When Mental Health Affects Relationships – Seek Free Relationship Counseling Online

Updated March 27, 2024by MyTherapist Editorial Team

Today, approximately 20% or one in five Americans is living with a mental health disorder. This means that most Americans, at the least, know someone who has a mental illness. When you are in a friendship or relationship with someone who is struggling with their mental health, that can also have repercussions on your personal well-being. Some people may be so focused on helping their loved one overcome difficult symptoms that they don’t stop to realize when their own mental health is at risk. 

People in relationships with those experiencing symptoms of conditions like anxiety, depression, and post-traumatic stress disorder (PTSD) may also benefit from the support of individual or relationship counseling. What makes sense for one couple may look different for another, and that’s okay. This article aims to arm you with information about how mental illness can impact relationships and what you can do to get the support you need for yourself and/or your loved one.

How mental health disorders can affect relationships

When a person is living with a mental health disorder, their loved ones, friends, and families can be affected. Depending on the nature of the struggle, loved ones may feel a wide spectrum of emotions, including shame, guilt, confusion, anger, grief, fear, sadness, and helplessness.

Confusion is to be expected, as you may never have lived so intimately with someone who has an eating disorder or substance use disorder. You may be confused about your loved one’s erratic or distant behavior, which may feel abrupt. 

Why might you feel shame or guilt? Perhaps you feel you like may have contributed to your loved one experiencing negative emotions. Maybe you wonder if something you did may have triggered your loved one living with PTSD, or you might feel guilty for wanting to drink around your partner who is trying to abstain from alcohol and illicit substances.

Sadness and grief are natural emotions when living with someone who is struggling with severe mental health challenges. You may feel like you are losing the part of them that initially attracted you to them or maybe their actions cause you to feel helpless about your future. In other situations, you might feel just plain angry – angry at your loved one for lashing out, withdrawing, acting out of control, or lying to your face. 

Imagine a parent, for example, who is frustrated with their teenage child for performing poorly in school, refusing to engage in activities with friends, and not involving themselves in family activities. Sometimes, the behavior and actions of people living with mental health conditions like narcissistic personality disorder or major depressive disorder can feel personal, but it is imperative to remember that’s not the case. 

Try to think of behavior as representative of a communication, perhaps a need that is not being met. Children and teenagers, especially, may not be well-practiced in communicating their needs effectively. Even adults struggle to ask for what they need when they need it, sometimes! 

It can be challenging to hold so many complex emotions simultaneously while also showing grace and empathy toward someone you love. You likely want to help your partner, child, family member, or friend, but you know that it’s important your own feelings and thoughts are heard and validated. Is there a happy medium? A way to support your loved one while preserving your own mental health? 

How to help a loved one who has a mental health disorder

Before discussing strategies to support your loved one in overcoming mental health challenges, it is important to emphasize the need for boundaries. Helping your partner does not mean doing whatever they want, acting like their condition isn’t real, or telling them what they must do if they want to remain in a relationship with you. Ultimatums are rarely effective. Instead, the following suggestions will also encourage you, as a main figure in their support system, to maintain boundaries and communicate firmly, but with empathy.

Know the signs of mental disorders

The first step to helping someone through a situation requires that you be informed – this does not mean that you need to have the entire Diagnostic and Statistical Manual of Mental Disorders memorized from back to front! It simply means that there are certain signs that should cause your antennae to perk up if you notice them consistently. While the following signs below don’t necessarily mean that a loved one has a mental health disorder, meeting many criteria can be telling:

  • Withdrawal from activities that were previously enjoyed; apathy about participation in interests or activities
  • Sleep or appetite changes
  • Diminished academic or work performance
  • Changes in mood, including rapid or dramatic mood swings
  • Reduced energy levels
  • Problems with thinking, concentration, or speech
  • Increased sensitivity to sounds, touch, sights, or smells and avoiding stimulation
  • Feeling disconnected from one’s surroundings
  • Illogical or exaggerated thinking or feelings about personal power
  • Unusual behavior that’s out of character
  • Suspiciousness or excessive fear
  • Detachment from reality
  • Problems with alcohol or drug use
  • Excessive anger or hostility
  • Thoughts of or actions relating to suicide

If you or a loved one is considering or is in danger of suicide, it’s crucial to seek help right away. Call 9-1-1 in the event of a crisis or immediate risk of harm. Support is 24/7 through the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or on the website at suicidepreventionlifeline.org/chat.

