Mental Health Strong: A Christian's Guide to Walking Resiliently Alongside Your Spouse with a Mental Health Condition

By Erin Ramachandran

Do you feel hopeless, tired, and worn out? Do you feel as though you’re losing your own mind? Are you ready to give up on your marriage because of your spouse’s mental health or addiction challenge?
Twenty percent of the US adult population is diagnosed with a mental health condition each year. Fifty percent of the US adult population is married. Twenty to 80 percent of marriages where a mental health condition exists are more likely to end in divorce depending upon the diagnosis. In Mental Health Strong, Erin Ramachandran and her husband, Keith, believe their purpose is to help marriages affected by this 20/50/80 statistic not merely survive but thrive. They encourage marriages impacted by mental health or addiction challenges to work toward being Mental Health Strong.
Written from the perspective of a spouse whose partner battles multiple mental health conditions, this guide offers real-life, faith-based, practical examples and resources. Mental Health Strong leverages more than fifty resources that have worked for Erin as she lives with the realities of her husband’s mental illness day in and day out. Erin shares steps, which include prayers and Bible verses, that spouses can adopt to walking resiliently alongside their partners against the backdrop of a mental health condition.

• Language: English
• Publisher: iUniverse
• Release date: May 20, 2019
• ISBN: 9781532069291

Erin Ramachandran

Erin Ramachandran holds a master’s degree in healthcare administration and is a certified Mental Health First Aid instructor and an award-winning author. Ramachandran has worked in the health care industry for more than fifteen years, and is a mental health and wellness program director at one of the nation’s largest not-for-profit health plans. Erin and her husband, Keith are Christ-followers, have been married for over twelve years, and reside in Southern California.

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Copyright © 2019 Erin Ramachandran.

All rights reserved. No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including photocopying, recording, taping or by any information storage retrieval system without the written permission of the author except in the case of brief quotations embodied in critical articles and reviews.

The information, ideas, and suggestions in this book are not intended as a substitute for professional advice. Before following any suggestions contained in this book, you should consult your personal physician or mental health professional. Neither the author nor the publisher shall be liable or responsible for any loss or damage allegedly arising as a consequence of your use or application of any information or suggestions in this book.

Scripture quotations marked NIV are taken from the Holy Bible, New International Version®. NIV®. Copyright © 1973, 1978, 1984 by International Bible Society. Used by permission of Zondervan. All rights reserved. [Biblica]

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ISBN: 978-1-5320-6928-4 (sc)

ISBN: 978-1-5320-7552-0 (hc)

ISBN: 978-1-5320-6929-1 (e)

Library of Congress Control Number: 2019903359

iUniverse rev. date: 12/02/2020

CONTENTS

Purpose

Prologue

Introduction

Chapter 1 Something’s Not Right

Chapter 2 Mental Health and Marriage

Chapter 3 Relationship Cycle

Chapter 4 My Role

Chapter 5 Helping versus Enabling

Chapter 6 Difficult Situations

Chapter 7 Step 1 —Make the Diagnosis Clear

Chapter 8 Step 2 —Help for You and Your Spouse

Chapter 9 Step 3 —Set Some Boundaries

Chapter 10 Step 4 —Take Time for Self-Care

Chapter 11 Step 5 —Remember to Grieve

Chapter 12 Step 6 —Own the Journey

Chapter 13 Step 7 —Not Again—Expect Relapses

Chapter 14 Step 8 —Gift of Mental Health

Epilogue

Appendices

Acknowledgments

Bibliography

About the Author

To God. Yes, I still trust you.

Edited first by Keith Ramachandran, my covenantal husband, whom I love. We are a healing team as we battle mental health struggles and continue to work toward being Mental Health Strong together. I would not want to be married to anyone else but you. Thank you for being willing to be vulnerable, courageous, and faithful with sharing our story. I love you.

tree.psd

DISCLAIMER

This book is not intended to substitute medical advice of physicians and/or mental health professionals. The reader should regularly consult with medical professionals relating to the symptoms that require a diagnosis or medical attention. This book is intended to be a self-help tool inspired by real-life experiences, resources, input from others, and prayer that have helped me walk alongside my husband and be a healing team with him. We both strive to be Mental Health Strong.

ABSTRACT

Do you feel hopeless, tired, and worn out? Do you feel angry and contemptuous? Do you feel as though you’re losing your own mind? Are you ready to give up on your marriage because of your spouse’s mental health or addiction challenge? If so, then this book is for you. What’s different about this book? It’s written with real-life, practical examples from the eyes of a spouse living this, day in and day out.

Every marriage needs work, and for your marriage and mine, this is our battle. This book leverages more than fifty resources that have worked in walking alongside my spouse in the hopes of helping the millions who live in similar marriages. I believe that if you put these steps into practice, you’ll be different, and you’ll have hope again in your relationship. May marriages with mental health and addiction challenges not only survive but thrive.

