When Your Partner Is Depressed
What to do, how to cope, and where to turn for help

By Julia Thorne

When Sarah Goodman's husband, Tim, suffered bouts of depression, it was difficult to live with him. "Tim came home from work, barely spoke to me, sat down in front of the TV, and fell asleep," says Sarah. "Half the time I had supper alone in the kitchen, crying while I ate." In the beginning, Sarah worked hard to try to cheer Tim up. When he didn't notice her efforts, she stopped trying, burned out by attempts that went nowhere. After five years of marriage and many depressive episodes, Tim and Sarah had lost their intimacy and their trust. Before long, Sarah herself suffered from bouts of depression, too.

Finally, a friend intervened and suggested that Sarah see a counselor. Recognizing that something needed to change in order to salvage the relationship, Sarah agreed. Through therapy, Sarah not only learned how to preserve her own emotional well-being during her husband's bouts of depression, but she acquired the tools necessary to help Tim control this debilitating illness.

The Goodmans, whose names have been changed to protect their privacy, are hardly alone in their struggle with depression. According to the National Institute of Mental Health (NIMH), depression will affect almost 19 million Americans each year, with millions more suffering undiagnosed and therefore susceptible to consequences, such as job loss, divorce, or even suicide. With so many depressed people, it's fair to assume that at least half have partners or spouses who are trying to understand and live with this confusing disease. Many of these partners don't know that depression is an illness—a potentially curable one that responds to treatment in more than 80 percent of studied cases. "It's probably the most treatable of all serious mental illnesses," says William Beardslee, MD, psychiatrist in chief at Children's Hospital Boston and author of Out of the Darkened Room: Protecting the Children and Strengthening the Family When a Parent Is Depressed (Little, Brown, 2002).

Figure Out The Problem
With such hopeful recovery rates, it makes sense to seek treatment for a loved one if you think he or she may indeed be depressed. Unfortunately, diagnosing depression can be tricky. To discover if your partner is clinically depressed, you'll eventually need to consult a trained professional. See a family doctor, whether that's an internist or a gynecologist, for advice on appropriate care. Most communities have mental health centers that can also direct you to a qualified caregiver. Your referrals should lead you to a trained psychotherapist for therapy and a psychiatrist or psychopharmacologist for therapy, medication, or both.

But even before you seek professional help, there are signals that should send up red flags. These include irritability; mood swings; anger; sudden eruptive outbursts; withdrawal and isolation; low motivation; eating disorders; substance and alcohol abuse; physical, sexual, and verbal abuse; or any combination of these behaviors. (For more help on determining if your partner should seek counseling, see "Just Down ... or Depressed?")

Although you may recognize some of these symptoms in your partner, don't be surprised or alarmed if you also see them in yourself. The truth is, depression is contagious. As in Sarah and Tim's relationship, your partner's blue moods can spread to you. "Family systems and partnerships are like a mobile," says Dorothy Dacar, MEd, LCPC, a family counselor in Bozeman, Montana. "When one of the components moves, the other adjusts. When one person is out of balance, everyone gets moved." Often the "healthy" partner is left feeling alone in the relationship because depressed individuals tend to withdraw emotionally. Eventually, feelings of anger and resentment may compound this sense of alienation. So it's important to realize you may need counseling, too.

Take Steps To Get Better
So what can you do to help your partner if you suspect or know that he or she is depressed? First of all, assure him that he isn't "crazy." Depression is a biological illness, just like heart disease or diabetes, and there is no need to be ashamed of it. "There's a lot of evidence that depression rearranges basic body functions, such as sleeping, eating, and energy," says Beardslee. "If you look at electroencephalograms (EEGs) of depressed people, they look very different from those of 'normal' people." Explain to your partner that he needs help recovering from depression just as he would from a medical illness.

Naming depression—actually having your partner say out loud that he is depressed—can also help begin the healing process. "When you talk about depression and give it a name, there is a real sense of freedom for the sufferer, and that makes it easier for him to get help," explains Dacar. "Depression is a difficult illness to fight alone, but if one person in the relationship changes [the dynamics], it can change the whole system."

Did you know?
Depression can be a family trait. In fact, a sibling, parent, or child of an individual with major depressive illness has eight times the risk of developing depression than the general population, according to a 2001 University of Pittsburgh study on depression in families (American Journal of Medical Genetics, 2002, vol. 114, no. 2). One thing you must do is recognize the toll living with a depressed partner can take on you. When your partner or spouse isolates himself from friends, family, and the community, this simultaneously shuts you off from your own social life. That's why it's so important to reach out to a support group outside of your relationship for solace and a place to go with your worries. "Dealing with depression means finding and connecting with many resources— community, religious faith groups, caregivers, friends, and family," says Beardslee. "Depression disrupts your usual connections to all of these relationships that you need now. Each of us must be responsible for making our own connections because every positive action we take for ourselves will contribute to our relationship," he says. "Changing patterns of behavior and communication isn't an easy task, but it can be done through connecting with others." Turning to others for support will be beneficial to you—and will set a gentle example for your partner to do the same.

It's also important to remember that your partner's depression is not your fault or a fault of your relationship; nor can you "fix" your partner's illness. There are no quick fixes when it comes to depression. Although your gut reaction may be to rush in and try to "make things better," this will only act like a Band-Aid on a wound, covering the sore. Healing from depression must come from the inside out, and each person with depression must make the personal changes necessary to get better. Likewise, try to avoid telling your depressed partner to "buck up" or "get out and do something." His emotional pain has incapacitated him. Depressed individuals suffer from low self-esteem, and trying to "make them better" can actually fuel feelings of inadequacy. Instead, encourage your partner to get help. "Remind him that if he had any other kind of medical disease, he would go to a professional," says Dacar. "This isn't about something bad about him, or not having a strong will." She adds that a depressed person is in so much psychic pain that he may welcome acknowledgment that although life isn't good for him right now, you want to help change that fact. Expressing that you may even be willing to go to therapy with him if he is resistant to going alone is another helpful offer.

On a more practical, day-to-day level, there are steps you can take to make living with your depressed loved one easier on yourself. Simple distractions, such as taking a walk or just getting outdoors, are great ways to escape your partner's mood and improve your own state of mind. If you need a quick pick-me-up, do something nice for yourself, such as indulging in a good meal or renting an uplifting movie. And don't feel guilty if your partner isn't able to enjoy these acts with you. One thing to avoid: the TV. Inactivity from sitting in front of the television, and the constant negative messages on the news, can rob even the happiest people of their sense of well-being. "Obviously, the news these days is particularly depressing," says Beardslee. "But the main thing is not only not to watch TV, but to try to do things that bring you relaxation and don't upset you: Listen to music, be with a friend."

Feel Happy Again
Through counseling, Sarah began to understand the dynamics of her depressive relationship and recognize her and Tim's behavioral patterns and how they pushed each other away. Sarah started to bring home books her therapist suggested and left them on the coffee table to stir up healthy, positive discussion with Tim. As Sarah improved with the help of her counselor, Tim noticed, and one day when Sarah suggested they see her counselor together, Tim agreed.

With help, depression took on a new meaning for Tim. It was no longer a mental illness lost in a stigma of shame, but an emotional illness he could use to map a happier life. Slowly, Tim identified behaviors that triggered depressive feelings and began to avoid choices that made him feel bad. Today, Sarah and Tim are happily married with two children. They have found a new and vibrant relationship based on working together, communicating thoughtfully, and respecting each other's emotional wounds. Most important, they have a special intimacy because they have gone through this healing process together.