Figuring out a way and reason/s to live are the most difficult things for a clinically depressed person to tackle. And equally difficult for the other person/s to understand. If there is no pleasure in anything - anhedonia - then there are no incentives to persevere.
We do more of what we love, after all. What is the sense of persevering if we cannot appreciate the most basic things - a blue sky, a simple walk in the woods, the pleasure of building something, or of getting lost a book?
I encourage everyone living with someone in this situation to be proactive and dogged. A noodge, in other words. Suggest things often and vociferously. Eventually it will sink in and even the most defiant of depressed persons will eventually come around. I find personally that anger is often the best motivator, in getting the tuchus off the couch and engaged in doing something productive.
If daily exercise can be maintained, the need for meds declines, IMHO. But if that doesn't do it, lithium, or ideally, a combo of medication and talk therapy - in addition to exercise. Get out of the house. However painful it may be, get thee or them to a book sale, a potluck, a public talk, whatever. Get the tuchus off the couch. Now go already!
3
Clinical depression is such a severe state of mind the sufferer is doing everything in their power to stay on this side of being alive. Take that in.
7
ive fallen in and out of depression witnessing the abrupt change in society since 2020. I feel some are begging for compassion while the business folks and landlords run away with profits beyond imagination. the unmitigated greed and got mine mentality is truly distressing to witness. turning housing into a profit bearing machine has led me right into disgusted depression knowing our country is for sale to anyone and everyone that's got cash on hand. no thanks to those who sold off homes to LLCs and investors. may you reap what you sow.
1
The challenge for both the patient and the caregiver(s) is to treat depression as the life-and-death medical situation it is. Treat it as if it was a deadly illness that must be attacked immediately and unrelentingly until it is driven into remission. That means it is a full-family mobilization, and major disruptions to normal life are not only needed, but to be expected and tolerated as well. It is all-hands-on-deck until the crisis has passed.
5
I realize it makes sense to always suggest to therapy to people or to “reach out to their healthcare provider.” Can we please get real? It is so hard to access care in my worst moments I’ve called 988 for solace. Thanks God they were there. I have health insurance and cannot access care- riddle me that! The advice that all people spout to “see a therapist” is just so absolutely frustrating and alienating- if I could, I would!
21
Three years of COVID has been very depressing…the isolation, the fear, the losses, the physical affects - who wouldn’t be depressed?
6
One thing not mentioned in this article is that the partner without depression is likely shouldering a huge burden of managing the household and/or family. When my spouse was in a deep depression for about three years the work of cleaning, shopping, cooking, managing child schedules, etc. fell almost 100% to me. If I were to have pointed that out or nudged that would have simply increased my spouse's shame and self-loathing which were a huge part of the depression in the first place. (And I very much tried to take the view that I would be doing this willingly if they had cancer.) AND, if the spouse's depression impacts work, money may also me tight. But if there's room in the budget, a house cleaner or meal delivery may go a lot further than the "self-care" described in this article.
All I could really fit in was savoring my morning moments before they and the kids woke up and the cycle began again, and listening to podcasts when doing the washing, cooking, driving, etc. For me, there was no choice but to shoulder this. It wasn't my partner's fault, and it just was extremely taxing. and scary. But I can say that even after many hopeless moments, at this moment we are on the other side. It took so many different medications and other substantial lifestyle changes. I almost can't believe we are here and I am abundantly aware that circumstances could change again tomorrow. For those of you shouldering these burdens right now I really, really am thinking of you.
52
Very well said, thank you. And kudos to you for keeping things humming. Partnerships can be amazing.
5
@Mary M.
You are a very strong, courageous, and exemplary person!
3
A spouse's depression affects everyone. Then add manic episodes, where out-of-control spending, reckless behavior, blunting of emotions, and "you are the crazy one" and that makes life intolerable, exhausting and scary.
A mental health nurse, and friend, said, "you can't work harder than they are willing to work". When they don't maybe you have to save yourself.
I did and I found my happiness again.
11
@Andrea I am getting out of such a situation now. I, too, hope to find happiness again.
2
My wife suffers from depression and periodically has suicidal feelings. It’s severe. A few things I’ve learned and aren’t really covered in this article.
1. There likely is no cause. This is important to understand.
2. Realize that dealing with depression is not necessarily in your wheelhouse and your partner needs to seek professional help. But you can and need to still be there..
3. Help them understand they are going through a super low period. Comfort them that all will be ok. This will improve. Be patient. It’s hard to be patient, but you have to hug, comfort and be sincerely positive until it improves. It’s normal to want to roll your eyes or get angry. Words of encouragement may sound corny but it’s what they desperately need.
4. Throw logic out. Don’t ask them how they can be depressed while they have a nice house, drive a nice car, have loving family, etc. don’t remind them that other ppl have it worse. Throw all that away and accept their depression as real because it is. Don’t shame them “how can you be depressed while poor ppl in Somalia can’t even get food”. All that does is tell them you don’t understand and shames them. Don’t argue or judge. Be totally and unconditionally accepting.
24
I fear every day that my husband will leave me because of my depression (been married almost 4 years) and I’ve had depression since I was a young teen. My reaction to reading some of the comments here, where that did finally happen to some couples - the spouse leaving after decades….I’m just so scared.
I’ve medication for 20 years, ketamine injections, yoga & mindfulness, talk therapy, psychoanalysis, the “I love myself” mantra…
I’m prone to negative thoughts , hating myself , suicidal ideation.
I know he just wants me to be happy and I know he would be so happy if I was more positive and light. I don’t want to end up decades from now with him leaving, saying that he could it take it anymore.
6
@Tanya, I hope you see the encouraging messages here, too. You are loved, even by this someone who does not know you.
1
@Tanya It seems like you feel unilaterally responsible for whatever problems your marriage could have. That’s the dominant societal message when an abled and disabled person marry: If anything in the marriage works, the disabled person gets none of the credit, even as they’re solely “responsible” for anything that goes wrong. It’s a toxic message that hasn’t been refuted in this article. Don’t fall for it. You deserve genuine and consistent care and love from your husband. And, if you’re not getting it, you’ll be better off without him.
Trying to support someone with depression can at times be very difficult, infuriating. and make some partners want to leave. But, I wonder if they would have the same response to a spouse that is suffering from cancer. Would someone get angry that their spouse is sleeping in the bed instead of eating well and getting some fresh air? That they are not attending as much to their children? That they aren't interested in having sex? They are in pain and feeling hopeless?
Sticking with someone who has any serious illness is hard. And it puts an unfair burden on the person who is not sick. But before leaving the relationship, a person should ask if they would do the same if the person had any other serious medical problem. Maybe they would. But, probably not.
8
I'll tell you one thing Congress could do to reduce the prevalence of depression. Eliminate seasonal clock changes. Two weeks later and I still can't get a decent night's sleep. It's depressing!
6
I could not do it.
After 17 years, many excellent therapists, trying many, many combinations of therapies, prescriptions, treatments… I couldn’t continue to stay with my wonderful, depressed partner.
If I’d have known what this life with a depressed partner entailed, I would not have begun the relationship.
He still struggles.
I don’t know how to say this, but the lightness and freedom that came from leaving was almost overwhelming.
25
@J Same for me and I agree with you 100%. Your description is perfect and comforting. The day I left was not the best day in my life but it felt so good. Such a huge burden was lifted from my shoulders.
1
I made a decision to not get married because of my depression. I couldn't imagine burdening another with my little-understood condition.
10
In my experience depression creates an emotional numbness resulting in strangely robotic behaviour, absolutely contrary to constant crying and expression of angst. I cured my depression by coming to the realization that I had been conditioned as a kid to repress negative emotions, and by giving myself permission and acceptance in feeling those emotions, I came out of the depression and accompanying anxiety. Crying was like the opening of a valve that allowed all of the sadness to come out of me. So you can certainly support your partner, but only your partner can break their emotional log jam of depression.
11
well, what do you do if they are not interested in helping themselves?
6
@Angela One has to back away to protect personal boundaries. Not consciously (although some may)
attempt to emotionally and at times physically
"drain" a partner. This can be a reality. Enhanced Self Care for the partner is necessary. Time away can be essential as to disengage from the actual "heaviness" of another's depression. If the depressed individual is addressing this through meds, therapy,
attempts at enlivening experiences, some extra support is truly beneficial. Words of warning though...do not engage in "woe is me" thoughts and
behaviors, unless the depressed individual is truly
attempting to address this. Unfortunately depression
can be somewhat "contagious" especially for the
partner who may be predisposed. But for both, hope
is always essential and strong medicine.
1
There is hope. Forty four years ago when I was newly married and 22 years old I suffered from debilitating depression for two years. Medication didn’t help and in fact made me feel worse. The psychiatrist I was seeing also didn’t help. I had my doubts about him and so did my husband. In fact my husband pleaded with me to leave this psychiatrist but I was in a vulnerable position and was afraid to leave. My spouse who was 24 at the time went in search of a new therapist. He found someone wonderful. Believe it or not the original psychiatrist did me a favor by propositioning me for sex. Unbelievable! It was then that I knew I had to leave. The new therapist was a lifesaver. In time the depression lifted. My husband and I went on to have three wonderful children and a good life. Something I could never have imagined when I was depressed. Through 45 years of marriage we’ve had our ups and downs but no matter what has happened I remain eternally grateful to my husband for getting me through this horrific time. To all those who suffer through this devastating disease and to their spouses who accompany them along this difficult journey I wish you Godspeed. Please know that even those who don’t know you but understand think of you with love and compassion.
36
@Anne
Thank you for your well expressed comments.
I am happy for you that you continue to feel better!
I’m familiar with someone who suffered from depression and when they left their decades long relationship, they were taken advantage of financially. It was horrible and I wish I could have done more for them.
Thank you for sharing your experience with your wife. It helps lessen the stigma.
10
couples therapy - helping us get through this period of shifting sands - my husband's depression ballooned, mushroomed, and took the air out of the room. for months I tried to help and couldn't figure out how to live with the situation - then we started couples therapy and I'm able to breathe now, we can talk about the situation now, we can acknowledge the pain, I have hope again.
19
@Amy Carlson I hope your husband is also getting individual treatment for his depression.
5
Most people don't get enough Vitamin D. Get a Vitamin D blood test and keep your level between 50 and 90 through Vitamin D supplements as needed. Get your thyroid checked and treated with medication as needed. Not to discount other necessary treatments but these two steps have kept depression at bay for me.
15
As a therapist, I believe there are more ways to view depression than are captured by existing DSM categories: a) 'chemical imbalance' depression, where psychotropics are probably essential but they may not be for what I think of as b) circumstantial depression (e.g., induced by the blight of the world around you locally or globally); singling out two circumstances: c) depression from trauma, received or witnessed, especially childhood chronic trauma; and d) depression related to grief and loss (and i believe we grieve more than deaths but also divorce, absent parents, losses of innocence or trust, as with betrayals).
In that last regard, I know from experience there can come a time in the grief process (which lasts far longer than our society tends to accommodate) when one can begin to wonder if it's depression or still grief that is working through. Anyone straddling grief and depression might value Kay Redfield Jamison's book "Nothing Was the Same." She is a clinical psychologist/professor of psychiatry who I cite for two books in particular.
Her earlier book, "An Unquiet Mind," drew on her experience living with bipolar and, at the time (1995) incorporating first-person experience into a psychiatric perspective was ground-breaking.
After losing her husband, she wrote "Nothing Was the Same" (2009), which includes a chapter I highly recommend called "Mourning and Melancholia." I've never read a better depiction of distinctions between grief and depression.
44
@Carolyn
Thank you so much for this perspective. The losses I sustained during the first two years of pandemic were so massive and unending that I emerged full of anxiety. With grit and the help of a therapist and the only medication I can take, I make strides back toward the bold, frisky woman I had been. But it is grief that could not be processed at the right time that has caused this. I know it. I feel it. I'm still full of unshed tears.
24
@hotGumption "I'm still full of unshed tears". Congratulations for I believe absolutely nailing the underlying cause of non-chemical depression. I hope that you recover fully as you so much deserve from your horrible losses.
4
The editor who is mediating these comments is causing harm by publishing non-scientific and mythical definitions of medically diagnosed depression. It’s not lack of self love or anger turned in on oneself. Depression is a medical condition.
22
@Nellie
Someone below made the comparison with "schizophrenic," which i think is an apt analogy. That and "depression" both have medical scientific definitional criteria established in the DSM, but both also have "lay" uses by the general public that are routinely applied to conditions that do not meet or even intend to refer to those DSM criteria.
So i think it becomes important for this or any article on depression to begin with awareness of that potential source of confusion and establish whether they're talking about the professional or the lay meaning of the word. As a lay concept, I as a therapist think there's some truth (often, certainly not always) to the aphorism that "Depression is anger turned inward" (in that vein, i also think the reverse is often true, that anger is depression turned outward.)
But such aphorisms and other 'lay' uses of the word "depression" (as with "schizophrenic") do need to be understood to be quite distinct from their use in psychological diagnosis.
15
The myths and misunderstandings abound regarding clinical depression. Diagnosed depression is not self-hatred. It’s feeling melancholy that people can snap out of. It’s not contagious and addictive. It should not be combined by insurance companies under the same umbrella as addiction. It’s a physical, medical brain-health diagnosis.
10
@Mimi W. did you leave out the word *not* in the third sentence?
19
We live in a large-ish city and have health coverage, but trying to get a therapist to even return a phone call to set up an appointment has been impossible. Online therapy, same—it's like yelling into a void.
Also, try being a little shy and in your 50s while attempting to make new friends in a new city—also impossible.
The point: even when you already know everything mentioned in this article, getting help is a losing battle.
29
@Quiz
Have you checked to see if there is a community counseling center in your town? I refer to places with large staffs of therapists usually including those doing their internships (who can be just as good a fit sometimes as a more established therapist) and usually offer sliding scale fees to meet what is affordable for low-income clients. Most "large-ish" (?) and upwards sized cities have such centers and, while they too can be 'booked up' at some seasons of the year, they will readily do an intake session with you and get you on a waiting list, which might take a month or more sometimes but at least you'd have a foot in the door. It is crucial that funding for more access like this in more communities be allocated.
I have worked as therapist in two such centers in two very different cities, one now that is medium-large, and i do believe in them as vital to increasing the accessibility that you and so many are confronting especially since Covid hit.
7
The advice to seek therapy overlooks important details--the cost and availability of an effective therapist and the likelihood that your insurance, if you have it, won't cover the cost. My spouse had four sessions with a therapist. The cost $1000.00 and the insurance coverage $0. End of therapy. The situation is worse in rural areas where insurance choices are few. I guess there are not enough opportunities to profit from human suffering.
25
@Freddy
It saddens me that this experience has resulted in cynicism about the motivations (if you meant in the therapy field, but perhaps you meant in the insurance industry).
Ethically, you should never have begun therapy without first establishing an affordable fee that you would sign off on in an "informed consent" form.
