The difficulties that depression adds to a marriage need to be addressed if the marriage is to thrive; here’s some tips from the pros:
On the problem:
Studies show that depression in one partner affects both parties in the marriage. Given that major depressive disorder affects 14.8 million American adults in a given year—or about 6.7 percent of the U.S. population ages 18 and older—the potential number of married Americans touched by depression could be as high as 28 million annually. Researcher Mark A. Whisman, PhD, of the University of Colorado at Boulder, drew a strong connection between seeking mental health services and survival of the marriage.
On the importance of an accurate diagnosis:
In some cases where depression has not been diagnosed, that behavior can be misinterpreted by the other spouse, says Reef Karim, MD, an assistant clinical professor at the UCLA Semel Institute for Neuroscience. “I’ve encountered a number of times when I’m doing couples therapy that one spouse thinks that the other has fallen out of love or is having an affair, or that they don’t make their partner happy any longer, but in reality, the other spouse has depression.” There are many instances when people don’t know that they are depressed, Karim added.
On open communication:
Experts agree that the more a couple can talk about depression the better. “It empowers both partners to feel that they are on the same team in managing and working through the process of depression,” says Michael E. Silverman, PhD, an assistant professor in the Department of Psychiatry at Mount Sinai School of Medicine in New York City, adding that when one person is depressed, the communication lines generally break down. “The depressed person will also withdraw, will not initiate conversation or activities, and will not take advantage of opportunities or take risks.”
On seeking marital counseling:
A growing body of research indicates that couples therapy reduces marital distress when one partner has depression. In the July 2002 issue of the Journal of Marital and Family Therapy, it concludes that since depression is a chronic illness, “therapy aimed at helping couples learn to adapt to the depressed individual’s symptoms holds the promise of improving their quality of life.” What’s more, “Inviting the spouse to join a therapy session serves a double purpose,” explains Oren Amitay, PhD, a clinical psychologist and an instructor at Ryerson University in Toronto. “One is to help my client convey to the spouse what’s reasonable to expect from them. I also let the client know that this is the chance for the spouse to vent or show their frustrations.”
On suicidal ideations:
While it’s certainly an emotionally difficult topic to approach, experts say it’s critical for the couple to discuss what to do if the spouse with depression becomes suicidal. “It’s very important to openly discuss a plan if this were to happen,’ says Elizabeth Lombardo, PhD, a clinical psychologist in Wexford, Pennsylvania. “Developing this plan will not plant a seed in the person’s mind and increase the likelihood of suicidal ideations.”
On having children:
Dr. Lombardo lists some of the things to consider when planning for children: how well the spouse with depression will be able to care for a child, how the added stress of raising a child will affect the course of depression, how to handle the additional costs of raising a child and the likelihood that the child also will have depression. If the couple decides to have a child, they should consider whether and how the child will be told about the depression, how to minimize adverse effects on the child and how to care for the child when the spouse with depression can’t.
On avoiding social situations:
It’s natural for those with depression to not only withdraw from their spouse, but to also avoid social situations. This can cause challenges since couples are generally expected to socialize as a couple. Antisocial behaviors link to the body’s need to conserve energy during depression, says Scott Haltzman, MD, a psychiatrist, clinical assistant professor at Brown University in Providence, Rhode Island. “It feels like any effort to do anything beyond what you need to survive, such as socializing and having any contact with the outside world, demands an extraordinary amount of energy and the body chooses to avoid it.”
On preventing social separation:
What can happen is that the spouse without depression may end up making his or her own social life, either out of boredom or resentment. Research concludes that boredom reduces closeness in a marriage, resulting in reduced satisfaction in the relationship. “One of the best ways to protect a marriage is to avoid boredom,” says Dr. Silverman. “People need to grow and to see their spouse grow. Without growth, it becomes very easy for the spouse who is not depressed to become impatient and frustrated.”
On added stress and responsibilities:
When one spouse struggles with major depression, the day to day responsibilities like cooking, chores and children, fall more heavily on the other spouse. This often leads to guilt on the one side and resentment on the other. “One of the symptoms of major depressive disorder, and other forms of depression, can be that people feel overwhelmed by what may seem to be the smallest project,” says Wayne Denton, MD, PhD, a psychiatrist in Dallas, Texas. Couples need to recognize this and address the root cause.
related: Depression & Your Marriage
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