The path forward after a partner or spouse has been diagnosed with depression is hard to see and harder to follow. There’s a fine line between being supportive and being overbearing. There’s a risk of exacerbating the condition or creating cycles of personal emotional self-harm. How much of yourself do you have to give to your partner in support, and what is the true cost if you forget yourself in the process? The question of how to help someone with depression without jeopardizing other bonds is complicated. There are a lot of questions. Some lack answers, but — and this is the thinnest of silver linings — most don’t.
Before seeking answers, however, it’s important to get context. The most important here comes in the form of a fact: Depression, no matter the severity, looks different in different people.
“Some of the symptoms of depression are not starkly different from that person’s overall personality,” says Dr. Michael Dulchin, a practicing psychiatrist who specializes in adult depression. “Sometimes it just exacerbates some of their underlying personality traits, and makes them behave in ways that their spouse already doesn’t like.” Other times, Dulchin says, a loved one with depression appears to become an entirely different person when going through a depressive episode.
Before one can help someone with depression, they need to understand how that person manifests symptoms.They also need to make sure the person is actually depressed. Depression is not just lingering sadness. It is a clinical diagnosis and one that should be made by a doctor. Partners can help with that process by being observant, but they should not put that label on their loved ones (unless they are trained to do so).
Without breathing down their neck, a concerned person should keep note of any changes in how their partner is sleeping, their appetite, or their temper. They alone know when their partner’s behavior changes. There’s also what’s called a “foreshortened future,” which is when a person begins to focus exclusively on the immediate future, rather than plans that may be far off, like a vacation. It suggests that the person is going through a present that is so overwhelming and distressing that they can’t see past it.
Dulchin recommends looking at depression, and depressive episodes, through a three-tiered approach. “People are what they feel, what they think, and how they choose to act,” says Dulchin. “A spouse talking to a depressed partner asks how they feel, how they think about how they feel, and then says, ‘Let’s together decide how you’re going to act, based on those two things.’ “
Even if someone’s partner feels like crap, and knows why they feel like crap, it’s important to have that conversation and take action based on that conversation, any specific requests that arise, and expert recommendations. There are other supportive behaviors that go beyond open dialogue and behavior monitoring. Challenging a partner to occasionally do things that may be difficult helps them keep their worlds open.
“When somebody is scared and overwhelmed, on the one hand, you want to say, ‘You don’t have to go to that party tonight because you’re feeling bad. Don’t push yourself.’ On the other hand, you don’t want to say that again, and again, and again, until somebody has no social life and doesn’t get invited to parties.”
That would be what Dr. Dulchin refers to as allowing someone’s life to “get smaller.” In other words, it’s okay to have some me time, but me time can’t become all the time, because that isolation will compound the issues of depression. It also won’t help a partner push themselves to experience things even if they may not be feeling great.
And then there’s the issue of taking care of one’s self while they’re supporting a partner. This is very important because depression can, and has, ruined relationships. It is a priority.
“If you have a really supportive, caring husband who is doing a lot more with the kids, and a lot for his wife, he may neglect himself,” explains Dr. David Schrecker, a practicing psychiatrist who knows from experience that this is an untenable situation. Husbands whose wives have been diagnosed with depression, he says, should still strive to make themselves happy. Relationships shouldn’t center on illness or distress. Also, the consequences of not doing so can be drastic.
“Spouses can become despondent and stressed out and angry towards their spouse. Obviously, that’s not going to help anything,” says Schrecker. “Doing too much is masochistic, and then in turn, it hurts everybody. Finding that balance is important.”
Like any partnership, there will always be a give-and-take. And in any healthy marriage, no matter the mental health of either partner, both partners need to focus on themselves, so that they can effectively focus on each other and provide the support that they need.
Both doctors agree that there is a risk of partners feeling inadequate when their husbands or wives are going through a depressive episode or are diagnosed. Dulchin said that the skill of a psychiatrist is feeling inadequate, but knowing to not worry about it too much, because no matter how hard someone tries to support their partner, or patient, it could take a long time before things get “better.”
While it’s difficult at times for husbands to communicate, Schrecker stresses that it’s deeply important. “A lot of men have a difficult time and often shut down. They always want to fix things. It’s hard for them to just sit and listen when a woman is talking about how she’s feeling, when that can be very helpful.”
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