I'm a strong advocate of soon-to-be-married and married couples going to the doctor together. It's the only way you can both truly be on the same page about your health issues. If your wife is pre-diabetic or your husband is possibly battling IBS, these are serious things a spouse can be supportive about if he or she truly understands what the heck is going on. But what about when the illness is inside the head and not visible to the rest of the world?
How do you know, and what do you do, when your wife or husband starts suffering from a psychological condition? How can you tell the difference between a series of bad days and a real problem? How is a husband or wife to know when their occasionally moody spouse has gone from having a "glass is half-full attitude" as usual to actually suffering from clinical depression? Simple answer: you can't. But you shouldn't ignore your gut instincts either.
A dear friend of mine was recently diagnosed as "bipolar." It wasn't a huge surprise (to her) because she'd been diagnosed as such in high school, but hadn't followed through with proper treatment. Let's just say she spent the bulk of her 20s self-medicating and got through okay. She finished school, got married, and had two beautiful children -- but then everything went haywire on her. Her husband, who loves her very much, was at a complete loss when she started cycling up and down between her manic and depressed phases, but he didn't tell anyone because he didn't want to embarrass his wife and wasn't sure what to do. It was terrifying to witness her spiraling out of control while he sat there watching.
Frighteningly, more people battle depression, anxiety and a whole host of other truly devastating mental disorders without ever getting the real medical help they need because nobody -- not even their spouse -- understands what's going on enough to try and help. Young mothers who fall apart are immediately labeled "overwhelmed" by motherhood instead of anyone making any serious attempt to diagnose what's going on. Maybe it is just stress, but sometimes after you have a baby, your body changes dramatically and your hormones go haywire causing emotional issues. Sometimes it's bigger than the baby blues.
Unfortunately, society has made mental illness into "crazy" and that has a connotation that means you need to hide what's going on inside you, lest ye be judged. Even by your husband or wife. Post-partum depression is an excellent example. Most of us are familiar with the "baby blues" and yet, even celebrities like Tom Cruise have done their best to mitigate how serious a condition it can be. Nobody expects you to hide your diabetes or epilepsy because you can't help that and you're actually safer if the people around you know about it. How can it not be the same for mental illnesses? It's because mental illness isn't like diabetes or epilepsy. You don't start passing out from low sugar or having public seizures. There may be no outward physical signs at all, but that doesn't mean that to the person suffering the illness, it isn't every bit as earth shattering as a seizure on pavement in a public parking lot. Somebody battling an anxiety attack in public may look just fine to the guy in line next to them at Home Depot, but inside, that person might think he or she is dying. Most of the time, only the people closest to the sick person (sometimes only the husband or wife) are even aware the problems exist, and even then they don't necessarily know when something is going on in the moment.
Sadly, mental illness often manifests itself in a marriage as big, ugly, nasty fights. Or silent standoffs. It really depends on the personality of the couple and what the illness is. A woman suffering from manic-depression might stay up cleaning the house all night during a manic episode but be unable to do more than put on sweatpants and shuttle the kids to and from school on a bad day. She might go from being the supermom all the other mothers love to hate to sobbing hysterically on the floor unable to communicate what is killing her to her terrified and useless husband who is standing there not understanding what's going on at all. It's a scary situation for everyone involved, but that's exactly what happened to my friend.
Unfortunately, in the calm after the storm, after the lovely Xanax or whatever finally kicks in, nobody wants to talk about what just happened. Nobody wants to follow up on the promises to find help. Nobody wants to remember the horrible things that were said. But they do. How do you forget that? Over time, it undermines the marriage. The more balanced spouse stops sharing stress with the less balanced spouse because he or she doesn't want to put more on their already overwhelmed husband or wife. Holding back drives a wedge, and the person who is sick feels it, even if they don't understand it. And they know they are the cause and so they try to hide their illness rather than getting help. It's a vicious cycle that often ends up with a divorce or a funeral, or both. My husband has a friend who carries his wife's prior psych ward commitment papers around with him because he says he never knows when they may come in handy. That's just a sad way to live.
Fortunately, in my friend's case, her girlfriends were looking out for her. When her husband didn't intervene, they did -- involving him in the process, of course -- getting her a mood disorder specialist and stepping in to help with her kids so she could go into an inpatient environment for a few days while they put her on the hard core medications to help her live a normal life. It's not over for her -- she'll be dealing with her mental illness for the rest of her life. She'll probably be back in the hospital for a few days a couple of times every year because medications like Lithium have to be closely monitored and tweaked occasionally (some bipolars swear the change of seasons screws them up like clockwork). That doesn't mean she can't be a fabulous wife and mother 99 percent of the time -- it just means her off-days are going to be worse than the average person's.
So what can you do if you think your husband or wife may be suffering from mental illness or a nervous breakdown? Confront him or her, gently, about it. Make an appointment with a physician or psychiatrist together so you can discuss the changes you, as the spouse, have observed in the person you know and love best in the world. If your spouse won't cooperate, make an appointment with their doctor yourself and ask for guidance. Don't ambush -- it's not an intervention and the sick person isn't the "offending party," so to speak. Think of your spouse as a "victim" to the illness and if you think something is really wrong, try to go to the doctor TOGETHER for help.
Your best back-up is the person who sees you daily and knows you best. If something seems off to you, it probably is. Don't ignore the signs. Sadly, mental illness is everywhere around us. Many people get the help they need and have perfectly happy normal lives. "Better living through modern pharmaceuticals," my husband always jokes. But it's not a joke. It's the reality of this 24/7, crazy, technology-driven world in which we live today where life's daily challenges can make it hard to cope with everyday life. Don't ignore the signs of mental illness in yourself or someone you love -- there is help available. As the husband or wife or somebody who is suffering from a psychological problem, it's your duty to get them help. And it's key if your goal is to live a long happily married life together.