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Keeping your relationship together can be hard enough, without having to deal with depression or anxiety.
Here's what to expect and how to cope when psychological problems come into play.
Does this sound like you or your significant other -- excessive sleepiness or insomnia, appetite changes, a libido that's kaput, and unwanted, nasty feelings of depression or anxiety that just won't quit?
Or maybe it's a condition with names like OCD or ADHD that's left you or your mate emotionally and physically bankrupt.
It's easy to find couples who are struggling with mental health problems despite the stigma and shame that may keep many people from talking about it.
After all, the National Institute of Mental Health (NIMH) estimates that during any given year one in five adults suffers from a diagnosable mental disorder in the U.S. alone.
Just as easy to find are couples who haven't made it through the struggle.
"One of the main reasons for marital problems and divorce is unrecognized depression," says Anne Sheffield, author of Depression Fallout, a book about how depression affects relationships.
Having suffered from depression herself -- depression that also afflicted her mother and daughter -- she knows firsthand how devastating it can be for both partners.
Mental health problems take their toll on relationships, and often people don't even realize what's happening.
"Sometimes depression is like a third entity in the marital system, and it can have great prominence in the relationship," says Eileen Sullivan-Leggett, PhD, MFT, a psychotherapist based in Kentfield, Calif.
Sullivan-Leggett is also on the advisory board at the Hoffman Institute, where programs help couples break negative cycles and patterns of behavior and thinking.
"It's a family condition," says Julie Totten, the president and founder of Families for Depression Awareness.
Partners of people with mental health problems are often left wondering where they fit in or how they can help the person they love.
Left untreated, psychological conditions can take a toll on your relationship, but there is help available.
Here's expert advice for couples about what to expect and how to cope.
The first step to healing, recovering, or treating a psychological problem or mental disorder is to recognize its existence.
Sheffield runs a web site that has a forum where people -- almost all in relationships -- have vented and discussed these issues for about five years.
She's observed that a lot of couples go through an initial stage of bewilderment when one partner notices a significant and sudden change in their partners' personality, but it isn't necessarily linked to a psychological problem.
Any couple that is having inexplicable problems should consider the possibility that depression is at play, says Sheffield.
One of the most extreme examples is when one partner has a total change of heart.
"If they suddenly become very critical, distant, and unresponsive -- if they flinch when you try to put your arm around their shoulders -- you should consider the possibility that they are one of the 20 million people in the United States who suffer from depression," she says.
Broaching a Difficult Topic (or a Difficult Partner) So what do you do if you know that there is a psychological problem going on with your partner, but they refuse to see it?
There is a limit to what you can do, but the first step is recognizing what is happening instead of the more tempting yet destructive option of basking in denial.
"I know from the message boards that there is a lot of stigma, and people feel this is something that has to be hidden," Sheffield says.
You need to accept what is happening and discuss it with your partner, which can be touchy.
Sheffield recommends that you try focusing on the physical symptoms that often accompany problems like depression.
People make the mistake of thinking a mental health condition is just a problem with thinking, when in fact the condition might also have long and short-term physical side effects.
"Know the negative impact that depression has on health," she says.
There is plenty of research that connects mental health disorders to physical problems.
Sheffield says depression increases our risk of death after heart attack and contributes to heart disease and diabetes; studies also show a link between depression and cancer.
"Depression is a very dangerous illness physically.
When your [stress hormone] levels are elevated, as they are when you suffer from depression, it's as though your body is in total stress all the time and gets no relief.
Other conditions might be accompanied by very different side effects including anxiety, excessive worry, obsessive thoughts, and an inability to concentrate.
Telling your partner about the symptoms you are noticing -- instead of diagnosing them with a condition -- might get them to visit a doctor who is better equipped to point out the possibility of an underlying mental health condition.
Sex, alcohol, and food can all be very enjoyable parts of our lives, but they can also be used excessively to cope with depression, anxiety, or other psychological conditions.
It's important to recognize when something is being used to mask a problem.
If you sense that this is happening with you or your partner, don't ignore it.
The consequences can be serious for the relationship and the individual.
"Over time, a lot of the joy in a relationship -- the sort of juice that brought the couple together -- can dry up," Sullivan-Leggett says.
When this happens because of a psychological issue, self-medication is common, she says, and can come in the form of drugs, alcohol, television, and food.
Sex too can become a form of self-medication, but often this occurs outside of the relationship, despite libido problems or a lack of sexual interest within the relationship.
Hopefully once you or your partner accepts and acknowledges that there is a psychological problem worth exploring, you will seek treatment and address some of the related issues with a physician and a therapist.
This doesn't have to be something that is only done individually.
"If your husband or wife agrees to it, you can go to meetings with the clinician," she says, making it easier for you to help monitor treatments.
Totten started Families for Depression Awareness after her brother committed suicide when he was 26 years old.
After helping her father get diagnosed and treated for his depression, Totten realized there was a real gap in information and support for family members to help those battling mental illness.
