love you and care for you. I believe there’s something more serious going on. I’ve asked you to go to the doctor’s, and you have chosen not to. I can’t force you to go, but it’s impacting our relationship and connection. If you’re unwilling to go in XX amount of time (I used a month), then I’m going to ask you to move out.” Of course, only say this if you’re willing to have this boundary. You can’t force him or her to change, but you can choose what you’re willing or unwilling to live with.

How do I keep myself sane?

It’s very important to do self-care, keep balance, share your feelings by not stuffing them (in a journal, to God, to someone else, etc.) and find things in your life that bring you joy. I had many years in my marriage where I was alone, and God provided other areas to meet my needs. Find areas where you can fill yourself, areas you can pour into the marriage, and ways you can be with others. Crying out to God, praying, and surrendering the situation to him is also very important. I also think grieving the relationship and what you expected it to be is important too. Find friends also in crisis, maybe not in the exact same situation so you don’t try to fix each other, but just where you can listen and walk alongside each other. We have five people who have given us their house keys so that we can crash on their couches. We don’t use them often, but they’re there when we need a break.

How is intimacy impacted in the relationship?

One of our therapists said intimacy in a marriage reflects how the relationship is doing. For us, where it’s infrequent, that demonstrated how the connection at a physical and emotional level had a disconnect. It’s normal for intimacy to be impacted when there are mental health issues. Anxiety and depression greatly are impacted. If your loved one is on medication, it can lower the libido and drive for intimacy. The main thing is to try to not take it personally, identify it as an issue, discuss it as a couple, and figure out how you want to work together to resolve. This can include creating a schedule, identifying creative ways for intimacy, getting external help from a therapist or doctor, and so on. You must identify what works for you, but don’t ignore or give up on this. I know this can be a very shameful and embarrassing area in our overly sexualized culture. Remember that it’s very common with mental health struggles, and you can work together through it. Try to be understanding and not critical.

Will I ever be okay?

Yes. You’ll be okay. I remember during my burnout asking the doctor if my mind would ever be okay again, and she said, “Yes. You’ll do the right things that people who’ve walked before you did, and you’ll get better. Through trials, we’re refined, we become less judgmental, we become compassionate, and we become stronger people. You’ll be okay.”

You talked about grief, but no one died. Why did you incorporate that, and how do I know if I need it?

Yes, this is a common misconception. Grief is about working through losses, not just deaths. In severe mental health conditions, there’s normally trauma, grief, and the illness. You, also may have grief too due to living with someone with mental health condition. The relationship you thought it would be is no longer. I didn’t grieve until year eight or nine, and I wish I’d known about that earlier. Grieving allowed me to be able feel my feelings, go to the pit, and be able to move forward. Behind a lot of my angry and controlling nature was sadness, disappointment, fear, and grief. Going to these feelings deeply allowed me to be able to move forward. Grieving isn’t a one-time thing; you may have to grieve multiple times, depending on the number of losses. Each person is different, but I don’t think our culture talks about this enough and its impacts on relationships and mental health.

How do I know if I’m enabling?

Enabling are behaviors that your spouse can do but are normally hard for him or her to do, and that’s why your spouse asks you to do them since it’s easier for you. It shields the person from feeling the impact of his or her behavior or the consequence. Now you want to have balance with this, as you don’t want to be so rigid that there’s no grace for the person. I like to use the following questions: (1) Do I want to help? (2) Is your loved one able to do it him- or herself, or does helping him or her keep your spouse from doing the hard work? and (3) Does helping hinder my ability to care for myself? These questions help me to determine if it’s enabling or helping.

How do I stop enabling?

The best way is to identify the behaviors, write them down, and talk to someone about them who knows the condition of your loved one who can help think it through. Then discuss with your loved one, begin implementing the changes in behaviors, and have accountability. Give yourself grace when you don’t do it well, as it takes practice. And remember: this is hard. Two steps forward and one step back; but you’ll get there!

Separation and Divorce

When and how do I know if I need to separate?

Is your spouse’s condition affecting you where you’re not able to function? Or is your spouse physically, emotionally or sexually abusing you? For me, it wasn’t abuse but it was where I was not able to function. I was having trouble going to work (where I was the one with a stable job) and I was crying multiple times throughout the day. Not being able to function for me was the sign that the current situation couldn’t continue, and something needed to change. This is, of course, one of the last resorts but may need to be leveraged. It’s important if you separate that you have a plan to get back together; otherwise, you’ll stay apart. Make sure to be working with wise people around you, including a personal therapist and possibly a marriage therapist as well.

When and how do I know if I need to get a divorce?

If your loved one is not willing to get help and is getting worse and worse and you have tried separation and that’s not impacting a change, then I would question whether your spouse wants to be married. At that point, you would need to decide what you want to do. I would encourage you to have a therapist or wise people around you, helping to make this decision.

What do I do if I got a divorced and now after reading your book, I want to try again in our marriage?

First of all, this brings us joy. This is one of the exact reasons this book has been written. To bring restoration and hope to marriages. There are many marriages that have been divorced and have now re-married. Yours could be this too. The important thing is to invite God into this process and ask Him to do the amazing transformation that only He can do. My encouragement to you is to join the Rejoice Marriage Ministries distribution to start praying with other standers. Then I would work with a counselor to help determine what is the best way to move forward.

Seeking Support

What type of support network do I need and how do I build that?

You are correct that it is important to build a team around you. The team should include doctors, therapists, friends, family, and church. In order to find friends, you need to be a friend too. Join activities that you enjoy doing to meet people. Join a church, get involved and look into a bible study. Ask God to help you develop strong relationships and see how He works.

Where do I go to find a support group?

There are several ways to find a support group. NAMI has family-to-family support groups. You can find them on Google. Also check  Ask your doctors and therapists. Ask your local churches and friends/family. You can always start one as well. I have several that I go to. There’s a family-to- family NAMI group I go to, and an OCD family group as well. In addition, we have our small group (or Bible study) who love us as well as our family and friends. Celebrate Recovery ( has great support groups as well. Also, there is aa mobile pp called 7 Cups that offers free therapy through texting. Pray and ask God to connect you to the right people.

Help in Crisis

I think my spouse is thinking about suicide. What should I do?

Suicide is serious and should be handled seriously. If a spouse, discusses or threatens suicide or harming themselves, call 911 right away. You can also choose to call the SUICIDE prevention hotline number at 800-273-TALK (8255).  If your spouse is not discussing suicide, but you have a hunch he/she is thinking about it, the next step is to ask them about it. You can ask something like this, “Are you thinking about killing yourself?” If he / she responds, “Yes.” Then you ask, “Do you have a plan on how you would do it?” If he or she responds yes, then again call 911 or take to the nearest hospital.


What to do about medication?

Medication is a topic of lots of discussion in the mental health field. The first thing is make sure you and your spouse are on the same page about medication. It is ok to be on medication and it is ok to not be. Work with your psychiatrist to figure out what is the right medication if choosing to go on it. Many people have said the medication has changed their lives to help with the chemical imbalance and others have said the opposite. Each medication works different on each person so sometimes it is a trial and error. For us, medication has helped Keith’s condition and it has taken time to figure out the right one for him.

Other Questions

What is Mental Health Strong’s stance toward inclusion and diversity?

We honor and respect any individual or couple impacted by a mental health or addiction challenge regardless of race, color, national or ethnic origin, religious affiliation or lack thereof, sex at birth, gender, sexual orientation, disability or relationship status (e.g., dating, engaged, married, separated or divorced).  We believe every individual is endowed with intrinsic worth, dignity, and value, and is to be cherished and respected.

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