By Stephanie and Andrew Downing
Marriage is difficult for anyone, but it’s even more challenging when you add in the complications of mental illness. My husband, Andrew, has schizophrenia. We’ve lived together for nearly 15 years and we’ve found success as a married couple, but our journey has been filled with many obstacles.
Beyond my relationship with Andrew, I am also a mental health practitioner. Whether I’m caring for someone with schizophrenia or depression, I often walk the narrow, unforgiving line of when to push and when to administer a large helping of mercy. Though challenging people to improve their quality of life is risky, if we don't, those who are struggling may continue to struggle.
People have asked me so many times when and how to encourage, or push, someone struggling with a mental illness. Here is what has worked for me:
An act of mercy starts with an open mind and a sensitive, understanding voice while communicating. I constantly challenge myself to see the bigger picture and put aside my own frustrations, so I don’t come across as judgmental or abrasive. As this type of personality can prevent an empathetic viewpoint. If I am open about my own problems around my husband, he might be more willing to talk about his own struggles.
To push someone successfully, knowing when symptoms are flaring is helpful. Phone calls, text messaging or other forms of digital communication can make it difficult to assess symptoms. Body language and word choice, comparatively, offer a wealth of information. For example, anxiety can cause a person’s body to twitch and tighten.
Unfortunately, caregivers often have to challenge struggling individuals during difficult times. Waiting for peaceful moments or willing ears is not always an option. That's where the art of confrontation and mercy merge into one cohesive act of love. However, yelling or speaking from a platform of self-assumed intelligence, pride, anger or bitterness typically results in a negative outcome. People tend to respond well to a loving presentation of information that reinforces equality.
Healthy relationships start with the understanding that mental health conditions have labels, but those labels don’t represent the person. Treat your loved one as a person who is equal to you, not as a lesser person because they have mental illness. If their relationship with you isn’t built on mutual respect and admiration, it will be very difficult for them to grow or be challenged by you.
With all this said, keep in mind that no one has absolute control over another human beings’ actions. Caregivers must let go at times to remain healthy themselves. Holding on to bitterness or regret can cause a caregiver emotional turmoil.
Expect to make mistakes as you grow into your role as caretaker. Though I have often felt guilty for making his life harder with my pushing, Andrew often tells me he may have been lost to a permanent state of delusion without our relationship. I know that my presence in his life has challenged him to be the best he knows how to be. Never give up on the person you love, and try to remember the immense challenges that a person with a mental health condition faces each day.
Stephanie and Andrew Downing are the authors of “Marriage and Schizophrenia: Eyes on the Prize.” You can learn how Stephanie failed and succeeded at pushing Andrew to be his best through the immense challenges presented by schizophrenia.
We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.
Check out our Submission Guidelines for more information.
Call the NAMI Helpline at
In a crisis,
Find Your Local NAMI