It takes working in tandem to keep a relationship healthy when one of you has depression
By Robin L. Flanigan
Depression makes an unwelcome third wheel in a relationship.
Emotional support, household help, even income—in the grip of depression, all that and more becomes harder to contribute to the partnership. Depressive irritability may increase conflict, while pessimism and hopelessness are just hard to be around.
Yes, it’s on the person with depression to do as much as possible to manage the condition. Yet the health of the relationship often depends on how well both parties pull together. And that comes down to communication, compassion, and a commitment to teamwork—from both sides.
“My goal in working with couples is to find a way to elicit the energy of the ‘we,’ rather than the ‘you and me,’ ” says therapist Stuart N. Simon, LICSW, a faculty member at the Gestalt International Study Center in Massachusetts.
Simon says that shift in perspective helps diminish feelings of guilt for the person with depression and “gives the partner an opportunity for more empathy,” which counteracts feelings of resentment.
Marianne A. of Orem, Utah, admits to “a lot of self-loathing” because of how her depression affects her husband of 17 years.
“Sometimes I wondered why he wanted to stay with me because I can’t do anything, I can’t give you anything, I’m just a burden,” she says of that state of mind, adding, “When I’m in a better place, I know I support him, too.”
“Sometimes I wondered why he wanted to stay with me… When I’m in a better place, I know I support him, too.”
Marianne and her husband, Ryan, have two sons, ages 10 and 12. When the boys were little and Marianne’s depression was at its worst, it was all she could do to keep them fed and in clean diapers. Even now, she’ll hand off evening chores like kitchen clean-up and bedtime if she’s beginning to feel overwhelmed.
For his part, Ryan says taking on extra chores to help his wife stay well is a lot less work than weathering a depressive crisis. He is also helped by “a kind of radical acceptance” that his wife’s illness is just part of their reality.
“One of the things I’ve learned to do is focus my gratitude on what we do have … steering away from any sense of self-pity or ‘life would be better if …’” he says.
Depression also can erode a couple’s sense of companionship, in terms of both partner intimacy and socializing together.
Katherine Robredo, MSW, LCSW, a marriage and family therapist in Fort Collins, points out that one individual’s patterns of avoidance and self-isolation affect the family ecosystem as a whole.
“That might translate as normally going to church together and you stop going, maybe not having conversations at the dinner table, or you avoid having friends over or being around the other person,” explains Robredo.
Al L. recalls how turning inward ended up pushing away his wife, Jill, during his last significant depressive episode a few years ago. The Minnesota couple have four children, ages 5 to 10, and Jill had to try to hold it all together while Al went emotionally MIA.
“I wasn’t very communicative, and she was frustrated not knowing how to help me while taking care of four kids and being responsible for everything, essentially.”
Normally outgoing, Al shrank into himself when they went out together. He recalls sitting silent at the kitchen counter, trapped in a spiral of negative thoughts, when he and Jill were at a friend’s house. The same thing happened when they attended a hockey game with Jill’s co-workers.
As Al tells it, his wife got so fed up she ended up buying a solo ticket to a fund-raising silent auction that they attend together every year. He understood why, but admits it was “tough and hurtful and challenging for me.”
In an educational piece that Robredo prepared for the National Healthy Marriage Resource Center, she cites research showing that when one partner in a relationship is anxious or depressed, both partners are more likely to say their marriage is unhappy.
There’s little hard evidence on how many marriages break down due to the toxic byproducts of depression. One interesting line of research into how relationships are affected by one partner’s chronic condition—medical or psychiatric—looks at a concept called “dyadic coping.”
The term refers to how couples work together (or not), as distinct from each individual’s personal coping strategies. In general, studies show that the more positive a couple’s dyadic coping, the more likely they are to express satisfaction with their relationship and quality of life.
Positive dyadic coping has three prongs:
- Both people working in common to solve problems, gather information, and communicate feelings.
- The well person offering practical and moral support, such as taking on daily tasks and expressing sympathetic understanding.
- The other partner asking for practical and moral support in order to reduce stress levels.
