Marriage does not usually become difficult because two people suddenly stop loving each other.
Sometimes it happens slowly.
One person comes home tired from work. The other has spent the whole day managing the house or looking after children. There are bills to think about, responsibilities toward parents, pressure from work, and perhaps very little time left for the two of them.
A small disagreement becomes an argument. The argument is never properly resolved. After some time, both people become careful about what they say. They may still live together, eat together and take care of the family, but emotionally they start feeling far apart.
I have seen how relationship difficulties can become closely connected with mental health. A person may come to a psychiatrist saying, “I am feeling anxious all the time,” or “I cannot sleep,” when a significant part of the distress is coming from ongoing conflict at home.
At the same time, not every marital problem is a psychiatric problem. Sometimes two people simply need to understand each other better, communicate differently, or find a healthier way of dealing with disagreements.
Relationships in changing Nepali families
Marriage and family life in Nepal are changing.
Many couples today are trying to balance traditional family expectations with a more independent way of living. Both partners may be working. Couples may live away from their parents, or they may live in the same household with parents and other family members. Some couples spend long periods apart because one partner works or studies abroad.
There are also newer pressures.
Social media can create unrealistic comparisons. Couples may compare their relationship, holidays, lifestyle or financial situation with what they see online. Work can continue through phones even after reaching home. Parenting decisions can become another source of disagreement.
And sometimes the problem is not one major event. It is the accumulation of many small things.
“तिमीले मलाई कहिल्यै बुझ्दैनौ।”
“तिमीलाई परिवारको मतलब नै छैन।”
“सबै कुरा मैले मात्र गर्नुपर्छ।”
“You always take your family’s side.”
“You don’t talk to me anymore.”
When these sentences become part of everyday communication, the relationship can become exhausting for both partners.
When communication becomes the real problem
Most couples argue from time to time. Disagreement itself does not necessarily mean that a marriage is unhealthy.
The more important question is how the couple handles disagreement.
There is a big difference between saying:
“I felt hurt when you made that decision without talking to me.”
and:
“You never care about me. You are always like this.”
The first statement talks about a particular situation and feeling. The second attacks the person.
This difference may seem small, but during repeated conflicts it can change the entire pattern of a relationship.
One partner criticizes. The other becomes defensive. Then the first person becomes more frustrated and speaks more strongly. The second person withdraws or stops responding. Eventually, both feel that the other person is the problem.
This cycle can continue for months or years.
Sometimes couples come to counseling expecting someone to decide who is right. That is usually not the most useful goal. The more helpful question is often:
“What is happening between us, and how can we change this pattern?”
Not every argument is really about the argument
- A couple may argue about money, household work, visiting relatives, parenting, or spending time with friends.
- But underneath the argument, there may be another concern.
- One partner may be feeling unappreciated.
- Another may be feeling controlled.
- Someone may be worried about financial security.
- Someone may feel that their partner gives more importance to their parents than to the marriage.
- Sometimes there is loneliness or a lack of emotional connection.
- Sometimes sexual or intimacy-related difficulties are making both partners frustrated, but neither feels comfortable talking about them openly.
This is why simply telling a couple to “communicate more” is not always enough. They may need help understanding what they are actually trying to communicate.
The role of mental health in marriage
Our emotional state affects how we behave with the people closest to us.
When someone is depressed, for example, they may become withdrawn, irritable, less interested in conversation, or less able to participate in family activities.
Someone with significant anxiety may become overly worried, seek repeated reassurance, or have difficulty relaxing.
Poor sleep can also make patience and emotional regulation more difficult.
Alcohol or other substance use can create another layer of difficulty within a relationship.
In such situations, treating the relationship problem alone may not be enough. The underlying mental-health problem may also need attention.
The opposite can happen too. Long-standing relationship conflict can contribute to stress, anxiety, sleep problems and low mood.
So I try to look at both sides: the person and the relationship around that person.
What can couples do differently?
One useful starting point is to stop trying to solve every disagreement at the moment emotions are at their highest.
If both partners are angry, continuing the argument for another hour does not necessarily produce a better solution.
Sometimes taking a short break and returning to the conversation later is healthier than saying things that cannot easily be taken back.
It also helps to discuss one issue at a time.
If the argument starts with household responsibilities, bringing up five old arguments, your in-laws, your partner’s friends and something that happened three years ago usually makes resolution harder.
Try to be specific.
Instead of “You don’t spend time with me,” you might say, “I miss having some time together without our phones.”
Instead of “You never help at home,” discuss the particular responsibilities that need to be shared.
And listening does not necessarily mean agreeing with everything your partner says.
Sometimes your partner mainly wants to feel understood before discussing a solution.
What about family and in-laws?
This is an area that can be particularly sensitive in Nepali families.
Marriage does not always involve only two people. Parents, siblings and other relatives may naturally remain important parts of family life.
The difficulty begins when a couple feels that they cannot make decisions together without outside pressure.
