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For better or worse: Marriage can affect your health

Learning to resolve conflicts can help improve your marriage and your health.

Every couple knows that marriage has its ups and downs—from the delights of the wedding day to the frustrations of finances.

Clearly, the way spouses relate to each other through these ups and downs can affect their relationship. But it may also affect their physical health, researchers have found.

Numerous links

More studies need to be done, but experts have found that marriage can influence health in a variety of ways, including:

Mental outlook. Married people, especially men, tend to have lower levels of depression, anxiety and other forms of psychological distress than people who are divorced, separated, single or widowed, according to the National Institute of Mental Health.

Evidence indicates that the aspect of marriage most important for psychological well-being is not the spouse's mere presence, but the emotional support that he or she provides. For the spouse receiving it, this support creates the sense of being cared about, loved, esteemed and valued as a person—of having someone who cares about his or her problems.

"On average, across all types of marriages, married people are generally happier and healthier than unmarried people," says Tamara L. Newton, PhD, co-author of a report on marriage and physical health, published in the American Psychological Association's journal Psychological Bulletin.

Studies showed, however, that troubled marriages can hurt health by contributing to depression and other mental and emotional problems. Unhappily married people have the highest rates of depression, according to Mental Health America.

Because depression alters cardiovascular, immune and hormone functions, it can contribute to a variety of health threats. What's more, depressed people are more likely to have poorer health habits, such as alcohol and drug abuse, inadequate sleep and nutrition, and less exercise, all of which can hurt health, according to the research review by Dr. Newton and her colleague Janice Kiecolt-Glaser, PhD, the lead author of the report.

Immune system. Several studies have found a link between marital quality and immune function.

One study cited by Drs. Kiecolt-Glaser and Newton found that men and women who reported low marital quality were more likely to have dental cavities and gum disease—conditions that are affected by the immune system—than those who reported high marital quality.

In another study, hostile arguments were associated with an increase in levels of stress hormones. These changes could make people more susceptible to illness, particularly infectious diseases.

Changes in stress hormones tend to affect women more dramatically than men, according to the research review by Drs. Kiecolt-Glaser and Newton.

"We have seen that changes in stress hormones stay elevated over the course of a day, even after marital conflict has ended," Dr. Newton says. "This may occur because spouses are ruminating about the conflict—continuing to feel angry long after the argument has ended."

Health habits. Studies have found that supportive marriages tend to encourage healthful behaviors—and discourage unhealthful ones.

For example, Drs. Kiecolt-Glaser and Newton cite a study of married men that showed that positive marital interaction reduced the likelihood of risky health habits (poor eating, substance abuse and inadequate sleep).

Troubled marriages, on the other hand, have been linked with an increase in poor health habits.

"Some of the strongest data indicate that marital conflict may be both a precursor and a consequence of alcohol and drug abuse," Drs. Kiecolt-Glaser and Newton say in their research review.

Sense of well-being. Two studies found that married women who described their relationships with their partners as more rewarding reported fewer medical symptoms and rated their health as better than women whose relationships were less satisfying.

Another study of married women linked marital harmony with better sleep and fewer visits to the doctor.

Two studies of men and women linked higher marital satisfaction with higher self-rated health.

Overall lifespan. In one 15-year study, wives who reported more companionship and equality of decision-making with their husbands had a lower risk of death from all causes.

Blood pressure. In a study of husbands and wives with high blood pressure, those who had closer and more cohesive relationships had lower blood pressure while sleeping at night and over the course of 24 hours.

Marital disagreement, on the other hand, has been linked with heightened blood pressure and heart rates: In one study, women who reported lower marital satisfaction had higher systolic blood pressure (the top number in a blood pressure reading) and heart rate responses while simply recalling marital conflict than women who were highly satisfied with their marriages.

Heart function. A study of 292 women found that those with severe marital stress were three times more likely to have a cardiac event (such as a heart attack) than women without marital stress. The study was published in The Journal of the American Medical Association.

In perspective

How long does it take for marriage to affect physical health?

"It is important to remember that health problems develop under very different time frames," says Dr. Newton, also an associate professor of psychology at the University of Louisville. "For example, heart disease may take decades to develop. In contrast, a cold may develop over the course of one week."

Research has shown that persistent marital problems can contribute to both types of health conditions—those that take a long time to develop, and those that tend to develop more quickly.

"This doesn't mean that a couple must necessarily argue nonstop day in and day out for conflict to take a toll," Dr. Newton says. "I would guess that conflict is more likely to take a toll among couples who are not able to 'switch gears' after an argument—that is, couples who cannot come to a resolution or who cannot eventually find humor in the situation. Continued arguing or 'stewing' in negative feelings or resentment are both sources of chronic stress."

Dr. Kiecolt-Glaser says that one key to lowering stress during marital arguments is to concentrate on the issues at hand and reduce the amount of negative responses that result.

"We're not saying that conflicts in marriage are bad necessarily. They're completely normal," she says. "It's the way the couples disagreed that was later related to a rise in hormone levels and drop in immune function. The sarcasm, name-calling and backbiting are the problems. It's the quality of the disagreement."

Stepping forward

Fortunately for couples in conflict, professional counseling can help guide people toward healthier ways of relating.

"Marital therapy that focuses on communication patterns has been shown to be helpful," Dr. Newton says. "If couples can learn how to constructively talk and resolve their disagreements, they may feel happier together. This is difficult to do alone after a pattern has been established, but can be facilitated by a professional who is skilled in…marital therapy."

If you'd like to see a marriage therapist but aren't sure where to go, ask your doctor for a recommendation.

reviewed 7/3/2019

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