According to the National Health and Morbidity Survey 2015, the prevalence of mental health problems in Malaysia among adults showed an increasing trend, from 10.7% in 1996 to 29.2% in 2015.

More than half were married individuals.

It’s difficult when a loved one is experiencing a mental illness such as schizophrenia, bipolar disorder, or major depressive disorder.

In our society, the stigma of suffering mental illness can be perceived as shameful, not only to the person suffering from such an illness, but also to the family.

Coping with emerging symptoms of mental illness in a loved one can be even more challenging as the whole family is affected emotionally, socially, physically, and financially.

This, in turn, can lead to relationship problems and even estrangement.

Understandably, the spouse would be the first to bear the brunt of these symptoms. This can lead to considerable physical and emotional strain, which can be very overwhelming to the spouse.

Issues in mental illness

Depression – This is characterised by persistent low mood and disinterest in pleasurable activities in life.

Depression is associated with poor sleep, poor appetite, lethargy, decreased concentration, and substance and alcohol abuse.

Untreated depression can be serious and sometimes fatal as it puts the affected individual at a high risk of suicide.

The good news is that depression is highly treatable. Once diagnosed, most people who get help report substantial relief.

Bipolar disorder – Refers to two extremes: One represents a “high”, often manic phase characterised by elevated mood, exaggerated optimism and self-confidence, lavish spending, reckless behaviour and sexual promiscuity, among other traits.

During this phase they can be perceived to be fun-loving, interesting, upbeat and full of energy.

On the contrary, the other extreme represents a depressed mood, being withdrawn from others and even suicidal.

Such erratic behaviour can be quite challenging to the spouse.

Like depression, those with bipolar disorder have a tendency to abuse alcohol and narcotics. Their spouse often serves as an outlet for their overwhelming anger, misbehaviour and financial misdemeanours.

The spouse needs to remember that the person suffering from bipolar disorder does not directly control most of these behaviours. They are influenced by the imbalance of chemicals in their brain.

Approaching your spouse

Use a calm and loving tone while approaching your spouse to discuss treatment.

Do not be angry or emotional because your spouse could potentially respond with uncontrollable anger.

In previously diagnosed cases, it is important to reason out the need to comply with treatment and come up with an agreement.

Do not be angry or emotional when you approach your spouse about treatment issues. — Photos: Handout

For example, some people with bipolar disorder recognise that they may go on a spending spree when they are not well, and therefore, come to an agreement with the spouse to take charge of their finances.

On the other hand, if your spouse repeatedly refuses treatment, you must protect yourself from abuse or being emotionally decompensated by your involvement.

This is particularly true in the case of bipolar disorder where abuse can take the form of verbal, physical and financial abuse.

Empower yourself

There are several steps you can take to control the situation:

Learn more about your partner’s illness. This will enable you to understand your spouse’s behaviour.

Increase knowledge – Learn more about your partner’s illness. This will enable you to understand your spouse’s behaviour.

Similarly, talk to your doctor about your role in your partner’s illness. This will allow you to become a positive force in your spouse’s treatment.

Find support – People who have gone through similar experiences can provide you with the best support. This can be a relative, a friend, or a person you met at an awareness talk.

Take care of yourself – It is important to take care of your own needs. Eat a balanced and healthy diet with plenty of exercise and adequate rest.

Take some “alone time” to relax and unwind. Making time to do things you enjoy will help you keep your stress levels in check to prevent burnout or falling into depression yourself.

Ease your daily burden – Your partner may not be able to work, at least temporarily, and you may have to support the family financially.

You’ll also need to drive to and from appointments, and undertake other tasks related to taking care of your partner on top of managing your children, the house and work responsibilities.

Do not hesitate to ask your relatives, or friends for help with these day-to-day activities. You will be surprised how many will be willing to come forward and help.

Hope and fulfilment

The stigma of mental illness can make couples hesitant to look elsewhere for help, but by keeping the illness a secret, couples place an additional burden on themselves.

Coping with a spouse with mental illness will take some time to get used to.

Fortunately, despite the many challenges, with modern treatment, people with mental illnesses can still live a rich, fulfilling life – and as a spouse, so can you.

Finding help and support

The following organisations are committed to helping families and caregivers of persons with mental illness. Seek support from whichever organisation that you think is suitable in your situation.

• Malaysian Mental Health Association (MMHA) – http://mmha.org.my

• The Befrienders KL – http://www.befrienders.org.my

• Alzheimer’s Disease Foundation – http://www.adfm.org.my/

• National Alzheimer’s Caregivers Network – http://admalaysia.ning.com/

• Mental Health Association – http://d-home.org.my/

Datuk Dr Andrew Mohanraj is a consultant psychiatrist and the Malaysian Medical Health Association’s Deputy President. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting. For further information, e-mail starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.