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Communication Strategies with Mentally Ill Partners

Even during the best of times in a relationship, misunderstandings and disagreements occur.

When a partner is experiencing an illness, whether it’s mental or physical, the chances of struggles in communication skyrocket. Miscommunication during an illness can literally be deadly if the ill partner does not receive needed treatment because he/she was not able or willing to speak up.

Here are some tips to help with communication during tough times:

  • Have a plan before illness strikes. On a basic level, talking with your partner about what to do when illness occurs can prepare both of you for what will happen. Deciding what symptoms or signs of illness equate putting the care plan in motion can relieve stress of the unknown for both partners.

Psychiatric advance directives are similar to medical advance directives in that they are planned out while the patient is healthy, but are used when the patient is ill and perhaps cannot make the best decisions about care. This is typically used by healthcare providers, but must be given to them in order to be followed. Some states have online registries that the staff can access in an emergency. In states that do not, someone must provide the directive to the healthcare staff every time.

  • Remember that the ill partner is still an adult. It can be frustrating to deal with illness day in and day out, especially when you feel as if you are the one shouldering a lot of responsibility. However, the ill partner still has feelings, needs, and rights, so keeping your tone and content similar to how you would talk to a friend or another loved one will go a long way in keeping the peace.
  • Talk to your partner in person. Using Facebook, texting, email, or any other electronic communication to discuss difficult topics is asking for trouble. Yes, those other ways may feel “safer,” but in general, it’s easier to discern tone of voice and intent of the speaker when hearing the message in person.
  • Honesty is the best policy. If you feel your partner is not telling the whole truth about what is happening, or you are holding in feelings because you are afraid of “making things worse,” the most caring thing you can do is tell the truth. That does not give anyone permission to be “brutally honest,” as in, speaking cruelly about another. It does allow everyone to speak from a loving place when expressing concerns.

Consider the difference between “You didn’t take your meds again? [Frustrated sigh.] I can’t take you and your illness anymore!” versus “I am really concerned that you are having trouble managing your illness, and as your partner, I want to help, but don’t know how, which is very frustrating for me.” (Notice the “I” statements versus the accusatory “You didn’t” statement.)

  • Keep the discussion in the here and now. If your partner experiences chronic or recurring mental illness, it can be tempting to compare what’s happening now with past episodes of illness. While that can be helpful for identifying patterns of symptoms and being effective in illness management, it’s not helpful when brought into an argument about a current situation. Each episode of illness is unique, so stay focused on the context in which the problem is occurring now, and look for effective ways to manage the discord.

6 Steps to Better Communication has additional insight about ways to make sure everyone is having their say and being effective. 9 Steps to Better Communication Today has great advice as well.

What strategies have helped you communicate effectively with your partner?

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Communication Strategies with Mentally Ill Partners

Kate Thieda

Kate Thieda, MS, LPCA, NCC, is a patient advocate for Women's and Children's Services at Duke University Hospital in Durham, North Carolina. She is a licensed professional counselor associate and a National Certified Counselor who specializes in cognitive-behavioral and dialectical behavior therapies. Her book, Loving Someone With Anxiety, will be published by New Harbinger in the spring of 2013.

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APA Reference
Thieda, K. (2019). Communication Strategies with Mentally Ill Partners. Psych Central. Retrieved on August 5, 2020, from


Last updated: 31 Mar 2019
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