How to Deal with a Depressed Spouse

If you think your partner may be depressed, your first step is to pay attention to the clues to get the right diagnosis and treatment. Here's what to look for and how to take action.

how exercise saves your brain, depressedWhen one spouse is depressed, a marriage is depressed. This illness erodes emotional and sexual intimacy and suffuses a relationship with pessimism and resentment, anger and isolation. Even the sunniest, most capable partner can be pulled into depression’s strong undertow: You may be overwhelmed by extra household chores that your partner is too lethargic to finish, resentful because your spouse won’t just snap out of it, or feel that you’re somehow to blame for the illness itself. You may feel alone yet unwilling to tell anyone there’s depression in your household, or you may simply wonder when the sparkle and joy, the humor and fun seeped out of your relationship.

If there’s depression in your marriage, it’s time to act—for your partner and yourself. Waiting increases the chances that your relationship won’t last; depressed couples are nine times more likely to divorce. And trying to fight or make peace with this often misunderstood illness on your own raises risks for both of you. The longer a nondepressed spouse lives with a depressed partner, the higher his or her own risks for depression. The deeper a depressed spouse sinks, the tougher it may be to finally treat the depression—and the greater the risk for alcoholism, drug abuse, violence, and even suicide. The stakes are high, but the odds are that things will improve.

Remember, you’re not alone. An estimated 19 million Americans are currently going through depression. In the Reader’s Digest Marriage in America Survey, 42 percent of respondents named depression as a major challenge in their relationships. It’s not surprising that most said this insidious illness had a negative effect on them. But there was an unexpected ray of hope: One in four said depression had a positive outcome for their marriages. “Getting diagnosed and treated makes all the difference,” says Emily Scott-Lowe, Ph.D., an assistant visiting professor of social work at Pepperdine University, who leads workshops across the country about depression and marriage with her husband, Dennis Lowe, Ph.D., a psychologist and director of Pepperdine’s Center for the Family. “Just 33 percent of people with depression seek and get help. But when you do, your chances for significant improvement are 80 to 90 percent. Almost everyone gets some relief.”

Depression isn’t a choice or a little case of the blues. It’s a physical illness as serious and life-altering as diabetes, heart disease, or arthritis. A depressed spouse can’t just “snap out of it” or “get on with life.” The reason: Depression is marked by dramatic shifts in brain chemistry that alter mood, thoughts, sleep, appetite, and energy levels. Genetics usually make many of us susceptible to depression; any number of factors can trigger the slide, including prolonged or severe stress, financial problems, a big loss or change in your life, the birth of a child, parenthood, and even some health conditions and prescription drugs. Marriage itself even raises your risk: Up to 1 in 10 brides experience “postnuptial depression” in the months after the wedding. And up to half of all women and men in unhappy marriages may be depressed, perhaps due to marriage problems (though some experts suspect that undiagnosed depression is behind the problems).

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If you think your partner may be depressed, your first step is to pay attention to the clues—and help him or her get a diagnosis and treatment. These steps can help.

why men say no to sex, depressedBe alert to small changes. Depression can come on slowly, almost imperceptibly. “You look for all types of other explanations—we just had a new baby, it’s a tough time at work, it’s a phase,” Emily Scott-Lowe notes. “It can take a while to see the pattern or to be ready to accept that depression might be the cause.”

Often it’s up to the nondepressed spouse to take the lead: The illness itself often prevents depressed people from recognizing that something’s wrong or seeking help. They may feel too lethargic or withdrawn or may think they can fix it alone.

If you notice that your spouse isn’t acting, feeling, or thinking as he or she normally does, ask yourself if it could be depression, but don’t stop there. Depression may be the reason your spouse is working extremely long hours, drinking too much, using recreational drugs, or looking for thrills in risky activities. It can also look different in men and women.

Don’t wait for your spouse to hit bottom. Letting a depressed person sink low before offering help is an old-school approach borrowed from the early days of alcohol- and drug-addiction treatment. But the reasoning behind it is flawed and dangerous. Long-term depression is harder on your marriage, tougher to treat, and more likely to recur, and it leaves its victim in despair. The most chilling risk: It leaves open the very real possibility of suicide. About 60 percent of people who attempt suicide have major or minor depression or another mood disorder—and depressed men are four times more likely than depressed women to take their own lives.

Break the ice gently yet firmly. If you suspect your partner is depressed, don’t blurt out a layperson’s diagnosis: “You’re depressed!” or announce: “You better get help!” In order to begin the process of healing, approach your spouse with concern and with an action plan. You might say, “I’m concerned about how feeling tired and losing your appetite are affecting you. You deserve to feel better. Our doctor may be able to help you, and I’d like to arrange a time when we can meet with him. Next week, I can go on Wednesday or Friday. What’s good for you?”

Get a diagnosis—together. Dozens of health conditions—including heart disease, diabetes, lupus, viral infections, and chronic pain—can trigger the same symptoms as depression. So can scores of prescription medications, including some birth-control pills and drugs that treat acne, herpes, high blood pressure, high cholesterol, and cancer. Your family doctor can rule out underlying causes and decide whether or not it’s really depression.

Ask your spouse if it’s okay for you to attend this evaluation. “When you’re down that low, you may not be able to express what’s going on or even realize what all your symptoms are,” Emily Scott-Lowe notes. “And you may not be able to concentrate on the treatment recommendations your doctor is making. You need an ally in the room.”

Know that the odds are in your favor. As we noted, the success rate of depression treatment is as high as 90 percent. Usually the road back is relatively simple: antidepressants, counseling, or a combination of the two. That said, recovery may take time and patience. There may be an initial trial-and-error period while you try various antidepressants or see whether various therapy techniques, such as cognitive behavioral therapy and interpersonal counseling, are helpful. The results are worth it.

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