You would seem to be in a fairly large city if you were facing charges of $250/session. So I'll ask and suggest what I also did to Quiz above):
Have you checked to see if there is a community counseling center in your town? I refer to places with large staffs of therapists usually including those doing their internships (who can be just as good a fit sometimes as a more established therapist) and usually offer sliding scale fees to meet what is affordable for low-income clients. Most "large-ish" (?) and upwards sized cities have such centers and, while they too can be 'booked up' at some seasons of the year, they will readily do an intake session with you and get you on a waiting list, which might take a month or more sometimes but at least you'd have a foot in the door. It is crucial that funding for more access like this in more communities be allocated.
I have worked as therapist in two such centers in two very different cities, one now that is medium-large, and i do believe in them as vital to increasing the accessibility that you and so many are finding so lacking, especially since Covid hit.
7
@Freddy
It is a disgrace that mental health counseling is not covered by many insurance plans. I favor making one-payer insurance (Medicare) available as an option because private insurance means supporting a lot of high-paid CEOs and insurance industry employees.
I have a very depressed adult son who has no health insurance coverage and can only work part-time due to his depression. Long waiting lists for affordable counseling services.
I have excellent health coverage, but my HMO only allows 3 visits for "relationship issues." Not saying depression is necessarily related to relationships, but pointing out how limiting services are even under good coverage.
Although people suffering from depression deserve a lot of resources and information, I feel the needs of those having to live with someone going through this are often put on the back burner. So I’m glad to see an article like this addressing the struggles and mental health challenges that happen around living with someone who has severe depression.
It’s important to remember to take care of yourself first, and know that you can only do so much if the other person is unwilling to do the heavy work of getting to meetings or participating in their recovery.
You have to learn to know when to step back and take care of yourself if it looks like they are not going to do what’s best. It’s a very tricky road, but I found that if you don’t take care of yourself first then you’re not good to anybody else. You can also leave you burnt out or a bit calloused to the situation.
And on a final note, don’t be ashamed to let people know what you’re going through. Often times the spouse will keep their partners depression a secret from friends and family as they worry their spouse will be judged or they’ll be encourage just to leave them.
32
@Jlaw 30 years ago, my spouse was depressed for several years. I didn't know what to do. This manifested as anger & bitterness, and mostly I kept everything else going. Eventually a dr (not psychiatrist- rheumatologist!) prescribed an antidepressant and things got better. But i swore to myself that if it happened again (it hasn't), I would ask for more- require more- even from the depressed person. Some baseline things I wouldn't put up with again. I have no idea if that would have worked at all, but I do think family members need better advice. When it goes on a long time, the very fabric of your life together changes drastically.
10
@SG I think I understand your impulse to ask for more from the sick person, but it won't help much. If my leg is broken you CAN insist that I walk, but without care (maybe a cast and some pain meds) I just can't.
1
Had my ex-husband been supportive, rather than critical and mocking, when I was dealing with episodes of depression we might still be together.
37
@BrooklynBabe I definitely agree with you. What was most hurtful to me was the mocking. It broke my heart.
21
@BrooklynBabe
It's hurtful, sad and angering that you and Martha both had this experience, and perhaps the term "silver lining' seems too glib, but it seems you may have learned something important about your respective husbands sooner rather than later - and can have new antenna now for what to listen for early on in future potential partners. As in, those who mock, vilify, disrespect others will likely one day mock you. It's somewhat like learning to realize that 'friends' who gossip will also sooner or later gossip about you.
12
Being social, making new friends is next to impossible. The stigma of mental illness is still enormous.
25
Depression is contagious and addictive. Most people with depression will continue to have episodes for the rest of their lives. Take care of your own depression and stay away from other depressed people as they will bring you down. A depressed husband is very likely to cause depression to his wife and most men refuse to go to therapy or take antidepressants. If you don't have kids, it's best not to marry a depressed man or divorce him. I know it sounds cruel but we all know it's true.
14
That’s a wonderful solution, isolate depressed people more. Just leave them to suffer. Depression is not contagious, it is a medical condition for some people and it is not the same if you are situationally depressed. You are not as helpless and hopeless, you can do the self-help stuff they say here. As someone who has suffered with severe, disabling depression almost without relief for twenty years. I am grateful to those who are there when it gets hardest, those people are great friends.
40
@Rodger K I'm thankful that most people I am close to don't think remotely like you.
2
@Rodger K Depression is neither contagious nor addictive.
4
I highly recommend Dr. Mark Hyman's Broken Brain series. There is a body/mind connection. With all the toxicity in our world, no wonder there is so much mental and emotional illness. Detox, eliminate, and fortify!
14
For depression, detox? You’ve got to be kidding.
5
@PES I'm guessing detox in this setting is used as a concept, and not anything physical/medicine. "Detoxing" one's life, as it were. Maybe ending relationships that constantly drag you down, leaving jobs that are killing your soul, exploring new activities that might bring joy, and perhaps even changing diet and exercise attitudes. Lots of small changes that can help (notice I didn't say "cure".)
2
Exercise by whatever name or form sure helps counter-act depression. Lots of hooks to try to get somebody active, so try to find one that tickles that person.
B.
25
Also keep in mind that approximately 50% of depression diagnoses in the U.S. turn out to be incorrect. Yep, a big ol' HALF of them.
The patients are later rediagnosed as having bipolar disorder, a.k.a. manic depressive illness. I learned about this in "The Prozac Monologues," a memoir by Willa Goodfellow, a pastor who was educated at Yale and Reed College. (Smart lady!)
Here's an article from our local newspaper about it: https://nuggetnews.com/Content/Health/HEALTH/Article/Local-author-takes-readers-beyond-depression/117/221/29933
11
@Grassfed
We have known for years that Prozac and other SSRI’s when incorrectly given to someone with symptoms of depression, will trigger the underlying bipolar symptoms. That’s how they get re-diagnosed.
8
Those meds often don’t even help depression. It is still a misunderstood illness, and is not a “chemical imbalance” as of seratonin
3
I agree, just noting that it is still common for people to question whether a person who says they’re depressed is really just lazy or stubborn. People still roll their eyes about depression very hurtfully.
6
If someone is going through severe depression, unrelated to any life experience, it's known as endogenous depression.
In endogenous depression, the chemicals in the brain are not in the correct quantities to enable synaptic connections.
Improvement is usually through medication, and in some cases through ECT. Time itself can be a healer, but only after many months of Hell, when the limbic system tries to right itself.
When the brain is not functioning properly, no amount of ease or help from any source will benefit the person, until their condition improves.
21
I do think being there for someone will help a lot. I have severe depression, and no treatment has helped over twenty years. Just being there, carrying on a conversation and not judging and maybe doing something the depressed person enjoys like looking at art or watching a movie or walking around a nature preserve…motivation is so hard and one dreads being social, often, but it is such a reprieve from being in one’s head sometimes.
15
My adult son, after suffering for over 11 years, was recently correctly diagnosed with Bipolar 1. Following an acute manic episode, he has been in a crippling depression for the past three months. We are fortunate to live in an area with lots of available treatment, but it is shocking at how few providers are competent or caring. Mental health is an industry, and for many providers, money is the name of the game. My son is now living at home, so despondent that he is barely functioning. The situation is heartbreaking, and it’s taken a tremendous toll, both mental and physical, on the entire family. I have found that the most useful treatment for me and my husband has been attending a recently formed support group sponsored by the Depression and Bipolar Support Alliance for parents of bipolar children.
The groups are broken down by the age of the child, which is immeasurably helpful. I hope that my son, at some point, can enjoy life. In the meantime, despite some socializing and pursuing my own activities, I feel absolutely overwhelmed.
53
@Distressed Mom DBSA can be helpful - so can NAMI groups, and the online information and blogs found at BPHope.com (make sure to read the comments, because that's where the actual bipolar folks & their families share real information).
Signed,
Bipolar I
16
My older son has struggled with his mental health since he was 15. He’s now 32.
It feels like a life sentence for both of us ( and his brother, who he lives with)
10
Try as hard as you can to have hope. There are new medical treatments coming out. Miracles happen. I’m a longtime sufferer for whom nothing has helped and I’ve really tried everything. But hope is essential so do keep looking for it anywhere. Art can help.
9
I have the most wonderful, kind, generous husband and best friend. My world changed from black and white to technicolor when he came into my life. He is why I try to stay ahead of going down the rabbit hole, living as healthily as I can, and taking medication that helps…a little. But sometimes (or many times) I fail, and the worst part is seeing how much it hurts him that he can’t make everything better for me. I tell him he doesn’t need to do anything, just knowing someone like him values me makes all the difference, which is true. What I don’t tell him is the only reason I’m still here is knowing how much it would devastate him ( and my parents) if I did anything to myself.
54
@Touran9 You took the words right out of my mouth.
15
@Touran9 I seriously appreciate your commitment to NOT do any harm to yourself out of love and regard for those around you. Some depressives are so self involved that they don't consider the devastation they'd leave behind. But that also shows some regard for the world around you, and you show genuine love - so maybe you can apply a little more of that to yourself as well. You are worthy of life too.
3
First we must know that emotional despair is very painful and that there are many ways to explore how to understand what’s happening and what may be contributing to the distress.
Being told that a certain list of life experiences are simply symptoms of a disease (e.g. Depression) or pathology within the person rather than within a social/environmental/relational context is to confine ourselves to one narrative, the “medical model” view of psychological problems. This is most concerning.
18
For some of us, depression comes and goes. It’s awful.
For me at least, two things help more than medication: the dog, and the gym.
49
That is so true.
1
Not to mention - since March, 2020, the effects of COVID, and yes COVID has been real, depression has increased greatly. And that in itself is depressing.
23
@MIMA you mean covid restrictions caused crazy amount of depression and even suicides
3
@Rodger K not only the Covid restrictions , but the one million people dead from Covid in the USA , leaving behind families and friends, Plus many thousands sick with Covid, as well as the struggles getting people to get vaccinated or wear masks to protect one another , has been experienced as depressing!
6
The article says you can get a list of mental health providers and make appointments for the depressed person. I guess this depends on where you live. It is difficult if not impossible in Georgia. My federal EAP program would not even provide me list of providers for my son who was in the midst of psychosis. I also was turned down and had great difficulty when my spouse was so depressed he was sobbing on the toilet. The mental health system in the US is not set up to allow family intervention of any kind.
63
@Down South: you have no right to force treatment on anyone. Trying to force any mental health treatment on your family members doesn't demonstrate love or care, but instead disdain and a refusal to treat them as fellow humans. Show some respect and leave them alone.
7
My heart goes out to you, Down South, as your family struggles to cope. Having a child in psychosis is terrifying. You deserve nothing but kindness and support as you make hard decisions about how (and how much) to intervene. There are no easy answers, especially in communities with little access to care.
40
I recommend dialogic approaches (aka Open Dialogue) and understand that there were some offered through Emory University in Atlanta. Best wishes to you and your son and family.
12
I was married to a man who suffers from depression and refused to get help. Divorce was the only true help for me. Our son has moved 2,000 miles away, TBTG.
17
@Mary depressed husbands and boyfriends are one of main sources of depression in women and children especially since they often refuse to treat it
9
A very hard, painful read including comments. My own life has the same pain but I also lived a boomers life, “don’t be different and shake it off". It hit me at an early age and handling it was crippling. Rage was the result in my youth (I was also dyslexic, so very unpopular, AND frustrated). I wanted to leave HS behind, but a few friends who never knew my struggles kept me coming back and reliving vulnerable times. I always had a huge feeling of walking alone thru a crowded room from young on. Medicine, ‘on/off' counseling kept me going, but always a secret. I stopped all of it when I felt ’normal’, to which, booze for a hollow leg was the go to. After living an uneven existence my inevitable breakdown came in my 50s. Waking up in a hospital, plus ECTs, I finally accepted the "illness" and a program. I met my “Jeff" in my 30s and felt blessed to marry him. He made the same mistakes Jeff made, but his love for me helped us to find answers together. We shared a lot of the same issues which bonded us, but he didn’t have mental illness and I wanted him to leave me since it’s so hard to bear, but he saw it as an adventure for both of us. It wasn’t easy, but now we both discuss things with understanding of my illness, I make sure he has all his hobbies around him and true friends he can talk to. He is a wondrous creation! Unfortunately not all can be blessed with a ‘Jeff”, we need society to stop printing so may opinions and start doing what we already know needs to be done.
31
What an exemplary husband is Mr. Zuckerman. I wish more women had this kind of generous love and support from their spouses. Unfortunately, I don't think it is common for the "well" spouse to recognize the problem, react in a healthy way (don't take personally), offer to help, etc. More often they think the love has gone and it's time to move on.
47
@Kathy B I know Mr. Zuckerman quite well. I'd say he's more like above average, prone to leaving his stuff all around the house and forgetting to turn off the oven burners and misplacing his wallet. But thank you. (Honestly, it took me a long time and an 85,000-word memoir to get figure it all out, and I still have plenty to learn.)
87
Dealing with the depression of my mother has been the most difficult experience of my life. When she first suffered it, after the birth of my brother, I was seven years old and my father was the one who was her supporter. Then she was fine for more than thirty years, including the years when he was in declining health and died. At the age of seventy, her depression returned and suddenly my brother and I had to try to help her. When she finally agreed to get medical help, thankfully the medications worked and she was happy and engaged with life for another seventeen years. Then it recurred and this time nothing worked, despite the efforts of the top geriatric specialist and supporting psychiatrists in our region. Depression somehow morphed into dementia and the mother we knew was lost.
29
@Karenna The dementia-depression relation you mention really strikes me. My mother has suffered from depression for as long as I've known her (all my life), but it became severe after my brother passed away 15 years ago. Long story short, there was a crisis this past year, and, without her permission to reach out to actual medical professionals (rather than internet money-raking hacks), the rest of us family-members were left to our own devices to deal with it. I worked really hard to engage her in conversation about things she cares about; her past, her life-stories. When her mind is there, she's great. When not, she starts to resemble a lonely, isolated, confused dementia patient. I thought today, "use it or lose it" - by being able to continue to interact with things that are meaningful and cherished, I can't help but think it's good practice for staving off the emotional emptiness and self-world that comes with memory loss and lack of meaning-creation - .
Best of luck to you and your family; I wish myself the same - .
12
So hard when it interferes with earning money to support one's family.
24
If everyone were required to read the following book, I think the stigma of mental illness would be radically reduced: "Lincoln's Melancholy: How Depression Challenged a President and Fueled His Greatness" by Joshua Wolf Shenk.
16
Finding help for someone who is severely depressed and suicidal can be almost impossible. My sister is on Medicare and Medicaid, w/ medical services through Kaiser. The therapists they referred provided no assistance at all - she said one even fell asleep during her session. They also limited the number of visits.
