R. Murali Krishna, M.D. President

You probably know that you live in a state with a divorce rate among the highest in the nation. You probably know people who've struggled through the financial and legal problems a divorce brings.

But do you know about the mental and physical health effects on people who divorce? Do you know the emotional risks to children when their parents divorce? The evidence is not conclusive, but it's accumulating – and it's sobering. The effects of divorce are such that Harold Morowitz of Yale University asserts that "being divorced and a non-smoker is slightly less dangerous that smoking a pack or more a day and staying married."

What are the statistics? Susan Larson and David Larson, M.D., writing in the May/June 1990 issue of Physician, cite studies indicating that divorce increases the risks to health in a number of areas.

Divorced men and women are more likely to experience significant emotional and psychological problems than are people who are married. Divorced men are under psychiatric care, inpatient or outpatient, at a rate 10 times higher that married men. For women, the rate is five times higher. The suicide rate for divorced white males is four times higher than for married men.

To a much greater degree than people who are married, divorced men experience early death from heart disease, stroke, cancer. They are more likely to suffer from high blood pressure and the resulting effects on health. The rate of premature death from pneumonia is seven times higher for divorced men than for married men. According to researchers at the National Institute for Mental Health, the single most powerful predictor of stress-related physical or emotional illness is marital disruption.

Because 60 percent of divorces involve children, it's important to explore effects on their well-being, too. If there's good news, it's that about a third of children can be described as doing well and feeling good five years after their parent's divorce. The bad news is that at the five-year mark after a divorce, another third have at least some adjustment problems, and the final third are intensely unhappy, angry and dissatisfied with life, and often depressed and lonely. Children of divorce constitute 75 percent of all children receiving treatment for chemical dependency and 63 percent of all teens who commit suicide.

For adults, divorce is the loss of a dream. For children, divorce is loss of a parent. Either way, the loss can have lifelong impact on physical and emotional health.

While divorce need not be devastating, it's difficult to keep it from being damaging.
Certainly, sometimes divorce is necessary, such as when marriages involve verbal, physical or sexual abuse or a constant state of warfare. When parents have had to deal with the immense emotional burden of the death of a child, divorce is often an additional tragic outcome. But for marriages without these extremes, what can be done to maintain or restore a healthy relationship?

Good relationships start with clearly stated and understood expectations. When people marry, they each bring into the relationship a certain picture of what that relationship should be.
Suppose a woman believes that in a good marriage, her husband will phone her a couple of times daily and be home each day for dinner and an evening together. Suppose her husband believes that for their marriage to be sound, he must pour himself into his work in order to be a good provider. Instead of calling to check in during the day or be home at 5:30 each evening, he's intensely focused on work. If those sets of expectations have never been expressed and never been understood, it's likely there will be friction and frustration in the relationship.

It's not just clashing expectations about time together that can cause problems. Unstated or changed expectations about a wide variety of issues in marriage are the cause of misunderstandings and difficulties. Stating them, discussing them and coming to terms with them is necessary to achieve a healthy relationship.

Understanding each other's expectations is an important beginning, but of course there's much more, much of it common sense. A wife and husband must have sufficient time with each other in order to nurture the relationship and each other. They must be friends to each other, able to easily and honestly share their respective thoughts and feelings. As they go through life, they must grow together intellectually and spiritually. When they recognize shortcomings in the relationship, they must work together to resolve them.

An outward focus can also be helpful to a relationship. Looking for opportunities to help your community and serve others is a way in which spouses may share experiences and satisfaction. Studies show that people who are happiest are more often those involved in helping others in some form or fashion.

If, in the end, divorce proves to be necessary, seek to achieve it in the way that causes the least damage to children, your spouse and yourself. We've been taught in our society how to get things, not lose them, and you'll likely find that losing your primary relationship will be quite chaotic and painful. Make a committed, determined effort to create a relationship that works for everyone involved. The restructuring of your family is in your hands.

R. Murali Krishna, M.D., is president and COO of INTEGRIS Mental Health Inc., one of the state's largest providers of mental health services. He is also president of the James L. Hall Jr. Center for Mind, Body and Spirit. He has maintained a private psychiatry practice for more than 25 years and is a clinical professor of psychiatry at University of Oklahoma Health Sciences Center.