THIS

I love this article! Especially the part about depression, which was one of my ex's problems. The article said to insist that your depressed spouse get professional help, and not to accept it if they will not do this.

That helps me feel vindicated.

Thanks for the link.

It led me to this, which ended up landing with a bit more weight for me.

divorcesupport.about.com/od/abusiverelationships/tp/Withholding-Sex.htm

We all like to get some validation from others, that they like us, that they like what we did. Butter me up all you like ;-)  However, the underlying  perception of self, the attitude I am I, I am worth something, I am an ok person, this is my life and I will live it and relish it and make the most out of it -- that will have to come out of yourself. You have to love yourself. You have to love yourself before you can even truly accept love from others, ironically.

That is being grounded.

If you do not have that basic self esteem, that knowledge that you're worth something, then I think your best chances may lie in going to get help - take part in some therapeutic encounter groups or group therapy, maybe: that is i.m.o. the best venue to work on it. You will find that people in that hothouse environment will accept you for who you are, even if they may disagree with you on some things. And you can use that experience to bolster your self esteem, you can work on your issues and actually take strength from it.

When you take that self esteem into a relationship (any relationship, family, friends, significant other, business) then you can make decisions based on "how does this interaction sit with me" rather than "I am not worthy, I need to please the other person, I need to be thankful they don't dump me, cringe cringe, I have to make sacrifices and not think about my own wants and needs". 
Compromise and negotiation is good, but if one person has no self esteem, it usually ends up being a one-way street, and to be healthy it needs to be a two way street in my opinion.

What I personally have taken away from the group therapy environment is "What do I have to loose by being open about stuff and letting it all hang out?" Locking myself away inside myself, hiding out, not talking, not showing, not interacting and negotiating just means I am pissing my life away. And that was how I was imprinted by my parents ...
  ... I know I need to be somewhat sensitive of others, but I show my feelings, good or bad, I talk about what I think and what I want, and it really hasn't come back to bite me in the arse, ever, not in any context where I valued the outcome.

For instance
So some people think I am arrogant, elitist, an arsehole -- so what? I know that I'm smart, well educated, and I know what I want out of life. If some people don't get that then that's just 'tough'. The people who are worth while for me to interact with (never mind how smart or educated - I don't actually care) don't go around labeling me that way, they interact with me instead, and we each give what we can.
That's the difference. I don't have the slightest inclination to bow down and butter up those who reject me. Hey, not everybody is right for everybody.
Supposedly an Arabic proverb: "the dogs may bark, but the caravan moves on" - sometimes that's just how it is.

====
And to answer your question: if your marriage has taken your self esteem away, then yes, I think you are no longer healthy and you need to find help to get yourself sorted out.
It can be a lot like depression, in that you tend to isolate yourself and just let it get worse, because you think you're not worth the effort; but it's better not to dig that hole too
deep.
When I got to the point that my wife's constant accusations of abuse were making me doubt my sanity I took steps immediately. And that's the other side of healthy self esteem: you allow for the possibility that you may be wrong, or even that you're going nuts, but you have the confidence to do something about it off your own bat, instead of cowering in the corner, like I might've done in my teens when I was a bully-magnet.

That deserves a proper thank you, petrushka. Always helpful, you are. I think I'm working my out of the negative balance, but learning true self-esteem is certainly a life's work, for me anyway.

So. Very. True.  If I had it all to do again, I would do premarital counseling and make sure the man was committed, at the very least, to self-improvement.  When you marry a man who can't and won't evolve or work on himself, let alone the marriage, trouble is bound to ensue.  Some people simply refuse to grow.  My H even once told me that change is impossible.  And compromise?  What's that?

People have different definitions of love. My ex finally told me at the end that his was "sacrifice," in other words, sacrifice your needs and happiness for the other. Eff that!!