There may be disagreements about where to live, financial support to parents, household responsibilities, festivals, childcare, or how much time should be spent with each family.
There is no single rule that works for every Nepali family.
But couples often benefit from discussing these matters openly and deciding what they can agree on as a team.
Respecting parents and protecting the marriage do not necessarily have to be opposite things.
When one partner is not ready for counseling
This is very common.
One partner may say, “We don’t need counseling. We just need to forget the issue.”
Another may feel that nothing will change unless they get professional help.
If both partners are willing to attend, couples counseling can provide a structured space to discuss difficult issues. But sometimes only one person is initially willing to seek help.
That does not mean nothing can be done.
An individual consultation can still help someone understand their own emotional reactions, communication patterns, boundaries and choices.
With time, the other partner may also become more comfortable with seeking help.
When should a couple consider professional help?
You do not have to wait until a marriage reaches a crisis before asking for help.
It may be worth considering relationship counseling when the same argument keeps repeating without resolution, when communication has become mostly criticism or silence, when emotional distance is increasing, or when trust has been damaged and the couple does not know how to rebuild it.
Professional help can also be useful when relationship difficulties are accompanied by persistent anxiety, depression, sleep problems, anger, substance use, or significant distress.
And if there is violence, threats, intimidation, coercive control, or fear of the partner, the priority is safety. In such situations, the approach needs to be individualized rather than assuming that simply bringing both partners into the same counseling room is appropriate.
What happens in relationship counseling?
Relationship counseling is not about deciding which partner is the “bad” one.
A counseling session provides an opportunity to understand what has been happening between the partners, identify unhealthy communication patterns, and work toward more practical ways of handling disagreements.
Depending on the situation, sessions may involve both partners or, when clinically appropriate, individual sessions as well.
Sometimes the main issue is communication. Sometimes it is trust, anger, family conflict, emotional distance, parenting, intimacy, or the effect of an individual mental-health problem on the relationship.
There is no single formula for every couple.
At Dr. Purushottam Adhikari’s Mind Clinic in Raniban, Kathmandu, we also provide relationship and couples counseling for people who are struggling with relationship difficulties. The aim is not to give a couple a ready-made answer, but to understand their particular situation and work through it in a professional and non-judgmental setting.
Frequently Asked Questions
Is marriage counseling useful if we are not planning to separate?
Yes. Counseling does not have to mean that a marriage is about to end.
Some couples seek help because they want to improve communication, understand recurring conflicts, or prevent small problems from becoming larger ones.
Can couples counseling help with communication problems?
Communication difficulties are one of the reasons couples may seek counseling. The focus is not simply on “talking more,” but on understanding how each partner communicates, reacts during conflict, listens, and responds to the other person’s concerns.
Should both husband and wife attend relationship counseling?
Ideally, both partners can participate when the situation is appropriate. However, one partner may sometimes seek an individual consultation first. The appropriate format depends on the circumstances.
Can relationship problems cause anxiety or depression?
Ongoing relationship conflict can be a significant source of emotional stress. However, anxiety and depression have many possible causes. If someone has persistent symptoms, a proper mental-health assessment may be helpful rather than assuming that the relationship is the only cause.
Is couples counseling the same as psychiatric treatment?
No.
Couples counseling focuses mainly on relationship difficulties and interaction between partners. Psychiatric treatment is concerned with mental-health conditions and may involve assessment, psychotherapy, medication, or a combination depending on the person’s needs.
Sometimes both are relevant at the same time.
What if my husband or wife refuses counseling?
You can still seek help individually.
A psychiatrist or mental-health professional can help you understand your own reactions, identify what you can and cannot control, and think about healthier ways of responding to the situation.
Can relationship counseling be done online?
Depending on the situation and the clinical needs of the couple, counseling may be possible through online sessions. This can be particularly useful for couples living in different cities or countries.
However, not every situation is suitable for online counseling, so this should be discussed with the professional beforehand.
When is a relationship problem serious enough to see a psychiatrist?
If relationship difficulties are accompanied by persistent sadness, excessive anxiety, severe sleep problems, anger that feels difficult to control, substance use, significant functional impairment, or thoughts of self-harm or suicide, professional mental-health assessment should not be delayed.
If there is immediate danger or risk of violence, seek urgent local support and prioritize safety.
A final thought
A difficult period in a marriage does not automatically mean that the relationship has failed.
People change. Circumstances change. Expectations change. Sometimes couples simply lose the habit of talking to each other properly.
Getting help does not mean that either partner has failed. It can simply mean that the problem has become difficult to handle alone.
For some couples, the goal may be to rebuild communication and closeness. For others, the work may involve understanding whether a mental-health problem is affecting the relationship. And sometimes people need help making difficult decisions about the future of a relationship.
There is no single answer for every couple.
What matters is being able to talk about the problem honestly, safely and without unnecessary blame.
If you or your partner are struggling with relationship problems, marriage-related stress, communication difficulties, or emotional distress, professional relationship counseling or mental-health consultation can be one place to start.