Getty/Vadym Pastukh
Are you feeling impacted by your partner’s mental illness?

Start the conversation about your concerns

Talking to the person you’re worried about in a supportive, patient, caring way can be a good way to get the conversation started. A helpful tip to remember is to use “I” statements, such as “I care about you,” or “I would like to help you,” or “I would like to ask you to consider talking to an professional.” Avoiding demanding statements like “You should…” or “You are…” can also be a good practice. Stressing that seeking help is a sign of strength can also be encouraging.

One thing you definitely do not want to do is attempt to make a diagnosis, especially if you are not a licensed counselor. It is likely that, when you initiate this potentially difficult conversation, your loved one may feel defensive, sensitive, or emotional. Treat them like a human. Use open-ended questions to encourage them to share their feelings, worries, and observations. What they likely need from you is active listening, validation, and love – a professional is much better suited to make mental health diagnoses. You can affirm them for making a choice to learn more, track their symptoms, or seek help.

Address barriers to getting care and help find treatment options

Some people who are experiencing an illness—whether physical or mental—find that seeking treatment options can be a challenge. Helping your loved one make and keep appointments, finding the right providers, and communicating details about their condition from an outside perspective can make a difference. Encouraging them to take any medication and to follow up with therapy and continue self-care can also be helpful.

Keep in mind that patience is essential in helping someone overcome a condition like an eating disorder or substance use disorder. Generally, mental health conditions have no cure, but the symptoms can be managed effectively over time. If your partner relapses or experiences some form of a setback, do not berate them. Remind them that their progress was meaningful, that they can start over again, and that you are there to continue cheering supporting them.

Remember that knowledge is power

Use reputable sources to learn more about mental health conditions, treatments, and how to be most helpful. Your own primary care medical provider can be a good person to ask for recommendations of reputable sources. You can also encourage your loved one to talk openly with their own mental health care provider so that the provider has information to help individualize a treatment plan. Empowering your loved one to ask questions so that they understand their treatment plan, their condition, and what they might expect can also be a proactive step.

When researching about mental illness, keep in mind that there may be just as much inaccurate or incomplete information out there as there is valid information. Prioritize online sources that end in .gov or .edu, as they may be more credible than .com sites, which are generally designed for commercial purposes. Psychology studies published within the last decade are considered more reliable than studies that came out more than ten years ago; this is because research is constantly correcting previously held theories or contributing to gaps in knowledge. 

Another thing you’ll want to consider is how you discuss mental illness with your loved one and in your social circle. If your loved one has received a diagnosis of bulimia nervosa – an eating disorder – it is considered insensitive to refer to them as a “bulimic.” The same goes for a substance use disorder – referring to your loved one as an “alcoholic” or “addict” implies that they are defined by their mental health condition, which is not the case. 

Additionally, it is important to use empowering language when discussing your partner and their progress. Rather than calling them a “victim” of their circumstances, view them as a “survivor” instead. And whatever you do, never ever call them or someone else with a mental health condition “crazy.” If you’re confused about what is appropriate, there are plenty of sites that can help you show respect to your loved one. You can also ask your own counselor, and they will not judge you. 

At the end of the day, consider how you’d like to be treated and addressed if you were going through a challenging situation. You likely wouldn’t want to be defined by the condition and you would probably want people to assume you have the best intentions.

Seek support for yourself

When you’re in a relationship with a person living with a mental health disorder, it’s important to take care of yourself physically and emotionally. It can be very helpful to know your limitations and how to cope with your own emotions about the mental illness and your loved one. Regular self-care strategies, such as adequate sleep, good nutrition, and relaxation, can help you stay strong for yourself and your loved one. You can also seek support for yourself. 

Taking care of yourself, taking breaks to relax, and asking for help when you need it—with everything from emotional support to household work and more—can be important for your own physical and emotional help. Maybe your family members can be helpful in certain situations, while in others, family involvement can exacerbate the situation. You have the right to set boundaries – to accept help from people you trust and say, “No, thank you” when you don’t feel like it would be helpful. 

