Divorcing a Spouse with Mental Health Issues
You are not a bad person for wanting to leave. Mental illness is real, painful, and deserving of compassion — but it does not obligate you to stay in a marriage that is destroying you. This guide covers what you need to know about divorcing a spouse with a mental health condition: how it affects custody, what the courts look at, how to protect your children, and how to take care of yourself in the process.
If your spouse is threatening self-harm or suicide:
Call 988 (Suicide & Crisis Lifeline) immediately. If there is an immediate physical danger, call 911. You are not equipped to be your spouse's crisis counselor, and trying to be one puts both of you at risk. Professionals exist for exactly this situation.
How Specific Mental Health Conditions Affect Divorce
Not all mental health conditions create the same challenges in divorce. Understanding your spouse's specific condition helps you anticipate what to expect and prepare accordingly.
Borderline Personality Disorder (BPD)
BPD is characterized by intense fear of abandonment, unstable relationships, and extreme emotional reactions. Divorce — the ultimate abandonment — can trigger severe episodes. Expect rapid cycling between rage and desperation, threats to harm themselves, attempts to prevent the divorce at any cost, and potential false allegations. A spouse with BPD may idealize you one day and demonize you the next. Document everything. Keep communication in writing. Work with an attorney experienced in high-conflict divorce.
Narcissistic Personality Disorder (NPD)
Divorcing a narcissist is often one of the most difficult divorce experiences. NPD is marked by grandiosity, lack of empathy, a need for control, and a deep inability to accept perceived failure. Expect the narcissistic spouse to refuse to negotiate fairly, use children as leverage, drag out proceedings to maintain control, engage in financial manipulation, launch smear campaigns, and potentially fabricate evidence. The “gray rock” method — making yourself as uninteresting and unresponsive as possible — is a widely recommended communication strategy. Parallel parenting (rather than co-parenting) is often the only workable custody arrangement.
Bipolar Disorder
Bipolar disorder involves alternating episodes of mania (or hypomania) and depression. During manic episodes, a spouse may engage in reckless spending, infidelity, substance abuse, grandiose plans, or aggressive behavior. During depressive episodes, they may be unable to care for children or themselves. For divorce proceedings, the key issues are medication compliance, financial recklessness during manic episodes (courts can consider this “marital waste”), and the impact on parenting stability. Courts look favorably on treatment compliance and unfavorably on refusal to manage the condition.
Severe Depression
A deeply depressed spouse may be unable to participate meaningfully in divorce proceedings — missing deadlines, failing to respond to motions, or being unable to advocate for themselves. This can create guilt for you and potential delays. Courts may appoint a guardian ad litem if the spouse is truly incapacitated. If your spouse's depression means they cannot care for children safely (leaving them unsupervised, inability to maintain routines, neglect), document these incidents carefully. Depression is treatable, and courts consider whether the parent is seeking treatment.
Anxiety Disorders
Severe anxiety — including generalized anxiety disorder, panic disorder, and agoraphobia — can complicate divorce by making a spouse unable to attend hearings, participate in mediation, or manage the logistics of separation. Anxiety disorders are less likely to directly affect custody decisions unless they significantly impair parenting. However, a spouse with severe anxiety may resist any changes to routine, making negotiations about custody schedules, moving, or property division extremely difficult.
Post-Traumatic Stress Disorder (PTSD)
PTSD from combat, assault, childhood trauma, or other experiences can manifest as hypervigilance, emotional numbness, explosive anger, nightmares, and avoidance behaviors. In divorce, a spouse with PTSD may have difficulty with conflict-heavy proceedings, may react disproportionately to perceived threats, and may struggle with transitions (custody exchanges, moving). Courts consider whether PTSD is being treated and whether it affects the children's safety or well-being. If your spouse is a veteran, VA resources may be available for treatment, which can factor into custody evaluations.
How Mental Illness Affects Custody Decisions
This is the question that keeps most people up at night: will my spouse's mental illness affect who gets the kids? The short answer is — it depends.
Courts use a “best interest of the child” standard in all 50 states. Mental illness is one factor among many. A diagnosis alone is not enough — courts look at the practical impact.
What courts evaluate:
- ✓Is the condition being treated? A parent actively in therapy and on prescribed medication is viewed very differently from one who refuses treatment.
- ✓Is the parent medication-compliant? Judges take medication compliance seriously, especially for conditions like bipolar disorder or schizophrenia where non-compliance creates immediate risk.
- ✓Does the illness affect parenting ability? Can the parent maintain routines, provide supervision, ensure safety, get children to school, and meet their emotional needs?