Let’s be Mental Health Strong together!

MENTAL HEALTH

STRONG BRAND

Did you know that 20 percent of the U.S. adult population has a mental health diagnosis? Did you know that 50 percent of the U.S. adult population is married? Did you know that 20–80 percent of marriages with mental health diagnoses are more likely to end in divorce? Keith and I believe our purpose is to walk alongside and help transform lives affected by the 20/50/80 statistic. We want to encourage marriages impacted by mental health to work toward being Mental Health Strong.

This is a three-part series. The first book is written from my perspective—the person walking alongside his or her spouse with a mental health diagnosis—and how to be Mental Health Strong. Keith is working on book number two called Mental Health Strong Living—sharing about how to thrive in life and marriage when you have a mental health diagnosis. Then the third book will be us writing together on how to have a Mental Health Strong Marriage.

We are using the tree image on the cover page to symbolize the journey of a marriage with a mental health condition. The roots are twisted to depict marital struggles. The trunk symbolizes the work that needs to be done to grow the marriage so that it thrives. The leaves depict the strength and vitality that results from growth and perseverance. Finally, the fruit symbolizes the beauty that arises from the ashes of trials, which is of benefit to others. A close observation of the foliage of the tree reveals both the growth of the individual (symbolized by individual branches) and the maturation of the marriage (symbolized by the overall canopy of the tree and fruit).

To God be the glory! May marriages not only survive but thrive!

PURPOSE

Our story is all about God. God is the one who brought us together. God is the reason that we’re still together, and God is the reason for how this book helps others. God is the author and designer of marriage and we believe God uses marital challenges to transform people’s lives.

What you need to know is that our marriage is not a fairy tale, far from it. Our marriage has been severely impacted by mental health challenges. I struggle with mild anxiety, and I had an episode of burnout and panic attacks (midlife crises at the early age of twenty-seven). Keith, my incredible husband, struggles daily with Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), anxiety, and depression. We didn’t know we had any of these mental health struggles prior to marriage. With God and through the support of others and many resources, we’re still together today. Our desire and purpose are to help marriages thrive when a spouse has been diagnosed with a mental health condition, also known as a mental illness. Marriage, in general is hard, and when you then add in a mind not working properly and then stir in the regular trials of life, you have one perfect storm.

Do you know that in California you can nullify a marriage or have legal grounds to end the marriage based on the options of an unsound mind or permanent legal incapacity to make decisions? My guess is that these options exist because many people end their marriages because their spouses have unsound minds, partly because of possible mental health diagnoses or mental health issues that have not been identified. If you’re thinking, How does she know this? In full transparency, I’ve filled out these papers before. It’s okay if you have too or if you’ve thought about it. Living with a spouse with mental health or addiction challenges is hard. It’s not just hard; it’s very hard.

The more I learn about mental health conditions, the more complex they seem. We must remember that they are brain disorders, and many times, people are born with the genetic predispositions for them. Also, the more severe the struggles, the more multi-faceted they are. It seems that many times the mental health struggles involve physical (genetic disposition or chemical imbalance), emotional (trauma, grief and/or loss), spiritual (impacts outside this physical world), relational (hurts from others and/or hurts to others or ourselves) and possible financial aspects. They’re complex and complicated for a reason. And many times, there are multiple triggers that make them worse. The thing to remember is that not one thing caused them. No one has asked or desired to develop these struggles. So, stop blaming yourself, your spouse, or others. We just need to accept the mental health struggles in the marriage and work through them just like we would any other medical condition. We also need to accept and learn that many times we need a multi-faceted approach for taking them on.

We want to walk alongside you in three different ways:

1) We want to help reduce the shame that you or your spouse feel(s). When a spouse has diabetes, cancer, or some other health issue, we tend to provide compassion and no judgment. But if a loved one has a condition where his or her mind is not functioning properly, like anxiety, depression, bipolar, addictions and so on, we think the person can just snap out of it and we’re too scared or ashamed to bring it up when they are not able to—we keep it in secret. By sharing our stories and the messiness of mental health, our hope is that we can reduce some of the shame you may feel in your marriage and help you understand that you’re not alone. There are numerous of marriages like yours and ours.

2) We want to provide you with resources that have worked for us. This book includes real-life, practical resources to access. Some are free, some require your health insurance, and some have significant costs. In general, mental health help in the United States has lots of opportunities. I think we are on a wave of change and we will see more great strides ahead. We’ve shared what has and hasn’t worked for us. A disclaimer though, there’s no magic formula to cure you and/or your spouse, and some things that may have worked for us may not work for you. The good news though is that there are many treatment options and resources to help as you discover what works for you. Recovery is possible!