I found an out of network psychologist for her and have been paying out of pocket, but after almost a year of visits, it's now too much for my budget. She says he has helped and that she no longer wakes up every day wishing she was dead. At least that's something. I continue to pay for her sessions until she assures me she has the tools to go through this depression on her own - but it is ruining my own financial planning.
This country MUST do better when it comes to treating those with mental illness. The psychologist she sees recommended a program that has been known to help those who are suicidal. When she asked Kaiser if they would cover it, they told her "not until you attempt suicide." What would their response be if her attempt was successful?
We also must do better when it comes to training therapists. Having a therapist fall asleep during your session is unacceptable. And far too many of them just don't understand suicidal depression. Moreover, state laws that require therapists to report those who are suicidal to authorities keep people from getting the help they truly need for fear of ending up in the psych ward of the local hospital.
65
@Zhanna... Exactly! And that fear is well founded.
When I *of my own volition* sought help at our public hospital following a suicide attempt, I was literally tied down in the ER until a doctor could see me. (Being so restrained only reminded me of the rape that was part of my reason for being suicidal in the first place).
Then I was sent to another floor, where I was met by a nurse whose words I'll never forget: "You are a criminal, and you will be treated as such. Now sit here and think about what you've done."
31
@Roxanne Ivey OMG - that's awful. This is so wrong. These people are supposed to be in a healing profession and all they do is make things worse. I'm so sorry this happened to you. I hope you are doing better now, because all they did was give you another trauma to recover from.
33
@Roxanne Ivey what an awful experience - I'm so sorry! It seems like too much of the mental health field is the blind leading the blind. Our culture celebrates youth and stupidity, and acquiring certificates, but where is the talk of wisdom? Of elders having found a way through complicated/difficult life that works and gets one through awful times with tried and true ways?
In any case, it's good you are here to tell the story, and surely your experience can help others. Congratulations on your strength and perseverance through those difficult times.
13
You can't even describe it when you are feeling it. Empty, disconnected. It's bad.
Do not tell your spouse "Don't feel like that". Or "Look at all you have." Or "Cheer up". Just be there. That alone is huge. My spouse continues to have his own life as well so I don't have the added burden of feeling like I am bringing him down.
My depression passes, thank goodness.
41
Depression is a failure of self love. We write a story about ourselves as we develop and mature and as the star in our story, we shore ourselves up with a subjective narrative. Sometimes its external events, or internal chemistry (or both) that rearrange the narrative, such that we fall from grace. Medications are often helpful, professional help can make a huge difference, but the loving support from family or friends is essential. In time, and with good care and some luck, the pages get ripped out, reassembled, edited, and a new narrative emerges.
If you aren't well insured, or well to do, its extremely hard to get good psychiatric help. That's criminal in a country as wealthy and as enlightened as ours.
28
@ach the best description that helped me is that depression is anger turned inward - on yourself instead of others which leads to self loathing and despair. I had to acknowledge that truth which leads to finding out why the anger is there, and that I had a right to my feelings even when they are negative or "bad". Biochemical imbalances are also very real.
17
@ach "Depression is a failure of self love." for some perhaps but as a blanket statement this is tripe (accept perhaps if you a accept that 'love' is a minor neural chemical reaction)
grandmother, father, brother . . . oh and myself aware since early adolescence that my patterns of 'light & dark' were out of sync with dominant society. was successful and accepted at the beginning of 'manic' periods (which even after 50 years always, always sneak up & only after some small slightly different behavior is reviewed do I go, "Uh-Oh ! Dangerous road ahead") which have universally led to the crash & burn . . . this is not always followed immediately by the depressive cycle but when depression hits mediating damage from end of manic phase is excruciating (added to the void (painful but void) of depression).
My brother, whose presentation & symptoms were different went on medication about the time he was thirty stayed on it for 30 yrs. (until he died; he still struggled, none of the slowly evolving pharma regimens were panacea but, he functioned as a physician). My forays into clinical intervention were not, are not, as successful. But pretty sure self love, except as a Serotonin-Oxytocin two step, has never been a factor. Admittedly side effects of how she was perceived, for my grandmother (died in the 50s), were 'self esteem' issues.
8
@ach "failure of self love"?
How does that dovetail with the continual drumbeat that mental health issues are no different than physical ones? The public is told this all the time. If this is indeed true then wouldn't developing cancer be seen as a "failure of self love"?
13
What I have not heard addressed here in the comments is the hygiene issue mentioned in the article: when depressed (and also drinking) my former partner would give up showering and changing his clothes for months at a time. No sponge baths. Nothing. In a small house all of the soft surfaces stunk. I could not sleep beside him, even with the windows open. Asking him to please take a shower produced snarls from him. There is more to the story, of course, but the squalor drove me first to sleeping on the kitchen floor, then to sleeping in the backyard and, finally, to leaving him. We remained friends after a fashion because we did love one another.
34
I’d like to lay down one truth here. Depressed people are very good at hiding their depression. Also depression automatically leads to suicidal thoughts, and this progression isn’t due to a lazy or undisciplined mind.
12
@Tom Hayden
If you're going to "lay down truth," you should choose your words carefully. Not all depressed people are good at hiding their depression, and definitely depression does not lead "automatically" to suicidal thoughts - for some people it does, but it's hardly true of all depressed people.
37
Reading this let me know I'm not alone. Knowing others are coping with a partner struggling with depression encourages me to be more patient and understanding with my loved one. Thank you for this article.
36
Mr. Zuckerman is involved with NAMI, I have to say that I am disappointed in them. Through a Facebook ad I signed up to get a monthly newsletter. I received a confirmation email. I have yet to receive the newsletter. It has been several months now. I even sent an email and received no response. The ad came up again so I signed up again. I gotten what I got the first time, nothing. I’m very leary of NAMI. I would encourage people to search their local and county governments and their local houses of worship for assistance. There’s also the national 988 helpline.
5
I don’t know what’s going on with your newsletter sign-up, but it’s certainly not fair to sweep NAMI under the rug based on this issue. My experience with NAMI has been wonderful. They are a well-respected resource here in Chicago. My daughter went through a really rough time and was able to attend their free online support groups. NAMI is doing great work.
31
@Michael Yochim Sorry to hear that, Mr. Yochim. Most of my NAMI involvement has been with the state chapter in Minnesota, which is great. I've also had good experiences with NAMI chapters in the Chicago area, California, and even Fort Wayne, Indiana, random places less so than the national office, though I do get mailings from them. Check NAMI-MN's website and you'll see tons of educational resources. Sorry to hear about Yonkers. My daughter lives close by.
9
@Michael Yochim So sorry to hear about your NAMI experience. It might help if you just reach out to your own LOCAL chapter of NAMI in your area? I go to the Santa Clara County NAMI here in San Jose, CA, and they truly helped me. They have classes for family members called FAMILY TO FAMILY, as well as various support groups. Going local makes a huge difference...hope you can get the support you need! There are so many of us out there struggling to help family members...we need our own therapy and help.
6
It's important to know that depressed people aren't just sad - they can be vicious, pointed, downright mean. Attempts to help can be met with such vemon that the best one can do is to take the word "help" out of your vocubulary and mindset. It comes down to helping yourself not to be consumed by a process that the depressed person needs to be led through/find to emerge from it. Don't go it alone...get a professional to set the process parameters in place so when needed, it's already there to follow.
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@Patricia Also note that depression is often misdiagnosed. Many depressed patients turn out to be bipolar patients (like myself). Rage, irritability, and hypersensitivity to things like the noise a fan or washing machine makes -- these are common in various types of bipolar episodes.
If i saw depression plus snarling rage frequently in a loved one, I would suspect that perhaps an additional diagnosis might be reached.
5
It is my understanding that "seeking" help in the USA seems to be a rather depressing undertaking.
72
@sfreud It's difficult AND expensive, and if you find yourself connected with someone or some group that is less than able to help, you end up with huge bills and worse off than when you started. Signed, the voice of experience.
24
Having read at least half of the 251 comments with many citing a situation where both individuals in a relationship experience some form of depression in concert with another person, whether it be a spouse or close personal friend.
My intention is not to criticize anyone's actions, feelings or to cast guilt on any party. What I feel needs to be added to the dialogue when discussing depression is that dysfunction, which can take on many, many levels occurs and can be a contributing factor to mental illness and all of its insidious characteristics. All, coming into birth exhibit some form of dysfunctional attributes that appear from the onset of being an infant to adulthood.
Likes attract likes along with all the negative components set in a mutual relationship involving two people.
Many people seem to gravitate to others that have similar physical qualities that are of interest to the other person.
This certainly also holds true for the psychological attraction, good or bad, which is instilled very early in life where we try to aid in remediating the damaged goods of that other person. Yes we can be swept into this abyss but through medical intervention, personal enlightenment or time itself, there is hope for those who have entered this horrible situation. I speak from personal involvement.
Everyone commenting in this article, please know that you are not alone in this subject matter and there are numerous avenues a person can research and seek help.
9
My husband sunk into a terrible depression years before I was diagnosed with Bipolar II. Surprise, his mom had a vicious strain of bipolar that resisted treatment and left him and his siblings in chaos for their entire childhoods. I feel both guilty and resentful.
He briefly lifted from his depression after my diagnosis and we had a beautiful and intense reunion that lasted for months until our son was diagnosed with bipolar, and my husband disappeared again.
I love the man I live with, but he’s not *that* guy. Most days I’m just trudging forward trying to keep all our family’s parts moving forward. He knows this is the case and is paralyzed.
What you said here made me angry and then sad because you’re right. We had no idea. But here we are. I could go on, but I think I’ll just email this article to myself as a reminder to call NAMI. Again.
10
@MF
Thank you, MF. My hope is you are able to navigate daily, concerning the words expressed in your comment.
Little do we know what our lives present us. Please understand that even though we have limitations in our knowledge, to serve others is one of the main purposes for us here on earth.
You pass that category will flying colors and my utmost respect. God bless you!
7
In very severe and chronic cases of depression, assisted suicide can be the best and most compassionate help.
22
@sfreud what?!
4
It would seem better to keep trying to find effective treatment.
3
@sfreud Please, suicide just creates more depression for the survivors and is far from compassionate "help."
11
Non-attorney spokesperson and other commenters, For practical, concrete actions that you and your loved one can take I recommend the book Defeating Depression by Howard Stone. There is at least one other book with the same title; this one has a white cover with red boxing gloves. Full disclosure: the author, a psychologist and professor emeritus of pastoral care and counseling at TCU, is my husband and I edited the manuscript. His specialty has always been brief, solution focused counseling.
10
@Karen Stone looking online; is there an excerpt available somewhere?
1
I don’t find much practical advice here. Learning about depression and taking care of yourself are matters of common sense. While I consulted a psychiatrist and took anti-depressants for seven years, I attempted suicide after my psychiatrist doubled the doses. I spent a week in a coma and another two weeks as an inpatient. I got better only when I insisted that my new doctor wean me off all medications. I get depressed often but sort of ignore it. I escape into books, music, great films that take my mind off the collapse of America and the rise of cruel, insane gun-toting nut republicans. My husband gets take-out, maintains positivity, does his own thing when I’m too morose. He is the primary reason I’ve kept myself alive.
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@Non-Attorney Spokesperson best wishes to you and your husband and I am with you on reading, music and good movies - and a living spouse. There is a lot of value in positive distraction.
15
I’m happy you found what works for you. But to say that self care for example is common sense is incorrect. Nothing about depression is common sense. Everyone’s experience and knowledge is different. I feel you’re painting with a broad brush.
9
@Laurie I'm totally with you on reading, movies, etc. I think the arts have saved many...especially during the COVID shutdown!
6
Sure: "socialize, socialize, socialize". In a Pandemic? If you are immune-compromised?
22
@Mary Comfort Hi. I sure know what you mean. Different challenges for all of us. True extroverts and those with health challenges had it harder than I did. Still, I had to get out of my comfort zone, which ain't easy at my age. I had to figure out how to build and maintain friendships and support. Our NAMI support groups (my wife facilitates one, too) switched to Zoom, which has worked out well. Our neighbors met out in the alley for a weekly sing-along and occasional coffee dates. I attended my synagogue virtually and ice-skated and snow-shoed alone in the winter and camped and played tennis in the summer and did YouTube Yoga with Adriene (highly recommended). One bottom line is that I "came out" about my situation. But that's just me, and I know I'm lucky.
18
Nope
1
As someone who suffers from depression, sometimes mild, sometimes moderate (never to the point I couldn't get out of bed, but intermittent periods of spiraling negative thoughts), I feel it's unfair to say "you need to stay with this person through their mental illness as long as they are trying to help themselves. " Not everyone is cut out for that. For people who are themselves fragile, this can pull them into a space that is difficult to recover from. People leave relationships for all kinds of reasons, I wouldn't fault someone for leaving over this.
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@Jackie
True. I descended into exactly that place last year in trying to help a friend. It was scary. The best I could finally do was help her find professional support and eventually step out of the picture to save myself. She deserved a much deserved better friend. But I felt myself being swept under due to my own fragility at the time. I will always consider her friendship to have been one of the most meaningful and dear in my entire life. She was/is a true rock star.
25
Add music to the blahs cure. Specifically YouTubes of live festival performances. The performers energy exchanged with vast audiences of delighted happy people is motivating and uplifting, sometimes epic. Try some new bands or voices, some classical ageless pieces. (I was old and cranky. Then I heard Wetleg. Now I’m young.)
16
@Macbloom I have bouts of depression, and not being able to listen to music is one of my signs or symptoms. I associate music with hope and particularly romantic hope. When I'm sad or full of grief; music ends up being a trigger and not a relief. Exercise saves me, but depression is different for everyone.
29
@Mary After my parents died, I found that listening to music was actually painful (and I was a music major in college!) I couldn't figure out what was wrong with me. In talking to my neighbor one day, she said the same happened to her when her husband died. It was a long time before either of us could listen to music again. I then read about someone else who had had the same experience. Not as uncommon as I thought. The human brain is a mystery, to be sure....
17
@Mary
I’m glad that you find exercise to help alleviate your condition. May you find healing and peace. I mention music because it pointedly wasn’t included in the article. I’m not a therapist or musician. Certainly “triggering” or antagonizing was not my intention.
Perhaps it helped someone.
4
I have mild depression that worsens in the winter. I find regular exercising, in my case swimming three days a week and walks on the other days is the best remedy. After coming back from the pool my whole body and brain feel alive.
A regular routine with healthy food and home cooked meals help. I also go to a mosque twice a week to pray and meditate.
New York has so many great performances and I go to see operas and ballets as often as I can get discount tickets. That way I have something to look forward to.
I take a mild anti depressant every day but the meds would not work without all the other activities.
My mother also suffered from depression and I have learned my coping mechanisms from her. She swam and did yoga every day.
I find the political situation in the US very worrying especially with the Midterms so close but I tell myself as one person there is only so much I can do and that life goes on.
