Many people are living with a spouse who is depressed and are suffering because of it. Depression can be frustrating and difficult for a spouse to know what to do.
“I’ve tried everything I can think of. No matter what I do to cheer him or get him out of the house, it doesn’t help, and sometimes just leads to an argument. Then I feel so bad afterwards, because I know he’s suffering too. Then I wind up being dragged down with him.”
Depression can be subtle (called Dysthymia) or dramatic (called Major Depression). Depression is a term that’s used to describe many things, but generally refers to a set of symptoms that can range from the very subtle, like a general sense of the blahs, to very extreme symptoms like not being able to get out of bed or suicidal acts. It is important to be knowledgeable about what the warning signs are, so you can take action before they get worse. Any of the following symptoms are concerning in themselves, and can often be treated through therapy. Medical reasons for these symptoms should also be ruled out first. It is also important to be mindful of the fact that everyone is different, and no one is just a set of symptoms. Having said that, here are a few warning signs.
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Loss of interest in activities
A depressed patient of mine found himself without any interest in sex, and felt very ashamed that he couldn’t “perform,” any longer. This made it very difficult for him to speak to his wife about his depression, afraid judgement, and hurting his wife’s feelings since she worried about her attractiveness. The shame and worry he was feeling made his depression worse. Loss of interest isn’t limited to sex, of course. A loss of interest in hobbies, sports, sex or work can be an indication that your partner has become depressed.
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Irritability
“No matter what I say, he seems to take it personally.” People who are depressed can be sensitive and grouchy, and therefore difficult to be around. In addition to having a cloud over their head, depression can make him irritable, often snapping at others, or have a dark or cynical world view. Partners can struggle with feeling badly for their depressed loved one while at the same time feeling frustrated with them due to the toll that their depression takes their relationship. If you feel angry at your depressed spouse, bear in mind that a certain amount of this is normal and inevitable. In order for your relationship to survive, it is important to find ways to express these feelings as productively as possible, which I’ll discuss in “4 Things You Should Do If You’re Partner is Depressed.” (Coming soon).
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Social isolation
People who are depressed often lose interest in socializing with friends and family, feeling that social contact is burdensome and pointless. This can cause a snowball effect, making them lonelier and more depressed. It can feel like a great deal of effort for depressed people to act “normal” or happier than they are. While social contact with loved ones or close friends can be beneficial to those who are depressed, pushing a depressed person to socialize simply for the sake of socializing can sometimes backfire, causing them to feel worse. It is important to check in with your depressed partner about what feels helpful, and only then nudge him to take the steps that you both agree would be helpful.
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Judgment of self or others
I had a patient put it succinctly once: “Sometimes I feel like I hate everyone, but I hate myself the most.”
Since depression is often the result of turning one’s anger against oneself, an important sign of depression is when your partner is overly hard on themselves for mistakes, frequently says negative things about themselves, or has difficulty realizing and really “feeling” the positive aspects of who they are. This can result in your depressed partner being very judgmental of themselves. Since we often treat those around us as we treat ourselves, they also may become judgmental of those who are closest to them, even you. They can hold you to unrealistically high standards, or be very dismissive. Again, instead of criticizing back, the most useful tack is try to be sympathetic, for example by saying something about how painful it must be to feel like everything sucks.
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Abuse of alcohol or drugs
“I’m just having fun! Relax!” can be the refrain of someone who is using substances to ease their pain. People who are depressed sometimes use substances to try to “treat” their emotional pain, or “self-medicate.” Abusing alcohol or drugs only leads to more emotional problems of course, and puts off the process of learning to cope with the feelings by using their internal resources. Your spouse may need substance abuse treatment in addition to psychotherapy to address this issue.
What to do?
Now that you’ve identified the warning signs of depression, what do you do if your spouse is suffering from depression? Addressing depression can be a very tricky task, especially if the depressed person is resistant to admitting the problem.
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Empathize
Compassionately talk with your partner about your concern. They may or may not be open to talking, but compassionate interest is a necessary ingredient in any effective approach. If they are simply unwilling to talk, you may need to back off. If they experience your concern as criticism, try to reassure them that you only have their best interest in mind, and that you don’t want them to feel alone in their suffering.
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Describe your own experience
It is important that your partner hear from you what it is like to be around them when they are depressed. Especially if they are in denial or refusing to get treatment, it may be important for them to understand how their depression affects you emotionally, so that they can see the seriousness of the problem. The object is not to make them feel guilty or blame them, but to help them come to grips with the realities around their depression. Spouses often hide how they feel from partners for fear of hurting them, when in fact keeping their experience secret can prolong the pain. It is also important not to expect your partner to take responsibility for your feelings. You are just sharing your reality so that he can take it into consideration.
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Don’t take responsibility for their feelings, either
We are all responsible for our actions, as well as the way we feel. Of course if you did something to hurt your spouse, you need to take responsibility for this, but partners are rarely responsible for their partner’s depression. Many partners feel as if they should somehow have the power to heal or help fix the depression, causing them a great deal of stress. In reality, depression is a serious, complicated disorder that almost always requires the help of a professional. For a partner to take responsibility for their partner’s feelings is not only ineffective, it is often harmful, causing undue stress on the relationship, and prolonging the healing process. Having healthy boundaries is not only necessary for a good relationship, it also is very important to retain your own sanity while trying to be helpful to your partner.
I had a client describe her husband as follows: “He just mopes around all the time! He drives me crazy.” When we dug deeper, we discovered that the thing that was driving her most crazy was the fact that she was feeling angry at herself for not being able to fix him. This often causes the depressed partner to feel like a burden, worsening the depression. It is okay for you to feel good even though your partner is depressed.
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Seek help
There are many therapies that are effective for depression. I prefer a modern insight-oriented approach, since I believe that it gets to the root of the problem and produces long-lasting results, as well as other benefits, instead of covering up symptoms temporarily, like some quick-fix therapies do. I make myself available to anyone who is looking for a good therapist, since the process can be very difficult. Medication or alternative therapies have also shown promise in treating depressions that don’t respond to therapy.
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VERIFIED EXPERTJohn is a doctorate in clinical psychology from the Wright Institute, Berkeley and has a post doctorate fellowship from the Children’s hospital, department of psychiatry, Oakland.
