Having a chronic illness such as diabetes, arthritis, or multiple sclerosis can take a toll on even the best relationship. The partner who's sick may not feel the way he or she did before the illness. And the person who's not sick may not know how to handle the changes. The strain may push both people's understanding of "in sickness and in health" to its breaking point.
Studies show that marriages in which one spouse has a chronic illness are more likely to fail if the spouses are young. And spouses who are caregivers are six times more likely to be depressed than spouses who do not need to be caregivers. Clinical psychologist Rosalind Kalb, vice president of the professional resource center at the National Multiple Sclerosis Society, says, "Even in the best marriages, it's hard. You feel trapped, out of control, and helpless." But with patience and commitment, there are ways you and your partner can deal with the strain a chronic illness can place on your relationship.

1. Communicate
Relationships can suffer when people don't discuss problems that have no easy or obvious solution, Kalb says. And that lack of discussion can lead to feelings of distance and a lack of intimacy.
"Finding ways to talk openly about challenges," she says, "is the first step toward effective problem-solving and the feelings of closeness that come from good teamwork."
Marybeth Calderone has limited use of her legs and hands because of a neurological disorder called Charcot-Marie-Tooth. Her husband Chris says that figuring out when to communicate is his biggest challenge.
"My wife gets frustrated with herself when she can't do things, like organize our 8-year-old daughter's desk," he says. "A lot of times, I'm not sure if Marybeth is angry at me or with her condition. Often, I try to figure it out on my own and don't say anything.”
The right level of communication is key. Boston College social work professor Karen Kayser says, "If the couple is consumed with talking about the illness, that's a problem. If they never talk about it, it's also a problem. You have to find a middle ground."







2. Ease Stressful Emotions

Kalb says it's normal to feel sad and to have anxiety because of a chronic illness. And many chronic illnesses, such as multiple sclerosis (MS), are unpredictable, which only adds to the anxiety.
"The best way to deal with anxiety is to identify the root of the worry and find strategies and resources to address it," she says. Here are four positive steps you and your partner can take to help one another find relief from stress.
  1. To feel more in control, learn more about the condition and how to tap into available resources.
  2. Consider counseling. You can go together or separately for counseling with a therapist, minister, rabbi, or other trained professional. A good choice for building coping skills is to work with someone trained in cognitive-behavioral therapy.
  3. Watch for depression. Sadness is a normal response to chronic illness. But clinical depression doesn't have to be.
  4. Acknowledge the loss of the way your relationship used to be. You are both experiencing it.
Mimi Mosher is legally blind and has MS. The latest wrinkle in her marriage with John is her transition to use of an electric wheelchair.
"On a recent trip with friends," Mimi says, "I was content sitting near the beach drawing. But Jonathan wanted me to stroll with the group on the beach, which meant switching to a wheelchair with oversized wheels. Aesthetically, I didn't want to do it, but he convinced me. Sometimes you have to do things to please your partner."



3. State Your Needs

Kalb says a partner with a chronic illness may give mixed messages. When feeling good, your partner may want to do things on his or her own but then become resentful when others don’t step up to help when he or she isn't feeling as well.
Kalb recommends that if your the person with the illness be clear and direct about what you want because your partner isn’t a mind reader.
Chronic illness can often shift the balance of a relationship. The more responsibilities one of you needs to take on, the greater the imbalance. If you're providing care, you can start to feel overwhelmed and resentful. And if you're receiving care, you can feel more like a patient than a partner. Kalb says such a shift can threaten self-esteem and create a huge sense of loss.



By Karen Bruno