Be 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 They may feel too lethargic or withdrawn or may think they can fix it alone.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.