- ✓Are the children safe? This is the court's primary concern. Any evidence of harm, neglect, or endangerment due to a parent's mental health condition carries enormous weight.
- ✓Has there been hospitalization? Frequent psychiatric hospitalizations can affect custody, particularly if they occur while the parent has the children.
- ✓Substance abuse co-occurrence. Mental illness combined with untreated substance abuse significantly increases the likelihood of custody restrictions.
Important: a well-managed mental health condition — even a serious one — typically does not result in loss of custody. Courts do not punish people for being ill. They evaluate whether the illness is being responsibly managed and whether the children are safe.
Requesting a Psychological Evaluation
If you believe your spouse's mental health condition is affecting their ability to parent, you can request a forensic psychological evaluation (sometimes called a “730 evaluation” in California or a “custody evaluation” in other states).
What it involves
A licensed psychologist interviews both parents and the children, conducts psychological testing (MMPI-2, MCMI-IV, PAI, and others), reviews records, and sometimes observes parent-child interactions. The evaluator produces a report with custody and visitation recommendations that carries significant weight with judges.
Cost
Forensic psychological evaluations typically cost $3,000 to $10,000, sometimes more. The cost is usually split between both parties, though a judge can order one party to pay if there is a significant income disparity.
Important caveat
Both parents are evaluated — not just the one you are concerned about. Be prepared for your own mental health to be scrutinized. This is not a weapon to deploy lightly. Only request an evaluation if there are genuine concerns about your children's safety and well-being.
Documenting Mental Health Concerns
If your spouse's mental illness is affecting your children or the divorce process, documentation is your most powerful tool. Courts rely on evidence, not opinions.
- 1.Keep a detailed log. Record dates, times, and descriptions of concerning incidents. What happened, who was present, what was said. Be factual, not emotional — “Spouse did not pick up children from school on 3/15 because they could not get out of bed” is stronger than “Spouse was depressed again.”
- 2.Save text messages and emails. Written communications where your spouse describes their mental state, expresses inability to care for the children, or makes threats are critical evidence. Screenshot and back up everything.
- 3.Document police and emergency calls. If you have called 911, the police, or a crisis team because of your spouse's behavior, obtain copies of the reports. These are public records.
- 4.Medical and therapy records. While you cannot access your spouse's medical records directly (HIPAA), your attorney can subpoena relevant records during divorce proceedings if there is a legitimate custody concern.
- 5.Third-party witnesses. Teachers, daycare providers, family members, and neighbors who have observed concerning behavior can provide declarations or testimony. Ask them to write down what they witnessed.
- 6.Financial records. Manic spending, impulsive purchases, gambling losses, or financial mismanagement tied to mental illness is documented through bank statements, credit card bills, and loan records.
Mental Illness vs. Abusive Behavior: A Critical Distinction
This may be the most important section in this guide. Many people struggle to separate mental illness from abuse because abusers frequently use their diagnosis as an excuse.
Mental illness is a medical condition. Abuse is a choice.
Many people with serious mental illness — including bipolar disorder, BPD, and PTSD — are never abusive. And many abusers have no diagnosable mental illness at all. When your spouse says “I only did that because of my condition,” ask yourself: do they treat their boss, friends, or strangers the same way they treat you? If the answer is no, the behavior is a choice, not a symptom.
Signs it is mental illness, not abuse
The behavior is consistent across all relationships (not just with you). They express genuine remorse after episodes. They actively seek treatment. The harmful behavior correlates with specific episodes or medication changes. They do not try to control you during their “good” periods.
Signs it is abuse enabled or excused by mental illness
The behavior is directed primarily at you and the children. They can control their behavior in public or at work. They use their diagnosis to avoid accountability (“You know I can't help it”). They refuse treatment but expect you to tolerate their behavior. They escalate when you try to set boundaries. They are charming to outsiders and cruel to you behind closed doors.
Why this matters: if your spouse is abusive, treating the mental illness will not stop the abuse. Abuse requires specialized intervention — batterer intervention programs, not just therapy or medication. In custody proceedings, domestic violence and abuse carry separate legal weight from mental illness, and many states have a legal presumption against custody for the abusive parent.
When Mental Illness Is Used as a Weapon in Court
Mental illness can be weaponized by either side in a divorce, and both scenarios are harmful.
Your spouse weaponizes their own illness
Some spouses use their mental illness to manipulate the process: threatening suicide if you proceed with divorce, claiming they are too sick to negotiate or attend hearings, using their diagnosis to garner sympathy from the judge, or telling the children that “your parent is making me sick by leaving.” Document every instance. Inform your attorney. The court needs to see the pattern.
