Marital Dynamics in the Face of Serious Mental Illness: Exploring Spousal Experiences, Addis Ababa, Ethiopia: Qualitative Study
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Date
2025-06-12
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Addis Ababa University
Abstract
Background: Serious mental illnesses (SMI) including schizophrenia, bipolar disorder, and major depressive disorder can severely disrupt marriage. In Ethiopia, limited mental health support and stigma future complicated how couples navigate marriage and stigma further complicate how couples navigate marriage in the face of SMI. While the impact of SMI on marital adjustment is acknowledged in global literature, little is known about how these challenges unfold in the Ethiopian context.
Objectives: The study aimed to explore the marital dynamic and lived experience of couples managing SMI, with particular attention to emotional connection, communication, role functioning, and coping.
Method: A descriptive phenomenological qualitative study was employed. Twelve participants (people with SMI and spouses of people with SMI) were recruited through purposive sampling from Amanuel Mental Specialized Hospital and Tikur Anbessa specialized hospital in Addis Ababa. Data were collected through in-depth semi-structured interviews and analyzed thematically.
Result: Three major themes emerged: (1) perception and experience of marriage, (2) emotional and relational life within the marriage, and (3) disruptions caused by the SMI. Spouses reported strained marital adjustment, especially when their partner ‘s low self-efficacy limited emotional reciprocity and role sharing. Challenges included sexual dissatisfaction, parenting strain, financial hardship, and social stigma. Coping strategies ranged from spiritual practice to family role adaptation and efforts to maintain stability for the children.
Conclusion: SMI places significant strain on marital relationships, challenging both emotional and structural aspects of marriage. Interventions should address communication, self-efficacy, and broader support systems to strengthen marital stability in families affected by SMI.
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A Thesis Report Submitted to the Department of Psychiatry, School of Medicine, College of Health Sciences