Negative dyadic coping includes distancing and detachment, giving grudging support, disparaging or dismissing what the partner is experiencing, and superficial empathy.
Maneet Bhatia, a licensed clinical psychologist in Toronto, says lack of emotional connection is often a contributing factor when partnerships falter.
“Really what it comes down to is empathy and attunement and compassion,” Bhatia says. “The foundation has to be putting yourselves in the shoes of your partner from a nonjudgmental place, and being mindful of the triggers and challenges both of you have in the relationship, without blame.”
“The foundation [of dyadic coping] has to be putting yourselves in the shoes of your partner from a nonjudgmental place, and being mindful of the triggers and challenges both of you have in the relationship, without blame.”
For Marianne, her numbed emotions fed a growing sense of distance during a tough period for her young family. Ryan was working toward his doctoral degree in medical family therapy and Marianne was home with a toddler, an infant, and persisting depression that left her feeling hollow and barely functional.
“We never thought we’d separate or anything like that, but we were just surviving.… There was very little enjoyment of each other,” she says.
All along, however, Ryan offered empathy. He understood that she was grappling with misfiring brain chemistry, and made it clear they were in the fight together.
“He said, ‘This is not you. This is something that happened to you,’” Marianne reports. “Actually, he said, ‘This is something that happened to us. It happened in your body, but it happened to us.’ ”
Are We Communicating?
Mental health experts emphasize that the couples best poised to weather the challenges of depression accept that it’s a brain-based disorder, not a chosen state of mind. They also recommend that both partners learn as much as they can about the condition and how to manage it.
Equally important: practicing communication techniques that encourage mutual understanding.
One that Robredo deploys in couples counseling is known as “mirroring.” The couple pick a topic that’s been troubling one or both of them, sit together on her couch, and take turns sharing their personal truths.
“It’s short sound bites, exactly what you feel,” Robredo explains. The other person’s job is to stay neutral: “Don’t get defensive, don’t get angry … just listen and see things from [the other] point of view.”
Robredo adds that it’s important to make sure nothing is lost in translation due to depression’s pessimistic filter. She recalls one session where the wife said something like, “I couldn’t believe you fell in love with me and I’m so happy we’re together.” The husband, who was depressed, interpreted that as: “So you don’t believe I love you and our whole marriage is a joke.”
It works the other way, too. With the best will in the world, there’s no guarantee that someone who has never experienced depression will truly “get it.”
Clint E. of Oregon says he was drawn initially to Melodie, his wife of 12 years, because she always had a smile on her face. But her naturally upbeat nature means she has a hard time understanding why her husband becomes distressed—and why she can’t make him “snap out of it.”
“It’s hard when her default setting is to be happy and content, and mine is more to feel like a failure,” admits Clint, who has depression and generalized anxiety disorder. “That’s where it causes a rift.”
However, he has noticed his wife adopting a different approach when she’s baffled by something in his behavior.
Late last year, for example, Clint left work early after having an emotional meltdown. Melodie expressed empathy, asked thoughtful questions, and listed some positive things he’d be able to do, like taking their three children camping the previous weekend.
“She’s gotten very good at probing a little more and trying to help me navigate my own thoughts,” says Clint. “It’s gotten to the point where I feel open about telling her how I feel.”
Individual psychotherapy has helped Clint and Melodie get better at dyadic coping. Al has worked on opening up about what he’s experiencing and encouraging Jill to do things for herself, such as go out with friends. She has started to give more recognition to Al’s efforts to overcome the drag of depression, such as joking around with the kids and offering to do the carpool.
Al also ramped up his self-care: journaling, exercising more, attending a support group for men with depression. That peer support wound up having a positive impact on his marriage.
“A lot of times guys are dealing with stress with their wives, and that’s part of the depression,” says Al. “Finding a group I could trust, where I could talk about that, was really helpful.”
Being honest about what you’re feeling and what will help you feel better may not come naturally at first, especially for “people pleasers” like Jen S. of North Carolina. Jen describes herself as “a little more selfish” when talking about improving how she communicates with her husband, Jason.