Your spouse weaponizes YOUR mental health
A common tactic, especially from narcissistic spouses: claiming that you are the mentally unstable one. They may point to your anxiety, depression, or therapy attendance as evidence that you are unfit to parent. This is why it is important to have your own mental health treatment well-documented — seeking help is a sign of strength, not weakness, and courts generally view it favorably.
Stigma in the courtroom
Unfortunately, mental health stigma still exists in family courts. Some judges may give too much weight to a diagnosis and not enough to treatment compliance. Others may dismiss legitimate concerns as “just anxiety” or “just depression.” An experienced family law attorney who has handled cases involving mental health is invaluable here.
When Your Spouse Threatens Self-Harm During Divorce
This is one of the most terrifying situations you can face. Your spouse says they will hurt or kill themselves if you go through with the divorce. Here is what you need to know:
Take every threat seriously. Call 988 immediately.
Even if you suspect the threat is manipulative, respond as if it is real. Call 988 (Suicide & Crisis Lifeline) or 911 if there is immediate danger. Let trained professionals assess the situation. You are not qualified to determine whether a threat is genuine — and if you are wrong, the consequences are irreversible.
- •You are not responsible for your spouse's choices. This is the hardest truth. You cannot prevent another adult from harming themselves by staying in a marriage. Staying out of guilt creates a hostage situation, not a partnership.
- •Document every threat. Dates, times, exact words, witnesses. Share these with your attorney and the court. A pattern of self-harm threats is relevant to custody and safety evaluations.
- •Alert their support system. Inform your spouse's family, close friends, or therapist about the threats. Shift the responsibility for their safety to people who can actually help.
- •Do not negotiate under threat. If your spouse makes custody, financial, or other demands coupled with self-harm threats, do not agree to anything in the moment. Tell them you care about their safety, direct them to 988, and discuss the demands later with your attorney present.
- •Get your own support. Living under the weight of another person's self-harm threats is traumatic. Talk to a therapist who specializes in trauma or codependency. You need someone in your corner.
Protecting Your Children
Children are often the most vulnerable people in a divorce involving mental illness. They may have been exposed to erratic behavior, emotional volatility, or instability for years. Here is how to protect them during and after the divorce.
- 1.Do not badmouth the other parent. Even if their behavior is genuinely harmful, children love both parents. Saying “your father is crazy” or “your mother is mentally ill” damages the child, not the ex. Let the child form their own understanding over time.
- 2.Get the children into therapy. A child therapist provides a safe space for your children to process what they have experienced. Choose a therapist experienced in divorce and parental mental illness.
- 3.Create stability. Predictable routines, consistent rules, and a calm home environment are the best antidote to the chaos of a mentally ill parent. Be the anchor.
- 4.Age-appropriate honesty. Children know something is wrong. Saying nothing creates more anxiety than a simple, honest explanation: “Mom/Dad has an illness that affects their brain and their feelings. They are getting help. It is not your fault.”
- 5.Request supervised visitation if needed. If your spouse's condition creates genuine safety risks for the children, request supervised visitation. Courts can order visits at supervised visitation centers where trained staff are present.
- 6.Build a safety plan with your children. Age-appropriately teach older children what to do if the other parent has an episode: call you, call 911, go to a neighbor's house. They should never feel they are responsible for managing their parent's mental health.
Court-Ordered Treatment and Medication Compliance
Courts have the authority to order a parent to comply with mental health treatment as a condition of custody or visitation. This is one of the most effective tools available when a spouse refuses voluntary treatment.
What courts can order
Continuation of psychiatric medication, regular therapy attendance, substance abuse treatment, anger management programs, parenting classes, and periodic compliance reporting from the treating provider. Violation of court-ordered treatment can result in modified custody or supervised visitation.
Medication compliance in custody orders
For conditions like bipolar disorder or schizophrenia, medication compliance is frequently written into custody orders. The order may require the parent to provide proof of prescription refills, attend regular psychiatric appointments, or have their therapist submit periodic compliance reports to the court. If the parent stops taking medication, the other parent can file a motion for modification.
Limitations
Courts cannot force someone to take medication — this is a constitutional right. However, they can make custody contingent on treatment compliance. The practical effect is the same: take your medication or lose time with your children. If your spouse repeatedly violates treatment orders, document every violation and file a motion to modify custody.
