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 They may feel too lethargic or withdrawn or may think they can fix it alone.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