When Your Spouse Is Mentally Ill

“I think someone is listening in to our phones.” This was the first hint of the coming crisis that would dismantle my life as I knew it. My husband shared with me his growing paranoia. Someone was watching us from the lot across the street. He couldn't tell me details because they were listening in to our conversations at home as well. He thought they might try to kill him on his way to work.

At first, he was very convincing. I loved my husband. He was funny and smart. I respected him and had looked to him for advice throughout our marriage. So when he said he thought our phones were being monitored because of something going on at his work, I believed him.

But as the days went on, it became clear that something was going on inside of his brain. Our youngest child had kept him awake most of the night the week before, and he’d been unable to get a good night’s sleep for several days in a row. I chalked his confusion up to sleep deprivation.

But then he said someone wanted him to go to the hospital and insisted I call an ambulance. By the time I got to the hospital, my husband was sedated and restrained in a hospital bed. (In his confusion, he had tried to push the doctors out of his room.) Words cannot adequately describe the shock and fear I felt when I first saw him handcuffed to his bed.

Descending downward

And so began my own disturbing descent into the world of mental illness. It became clear that my husband's descent had begun some time back without either of us realizing what was happening. At first, his doctor, my pastor, and I all believed his erratic behavior was a one-time occurrence of hallucinations due to sleep deprivation. After getting some sleep and taking antipsychotics in the hospital, he got a little bit better. But a few months later, after he stopped taking the antipsychotics, his symptoms came back in full force.

When he needed a second hospital stay, it was clear that this was much more than sleep deprivation. I remember the doctor who’d treated him during his first hospital stay coming out of the psychiatry ward to sit with me in the waiting area after my husband was admitted the second time. He simply said, “I am so sorry.” Nothing more needed to be said; we both knew the diagnosis this second time around would be much more serious. My husband was eventually diagnosed with schizoaffective disorder. The prognosis was not good, and the road forward would never be easy again—for my husband or myself.

As a Christian wife who dearly loved my husband, I wanted to do right by him as he faced this illness—but I had no idea what to do. How much should I engage with his delusions? How much should I push back? Should he be involuntarily hospitalized? Were his various medications compounding his symptoms?

My pastor, to whom I turned for counsel, didn't have answers either, but he and his wife listened and loved my family well. I looked for secular resources for spouses of the mentally ill. I went to a local NAMI (National Alliance on Mental Illness) support group, but it consisted primarily of parents or siblings of the mentally ill. My position was so different: How could I cope as the wife of someone struggling with intense paranoia?

A delusional partner

My husband and I had been true partners in our home. We parented together and shared the weight of responsibilities. I was dependent on him financially but also in a thousand other ways. We’d had a good marriage in which we each contributed—like we were shouldering a heavy sofa together, each carrying our part. But his mental illness caused him to crumble under the weight of our responsibilities, and I had to carry more and more by myself. Though I wanted to curl up in the fetal position, I couldn't. I had small children and a house payment. I either had to get a smaller sofa or figure out how to carry this one by myself.

The loss of our spiritual partnership was especially hurtful. Night after night, I cried out to God in the dark. Before all of this happened, God had led us to move away from immediate family in order to minister in a new town. We had been confident together of God's plan for our family, and I turned to my husband regularly for spiritual counsel and encouragement. Now, how could we bring the Good News to our community when my husband was living in a completely different reality? What was God's plan in all of this? What should I do? I wrestled with God to understand what was happening.

All of the relationships we’d developed as a couple fell victim to my husband's paranoia; he was convinced by the voices in his head that they were in a conspiracy against him. At first, I allowed his delusions to distance me from my own friendships, in our church in particular. But, over time, I realized I would not survive without the family of Christ helping me navigate what I could not navigate on my own. When the person I was closest to on earth began living in a delusional world, I needed to surround myself with spiritually sound people who could keep me grounded in reality. I remain thankful today for this grace-filled Christian community that has patiently loved both him and me. They have been a life jacket that held my head above water when I felt like I was going down.