The Guilt About Leaving a Sick Spouse
If you are reading this, you probably already feel terrible. You made vows — “in sickness and in health.” Leaving someone who is ill feels like a moral failure. Society reinforces this: friends say “but they're sick,” family says “you need to be more patient,” and your own conscience says “what kind of person leaves someone who is suffering?”
Here is the truth no one tells you:
“In sickness and in health” assumes both partners are trying. It assumes the sick partner accepts help, seeks treatment, and works to minimize the impact on the family. It does not mean you must sacrifice your health, your children's stability, and your entire life to care for someone who refuses to care for themselves.
Caregiver burnout is real and devastating. Research from the National Alliance on Mental Illness (NAMI) shows that spouses of people with serious mental illness experience higher rates of depression, anxiety, physical illness, and social isolation. You cannot pour from an empty cup — and staying in a marriage that is destroying you helps no one, least of all your children.
Leaving does not mean you do not care. It means you have recognized that this situation is beyond what one person can fix, and you are choosing to save yourself and your children. That is not weakness. That is survival.
Protecting Your Own Mental Health During the Process
Divorcing a spouse with mental health issues takes an extraordinary toll on your own mental health. You may be dealing with years of accumulated trauma, hypervigilance, codependency, and emotional exhaustion. The divorce process itself — especially a high-conflict one — piles on additional stress.
- •Get your own therapist. Not a couples therapist. Your own individual therapist who specializes in trauma, codependency, or personality disorder dynamics. This is non-negotiable.
- •Join a support group. NAMI (National Alliance on Mental Illness) offers free support groups for family members of people with mental illness. Al-Anon and CoDA (Co-Dependents Anonymous) can also help if codependency is part of your dynamic.
- •Set firm boundaries. You are no longer responsible for managing your spouse's mental health. Set boundaries around communication (written only, through attorneys if necessary), response times, and emotional involvement. “I care about you, but I am not your therapist” is a valid statement.
- •Watch for trauma responses. If you have been living with someone with untreated mental illness for years, you may have developed your own PTSD, anxiety, or depression. These are not character flaws — they are normal responses to abnormal circumstances.
- •Physical self-care. Sleep, nutrition, and exercise are not luxuries — they are necessities. Chronic stress destroys your body. Prioritize sleep above almost everything else; everything looks worse when you are exhausted.
Caregiver Burnout: When You Have Nothing Left to Give
Many spouses of people with mental illness have been functioning as unpaid, untrained mental health caregivers for years — sometimes decades. By the time they consider divorce, they are running on fumes.
Signs of caregiver burnout:
- •Constant exhaustion that sleep does not fix
- •Feeling numb, detached, or unable to feel joy
- •Resentment toward your spouse that you cannot shake
- •Neglecting your own health, friendships, and interests
- •Feeling like you have lost yourself
- •Snapping at your children or withdrawing from them
- •Physical symptoms: headaches, stomach problems, insomnia, chronic pain
- •Feeling trapped, hopeless, or like things will never change
If you recognize yourself in that list, please hear this: you have been carrying a weight that no one person was meant to carry alone. The fact that you are burned out does not mean you failed — it means the situation exceeded what any human being could sustain. Getting out is not giving up. It is finally putting on your own oxygen mask.
Safety Concerns During Divorce
Certain mental health conditions can create genuine safety risks during the divorce process, particularly when combined with substance abuse, access to weapons, or a history of violence.
- •Create a safety plan. If your spouse has a history of violence, threats, or unpredictable behavior during episodes, have a safety plan in place before you serve divorce papers. Know where you will go, what you will take, and who you will call.
- •Consider the timing of service. Work with your attorney on when and how to serve divorce papers. For a spouse with severe mental illness, the moment they receive papers can be a crisis trigger. Some attorneys recommend having a family member or therapist present, or ensuring the spouse has access to their support system.
- •Secure firearms and weapons. If your spouse has access to firearms and has a mental health condition that includes suicidal ideation, impulsivity, or rage episodes, talk to your attorney about requesting a temporary restraining order that includes firearm removal.
- •Protect digital safety. A spouse in crisis may monitor your phone, email, or location. Change passwords, check for tracking apps, and use a separate device for sensitive communications.
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Legal Disclaimer: This article is for informational purposes only and does not constitute legal or medical advice. Mental health conditions, custody laws, and court procedures vary significantly by state. The information above provides general guidance but your specific situation may differ.
Always consult with a licensed family law attorney in your state for legal advice specific to your circumstances. For mental health emergencies, call 988 (Suicide & Crisis Lifeline) or 911. For domestic violence, contact the National Domestic Violence Hotline at 1-800-799-7233.