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.

By Sarì Harrar and Rita DeMaria | Ph.D. from The 7 Stages of Marriage

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 They may feel too lethargic or withdrawn or may think they can fix it alone.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

  • Your Comments

    • jdw1981

      People who suffer from depression never think about the impact it is having on the people around them. While having support is great, it cannot last forever, there are exceptions, but the rule is most people don’t want to be around someone that thinks everyone hates them, in turn making everyone around them not want to be around.

      The battle with depression is 100% on the depressed person, no amount of support from outside sources other than a medical professional and medication, can help, the choice is yours. Now my wife suffers from depression, but I also suffer from her depression, people always forget the people around, like my daughter who has to live her life seeing my wife distance herself from everyone, make claims that everyone hates her and never trust people. My daughter will grow up with these things in mind, possibly causing the cycle to repeat.

      I have tried to support, I have for years, but when people lash out at “unsupportive” loved ones or people who have to leave after years of this, I think it is unfair because most these people have tried everything they could to help these people, but 99 times out of 100, the person they married has long since left, and now there is this person who hates everything or wants to die or whatever it is on any given day.

      My wife chooses to cancel doctors appointments, claims every single doctor is a fool and cannot help her. Every time we bring anything up, it will trigger a fight, every time sex comes up, it will start a fight. I just hope someone will read this and see that unless you try, nothing will change, your loved one is doing most likely everything they can, but they cant do everything, not forever. If you want them to stay, you have to try, and if they leave, know that they most likely did everything they could but couldn’t suffer along side anymore.

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    • jessica

      I suffer from depression I’ve tried to kill my self 3 times. My spouse doesn’t care he yells at me and threatening to take the kids from me so now I’m forcing my self to do things like eat just so I don’t lose my kids I need help, I’m at my end

      • Nikki

        Jessica, if you need someone to talk to, never be afraid to call your community health line. You are not alone in this world no matter how depression makes you feel. You are stronger than you know and brighter than you can imagine. I wish you the best in life.

    • Guest

      I am just starting to recover from clinical depression. I have had some degree of depression for the last 5 or 6 years. The last three have been pretty tuff, most of all on my wife who has stood by me through the worst of it. I have been a monster at times, verbally attacking the one person who loved me the most. I have been caught up so much in my own little world of what I can or can’t do or just struggling to deal with the day. Especially when I drank, I initially felt good and almost normal, but that was short lived and by the end of the night I would become incredibly over sensitive seeing everything as an attack, normally when there wasn’t one, and defended myself aggressively with a sharp tongue. All the while my beautiful, bright, happy wife was slowly being eroded away and all I could do was keep pushing.

      To those spouses and loved ones struggling to deal with this, please try to remember that through all of the bad times, it is not the real person you know saying those things that hurt so much. Although it comes from their mouths, they are not truly to blame so please remember to take the advice and blame the disease not the person, as it will help great deal.

      Unfortunately it could be too late for me, after all the arguments and hurtful words, it has taken its toll on my wife and she is no longer sure she sees a future for our marriage. I can’t blame her as she did not have the same support she gave me or any of the great information you can read in the article, so she blames me directly. I’m in no good position to argue after all that’s been said, but I’m not going to give up fighting to win back her love and respect.

      • Guest

        Your wife may also need lots of time and some emotional space. My husband also has clinical depression, and it was several years before he sought help, similarly with around three years of his depression being extremely bad. We told no-one and, incredibly, he managed to keep working and keep up a facade of relative normality when socialising. But in private he was completely withdrawn and cold (afterwards he would describe the feeling as just empty), a completely different person to the bright and engaging one I had knew, and the chemistry between us changed us completely. In time, I realised I was no longer in love with him, in fact I did not even know or like the man his depression had made him. I felt lost and alone. I thought about leaving every day for about year, but we’d been together over a deade and I loved him (or the memory of him) and couldn’t abandon him.

        Thankfully I didn’t leave. He hit some sort of crisis point on a holiday with a group of friends, no doubt a result of not being able to take having to keep up the facade and of beinging on the outside looking in at everyone enjoying each others’ company – which must have been exhausting for him. We talked and he promised to seek help. He saw his GP and a counsellor. A week after he began taking citalopram he suddenly became, well, his true self again – which of course was still sensitive and lacking self-esteem at times, as with most of us, but his cognitive and physical symptoms disappeared, he had energy, he could concentrate, he was interested in things, including me. It was amazing.