3) We hope this book inspires you in your faith journey. For us, Jesus is the reason we’re still together. He is the foundation of our faith. Now, know that if you’re not a person of faith, you don’t need to stop reading this book right now. You can use points one and two and perhaps this book will encourage you to discover or rediscover your spiritual journey. If you are a person of faith, we hope this book helps you grow in your walk with Christ. We exhort you to ask God to intervene and watch Him work wherever your faith is. We have seen God answer prayers in our own lives time and time again.

Our desire is for each partner to become Mental Health Strong. This is the brand that we believe God has inspired us to use. We want each spouse to choose to work toward what he or she needs to do individually and then to choose to work on what you need to do as a couple.

In closing, we hope this book is helpful to you. If this book is not helpful, we encourage you to not to be critical, judgmental, or give up. This mental health space is very complex, and we need more resources and stories to help. Maybe your story can help too. Figure out what works for you and consider writing about it as well. Everyone and every relationship is different, and we need more resources on the topic of mental health and marriage. Let’s work together to help change the stigma of mental health, build resilience, and join this journey of providing compassion instead of judgment, resources instead of shame, and hope instead of giving up.

PROLOGUE

After ten years of marriage, Keith and I were driving to our ten-year anniversary trip to Catalina. We wanted to calculate how many hours the OCD rituals/behaviors had impacted our marriage. When we finished the math, to our surprise—and of course disbelief—on our anniversary of October 27, Keith had spent 27 percent of his time over ten years (approximately 23,650 hours) on doing rituals and engaging in destructive repetitive behaviors. Say what? We were shocked. Twenty-seven percent on our ten-year anniversary? How could this be? If sleeping is another 33 percent (27% + 33% = 60%), that means only 40 percent of the time we had left. Then incorporate work, which is another 33 percent of the time, and that means we’re left with only 7 percent of the time that Keith and I connected over the ten years of marriage.

Now I understand why I felt so alone—because I was alone 93 percent of the time. No one in my life struggled in a marriage like we did. We were having trouble doing the daily basics of marriage (e.g., doing things together, getting to places on time, being on a schedule, getting to work, sex on a consistent basis, and enjoying each other). One of our marriage therapists labeled us each as married to OCD and said that OCD was the mistress in our relationship.

I’ve not found many books to help our situation. There are very few books on marriage and mental health struggles, even fewer on marriages with OCD and depression impacting them. No one in my network had the same situation, or if there was, it was never discussed, or it wasn’t as severe. I couldn’t find a how-to guide or adequate resources that were applicable to our situation. I found several books written for individuals struggling with mental health or addiction challenges but very few that offered help to the spouse walking alongside the loved one who had been diagnosed. Then I would read marriage books and our marriage wasn’t like theirs. I felt so different than others. In fact, I shared with a few others that I felt like Noah (from the Bible), building an ark and knowing it was going to rain but not knowing when. And everyone around me thinking this woman is crazy as I kept persevering and trusting God in our marriage.

Last year in 2018, we went to a mental health conference and during the question-and-answer period, an audience member asked, Do you recommend any books or resources for a loved one living with someone with OCD? There wasn’t one book suggested. My husband was sitting next to me. We both looked at each other and said, You have to publish this book. People need it.

To give you a little insight on what to expect in the coming pages, the book is split into two parts. The first six chapters focus on the what—mental health conditions and impacts on the relationship. Then the remaining chapters focus on the how—with practical steps to work toward being Mental Health Strong. The eight steps are built in the acronym for Mental Health Strong as MH Strong for ease of remembering. Each chapter will include the following:

• a real-life story to encourage you

• one or more practical resource(s) with the resource reference in the Appendix

• the lie that you may believe and the truth to counter it

• a Bible verse(s) and a song to offer encouragement and perspective

• a prayer for peace and hope

Lastly, at the end of the book are a series of resources and tools to help you on your journey.

Join us on this journey of mental health and marriage. We’d love to hear from you about what has helped. As I shared before, we’re thinking about writing a three-part series. If you think this is a good idea, please let us know. Also, share your stories of what has worked and not worked in your relationship. You can reach us at [e-mail] or go directly to our website at www.mentalhealthstrong.com.

Please know that our motives for writing this book are not to make money. I have an amazing job that God has blessed me with and that I love. I wrote this book to share what I’ve learned to help others and to give back. Any money raised through this book will go back to helping those who struggle with mental health or addiction challenges, their faith and marriages.

And of course, we’ve not arrived. The battle is still real and still there every day. We still struggle but struggle less. There are still days when I get angry at the condition. There are still days that Keith can’t get out of the house. The good news though and the growth made is that we now know what to do and we are fighting the illness not one another. I went from criticizing Keith to sharing my feelings and concerns. Keith went from cleaning/straightening sixteen hours a day to recognizing his triggers and minimizing the behaviors to one to two hours. We went from being disconnected to connected. We now have fun again and enjoy one another. In fact, it is not unusual