If you can exercise every day as much as you can, that is the best remedy for depression. Our bodies were made to move.
38
The most helpful thing my husband does for me as a severely depressed person, is to help me get help that I will accept but am unable to get myself. Not metaphorically, but literally. I don't think he understood why it was so difficult for me to get an affordable therapist until I became so depressed that I asked him to do it for me. The bureaucratic process can be overwhelming, and it took him over a month.
The difficulty of getting mental health care, even when you are willing to accept it, cannot be overstated, and helping your partner get that help is the best thing you can do.
44
@laura: it's good that you asked your husband to do what you couldn't do yourself. A warning to anyone tempted to offer anyone 'help': DO NOT make appointments or seek out treatment options for someone unless they specifically ask you to. That kind of coercion is abusive. If they ask for help, offer it, otherwise keep it to yourself.
18
No article on depression should omit discussion of the possible value of psychedelics or sacred plant medicines- especially in combination with an exploration of spirituality. Developing a wider perspective or a reason to live is absolutely essential to surviving this disease.
27
Saying, "Hey, I'm going grocery shopping, want to come along?" Or, "I got a free afternoon. How about a ride through some farmland/to the park/around the neighborhood?" Or, "Going for a walk in 20 minutes. Wanna come?" can be the very best thing you can say to your depressive loved one.
Regardless of our response, please don't think it's you. And please keep asking. Sound like you really do desire our company.
I've been depressed since my teens. After 50 years of learning to "deal" with my feelings, I'm not about to write them off or stop seeing my therapist or kill myself (huh?!). Thoughts come, thoughts go. Most emotions, too. But a level of sadness remains.
Scheduling regular creative sessions and drawing, painting, writing, and then Zoom-meeting and outdoor gathering with friends and other artists does the trick for me.
I'm fortunate to have found creative activities that produce work people find beautiful and/or interesting enough that they will pay to own or read it, and a spouse who considers our life together an adventure.
36
@maybemd
Thank you!
6
It is so difficult - and such a minefield of things to get through. Framing the way you say things, considering all the negative ways a negative voice in someone’s head can twist words that a partner means positively into something awful. I found so much that was helpful for me in navigating these times through NAMI (National Alliance on Mental Illness). Just going to weekly support groups allowed me to reframe expectations (its easy to get caught up and measure your mentally ill loved one against other people that you see in social, out in the world, etc), talking with other people is a great way to remember how big the little accomplishments really are. Their 6 week course for friends and family saved us. Such a powerful resource, inexpensive and I believe they are in every state. In my city they work with the police to try and have better mental illness support and knowledge in emergency situations.
21
A lot of this rings familiar to me. My wife is bipolar and also suffers from complex PTSD. Like many people living with mental illness, she also struggles with substance abuse. Despite a range of medications and treatments, her moods cycle frequently and it keeps me and other loved ones constantly off balance. We have moments of such beauty, mainly in the music that we create together, and yet also dark moments of deep disease and dysphoria. That’s our reality. My wife’s depression does not express as sadness or emptiness, rather as agitation and anger. It has taken years to internalize some of the advice offered here, like don’t take it personally and make sure to take care of yourself. I would add setting clear boundaries like emotional and verbal abuse is never acceptable. We are also fortunate in that we are financially able to maintain separate residences and so can give each other space. We have created an unconventional marriage; it works for us
It is her own journey. I as her partner can only be there in a certain scope. A physician friend told me once she sees two kinds of couples in the hospital. There are those who try to share the burden—fight for, fight with, feel for, feel with. It’s all too much and it leads to a codependent dynamic and the stress multiplies and responsibility that should be one adult’s become hazy. Then there are those who visit with a good attitude then leave at the right time with an encouraging but honest attitude. That’s what I strive for
36
Do they have the other signs of hypothyroidism? Feel cold? Have a lower body temperature? in the past your temperature was low and you were fatigued, they gave you thyroid replacement. Now it is difficult to get thyroid medication, TSH usually comes back normal, but that means another missed diagnosis. 60% of people with thyroid issues do not know it according to the American Thyroid Association. a whole lot of depression, one of the primary signs of hypothyroidism, along with brain fog and hair loss.
35
I am a middle-aged spouse of someone who suffers from depression. I feel like there has been a struggle between trying to fix and allowing someone to suffer. It has taken years for us (me?) to recognize a depressive episode. It is not just a lack of sleep, or poor eating, or lack of exercise that leads to a loss in vitality and engagement. It seems obvious, but catching up on sleep by lying in bed and relaxing by watching hours of TV dont help. It has helped to be able to ask and recognize, "How are you feeling? dissociated ? disengaged?" CBT and medications have helped recover from episodes, but episodes keep reoccurring. It seems that combining CBT with pyschotherapy might help gain an understand of the emotional traumas that may trigger depressive episodes. Even saying the words "childhood trauma" can be difficult. How I could help more is to avoid or at least recognize triggering feelings of incompetence, worthlessness and unlovableness. It can be as simple as neatening to living room together, discussing the frustrations of child care, taking a walk together, an unrequited kiss on the head. It's hard not to beat yourself up sometimes. It seems even harder when we dont know that it's someone in your past who is egging you on.
27
The listening is so important
Your partner just wants to fix it to make you happy.
It’s difficult for them to fathom the depth of your own pain.
It’s even harder to face when your children either have no idea or worse yet just don’t care.finding a good counselor who gives you tools to help with coping is vital
Thank you for writing this
14
Are there any suggestions on how to handle the depressed individual's family request of keeping it quiet? Is full transparency surrounding the conditional helpful? Harmful? I'm sure it depends on facts and circumstances, but any guidelines would be appreciated.
11
@Tom C This may not be a satisfying response, but if you picture that depression is likely to -- as psychologists have said -- be rooted in early childhood (James Masterson talks of the "abandonment depression" in infancy); form in the child's repression of feeling owing to abuse, neglect and other means of lack of empathy; consist of "the loss of the real self in childhood" (Alice Miller, Arthur Janov), leading to a lifelong sense of emptiness, meaninglessness and absence of a sense of identity -- then it might not seem very kind to bruit the condition to the world. Of course, if you want to believe depression is genetic or a "chemical imbalance" (a debunked marketing ploy), then you might feel no compunction to letting the news out.
12
@Tom C
It maybe helpful to let them know that the "quiet" is not and the secret is already out. No one has the right to share someone else's story but no one has the right to 'keep quiet' on a medical condition that needs addressing. It has been my experience that families are more likely to enable the illness to progress through secrecy rather than have processes in place that all parties - including the ill party - knows will be enacted under specific conditions. Don't keep the person sick by agreeing to a family secret; talk to the depressed person about how they want their MEDICAL condition to be shared with appropriate persons.
11
@Tom C: In 7+ years of support groups for partners and spouses, I've heard a couple hundred answers to that question. My heart goes out to spouses whose in-laws tell them it's their fault or they're wrong or that they just don't want to deal with it. What's maddening is that if mental illness isn't discussed, the stigma and discrimination continue. I'm lucky to have gotten support from my own family. I will say that, as I described at length in "Unglued," one of the best things I did was "come out" to my neighbors when my wife was hospitalized the first time. I needed help! And my neighbors knew something was up, and as it turned out, so many of them had a family member with a mental illness, which no one ever talked about. It sort of changed everything for me.
8
A problem that I haven't read about, but have known of in my therapy practice, is the potential disaster of both partners having moderate to severe depression. This would, in most cases, not be a "coincidence." Therapists (and social media-savvy individuals) know that troubled people are prone to be attracted to troubled people. There are various "hidden" reasons for this, but a feel for it can be gotten by picturing the sad, loner child in school who feels worse in the company of the healthy, happy high-achiever. If the phenomenon of two married depressives were widely recognized, I'm sure there would be some very interesting remedies proposed by obscure academicians and Instagram savants. I would like the challenge of working with such couples.
21
@Fred L.
"I'm sure there would be some very interesting remedies proposed by obscure academicians and Instagram savants"
Not to mention drug companies. Don't give them ideas.
7
@Fred L. I like @DW's answer. I just want to add that based on my experience and a lot of other spouses I've met via NAMI, depression seems to be utterly contagious. Or put it this way: Severe depression is depressing. That doesn't mean we spouses end up on meds. It means we have to work extra hard at figuring out how to live our lives well, and meaningfully, and joyfully, and lovingly. I'm the opposite of a savant, but for a real-life look at this specific challenge, you might want to take a look at my memoir, Unglued.
11
My late ex-husband had bipolar disease. When he was in one of his worst periods of depression, I would come home from work, climb into bed with him & hold him for perhaps half an hour before getting up to make dinner & supervise our two kids homework. Later, when out of his depression, he accused me of just giving him "administrative support", which was paying the bills & making sure the things that needed to happen happened. There were many hurtful things that happened over the course of our marriage, but that one cut the most.
59
@Judy Keith What a loving and tender way to help your husband! Depression is not only self destructive, but there's also the need to hurt the other. To share the pain. If not as cruelly direct as your husband, then often in a passive aggressive way.
10
@Judy Keith
I admire you for giving that extra bit of support to your husband. I wonder how many people actually grasped the entire picture. You came home from work, spent time with your husband, then went on to fix dinner and take care of your family. Day in and day out, and then was rewarded with being accused of a lack of support. I understand your situation as I experienced the same for many years but finally divorced after more than 25 years. I wish I could say it was smooth going since but unfortunately, as is very common, both my children were affected. One has been on medication since the age of 19 but not as effective as it could have been. I have coped as best I can with the anger and guilt shaming but feel like I have walked on eggs most of my life. Anyone that thinks that the caregiver isn’t affected should try it for awhile. Hoping it is better for you now. Just make a life for yourself , they are going to tell you that you are selfish regardless. Thanks.
11
@sfreud
???!!!
I was diagnosed with "mild clinical depression" when I was thirty, but was told at the time that I'd likely been depressed since a series of childhood traumas beginning when I was nine.
When I received my diagnosis, 35 years ago, it sent me on a journey to discover how best to mitigate the effects of my life-long companion, my depression.
Became an avid hiker and bicyclist, a runner and rock climber. Joined clubs to build friendships, learned to sail and backpack and how to organize large events (such as a bicycle rally that drew over 1,000 cyclists annually).
I began traveling, solo as well as with groups of friends. Europe, the Caribbean, Peru and Ecuador, Japan, Canada, England and Wales, lots of states including HI and Alaska.
Every endeavor begun to fight my depression added so much to my life. I learned to enjoy my own company, and became someone others wanted to spend time with.
I've been married twice; once to a man who refused to understand when my depression came to the forefront, and now to someone who considers our marriage "an adventure".
As I've aged and become less active, and we've entered this era of climate change, economic and social upheaval, political challenges, and pandemics, my depression has become more acute.
I figure it's okay, that I can acknowledge and "own" my depression.
I figure I've earned the right to my feelings. And then I get up and go work on a painting, or write another submittable short story.
6
The comments here are moving and, in some cases, so upsetting. Just from the stories here, it would appear that many people (often women) experience depression as a “falling in” that causes them to not engage as they used to, but many others (often men) experience it in a way that can be hostile, abusive, and sometimes violent to their partners. The advice given to a spouse in these two situations should be different. Yes, try to help. Yes, think about self care. But if you are being abused, your obligation to your mental and physical safety needs to come first. “Rough patches” in the marriage may be weathered but abuse should not be. If a depressed person is hurting you, you need to save yourself.
52
@Liz Thanks for that. Absolutely! Just last week a woman in our NAMI group used the word "abused" to describe her situation--not beat up, but psychologically and emotionally abused. (Me: "J~~, did you hear what you just said? The word you used?") Also, my wife and I were lucky that our kids were grown and gone when she became sick. For those with young children, what you said, @Liz, applies to them, too. I think kids' emotional and physical safety comes first, even before our own. But that's just me.
8
After helping a depressed person, you may feel depressed yourself. Come again. Why don’t you say that about diabetes or fibromyalgia? You know after helping someone with diabetes or fibromyalgia, you might get the same thing. I don’t think so. Thanks to anyone who seeks to help and assist, but depression is a mental illness and is not mental discouragement. The vagueness of this illness continues when what we say can be taken two different ways.
6
my brother had bad depression and I deal with it all the time. It triggers depression in me.
20
@jimbo It made sense to me. Household patterns of activity change if the caregiving partner does not maintain their own patterns of wellness, adapts the same behaviors as the partner with depression. For example, less exercising, eating well or engaging in social activity because they spend so much time in a caregiving role and increase of stress. These things impact our physiology and mental health. So the same process by which someone gets well is the same process by which another can become unwell (behavioral activation / deactivation). Though there are gradations in severity of depression for sure that should be acknowledged (major depression, bipolar, etc).
12
@jimbo depression is contagious, not in an infected type of way, but in a social contagion way.
And yes, behaviors that contribute to a lot of type 2 diabetes is also socially contagious, such as obesity. There are many diseases that have been found to be socially contagious. In fact, the more people you eat with, the more food you consume. This has been known for decades.
2
The isolation of the pandemic threw me into a deep dark place from which I am finally crawling with the help of a very good behavioral therapist and, frankly, my own resolve in the face of some agony. I am unable take medication which might help due to possible a very lethal interaction. The wonderful friend who would have understood and simply said, "hey, what's going on with you today?" fell into her own and very separate well from which the is still lost. Some of the most courageous people I know, and I count myself as one, have faced some mighty struggles largely on our own. My heart goes out to anyone in that category. Keep trucking as best you can, keep accepting whatever help you can get, and keep knowing that you are important to this world. The only buddy who would really have understood was Eddie, my 20-year-old cat, who died during the pandemic. I've lots friends, but sometimes it's a beloved animal who knows all.
88
@hotGumption I'm so very sorry about your loss of Eddie. It leaves a painful void to lose a companion who shared your life and loved you no matter what. Please know that I am thinking about you.
22
@Me
I thank you, deeply.
8
I think the priority is to find reliable professionals to help. I was and I would be able to cope with her depression for a while, but it would be extremely hard to continue indefinitely. We found a psychiatrist that helped her with the correct medication and was also able to talk to her and guide her back to no medication at all. When I started to see improvements was such a relief! Just knowing that she was healing made me stronger. And I also have to thank the neurologist who dismissed any neurological disturbance and advised her to find psychiatric help when she finally agreed to resort to a medical examination.
15
Thanks to near-death experiences at birth and a childhood that included chronic pain and disability that have continued into adulthood, anxiety and depression are indwelling for me. I have survived cancer, major reconstructive surgeries, and widowhood (twice) in 15 years. And yet I am still alive. There are sunsets to watch, thunderstorms at which to marvel, leaves to rake, my cat to snuggle, good food to eat. I take medication and talk to my therapist once a week. I now see suicidal ideation flares for what they really are - a fantasy, a wish to stop the pain that none of my relatives bother to understand (except my late husbands).