        But this is the reason why I’ve responded to your comment. While the world changed overnight again for him, it hadn’t for me. I hadn’t taken a drug that had rebalanced my chemicals. I did not feel energised. And I couldn’t just forget the feelings, the falling out of love, the lack of connection, the complete absence of intimacy and mutual understanding, of being on the same wave-length, of the past three years. To be honest, while relieved at the change, I was also broken and angry and incredibly resentful.

        But, again, we stuck it out. I got counselling. We got to know each other again and slowly-by-slowly I fell back in love with him. And that was amazing too because I really had through it couldn’t be as good as it used to be before the depression. But it was, better even. Not that this means its been all smooth-sailing. We’re both been irrevocably changed by the experience. My tolerance levels to his repeat stints of depression are nowhere near as high as they were at the start of his first bout (I begin to panic that we’re in for the long haul again, though we never are, hopefully becuase we both recognise the signs and address them much quicker). He feels guilty about what I went through (though he’s helped through difficult times my own, and it helps when support has become a two-way street). But we have a good relationship. We love and respect each other. We make each other laugh, a lot. (Though sadly he’s been having a incredibly bleak time for the past month, feeling empty again, which has sent me in to panic mode … hence how I found this website, scrabbling around for advice.)

        But, back to the reasons for the post … maybe your relationship is over … or maybe not. Your recognition of what your wife has been through is a good starting point. Maybe show her this and ask her to give it some time. But don’t expect her feelings to change too quickly. Treat it like you’re starting out all over again – which can be amazing in time, even with the baggage!). Take it slowly, and good luck with your recovery – personal and in your relationships.

        • karen watson

          I have been struggling for sometime with my husband feeling like he was depressed and would approach him that i thought he was depressed. Depression runs in his family strongly he has always been amazed at his family members and could not understand how they could not just snap out of it. So his is very sensitive to being called depressed. But he hit rock bottom on Christmas Eve walked out and did not participate in Christmas presents with his mom and dad. I told them I thought he was going through depression but the next day he acted a bit better and everyone excused his behavior. My kids and myself have been as you said above a different person than everyone else sees because he to had been keeping up a good facade for everyone not in our household. His father died two weeks ago suddenly remarkably he handled it well stayed strong for his mom and sister. But this past weekend he broke he is despondent and isolating his self. I have begged him to get help he keeps refusing until today he finally agreed to get help, but he works out of town so hard to get him into doctor and he knows it and will continue to keep putting it off. My kids are hurting and I am hurting and I am very angry. Thanks for the tip to point the anger at the disease not my husband. We have been married for 26 years and he just keeps telling me I would be better off without him that he is too messed up. I love him and want to help him but literally depression sucks the life out the one you love and then it starts sucking the life out of you. I have decided to seek counseling which is helping me to deal with my emotions/ Any advice on things he could read that might help him to overcome this disease before he gets to the doctor?

          • anon

            My husband has been suffering with depression for a few years. Isolating friends and beginning to find relatio ships with his family difficult because he os very short tempered and irritable. He wouldnt see a gp and snapped at me. Our love life stopped only making love at 2 or 3 am when he woke briefly as apparently he was less stressed then. He kept beimg so critical and irritable and worked compulsively. He said he felt like he was needed at work. I have recently found put he was gamblling too. We have two very small children and its felt unbearable. Family trips were like hell. I felt like leaving but instead I had an affair. The need for live and affection probably. My husband found out and has had a breakdown. Threatening to kill himself, he has also threatened to kill himself if I leave. He blamese for the depression and the breakdown. Everything really. I also feel so responsible. The depression is so hard. Im not sure we have the fight. This website has been great but any advice would be amazing.

      • cyndyt

        I hope you are no longer drinking. Share this comment you wrote with your wife. Sometimes it is easier to write your thoughts and feelings down, then give it to the person. After a time of stress on a relationship, it is often hard to speak to and express feelings without things going bad. Maybe the two of you can start with writing what you need to say to each other. Take her out, make her feel special again. She has stuck by you so far, she must love you and most likely misses the man she married. Good luck.