Relationship Issues and Your Health

Healthy vs unhealthy vs abusive relationships

Couples therapy is not recommended when there is ongoing abuse, as it can increase danger. Individual support and safety planning come first.

Common causes of relationship problems

• Communication patterns: criticism, contempt, defensiveness and withdrawal predict conflict and breakup
• Life stress: work pressure, unemployment, money problems, illness, caregiving and moving
• Life transitions: a new baby, children leaving home, retirement
• Trust breaches, including infidelity
• Different expectations about roles, chores, parenting or finances
• Sexual difficulties or mismatched desire
• Mental health conditions such as depression and anxiety
• Substance use: alcohol and drug problems strongly affect relationships. See alcohol abuse
• Grief and loss. See grief

How relationship problems affect health

Chronic relationship stress activates the body's stress response. It is associated with:

• anxiety and depression
• insomnia and poor sleep
• higher blood pressure and heart disease risk
• weakened immune function and slower wound healing
• headaches, digestive problems and muscle tension
• increased alcohol use
• low self-esteem

Supportive relationships, by contrast, are linked to better mental and physical health and longer life. When relationship stress triggers persistent emotional symptoms after a major change, such as separation, it may be an adjustment disorder.

Recognizing abuse

Intimate partner violence is common. CDC data indicate that about 1 in 3 women and 1 in 4 men in the US have experienced physical violence, sexual violence or stalking by an intimate partner. Abuse can be:

• Physical: hitting, pushing, choking or strangulation, restraining
• Emotional: humiliation, threats, gaslighting, constant criticism
• Controlling: monitoring your phone, limiting money, preventing you from seeing others
• Sexual: pressuring or forcing sexual activity
• Digital: tracking, harassing messages, sharing private images

Strangulation, threats to kill, access to guns, and escalating violence are signs of high danger. Advocates can help with safety planning, shelters, legal protection and support.

What helps

Things you can try together

• Choose a calm time to talk, not in the middle of an argument.
• Use "I" statements: "I feel hurt when plans change without warning," rather than "You never care."
• Listen to understand, and summarize what your partner said before responding.
• Take breaks when either of you feels overwhelmed, agreeing to return to the conversation.
• Focus on one issue at a time.
• Make time for positive interactions: appreciation, affection and shared activities.
• Agree on practical systems for money, chores and parenting.

Professional help

• Couples therapy: evidence-based approaches such as emotionally focused therapy and behavioral couples therapy improve satisfaction for many couples.
• Individual therapy: helps with your own feelings, patterns from past relationships, or deciding whether to stay or leave.
• Treatment of depression, anxiety or substance use in either partner.
• Sex therapy for sexual concerns.
• Family therapy when children or wider family are involved.

Your primary care doctor can refer you to counseling and check whether stress is affecting your health.

Frequently asked questions

What are signs of an unhealthy relationship?

Signs include frequent criticism or contempt, arguments that never resolve, feeling unheard, constant jealousy, emotional distance and feeling anxious or drained around your partner. Fear of your partner, control over your money, phone or friends, threats or violence are signs of abuse.

Can relationship problems cause depression?

Yes. Ongoing conflict, emotional distance or a breakup can contribute to depression and anxiety, and depression can in turn strain relationships. If low mood, loss of interest, sleep changes or hopelessness last more than 2 weeks, talk to a doctor or therapist.

Does couples therapy work?

For many couples, yes. Research shows that evidence-based couples therapies help a majority of couples improve communication and satisfaction, especially when started before problems become entrenched. Couples therapy is not appropriate when there is ongoing abuse.

Where can I get help if my partner is abusive?

In the US, contact the National Domestic Violence Hotline at 1-800-799-7233, text START to 88788, or chat online. Advocates are available 24 hours a day and can help with safety planning, shelter and legal options. Call 911 if you are in immediate danger.