My animal friends give my life meaning even though many people treat me as invisible. I add a puppy to my family in a few weeks. It is hard to feel sad for too long when there is a snuggly someone to smile adoringly at you.
Fellow depression sufferers, you are enough. Even if you don’t believe it, it is the truth.
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@Mathilda
What a beautiful and heartfelt comment! What an inspiration you are! Shine on.
4
@Mathilda ~ And it really is OK to let uncaring relatives slide. They are often a source of the alienation from love of Self that depression is.
"for her, depression is not sadness"
Not just for her. Nothing is more frustrating for a person with chronic depression than being asked, "why do you think you are always sad?" It makes you want to ignore the questioner. Depression is emptiness, bleakness, and endless fog of gray, a world of flatness with no peaks but plenty of deep crevasses. It is NOT being sad.
Also, asking a depressed person what you can do to help is the best way to get a one word answer. "Nothing." Or saying, "call please if you need anything, any time." Yeah, not happening.
People with chronic depression don't want you to fix them or suggest how they can fix themselves. We want you to listen and validate our feelings and state of mind.
I have suffered from depression since I was prepubescent, and my late wife was bipolar. We supported each other for 43 years. I realize not everyone can do this, but it worked for us.
54
@Mike P
Whatever happened to simply calling someone we know to be depressed or consumed by anxiety and saying: I am here for you. I love you. You matter. Affirmation.
10
In this day and age, another suggestion might be to remove any firearms from the residence.
108
@Anne: because going and stealing someone's stuff is going to build trust? What other medical conditions might you prescribe Theft for?
1
@Tom B
Removing firearms is recommended in any case where someone is depressed or whose mental health is shaky in any way.
5
"To help a loved one get diagnosis and treatment, you can call potential providers and set up appointments, or compile a list of clinicians for them to contact." Yeah, good luck with that.
In my area, where my partner has been seeking care, it has been impossible to find either a psychiatrist or psychologist who takes our insurance and is taking new patients.
I've heard from both types of professionals that no one who takes insurance has any space for new patients because the behavioral health field is overwhelmed and practitioners are burning out. And we're lucky that I'm not battling depression and able to search thoroughly.
What percentage of those "estimated 21 million adults in the United States [who] have experienced at least one major depressive episode" can get the few spots available for insured care? Or can afford the cost of uninsured care? I know several people who are suffering because they can't afford the out of pocket cost. A lot of Americans are suffering, and something has to change.
40
@Sonder I would add that it's not just about finding a therapist; it's about finding the right therapist.
Psychologists and psychiatrists are only people. Some may be incredibly helpful, but these gems can be hard to find, especially when standards for training and licensing vary so widely.
22
The positive outcome of experiencing unhelpful therapy is learning what you don’t want in your therapeutic interactions. I know I don’t want a trauma voyeur. The therapists (largely social workers) I found through my health insurance were eager to practice their latest modalities (CBT or trauma-informed) learned during their CEU classes. They lacked training in psychological theory and had zero oversight. The provider I found online, through one of the aggregators that emerged during the pandemic, was both better credentialed, more experienced, and more knowledgeable than any previous therapist. He was also more responsive to my needs. It was worth every dollar.
2
Arguing helped, distance helped, humor at the right time helped, so not much that is prescribed in this article. Not giving up helps, understanding some triggers and one's responsibility for those (in my case, my partner's fear of financial insecurity), respecting decisions about breaking up with friends and family when those relationships are too complex or even toxic to handle, that helps. Knowing the person well enough that just at that moment when they are ready to re-emerge, one is there ready for something special like a dinner in a nice place, or something more simple. And letting someone know one will always, always be there in some form or another, physically or not, but there.
58
@Paul What a very thoughtful and so very true message, thank you Paul.
17
I would be interested to see if the commenters urging people to ditch their depressed partners would suggest the same course of action on an article about supporting a partner living with cancer.
47
@Culinaria actually more women, relative to men, are ditched upon receipt of a cancer diagnosis.
Serious health issues, and such tragedies as death of children can weaken marriages to the breaking point. And frequently are an important factor in divorce.
29
@Mary
Yeah, it's pretty depressing, so to speak. Women tend to go into caretaking mode when a spouse is struggling, while a sizable fraction of men bounce when things are not picture perfect. Men are also more likely to leave if a child turns out to be disabled or chronically ill.
56
@Culinaria take it from me, married to someone with social anxiety, addiction, etc,for decades, and suffering the loss of 2 children and my only sibling I should have left years ago. My advice to anyone holding up others and getting nothing in return is a losing battle. There comes a time when one should take care of themselves.
28
I recognize my husband in this article. He often goes days without taking a shower. He frequently stays up all night watching stupid things on TV, then can't figure out why he's so tired. He rarely leaves the house except to go to church, where he beats his chest (Catholic Church) and proclaims to God that he's not worthy. He's a retired physician. He's been on many anti-depressants, none of which seem to work. Some made him sleepy, some made him jumpy, some did nothing at all. He's now begun trans magnetic therapy, which involves treatments to his brain. Six weeks of daily treatments (at a co-pay cost of $35 each treatment--good thing we have the money for it). If this doesn't work, I'm not sure what will. He also prays a lot, gets on my case because I don't. I take care of everything--payng bills, car repairs, etc. He refuses to learn about our finances because it's all computer-based.
And yet...If I can get him out of the house, he becomes his old self, cracking bad "dad" jokes and puns, laughing, engaging with people. I don't know, then, if it's the environment in the house or the interaction with people.
Take care of MY mental health? Seriously? What keeps me from needing mental health care is that I play tennis. Whacking a little yellow ball a few times per week helps me to release a lot of tension I feel. And yes, I do cater somewhat to my husband b/c I know what mental illness is. It's organic and not something he can control.
115
@Zander1948 My husband has been depressed for decades. It took a long time to understand that his anger and cynicism were depression. I spent years believing he was just an asshole. But whenever we were out in the world he was charming and funny and the most likeable guy! Our daughter has recognized the truth for years. Our son refuses to believe he's depressed because "If he can rise to the occasion and be great around other people, there's nothing wrong with him."
Eighteen months ago he was diagnosed with a cancer which he will not survive. Cancer has made things even more difficult and the treatment, which is in place to give him more time and keep him comfortable in the face of a bad prognosis often makes him sick. But even after two weeks when he barely ate or got out of bed, he walked into his oncologist's office like it was a party, telling the guy he was "great." I corrected that and thankfully the doctor appreciated the truth and adjusted his chemo. People see a happy go lucky guy and never suspect depression. (And he doesn't want anyone to know he has cancer either, because that is another example of how he's "a failure" --his words, definitely not mine.)
I'm grateful to be able to care for him, but it's challenging. My mental self-care is painting. I paint every day for the joy it gives me in spite of everything.
31
@Zander1948
Has he been evaluated for dementia? Or has he always had these obsessions and they just got worse when he retired? I think a lot of people just lose it when they retire when you go from a life where every minute is busy to a completely unstructured life things that were held at bay by sheer busyness just erupt.
6
@Zander1948
Not so sure about the control. In a way, a strong one, he seems to control a lot.
2
Very well-done article. Succinct & generally spot-on.
But for this: "And “socialize, socialize, socialize — whatever that looks like for you,” ...
Yeah, with CoVid still being a real risk factor for many, due to invisible, chronic, serious health conditions ... not an option.
And yes, that added 'bonus' to life has taken an extra toll, on the depressed and those who live with / around them.
12
@jazz one you can socialize out of doors during warmer weather.
4
Find a friend or relative who has been there done that. Nobody else could possibly understand
17
I have a good friend whose husband suffers from depression and has for decades. She suffers from all kinds of immune disorders. Now she has something the doctors can't pinpoint, she thinks it's long Covid. She is a very sensitive, empathetic person and I can't help but think her husband's long term depression is having a negative impact on her health.
41
At least four generations of depression/anxiety in my family, including a suicide (great-grandmother), and those who sought treatment starting in the 1960s. Included: Hospitalizations (some involuntary), suicide watch, electroconvulsive therapy, months of outpatient. As a primary person (fraternal twin has it, as does my son), here is what to remember: it is an illness, and only professional help can heal (or a very long time for resolution if no danger is involved); listen and be gentle, sufferers cannot “snap out of it”; get immediate help if talk of self-harm happens; physical activity helps heal, so take sufferer for a walk, even if just around the block; suggest an activity that requires concentration (so sufferer can concentrate on something outside themselves)— we do jigsaw puzzles; encourage sufferer to pursue at least some of “normal” activities—shopping, faith-based organizations— that include human interaction. Turn off 24-hour news and financial tv, which can raise anxiety. And…..take comfort from the normal part of your own life, continue your own activities, and don’t feel guilty if you are happy some of the time.
61
Just want to add that people can get better from depression! It might not ever totally go away but people suffering directly or indirectly (as family members) from various levels of depressive symptoms need to know that there are medicines and other treatments that can alleviate symptoms for most people.
28
@Nigella
A simple, and important message. I had a clinical depression a decade ago, tied to use of prednisone - unable to sleep, obsessed with a hearing loss, I eventually had a crisis that ended, briefly, in the part of the hospital where the doors have no locks. One of the most powerful things I heard in that bleak time was from a resident taking a history, who told me, “People can get better - we see it happen here every day.” Although I am not sure I believed them at the time, the words were a lifeline of sorts, that I have thought of often in the years since. And they were true. I am not the same person I was before that experience - mainly because of my sense of vulnerability (I will never again be able to sit complacently in the mindset that mental illness only happens to others, because, you know, I’m sane). But I have gotten better, and can see the joy and beauty - and read and think about the pain - of life, and be grateful for being a part of it, for the blink of an eye we call a lifetime.
1
Depression is contagious. It can make the supporting person angry, blocking them from further helping the depressed person.
Please be also aware: a depressed person can't just "snap out of it."
Motivate them and physically exercise with them.
You can start with a stroll and increase to more moderate rates of exercising.
A lot of people began to prefer exercise instead of their pills.
Also, listen to them.
A lot of people talk and know what to do, but they don't actually DO it.
26
@janellem8 refrain from placing the burden on the well spouse to do all of this. Sorry, it oftentimes does not work. I watched this first hand my sister trying to motivate her husband to help himself. It did NOTHING. Her only shot at a decent life was divorce after 29 years with at least half of those years spent trying to "motivate".
24
@janellem8
Have you ever tried to get a severely depressed person to exercise? Just gives them one more reason to resent you for being bossy/not understanding. Thing that worked best for us was task oriented activities that are essential to the household-
14
@Martine it’s about how one says things. The tone of voice can make a significant difference without being bossy.
There is a cure for depression, is one important point to share with people who go through the illness. The cure is escitalopram (for example Cipralex). Please share this tip as soon as possible. Depression does not take much either once the medication is taken. The patient gets significant improvement the same day and can very well stay outpatient without problems. Then the work starts on what caused the depression. Be humble and listen to each other.
It is common to mistake affective schizophrenia for depression. Cure for depression won't work for these patients, but neither they may require more than a day at hospital once the best practice psychiatry, 3-step method, is underway. Please get educated on the difference between depression and affective depression. Best wishes to you all.
14
Ciprolex is just one medication and doesn’t work for everyone. People’s brains are different and react differently to different anti-depressants. I tried about 5 different ones (as did my daughter) and nearly killed myself when on one of them, until one seemed to help. My Mum’s adopted son did in fact kill himself while on Zoloft - claimed it took all his emotions away and turned him into a zombie. There is no “one size fits all” for depression- that’s dangerous advice.
62
@Dr. Lukas Olsnes-Lea
"Patients with major depression respond to antidepressant treatment, but 10%–30% of them do not improve or show a partial response coupled with functional impairment, poor quality of life, suicide ideation and attempts, self-injurious behavior, and a high relapse rate. "
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363299/
9
How do you get a person that appears to be clinically depressed to go for a medical evaluation? In the age of all-covering privacy rights, there is no way I can advocate for him. What to do in such a situation? That’s what I would like to see an article on.
28
@Carmine: you have no right to compel anyone to receive treatment. Unless you were specifically asked by the potential patient, you have no right to compel or coerce any medical treatment of any kind.
4
@Tom B
But (IMO) if someone refuses help, the partner/support person has every right to exit, the best way being with psychiatric mediation that somewhat smooths or avoids any unkind abruptness.
2
@hotGumption: The partner has every right to leave, and to do so at any time; they have nothing compelling them to stay. To drug someone on the way out the door is gratuitously cruel. There is never a justification to medicate someone against their will.
1
“I don’t really enjoy life” is how my late older brother described his feelings, or maybe lack thereof. Those simple words devastated me for him. He died less than 9 months later. He suffered from bipolar disorder with depressive symptoms from his early 20s until his death at 57. We were close in age, and I realize now how many times I would lose him and then get him back again only to lose him again. I grieve that he was dealt that pack of cards, and I’m sorry that the rest of us felt the searing loss and the pain of unpredictability over and over again. I couldn’t fix it though, and neither could he. Two years after his death, I’m slowly letting go of the guilt. I’m glad he stayed around as long as he could.
103
My husband turns into a monster every winter. Like clockwork. A rageful, unhappy person who is miserable to live with. Then in April he is back to his wonderful self. I am so over it. It’s October and I feel sick with dread at coming months. He refuses to get help. I try talking to him gently each summer about considering things to help b/c of course this can’t be enjoyable for him. He never agrees. I don’t know what to do.
41
Has he ever tried or would be willing to try light therapy? There are sun lamps that you can purchase and they are very helpful for people with SAD. They are easy to use, some are more expensive than others but the cheaper ones work just as well.
34
@Kate
Gosh if you suffer from sad New Hampshire isn't optimal. But the sad lights do help to some extent.
12
@Kate
Divorce. Sorry, as someone with mental illness I have compassion for what others go through. But your mental health and happiness are also important.
20
I used to dread the moment I came home from work every day fearing that my husband had ended his life. It is hard on the partners of depressed people also. And getting treatment is not certainly the magic bullet for everyone, many different drugs and each time you try a new one you have to taper off and wait to get to a therapeutic dose on the next drug. Some people have intractable depression.
90
@Martine
Thanks for bringing this up. So often the mental health conversation goes, "if you're suffering, just seek help and everything will magically improve!" I've had generalized anxiety disorder for my whole life and have tried absolutely everything. Many different medications, many different CBT therapists and psychiatrists, exercise, diet, supplements, meditation, etc etc. So often when I open up to someone about my struggles, they act like I must be some lazy person who hasn't tried to improve my situation and says "you should really try therapy then!" or "how about a jog?" I want to punch these people in the face. For many of us, it isn't our fault that we're still suffering, and all this judgement just makes us feel even worse about ourselves. That said, I've had tiny improvements from some of these interventions, so it's worth it to try. Sometimes people need to shift their goal from "cure" to celebrating any improvement.
