Can marriage affect a woman's mental health?

Two of eight people who walk into psychiatrist Sabina Rao's clinic are women whose mental health issues are triggered by conflict and abuse (emotional, financial and physical) in marriage.

While it is known that abuse of any kind results in a range of mental health issues, Dr Rao points out that just the sudden change in both personal and environmental factors can also affect women's mental health.

Much like any other life-impacting decision, opting to be a part of a marriage/partnership is both exciting and challenging. While on the one hand it brings with it all the joys of partnership, on the other hand, it comes with the challenges of adjusting to a new environment, a new family and in many cases a new city/town away from the one a woman has lived in before marriage.

"The stresses and demands for adjustment on women are certainly higher. A new partnership often means many more unfamiliar factors for women than for men in India," says Bangalore based counselor, Simi Mathew. We explored the challenges women face when entering a new marriage and the mental health issues that may arise from them.

Adjustment to new environments

Marriage for Indian women often includes moving to a new space/geography. While some move into a new and unfamiliar family, others move away from their own families to a new city to join their partners. "That a woman will make this move and accept it is still a given. And this is true in both urban and rural spaces. Often the woman herself hesitates to talk about the emotional toll of this move to avoid being seen as fussy or too emotional," says Mathew. Depending on the support from her new family and spouse, and the extent of adjustment required, many women do adapt over time.  But for some others, the stress, sadness and helplessness that comes from being in a significantly new situation can also lead to an adjustment disorder, depression and anxiety.

Sense of self

“Marriage ( in the broad Indian context) comes as a shock to many women who have spent the first 25-30 years of their lives being encouraged to think freely. They have careers and opinions and when suddenly faced with in-laws who haven’t evolved at the same pace, or if their partner doesn’t accept parity, they start to lose their sense of self,” says Dr Rao. She adds that often suppressing these feelings of frustration and helplessness can give rise to symptoms of depression and anxiety. Any stressor that is not dealt with can snowball into a mental health issue. 

Expectation vs reality

But while several of the mental health issues in adjustment to marriage come from the outside, there’s also the factor of unrealistic expectations set by both partners. “Sadly, a lot of couples expect marriage to solve a lot of problems,” say Mathew. Couples should be encouraged to discuss their expectations from a partnership. An understanding that all relationships require work is very important for a good foundation. Unlike many other relationships, marriage includes two people with different emotional styles, different families and often a different value system, coming together to live in a very intimate setting. “The solution here is just simple communication,” says Mathew adding, “go to a counselor if that’s required. But know why you’re getting married.”

How to deal with the stresses of marriage

Mental health issues are often difficult to diagnose when in a marriage. Many symptoms are manifested as marital discord, disagreements or just unmet expectations, unless it is a severe symptom. Which is why it’s important for both partners to work towards the wellbeing of their partners.

1) Talk to your partner about what marriage means to you. Understand if you are on the same page with regards to your expectation from marriage. Include a mentor/ counselor to moderate this conversation.

2) Understand how living with your partner is going to affect your daily routine and life. Communicate your discomfort, if any, to your partner.

3) Husbands of women moving into a joint family need to be cognizant of new adjustments.  Understand that your partner is a person with agency and opinion.

When a woman has an existing mental health issue

Mental health issues come with a great deal of stigma, leading families of both men and women with mental health issues to not divulge the condition when marriage is on the cards. “Unethical as this practice is, when it comes to women, the issues that arise from secrecy and lack of support from her new family are several,” says psychiatrist Dr Ashlesha Bagadia.

• In order to keep the condition a secret, women often stop taking medication. When combined with stress in the environment, many women have relapses. There can be a relapse even in the absence of stress, due to the discontinuation of medication.

• Pregnancy can trigger some mental health issues when a woman has a pre-existing vulnerability.

But support from family can help women manage their mental health issues very well.  “Till you get into your natural rhythm and process how the relationship works, don’t take anything for granted. Work on it slowly and with patience. Marriage is not going to solve mental health issues. Bring your partner into the fold about how your illness works. "Have couples counselling,” recommends Mathew.