Getty/Vadym Pastukh

The benefits of strong relationships

Try to remember that you are not responsible for your loved one’s choices, actions, or healing process. You do not have to know the ins and outs of neuroscience or child development to be an effective support system; in fact, simply maintaining a strong support network can be one of the best ways to help.

Relationships can offer healthy connections and a sense of meaning. Even if you or a loved one is living with mental health concerns, positive relationships are very possible and can offer an array of benefits, such as:

  • Reduced stress: Those in healthy relationships experience less stress and less release of the stress hormone cortisol. Social and emotional support can help with stress-management.
  • Improved healing: Emotional support can lead to better outcomes in the event of illness or surgery.
  • Increased longevity: Those who have strong emotional support and social ties are more likely to live longer.
  • Healthier behaviors: People in healthy relationships tend to have healthier lifestyles. This may be a result of the healthy habits of friends or loved ones. For instance, people with habits like exercising, not smoking, and eating nutritiously might inspire or encourage people around them to do the same.
  • Enhanced sense of purpose: Positive relationships can help people feel a greater sense of well-being and meaning.
Are you feeling impacted by your partner’s mental illness?

Affordable and free resources for mental healthcare and support

If you or a loved is experiencing a mental health concern, know that there are many ways for you to reach out for free or affordable help. There are even free online counseling services -- specifically online couples counseling -- available nowadays.

The U.S. Department of Health and Human Services has a website with affordable healthcare resources. There is also a website for locating behavioral health treatment.

NAMI is the National Alliance on Mental Illness, and they have multiple resources available. NAMI Family-to-Family is a free educational program for families and loved ones of those who are experiencing a mental health condition. NAMI Family Support Group is a free support group for adults who have a relationship with someone who is living with a mental health disorder. Your healthcare provider may also be able to recommend resources for affordable or free online therapy, mental health care, counseling, and support in your community. 

At MyTherapist, you can connect with licensed mental health professionals who can offer you compassionate help, support, and guidance. One advantage of online therapy is that it is typically viewed as a more affordable alternative to in-person therapy; that’s because you don’t need to miss work or make a commute in traffic to meet with your therapist. Once matched, you simply decide when it works best to meet and how you’d like to interact with your counselor. You can text, call, or videoconference from any location with a secure internet connection – either individually or with your partner.

Online therapy is effective in treating various mental illnesses. One study recruited over 500 participants from outpatient addiction treatment programs to receive 12 weeks of either “treatment as usual” or treatment in addition to an internet-delivered behavioral intervention, which included motivational incentives. Results showed that those in the latter group not only had a lower dropout rate in the study, but that they had a greater rate of abstinence from illicit substances.

Let’s look at another condition newly included in the 5th edition of the DSM: binge eating disorder. Researchers used an online form of cognitive behavioral therapy (CBT) to determine if it was effective in reducing eating disorder pathology and increasing the number of consecutive binge-free days in adults diagnosed with binge eating disorder. Compared to the untreated waitlist control group, participants in the latter group experienced significant reductions in negative symptoms.   

Online couples therapy has also shown efficacy in helping couples increase the quality of their relationship, regardless of if a mental illness is present in one or both partners. In one trial, 15 couples participated in semi-structured interviews designed to gauge the effectiveness of an online couples education intervention. Participating couples experienced a positive shift in their expectations regarding the efficacy of online therapy and felt that the online formatting of therapy allowed them to truly immerse themselves in the process of repairing their relationship. 


Learning that your loved one has a mental health diagnosis can be a confusing time, but it can also be empowering. By learning more about how the mind works, what treatments can help mitigate symptoms, and ways to be supportive as a loving partner, you may find that you and your partner build an even stronger relationship. Just know that you are not alone in the recovery process, and there are professionals eager and available to help you get the support you need. When you’re ready to take the first step, reach out to the compassionate, licensed counselors at MyTherapist, who have successfully helped many couples navigate how to cope with mental illness.

For Additional Help & Support With Your ConcernsThis website is owned and operated by BetterHelp, who receives all fees associated with the platform.
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet Started
This website is owned and operated by BetterHelp, who receives all fees associated with the platform.