34
@EB I’ve been through the gauntlet, too. These days things are better so now that I’ve been going through a good stretch, I can define my “baseline” and use it as a way to identify how I’m doing. I totally agree with your conclusion: embracing improvement.
5
The challenge is that, objectively, there is a lot to be depressed about. The accelerating destruction of the environment, climate change, growing fascism here and abroad, terrible economic inequality and unequal opportunity, an utter refusal to acknowledge and deal with gun violence so that our children actively worry about school shootings. I am amazed that so many people go on as if things are perfectly fine when, in fact, nothing is fine. Depression is a logical response to the terribly unhappy times we are living in, especially when so many smart people in Washington D.C. collude to ensure we can't solve any of our problems; thereby making us feel even more helpless.
351
@KAR
No : anger, sadness, frustration, those are all logical - emotional - reactions.
As Mr Zuckerman explained about his wife -- deep depression is emptiness. An absence of life. An inability to feel any joy, or interest in the world or your corner of it. Deadness. but with pain.
36
@KAR There may be a lot in the world to "be depressed about", but CLINICAL depression is a disease. Poorly understood but likely related to brain chemistry. Being in a true utopia (however you define that) wouldn't help. I've been there.
27
@KAR Someone had to say this. Thank you.
15
What about the “caregiver” to a perpetually depressed spouse?
Years of holding the fort down, carrying the load for both, being neglected emotionally and physically? And the being resented because someone else is to blame, anyone other than the depressed person himself.
It’s no life. Two ships going down at once.
201
@berman my sister dealt with a spouse who refused to help himself. He failed to control his type 1 diabetes, he was depressed, he was 200 lbs overweight, he refused to help himself or get treatment (despite having gold plated health insurance). He refused marital counselling. He grew worse and worse over time. He sat in front of the TV all day long after he retired at age 50. My sister's quality of life plummeted to an unacceptable low. He was financially irresponsible that was jeopardizing their future. She saw her future as taking care of someone who had neglected himself over the decades. After 29 years, she divorced him. And she has never been happier. She was smart enough to not let her ship go down. She was smart enough to love herself first and mitigate all the damage by getting out.
197
@berman
No one is beholden to a person who refuses professional help (if accessible). As long as the depressant is doing his best then it's like dealing with other illnesses or disabilities, if you love him/her/x then you persist. But it doesn't mean you have to live with abuse or blame.
37
@Mary
Depressed people are justified in refusing help if that help comes in the form of “if you’d only lose weight” or “you need to exercise.”
As a thin person with depression, I’m really tired of being told to exercise. I can’t blithely go for a walk in my neighborhood; it’s dangerous. I can’t afford a gym, nor do I want to exercise in a box. “Just do ___” is not so simply.
6
I'm married to a woman who is battling depression. She has seen a therapist, and is currently taking daily medicine for her depression and for anxiety.
As the non-depressed person in the relationship, it's kind of frustrating that everything I read about dealing with a loved one that has depression basically comes down to "Do everything you can for them".
It's almost as if the depressed person has no responsibility in how their partner is feeling or dealing with any of this.
My wife knows she's depressed, but maybe does 10 percent of what she's supposed to do to deal with her depression. She's literally just taking medicine..not exercising, not trying to eat better, not seeing a counselor, nothing that can help her improve.
I never know what version of her I will get. The smallest thing will change her mood and it will stay that way for hours, sometimes even days.
She doesn't see how her state of mind affects me or the kids.
How can I help someone who appears as if they don't want to improve?
it's very frustrating at times.
317
@John It definitely sounds like you’re frustrated. May I ask what you’ve done to learn about depression? What I mean is what you’ve done to learn what she is actually experiencing/not experiencing and perceiving/not perceiving as someone who appears to be deeply depressed?
25
The judgment in your post is not too subtle. Maybe it's not that John is not "doing it right" and has every reason to feel frustrated. And every reason to be very worried about his kids. Being "curious" is a big buzzword these days; being "curious" about his wife's condition is not going to fix her problems or get John the help HE needs.
75
@John writes: "It's almost as if the depressed person has no responsibility in how their partner is feeling or dealing with any of this. My wife knows she's depressed, but maybe does 10 percent of what she's supposed to do to deal with her depression."
I read this definition of depression, and maybe it will shed some light: Depression is a state in which the cure for it could be there across the room, and the depressed person can't even force themself to get out of bed to take it.
It's difficult for someone who doesn't suffer from it to understand.
150
Very young children growing up with a clinically depressed parent may experience a life long trauma.
196
@Fletcher at age 50, I can confirm just that
28
@Fletcher This breaks my heart, because I am clinically depressed and have a 10 year old daughter. I try to explain my behavior and that I take medicine and exercise to make it better, but that it will probably never go away. I also set aside blocks of time, 20 or 30 minutes, where all I do is give her my attention (no phone). Some days I have energy to play with her. On days where I can only lay in bed, we read or play cards. It helps. I hope it's enough.
Rollo May described depression as the inability to construct a future. I describe it sometimes as grieving for yourself.
The writer is correct, it isn't sadness at all, it's far deeper. Like heartbreak, but without any source, the curse of depression is that there's no center, and so we can't find it, and so can't create a target or a cure.
But there's certainly a stigma, and so, so little empathy or understanding for the condition. People try to talk you out of it, but they never seem to understand that their uplifting thoughts often just emphasize the depths you're in; taking you deeper. Like truth itself, it lies at the bottom of a bottomless well. One finds the bottom. or it finds you.
136
Thank you for this. As someone with long standing depression, this is the most accurate description I’ve ever heard. It gives words to what I go through.
32
Beautifully said!
4
@Thierry La Jambe So beautifully written. Thank you.
1
Something that is rarely discussed or accepted is postpartum depression in either partner. Many people also have unresolved grief issues which cause shame and stigma. We need to get all of these realities out in the open and start teaching schoolchildren about healthy habits and relationships.
35
Setting limits and maintaining boundaries in a relationship is part of loving someone. We've been happily unmarried for 50 years, and have both gone through difficult emotional times, individually and as a couple. Love does not mean allowing your partner to hurt you; setting limits helps a person get well. If you don't know how to set clear boundaries, without being angry and hurtful, find a good couples therapist.
41
Medications for depression and anxiety can make them both worse. Learn about the side effects, they usually include possibly suicide. A good resource online is Dr. Kendra Campbell. Explains the biology behind psych meds. Also helpful are warm lines, look up online, there’s a variety. Also NAMI has warm lines plus Zoom support groups. These can be ways a person or couple can lean on other resources from home without the sick person relying solely on the partner.
14
@Bleex
Medications for depression and anxiety can also, for many people, make them both much better.
4
Yes but importantly many of these meds have black box warnings re suicide too. I know 3 family friends who killed themselves on prescription meds.
1
One caution: Helping your spouse find treatment can be trouble if he or she doesn't like the solution you found. You'll get blamed. And that will really mess things up.
26
@pat Knapp: if they haven't asked you to find a solution, you have no business harassing them with a solution. No one has a right to force anyone else to engage with any medical treatment, especially mental health treatments.
1
After I struggled with chronic depression through 10 rounds of IVF, my husband had affairs and then divorced me. Now he has a much younger wife and a new family. He is happier now.
27
I’m so sorry.
17
@anon_ed Vividly, I recall the pain of infertility. I experienced grief over, literally, decades. Finally it has eased . I hope for you this period is resolved sooner perhaps by a child, perhaps by “letting go.” (That is my least favorite thing to do, and I understand if you want to slap me for saying it!) I wish you comfort.
5
The partner: never criticizes, never questions, never demands.
The partner: asks, "what can I get us for dinner? would you like to go out today or would you be more comfortable at home? is there something I can get for you?'
The depressed person knows one thing for sure: Love.
30
@jdoe212 well that is quite a list of demands for the well partner and I hope the partner who is not suffering doesn't beat themselves up if they cannot live up to these suggestions, which can be difficult at times even if both partners are well and get along fine. Combine all those demands with a full time job, elder and childcare and maybe their own issues. There was no mention in the article of the couple having minor children in the home, elder parents to care for, or even jobs. These situations vary widely - context dependent. Hard road.
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@jdoe212 That does not sound like an adult-adult relationship. It sounds like a parent and child. This is fine if it is indeed a parent and child, but if it is a romantic relationship or a marriage, I am sure you can see how this would not be an acceptable partnership. A partnership requires both individuals to contribute, not one constantly caregiving the other, walking on eggshells, subsuming her own needs for him.
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@Kate exactly. This model is not sustainable over the long haul.
33
Excellent article and comments. My wife of over 40 years has unipolar depression and My mother had major depression issues. With this genetic backgrounds my two kids were Dx with bipolar and after a lot of issues are doing as well as can be expected. After all this time most of the suggestions are not, basically, new to me.
I would like to emphasize that NAMI has been a major assets in dealing with this illness, and we were active in the local chapter for many years. The support group meetings, courses etc helped get us through a lot. Look up www.NAMI.com.
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@Mike Correction, Mike. www.NAMI.org
13
Yes, NAMI is a lifesaver.
2
I would add that it's important to be honest with yourself about whether or not this is the relationship you want. Some people can hang with folks who are neurologically or psychologically different in a negative way (depressed, anxious, etc.) and sometimes not only does that partner help the "sick" one but vice-versa; seeing what they are going through can lead you to insights about yourself. BUT, if you DON'T want to be that person-- if it becomes too much for you and you find that your partner is making you miserable-- you should leave. Not just for your own sake, but also for theirs. Leave them the time and space to find someone who is a better match for them. You're not doing them any favors by reluctantly staying with them while wanting to see other people and not allowing them a chance to possibly meet someone who will love them warts and all.
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@Humanesque Of course we will ignore the possibility that leaving someone in the middle of a major depression may push them over the edge and cause them to commit suicide. If you must leave, if possible, do it when the person has recovered, and have counselors ready to help the abandoned person, for a major depressive relapse is almost guaranteed. Better yet, don't get involved with a person who has a history of depression. I have such a history and make it a point not to get involved with anyone after one failed marriage, in which my ex-spouse did exactly what you suggest, and with no prior notice or warning.
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@Robert "cause them to commit suicide."
No one "causes" another to commit suicide. Just like no one "causes" another to drink. No one "causes" the other to beat them. The person who commits suicide or engages in behavior that is dangerous to themselves or others is ultimately responsible.
15
@Humanesque You can say that about any relationship with any challenge.
Here are some ways to support a depressed partner:
Affirmation. Acknowledge the ways they are doing well and their efforts.
Support. Make sure you clear room in your schedule to take care of kids, meals, errands, home, etc so that person can go to appointments.
Don’t cast blame. It’s not your fault but it’s not theirs either.
And for the love of god, don’t call them whiny, dramatic, useless, toxic, selfish, borderline, lazy, unfit, bad mother, bad wife, or any of the other names/labels I’ve been called by my spouse while battling severe postpartum depression.
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This list is a better summary than what’s written in the article.
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@Caitlin I'm so sorry that happened to you.
2
I had it one time due to job loss and ensuing litigation. It was a nasty situation. I slept all day, general malaise, lost like 10 pounds. horrible even in moderate forms.
18
Reflective listening?
If I followed up with the suggestion after my partner said she was fine, I would get my head bitten off. Needless to say, she is now an ex. If someone is unwilling to let you in, you are walking on eggshells all the time. How does one get around this feeling? I do not know the answer.
21
@Morgan
Completely agree! I'm the depressed one in the relationship -- major bipolar with huge swings and prolonged, deep depressions. If I say I'm "fine" that means "please let's not talk about it now." I got the message from the first comment; my partner/child/friend has noticed I'm not OK. That's why they asked the question. I don't necessarily want them to elaborate, right then, on exactly what they noticed. I'm busy digesting the information that they noticed I'm off the rails, which I already know, and it's scary.
That's the moment when a compassionate person lets the subject drop and goes to get a bag of potato chips, or a kale salad.....whatever is satisfying and doesn't involve putting the depressed person on the spot. We get it. It's hard to be around us. We know.
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@Morgan indeed. i tried it once with my ex husband who was being cagey with me when it was obvious he was not fine. he blew up at me for nagging him and strangled me. so yeah, not doing that again for anyone. if they say they're fine, i'm leaving it at that.
3
@Expat Glad you got away from him. Strangling is a huge red flag that the domestic abuser may eventually kill you.
https://www.kob.com/archive/report-choking-strangulation-victims-750-more-likely-to-be-killed-by-offender/
1
Really nicely written story.
Sometimes, getting your spouse to acknowledge something’s wrong is brutally hard.
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I would add that it's important to be honest with yourself about whether or not this is the relationship you want. Some people can hang with folks who are neurologically or psychologically different in a negative way (depressed, anxious, etc.) and sometimes not only does that partner help the "sick" one but vice-versa; seeing what they are going through can lead you to insights about yourself. BUT, if you DON'T want to be that person-- if it becomes too much for you and you find that your partner is making you miserable-- you should leave. Not just for your own sake, but also for theirs. Leave them the time and space to find someone who is a better match for them. You're not doing them any favors by reluctantly staying with them while wanting to see other people and not allowing them a chance to possibly meet someone who will love them warts and all.
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@Humanesque If you think a depressed person has "the time and space to find" someone else you do not understand depression at all. Depression leaves its victims with no energy or motivation and no self-confidence to find anyone, let alone, "a better match." I understand that for loved ones, living with a spouse, partner, or family member can be extremely difficult. But don't kid yourself into thinking you're doing a depressed person a favor by leaving them. You are not. Your rejection will be experienced as a devastating abandonment. Try putting effort into supporting their efforts to find an effective treatment. When depressed people are properly treated they are completely different human beings.
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@Annie "Try putting effort into supporting their efforts to find an effective treatment"
You are making as assumption that the partner who feels like leaving has not done any of that. The commentator said " if it becomes too much for you and you find that your partner is making you miserable-- you should leave."
Every situation is different and a one sized fits all is not applicable when dealing with any illness in the context of a romantic relationship.
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@Mary Agree with you %100. I was primarily reacting to Humanesque's tone, along with the characterization of a partner's depressive illness (again, illness) as "negative," the stated expectation that those who suffer from it are fully capable of finding a "better match," and finally to the absence of an indication that she or he has tried to help or support a depressed partner in any way. But of course you are right that no one size fits all.
3
Did I miss the part of this article that would mention getting professional help from a psychopharmacologist and finding out which meds or tx might work?
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I would add that it's important to be honest with yourself about whether or not this is the relationship you want. Some people can hang with folks who are neurologically or psychologically different in a negative way (depressed, anxious, etc.) and sometimes not only does that partner help the "sick" one but vice-versa; seeing what they are going through can lead you to insights about yourself. BUT, if you DON'T want to be that person-- if it becomes too much for you and you find that your partner is making you miserable-- you should leave. Not just for your own sake, but also for theirs. Leave them the time and space to find someone who is a better match for them. You're not doing them any favors by reluctantly staying with them while wanting to see other people and not allowing them a chance to possibly meet someone who will love them warts and all.