“I’m really learning how to advocate for what I need, and not to feel bad about asking for that,” she explains. “But Jason is pretty supportive. He believes in the person I am now.”
Self-Care Times Two
The dynamics in Jen and Jason’s marriage inevitably changed when Jen was hit with postpartum depression three years ago. Jason remembers having to take the lead in their interactions, and Jen “would follow the best she could.”
On his own account, he admits it was sometimes tough to balance his frustration with the situation and his concern for Jen.
“I felt sad for her, and there were probably days where I felt a little aggravated because everything was falling on me,” he says. “But I would remind myself what was going on, that this was only her current condition, that it wasn’t that she wanted to put it all on me. She just didn’t have a choice right then.”
“I felt sad for her, and there were probably days where I felt a little aggravated… But I would remind myself what was going on, that this was only her current condition… She just didn’t have a choice right then.”
As much as the partner without depression wants to make things better, taking on the role of “fixer” or “caregiver” isn’t necessarily helpful, says to Michelle Emerick, PsyD, a staff psychologist at the University of Chicago who also has a private practice.
“It isn’t their responsibility to make the depression go away,” Emerick explains. “When they try to cheer their partner up, they [may] skip past encouragement and go to demanding.”
Furthermore, Emerick says, feeling overly responsible for someone else’s well-being sometimes leads to guilt or resentment when nothing you do seems to makes a difference. Burnout is another danger, since focusing so much on the other person’s needs sometimes means neglecting to take care of yourself.
Jason would allow himself short breaks, usually around 20 minutes and usually at night, to recharge on his own. He would sit at the coffee table with a nice dinner and watch TV, “let my mind shut down or wander, whichever mood I was in,” he recalls
The respite from his responsibilities was rejuvenating, allowing him to be more available to his wife and infant son the rest of the time.
Ryan A. finds his “me time” by getting up at 5:30 a.m.
“The morning hours are quiet and there are no expectations,” he explains. “Work’s not calling me yet, the kids don’t need me yet. That’s when I get a workout, because it’s not going to happen any other time.”
He also nourishes himself through photography, “taking time to slow down and notice what’s beautiful in the world,” like a stunning sunset. He sees his hobby as an apt metaphor for the life he shares with Marianne.
Even with depression in the equation, he says, “there are good moments. You have to be intentional about capturing them while they occur.”
How to Help
For the partner not experiencing depression firsthand, there is a fine line between useful encouragement and nagging about actions that will bolster wellness.
“One of the things I’ve definitely learned is that you cannot take upon yourself the responsibility for things that only she can do for herself,” says Ryan Anderson, PhD, a marriage and family therapist whose wife, Marianne, has depression. “It’s easy to fall into policing her behavior, and that doesn’t help.”
Furthermore, he says playing sheriff “reinforces the sense that she’s powerless and broken.” What does help:
Positive reinforcement. It’s important to acknowledge every tiny victory. “Really try to enter into their world and their perspective, and recognize that there’s far more effort going on than is visible from the outside,” Ryan says.
Respectful communication. “I never want to say something that conveys disappointment with the way she’s handling things,” Ryan says. Try to phrase questions from a place of curiosity. “Why didn’t you put the garbage out?” comes across as accusing. “I notice the garbage wasn’t taken out. Are you having a rough day?” shows openness to conversation.
Practical assistance. If your other half is open to it, look for concrete ways to share aspects of depression management. Offer to make medical appointments and/or provide transportation. Discuss whether there’s a sensitive way for you to check in about medication compliance. Pick up the slack around the house as necessary. When appropriate, be a companion in self-care, such as scheduling a regular daily walk together.
Reassurance. Clint E., who lives with depression and anxiety, appreciates getting a text in the middle of the day that just says hello or asks how a work meeting went. It’s also a boost to hear something like, “I’m still dedicated to you,” or, “I still love you.” Says Clint, “Those reassuring things seem cookie cutter, but sometimes they’re the sort of platitudes you need.”
Printed as “Coping as a Couple”, Spring 2017
via Esperanza – Hope To Cope
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