Marriage is the central relationship for the majority of adults, and morbidity and mortality are reliably lower for married individuals
than unmarried individuals across such diverse health
threats as cancer, heart attacks, and surgery.1 - 4 Although loss of a spouse through death or divorce can provoke adverse mental and physical health changes,1,5 - 7 the simple presence of a spouse is not necessarily protective; a troubled marriage is itself a prime source of stress, while simultaneously limiting the partner's ability to seek support in
other relationships.8 The impact of a turbulent marriage is substantial; for example, epidemiological data demonstrated that unhappy marriages were a potent risk
factor for major depressive disorder, associated with a 25-fold increase relative to untroubled marriages.9 Similarly,
other researchers found a 10-fold increase in risk for depressive symptoms associated with marital discord.10