2
There is so much advice about finding self-care, finding a therapist, which is all just a dream. Who has access to therapy? I'm guessing the same people who have access to dentistry, health care, disposable income, leisure time, safe and reliable transportation. The NYT's target audience.
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@SC What about telehealth if you don't have physical access to a therapist? This is more commonplace since Covid began.
4
And kiss your partner sex life goodbye. Either the illness or the SSRIs will kill it. There are alternatives that may not require someone else, but they take partner agreement for the sake of the relationship.
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@Ampleforth
Like what? This is part of what I'm facing and there seem to be a lot of sacrifices on my end. It doesn't seem to bother my spouse.
1
@Ampleforth " but they take partner agreement for the sake of the relationship."
No it doesn't.
5
I have suffered from major depressive disorder for much of my adult life. I have attempted suicide more than once. I have seen numerous psychiatrists and psychologists. I have tried a plethora of medications. I ended up having ECT (electroconvulsive therapy). Throughout it all, my husband of 43 years has been extremely supportive and understanding. One suggestion I have for people who are close to those suffering from any type of depression is to refrain from asking them how they are feeling. Whenever anyone asks me that question while I’m depressed, it always makes me feel worse.
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@Meredith Brady: When I was depressed, the worst thing was when someone would tell me I "looked depressed." Even if I hadn't been feeling depressed at the time such a remark, which reminded me of this problem, would plunge me into depression
28
So, when we see you visibly upset, sad, depressed, we're just supposed to act like all is good?
5
Did the ECT help?
1
I am so grateful for this article, because proper support and education makes such a difference for someone who is depressed and their loved ones.
I learned firsthand how scary and overwhelming it can be at first to realize the one you love is depressed and suicidal with no end in sight. Just like the article says, if left unchecked, those emotions can spiral into their own cycles of anxiety or depression.
What I learned is that I needed to respect the difficult journey that my wife was on and the way she experienced the world. My role was not to fix everything or cure her or "make her happy again". I also learned that, while it wasn't immediately apparent to me, that her depression was a normal response to her life circumstances. And I learned it was important for me to talk to someone else in confidence about how hard it was on me at first. Same thing for her - just talking to someone else is going through the same thing can be very affirming and is half the cure. While depression is awful, its silver lining is that it gives you a depth of understanding and connection with fellow sufferers if you can to find them. And sometimes those connections can heal you and help you come back more vitalized than before.
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Amen, Ryan, Amen. @ryan
It's said that depression is often what's behind anger issues. Is the partner supposed to put up with abuse because the abuser is ill with depression?
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@Lucy D no. People have a right to engage in behavior that reduces or eliminates harm to themselves and their dependents. That may mean moving out or causing the ill person to live somewhere else. Behavior has consequences, even if they are ill. No one has to be a punching bag under the guise of "support".
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@Lucy D Anger can be caused by a number of things: insecurity, powerlessness, frustration, lack of emotional regulation, etc. Mental illness is not an excuse for abusive behavior. No one should put up with abuse.
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@Lucy D Interesting question. What I've observed is actually the reverse. It's the "well" partner who is abusive toward the partner who's suffering from depression. And the depressed person is feeling so guilty about the fact that she's "ruining" her partner's life, that she acquiesces in the abuse.
14
As someone who has been dealing with pretty serious grief and emptiness following the loss of my partner, I think a lot about the impact of my needs on my friends and family. I do see a therapist and try to spread out my needs amongst my circle. But I try to remember that caregiving is hard and stressful and be mindful that despite my sadness, I need to have compassion for the people I love.
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@Mary Wishing you well. (Perhaps a grief counseling group may be helpful as you continue on this journey.)
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@Mary And I will say that I realize my (hopefully) short term grief is not the same as living with a partner with long-term depression.
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@Mary
You might be interested in Kay Redfield Jamison's book "Nothing Was the Same" ... She is a psychiatrist who is relevant here for two of her books. The first one, "An Unquiet Mind," was very noteworthy because she wrote from her own experience living with bipolar as well as her professional perspective and, at the time (1997) it was a rarity for a book to incorporate first-person experience and a psychiatrist's perspective.
A decade later, she lost her husband and professional partner, which led to "Nothing Was the Same" which includes one chapter in particular that i often give clients dealing with what you are - it's called "Mourning and Melancholia" and I've never read a better characterization of the distinctions between grief and depression as she brought her psychiatry background to both firsthand experiences of her own.
I know from my own experience that there can come a time in the grief process (which itself lasts much longer than our society tends to accommodate) when one can begin to wonder if it's depression or still grief that is working through - not that they are utterly distinct, clearly they merge, but Jamison gives an excellent account of how to assess where one is at vis-a-vis each process.
2
And sometimes you do all these things, for years, and nothing changes. Sometimes there is nothing you can do. Sometimes, living with a partner with major depressive disorder is a never ending hole. Sometimes, you are the target and outlet of all these emotions, leaving you solely responsible for the psyche of another.
Aristotle in his Nichomachean Ethics describes depression and mental disorders and states (without the benefit and sympathy of our modern medical knowledge of these conditions) that those characterized by them are “the most destructive” people on Earth.
We need to remove the stigma associated with mental health issues so people can get the help we need. But please don’t do so at the cost of ignoring the emotional, financial, social, and even cultural damage caused to those who suffer from said issues and those around them.
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Did Mrs Zuckerman see an endocrinologist? Subtle hormonal fluctuations can wreck havoc. A person needs a doctor who fully understands this. Regular mds are not schooled in this one bit.
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I was misdiagnosed for years, until a new psychiatrist asked if I’d ever had my thyroid checked…
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That’s right. Hypothyroidism can cause depression. Every GP and Psychiatrist should know that and order a TSH, Free T4 and Thyroid Antibody blood test for their patients.
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The problem is that we don't understand how the brain produces consciousness and therefore the chemical treatments for depression are usually ineffective. Depression meds help a third of those that take them. Recent studies indicate that SSRIs are based on a faulty premise, despite the advertising that we are saturated with. That leaves partners struggling to understand why the problem continues even with treatment. That brings guilt, shame .
19
In my experience it cannot be done. Depression makes a person unable to see outside themselves, and unable to have a healthy relationship. And there's nothing you can do about it that the depressed person doesn't experience as making things worse.
You have to help yourself.
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Every single person experiences depression differently. It's pretty dehumanizing to say that all people with depression cannot have good relationships.
I have been suffering with extremely severe depression for many years, and I have an amazing relationship with my boyfriend with whom I am now discussing marriage. Depression makes it hard for both of us, but it does not mean I simply "can't".
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@Kk I did say "in my experience" and I meant it. My attempts to help, empathize, or make things better for my depressed partner were never appreciated, because he experienced everything through the lens of depression, which means, nothing is every good, nothing is worth anything, nothing is appreciated, everything is experienced as being insufficient or even an attack. Good intentions were not enough. After years of it, I felt almost like I had PTSD from so many times hearing about life not being worth living, no appreciation or even acknowledgement of anything I did to help the relationship, nor any of my own emotional needs. It is my experience that depression is a deeply self-centered illness, that consumes the depressed person to the degree that they cannot even really see how it affects others around them.
YYMV.
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@Kate
You describe depression as if it were a corollary to selfishness. It’s not. People have legitimate reasons for depression, and in a depressive mode, the slightest “bad” thing can seem overwhelming. There is an entire science behind why people are prone to depression. It is not a character flaw.
5
Why are so many people depressed and anxious now? No one seems to be trying to get to the "why" here.
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@mbl14 I puzzle about this too. As a grandmother I am especially concerned for the young ones in the family, but also all upcoming generations. Here's the best I can come up with: Work is no longer strongly connected to sheer survival, especially in developed nations. Add to this, we're not doing good enough on rearing the young to know their basic goals in life. No wonder they can be rootless, passive, depressed. We tell them to follow their dreams, find themselves, get into a fancy college. These are inputs, not outcomes, and furthermore we aren't much help in defining concrete steps to connect the two. We told -- and showed -- our kids that they were to do their best in school, learn to take over self-care and much of the housework, work for money for their fun and first car, get a marketable skill, grow up, get out and have their own family. In their limited spare time, there was zero questioning or anxiety, just genuine appreciation for the respite and rewards they had earned themselves.
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@Jhs
Yes, and work used to be hunting & gathering to survive, so walking & running outdoors is about as close as we'll get.
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@Jhs
Depression is a medical condition .It's clear that you don't understand that ,given that which you shared about your children.
Why do you believe that you were a superior parent to today's parents ?
"In their limited spare time, there was zero questioning or anxiety, just genuine appreciation for the respite and rewards they had earned themselves."
That's what you imagine, not the reality.
There's no such thing as "zero anxiety", while "zero questioning" would reflect fear of parents. Children are supposed to question, and to be able to feel safe questioning without fear of punishment.
15
The article's point about the partner not taking this personally is such an important and frequently overlooked point. I went through a recent divorce at a relatively young age (30). My partner and I had been together for 3 very happy years. Then, my medication changed to manage other side effects, and the switch plunged me into depression. I was stuck in bed for a year, too depressed to do any of the things we used to enjoy doing together (going out, socializing, sex, exercise, etc.). My partner took it personally, and then ghosted me. It was devastating.
After that bad year, I was put back onto my previous medication, and became my old happy, outgoing, energetic self. I should have never tried to switch it out, but hindsight is always 20-20. As the article says, depression episodes can and do pass with treatment. Sometimes it can take several months or so. Partners should understand that before bailing.
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It was difficult to read this article. I recognized my partner was undergoing severe depression but he died before our pathetic healthcare system would allow treatment. Aside from all of the pain and suffering he experienced, his frequent, violent altercations, police interventions, court appearances, and jail time cost the taxpayers a lot more than a series of visits to a doc.
I expect this dismal situation to get worse once the republicans control congress and roll back the meager health coverage we have today.
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@Mary It sounds like he might have abused you. No one should have to put up with an abuser, whethrt he has depression or not.
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@Mary Yes, the mental health system is terrible. It must have been so hard to go through this. I empathize and hope you are able to take care of you in little ways. Being a caretaker is relentless and terrifying, meanwhile you get platitudes, people who avoid you, and professionals who let themselves off the hook at every turn. Oh, and the well-meaning "advice" is possibly the most dismal of all.
When one partner is withdrawn and inactive due to depression, the other partner needs to take the initiative in seeing that good treatment is provided.
That requires a careful diagnosis. In the hospital, every patient gets a medical exam to rule out things like thyroid problems.
Some patients get psychological testing to make sure the patient is well understood. And then, with these symptoms, medication is likely to be prescribed and needs to be closely monitored.
For many, a combination of psychotherapy and medication is more effective than either alone.
Then, if treatment isn't working, consider getting a second opinion. That doesn't mean the first doctor is doing anything wrong, but you want to leave no stone unturned.
Mood disorders are usually treatable.
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@RickP
Our corporate-based, insurance controlled health care system is much more difficult for most of us than your comment implies. Unfortunately.
Let's get the profit motives out of our medical system.
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@RickP, many years ago, I was at a woman’s retreat and met a woman who was obviously in the throes of a prolonged depression. She was constantly weeping, channeling a lot of her negative, obsessive thoughts into her absent husband, and considering divorce. She had a friend hovering around her validating every anti-husband statement — most women will recognize this sort of possessive “friend” who pushes for divorce — so she was in this kind of downward spiral.
The thing is, her husband was attempting to do just what you suggest. He had found people to assess her and help her. But her take on that loving concern was, she told me, that her husband was “trying to fix her” because he saw her as flawed and broken. Her fawning friend nodded vigorously, hearing that, so she was likely the source of the interpretation.
You can offer help, but help is not always welcomed.
10
This is good as far as it goes, but I take issue with the “socialize, socialize, socialize” advice for the non-affected partner. If that partner is escaping the home at every opportunity, and leaving the depressed spouse behind, that will exacerbate the spouse’s feeling of despair.
Been there.
What a clinically depressed person needs from a partner or spouse is love, support, understanding and patience. So, yes, go out and socialize with your neuronormative friends occasionally, but take time to take your depressed partner out — with or without other people. “Self care” can too easily morph into self-centered behavior and neglect of the unwell partner.
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@Passion for Peaches “Self care” can too easily morph into self-centered behavior and neglect of the unwell partner.
How did an article on a depressed person and perhaps how to assist turn into an indictment of spouses of said suffering people who will, upon having to deal with a depressed spouse, react by engaging in "self-centered behavior"? I
27
This article is fabulous and i say that as someone who has devoted their career to writing about maintaining healthy relationships when depression is involved.
Folks who found this article useful might want to check out my books, The Monster Under the Bed: Sex, Depression, and the Conversations We Aren’t Having (2020) and In It Together: Navigating Depression with Partners, Friends, and Family (2023, now available for preorder).
Sending lots of love to all of your out there struggling, I know what a tough battle it can be.
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@NJ Author
Opportunistic advertising.
Are the books for free or for profit?
12
@NJ Author Just pre-ordered. Thanks. :)
Do not try to save anyone.
Save yourself.
And support, understand, and create healthy routines and boundaries for yourself.
This piece did not describe the pit you can fall in when your partner is seriously, and particularly, chronically depressed.
The couple in the piece have the (somewhat) good fortune to know that there are medical treatments for the wife's disorder.
Many, many depressed people have trauma histories and depression that is either part of their personality disorder, situational, or heavily genetic.
Translation: drugs work poorly. Recovery is short, incomplete or non-existent.
Strap on for the ride.
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@C exactly. In particular, if there are minor children involved their needs need to be taken care of first. This situation can impact children so adversely. To remain with a severely depressed spouse is an option and a choice said adult makes every single day. This is not an option for children.
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@C
Agree with you and Mary about it being very very difficult for depression to go into remission. Mary you bring the too often overlooked situation of children in the home front and center, thank you!
However depression can go into remission - there is no cure - not yet - but it is not entirely a bleak picture. For 5 years I was seriously depressed. It was a struggle for all the reasons mentioned in the article and the comments. But with drugs, therapy, exercise, and family support I am in remission. It was not easy at all, most family care doctors do not really believe it is a disease. To see a specialist means waiting months. The first therapist I went to fired me after two sessions, my case was boring.
But people can be helped. Victims of war, abuse and other trauma will always struggle but life can become worth living again.
21
This is absolutely true. It's difficult being the non-depressed partner. I've learned to just leave my wife alone when she's in her sad, depressed mood. It's at least 3-4 days out of the week and it's frustrating.
12
Mental health services are unaffordable if available, but mostly unavailable.
I have been dealing with many depressed family members. They also have other conditions such as dementia, illness, unemployment etc. For me to get through the day without ‘losing’ it; I walk, work, sing, meditate, actively choose to be aware. I am not the solution but I am blamed for everything because I can still function. I have to forgive them every day.
They are all ill and suffering.
