This note is mostly for men.  Unfortuately many men are not very tuned in to the subtleties of relationships.  Things can be going wrong for some time before they notice.  I have seen some men who didn't realize there was a problem until coming home and finding all the furniture gone.  So, here are some clues.  If your spouse says "we need counselling", its time for counselling.  If you are mostly arguing and things feel rather cold and distant, its time to get help.  If you don't talk much and you are more like friends than lovers, something needs to be done.  Some men don't want to admit they need help, and think things can be worked out on their own.  Thats fine as long as you are actually doing something new to try to solve the problems.  But saying "we don't need help", then doing nothing, will just piss off your spouse.  At least doing something will show you are interested and concerned.  Don't wait until its too late.