Fight or flight

In such a crisis, the natural response for many of us is fight or flight. In my case, I could not run from his diagnosis, so I tried to fight it off valiantly. My greatest mistakes in that season came from my frustration as I tried to fight off the symptoms of his illness. What could I do? I wondered. How could I stop this? It was a great battle for me to eventually acknowledge, first, that I couldn't save my family and then, second, to hold on to faith that God could.

At times, I made mistakes. Other times, I made the best choices available to our family. The stakes were high, and I was haunted by the fear that it depended on me to figure out the right path. I had to lean deeply into what I knew of God—he is sovereign, compassionate, and wise. He is gracious and merciful. He was not holding an anvil over my family's head, ready to drop it if I didn't navigate everything perfectly. Most of all, I had to cling to the knowledge that Christ had paid the penalty for my sin, and I could come to God boldly and confidently to find help in my time of need.

Despite my best efforts to avoid such an outcome, our marriage eventually ended in divorce as my husband’s delusions painted me more and more as his enemy. In the years since the first occurrence of his symptoms, my now ex-husband (with whom I remain in close relationship) has never been fully freed from his psychosis (despite finally accepting antipsychotic medications), nor has he reached the point of being able to shoulder much in terms of family responsibilities. Instead, I have had to learn to be the emotional and physical provider for my children. I have also had a family safety net to lean on, and I continue to be blessed by a church family who supports me and my children in tangible ways.

Lessons learned

Though I often felt alone as mental illness invaded our marriage, I know I am not. Countless other couples face similar struggles. NAMI notes that 1 in 5 adults experiences a mental health condition every year and 1 in 17 live with a serious mental illness (schizophrenia, bipolar disorder, and so on). Through the years, I have learned some things about marriage and mental illness that I wished someone would have told me early on. If you or a loved one are facing a similar challenge with mental illness, here are a few important truths.

First, it's not your fault. Though you likely were never the perfect spouse, you did not cause this to happen to your husband or wife. Which leads to the second: You didn't cause this illness, but you cannot save your spouse from it either. You can certainly help your spouse, but you cannot find the perfect cure. Rather than scrambling for a magic bullet that will free your family from this devastating diagnosis, you need to hold tight to the truth that God is Savior, not you.

Next, trust in God's care for your spouse through doctors and other medical professionals. The best advice I got early on came from a pastor who simply encouraged me to listen to the doctors and consider their diagnosis seriously. The brain is an organ, like the heart or lungs, and God can use medical professionals to provide needed expertise and care. Though I evaluate advice from mental health professionals closely and work to line it up with my understanding of God and the Bible, I have found their help invaluable.

God has used this crisis in our family to catalyze a significant shift in my own thinking. In all honesty, I used to view mentally ill homeless men asking for money on street corners as scary—but now I envision my husband standing in their place. Now I get how a person can end up bedraggled, smelly, penniless, and confused. I get the trauma of needing help but scaring the people you approach in search of it. I now see the image-bearing dignity of mentally ill people in a way I did not see before. My previous lack of understanding was born out of my own privilege—and it is a severe mercy that I’ve come to understand it now.

In the midst of the despair that comes when a loved one is mentally ill, I encourage you to hope in the God of your salvation. At times, I’ve looked to my own “horses and chariots” to rescue our family (Ps. 20:7). I’ve worked down a checklist of things like pastoral interventions, psychiatric stays, and antipsychotic medicines that I hoped would somehow return the husband I’d known to our family. Though these tangible things have helped some, I’ve had to accept that they will not be his savior or my own.

God has provided for my family in supernatural ways that I could never have predicted. While I've continued to carry much of the weight of the figurative sofa myself, I now see that God's infinitely strong shoulders have born the vast majority of the weight, enabling me to go further under its burden than I could have envisioned in the first days of coming to terms with my husband’s illness. I thought I would be destroyed, first, by my husband's diagnosis and, second, by our divorce—but what I feared would destroy me and my children actually did not. God has proven himself faithful to us.

Wendy Alsup is a mom, math teacher, and author. Her most recent book is Companions in Suffering: Comfort for Times of Loss and Loneliness. This article was originally published with the writer’s name withheld.