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Dear Stubbie---
Holding you and your family
in my thoughts and prayers.
Hope you are gentle with yourself.
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@Stubbie
Goodness. I wish I could make things easier for you. I'm sorry. May this day bring you peace.
13
The ultimate treatment for severe unipolar or bipolar depression is ECT aka "shock therapy" which has been administered under anesthesia since the 1960's and has a 90% recovery rate in one month. I am a retired psychiatrist who has also received ECT for severe depression (unable to eat or sleep) so I have seen the illness from both sides. The major issues are lack of availability and irrational fears of the procedure.
44
@Ellie Sorock My father was depressed throughout the 1980's. Doctors tried putting him into a psychiatric hospital and horrible drugs (including Haldol) before administering shock treatment. He had to have a pacemaker put in first. The treatment worked for about 1.5 years and he was back to his old, wonderful self...making jokes and living his normal life. He fell into another depression and again, more shock treatment. This again lasted about 1.5 years. Another round of shock treatments but alas, they did not work. When he was depressed he was mean to my mother and could not leave the house...totally unlike his former normal, self.
12
@Max ECT has changed considerable in 40 years. For the profoundly depressed who are non functional it is a life saver.
16
@Ellie Sorock YES, YES, YES! My wife had her second major-depression episode in July 2021. It was horrible. The intelligent, warm, and compassionate woman whom I have known and loved for over 40 years was delusional, hollow, and lost. Her first episode in 2016 responded to medication within two months, but this latest episode did not. In early August 2021, I rushed her to the hospital after she overdosed. She was hospitalized in a facility that was designed for individuals with substance abuse. Her condition worsened in the hospital. I advocated for her to be released home to my care where the entire family supported her and made sure she attended therapy and took her medication. Having been through this before, I patiently waited for the medications to reverse the cycle. After several months there was no change. Her psychiatrist recommended ECT, but my wife adamantly refused, out of fear because how the treatment is depicted in movies and TV. In February, after pleading her for three continuous hours, I was able to convince her to give it a try. It was life changing. Within two weeks, she was back. During the darkest periods, for self-preservation, I took time to do things that I enjoy--I had dinner with friends and attended ballgames and car shows. But I never stopped advocating for my wife, even when it meant pushing her beyond her comfort zone. Depression is a giant monster that cannot be beaten alone. And ECT is a wonderful weapon.
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Thank you to the author and his wife for sharing their story. As a sufferer of both depression and anxiety, taking a complete battery of tests with a psychiatrist in 2016 was the first open door in turning my mental health around. I finally received a diagnosis of C-PTSD, anxiety and depression.
From there, I found a trauma-based therapist with expertise in Lifespan Integration and EMDR, who also specialized in somatic therapies of reconnecting yourself w/ your body and spirit.
Neuropsychotherapy has redefined therapy, moving from talking to brain remapping. As triggers fade, I was given the freedom to begin choosing how to react to things, have agency for the first time over toxic thought patterns. My life would be wholly different if not for these interventions.
I also regularly use tools such as STOPP which is a simple CBT practice as well as mild medication treatment.
My time in therapy gave me mental freedom and tools to manage my own mental health daily. Yes, things did get better, but as to someone's comment, it has been the hardest thing I've done, although is getting easier.
My husband has had his own mental health issues that he is also learning about and healing. We have tried to support each other and talk openly about our mutual struggles and victories. It has helped that we've both had to get help, both are healing.
Thank you again to the author and his wife. I'm glad she has so dramatically improved.
33
@Nan You were fortunate to have found a therapist to identify and address your needs so successfully. Too often the response is CBT and an effort by the therapist not to identify the triggers, traumas, or ACE, but just to 'remap' thought processes before the therapist has gained any real insight. There are also new approaches to depression under study that promise to open more doors for folks, just as trauma based therapy has done. I have been disappointed by, and have not had success with, doctors and therapists who have dimissed stories of serious trauma, if it not involve the standard PTSD definition as a 'threat to life or limb.' I hope this is changing; your story illustrates why I hope it will.
6
A jigsaw puzzle and a six pack goes a long way toward “easing one’s mind and leveling one’s head.”
9
@John Virgone
Drinking alcohol (ethanol=poison) can exacerbate depression and contribute to a host of other diseases. But that jigsaw puzzle is a great idea.
24
@John Virgone being "bummed out" and having depression are very different things.
7
Perhaps a crossword puzzle and two packs would be more suitable.
I'm currently living with a partner of 7 years who I now suspect may be suffering with bipolar disorder. Early on in our marriage, when he was overwhelmed by his overcommitments, his response was to threaten to kill himself. You can imagine how terrifying it was to hear someone you love make those statements. When I would probe with questions, he would say he didn't mean it. Regardless, it was the first red flag.
Now, years later, I'm seeing how severely it's impacted our relationship, as I distance myself from him when his agitation spills into every single interaction we have. Between that and trying to support my aging mother with dementia, who is having frequent panic attacks, I'm worn out. My self care includes daily time outdoors in the wilderness, but I'm about to find a therapist to speak with asap. I certainly can't manage 20 more years of this, and I suspect he'll exhaust himself and die prematurely as well if it continues to go untreated. I'm hopeful, but not optimistic, as even my attempts to discuss his inability to sleep through the night receive an agitated dismissal.
Can anyone recommend some virtual support groups with whom I can connect?
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@Bill The Cat, NAMI has groups for people supporting those with mental illness. I hope you'll be able to find a good therapist to see!
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@Bill The Cat I highly recommend NAMI peer support meetings. There are meetings occurring everyday throughout the US, many through zoom that you can join. You'll meet other people who are going through the same thing and they can help point you to resources to deal with your burnout. A book that is tremendous for bipolar is Julie Fast's, "Take Charge of Bipolar Disorder". Chapter 5 is excellent as it helps the care giver avoid what is called the "bipolar conversation" which is the circular, pointless conversation a loved one has while in the middle of an episode. Don't lose hope. Bipolar is so, so treatable. With proper treatment, meds, lifestyle changes & a good support system your loved one can have a full, full life. Xavier Amador's book, "I`m Not Sick, I Don`t
Need Help!" is also incredibly helpful. Hang in there, you're not alone.
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@Bill The Cat: I recommend Talkspace. It’s an app and you can talk with a therapist on your phone, with Zoom, or text. You are wise to seek help, your situation sounds really difficult.
You might also reach out to your city or county mental health services, they might be able to refer you to community resources to support you as a caregiver for your mom.
It’s really important that you talk with people who can look at your situation objectively and give you perspective. Although you have a duty to care for others, you also deserve a life where you also find happiness and joy.
Leading with questions and not rushing to share your opinion is a great framework for dealing with anyone, honestly - depressed or not! We'd all be better off if it was easier to state our feelings without receiving an avalanche of unsolicited advice.
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A supplement 5-HTP worked for me as well as any anti depressent
SSRI ,taking it on the advice. of a clinical social worker after my wife died from Parkinson's related issues last May.
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@Carlyle T.: You are taking synthetic serotonin.
That is essentially what 5-HTP is.
You might want a licensed medical professional to advise you further, since a LCSW is not a medical prescriber in any state, including ours.
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@Carlyle T.
A 5-HTP supplement can make depression and anxiety much worse if one has bipolar depression (which can often be mistaken for unipolar depression).
It’s be better to consult a doctor before taking or recommending any supplements.
Andrew Solomon says the opposite of sadness and depression is not “happiness” ( whatever that is).
Instead, the opposite of depression is vitality.
Vitality is the state of being strong and active.
People with recurrent depression should remind themselves and their loved ones that it will come back.
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@Mary Groth
Thank you for mentioning Andrew Solomon. His writings have helped me a lot.
While I normally eschew TedTalks, Andrew Solomon’s talk on the worst moments of our lives helped me tremendously. I have watched it multiple times and leaves me in a puddle at the end.
https://m.youtube.com/watch?v=RiM5a-vaNkg
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@Mary Groth Thank you for sharing this! I had never heard of Solomon, but the point of vitality rings so true. Many thanks for this resource.
Here’s my sincere advice to family and friends: let your loved one know you are available to help them with what’s they need. Then, back off. I had moderate depression for decades, especially in the winter. This has now been greatly exacerbated by family deaths.
I get very irritated when the husband hovers, asks the same questions and even questions the expressions on my face.
Yes, I’m on medication. I’m doing better. I will let you know when I need your help, or advice.
Understand???
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@Phyliss Dalmation couldn't agree more. Overcaring, hovering over a depressed person is sooo counterproductive. They know you care, and realize they're not available for others' needs as much as they might wish. I agree that some of the hovering may be overcompensation for realizing they contribute in some way to the depressive tendencies. Backing off and modeling healthy behavior, staying present in your own world can probably end up helping both parties.
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@Phyliss Dalmatian I'm so sorry! You are one of my favorite commenters because you are upbeat, determined and generally optimistic even in these frightful political times. I'm sure I'm not alone. Power on!
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What is the husband supposed to do when the person he wants not available? He's supposed to just sit there and walk on egg shells until you feel better? Did you ever think about how he feels when you're feeling the way you do?
I feel you husband's pain. We are stuck in a situation where we want to help, but we can't. We want to be around the non-depressed person, so we ask and try to figure it out to help you get out of your sad mood because it drains us, too.
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My nephew suffers from chronic depression that is intergenerational (biological) and impervious to any existing formulary including Ketamine and TMS. My response has been to scour the journals for the latest research and forward anything that sounds hopeful to his father. Yes, I'm trying to "fix it" at a distance but it beats standing idly by watching this young, brilliant mind suffer and fail. My only suggestion is to never stop searching for answers or solutions, keep talking with others and use their experience as a guide for next steps.
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@Tribal Elder There is a novel drug coming out called Auvelity. I don't know what the insurance coverage will be but it may work for those with resistant depression. I myself am looking into it because nothing has really worked for me either.
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Helpful article and thank you Doctor B for your comment.
i suffered from severe suicidal depression for many years as a young adult. I did not have enough money to get counseling, so realized I would either have to get it over with or figure out how to heal myself. As I had two young children and people who loved me, I chose the latter, arduously applying principles of Buddhism and cognitive therapy to change my thought processes on a minute by minute basis. It was the hardest thing I have ever done.
Unfortunately, my husband did not understand depression or mental illness and made everything worse by being reactive,
judgmental, and making it about HIM. In the depths of emotional pain, I had to take care of HIS feelings. His reaction to my pain was to tell me what I was feeling and why, and to assume that I was choosing to be depressed and could stop it if I wanted to. His lack of empathy and understanding of depression caused great damage. He did
care about me deeply, but did not have any tools for how to deal with me.
The people who really helped me simply listened, empathized, and conveyed trust in my ability to recover.
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People who don't treat their depression are the same as people who don't treat an open sore on their face, as far as I'm concerned. I understand it's hard, but when something so obvious affects someone, how can they not take action? Again, I know it's hard, I know how difficult it is. But talk about it!
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@Betty
You say you know how difficult it is, but suggesting that treating depression is the same as an open sore on one’s face indicates you don’t know how difficult it is.
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@Betty
This is a perfect example of the kind of misunderstanding and intolerance that is so unhelpful to people battling depression.
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@Betty Depression often manifests as a lack of energy or lack of drive. For me, when my depression flares up, it's almost impossible for me to get up and do things. I know my apartment is a mess, I know I should go out and socialize, but the prospect of all that becomes so daunting that it is debilitating.
It is hard to explain "I know I have to do something and it will make me feel better, but I just can't" to someone who doesn't experience it.
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"depression is not sadness so much as it is emptiness."
I felt this so deeply - and it is one of the hardest aspects about the experience of depression to relay! How do you talk about... nothing. Thank you for this thoughtful piece.
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Yes! My wonderfully supportive husband can tell when my chronic depression is trending downhill and claims to “get it,” but once in a while will ask what I have to be sad about, and the answer both literally and figuratively is NOTHING! Sometimes it feels like looking at the world through a paper towel tube — dark, incomplete, and flat.
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As a psychiatrist, I have since the 1970's treated people suffering from depression. No 2 cases are identical. It is crucial to distinguish Bipolar Disorder from unipolar depression. A combination of medication & psychotherapy is generally the most effective treatment plan.
When trying to support a loved one with depression, one must strive to avoid blaming the person for being depressed. Patients need someone who is available, attentive, & not too judgmental. Often they need empathy more than they need advice. Allowing someone to recover at a pace which they find comfortable demands a great deal of patience. But don't blame yourself if the other person doesn't get better.
Many episodes of depression are self-limited. But prompt diagnosis & early intervention improve the chances of successful treatment.
The shortage of mental health providers impairs our ability to provide the help which every patient needs. Primary care physicians play an increasing role in such care, & we are doing more to educate & train them in diagnosing & treating depression. Getting someone to a provider is often the most important first step to take when you recognize depression in a loved one.
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@Doctor B I learned more from your thoughtful comment than from the article. One of my dearest friends suffers from chronic depression and is treatment resistant. He is not bipolar. He has taken numerous drugs, including clinical ketamine infusions at UAB, and has engaged in talk and group therapies for many years. It just seems to be his lot in life to struggle with depression and there is no "cure". The best way I have found to help him is to let him talk, ask him open-ended questions, sometimes talk him down "off the ledge" when he is suicidal, and stay in close contact with him. I try to make him laugh by reminiscing about the old days when we, as two young lawyers, were often co-counsel in litigation cases. The only other thing I know to do is to listen to his wife and support her. She needs help and encouragement in dealing with his depression, too.
Thank you for your insights.
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@Mary You are a wonderful friend, Mary. I hope there are more Mary’s in this world. Kindness goes a long way. Thank you.
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@Doctor B
As one whose spouse and friends suffer from unipolar depression and received 'medication' and psychotherapy, the latter helps in the short and long term while the former, medications, seemed to help in the short term and were seriously problematic in the long term.
The side effects and occasionally the difficulties of longterm withdrawal should make their dispensing far more rare than they are.
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"But experts say it is also important to remember that you cannot force anyone to get help, and that pushing too hard can backfire."
No, however, you can lay out consequences (ones you are willing to backup with action) of what may happen if someone doesn't seek treatment, in particular, if their behavior is harming the family, in particular, children.
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@Mary When depressed for a long period of time I have found that it is like the old song line "Everybody's talking at me, cannot hear a word that they are saying". People get so caught up including therapists that they seem to stop listening. People including therapists seem to forget that sometimes people just need to talk without being analyzed. I have heard every platitude. I have stopped talking.
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@Mary and your level of expertise in this subject is what, exactly?
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@Michael J. Cartwright I was treated for depression 30 years ago for a while. I generally suffered from depression from the age of 13-about age 45, on and off. It has been gone now for 20 years. Seems like I outgrew it. People have a right to engage in behaviors that reduce or eliminate harm to themselves and to their dependents. If the depression suffer is causing harm, they have a right to find a way to mitigate that harm.
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