In my work through the years as a counselor, I've talked with many depressed individuals. I've also had personal experience with depression myself and know firsthand how debilitating it can be.
Nearly everyone at some point in their life will be affected by depression--either their own or someone else's, such as a spouse, parent, sibling, child, or friend. Just in the U.S. alone, depressive disorders affect approximately 18.8 million adults in any given year.
Statistics show that only twenty percent of those who experience depression will receive an appropriate treatment plan. Many depressed individuals will be too embarrassed to seek help and will suffer in silence, sometimes for years.
The effects of depression can negatively impact every aspect of a person's life--marriage, home life, work, and friendships. And the burden of living with a depressed spouse can take a heavy toll on the quality of a marriage.
Untreated depression poses a very real threat to a marriage. Recent research indicates that when one spouse suffers from depression, the likelihood is increased that both spouses will have an unhappy marriage.
This is because mental health and unhappy marriages are closely entwined. The harmful effects of depression are not limited to the depressed spouse but affect the partner, also
The depressed spouse will experience less happiness, satisfaction, and contentment in the marriage. At the same time, the partner will struggle with handling the increased isolation and social withdrawal of the depressed spouse, the loss of emotional intimacy (and often sexual intimacy as well), and the prevalent negativity in the relationship.
When one spouse is depressed, the depression colors everything in the relationship. The depressed spouse sees the world through a darkened lens that limits his or her perspective. Any negative events are interpreted even more negatively, neutral events are also interpreted negatively, and the positive happenings are often overlooked.
It's as though depressed individuals have blinders on that keep them from seeing any positive, hopeful opportunities right in front of them. Even if they did see them, they wouldn't have the energy to follow through.
The depressed spouse often loses interest in activities that used to bring pleasure and may experience fatigue and listlessness. There can be loss of sleep or sleeping too much; eating too much or too little; or problems focusing and concentrating.
Feelings of love and sexual desire may become dulled or absent when an individual is depressed. The biggest danger when this happens is that the depressed spouse may erroneously conclude that this means he (or she) is no longer in love with the mate.
Many depressed individuals report that they feel detached from what is happening, as though they are watching a movie. There can be a profound feeling of separation and isolation from others and a desire to avoid social contact. There can be feelings of sadness, hopelessness, dejection, and resignation. Or there can be feelings of irritation, agitation, anger, or emotional numbness.
Another danger to the marriage is that the partner of a depressed spouse can become depressed from the depressive atmosphere and energy in the relationship. Depression can be viewed as contagious when it creeps into a partner's outlook, attitudes, moods, conversation, behaviors, and reactions. When this happens, both spouses may feel they are helplessly sinking lower and lower into despair.
Blame and shame are involved in depression and can cause additional problems. If a spouse doesn't understand that the partner is depressed and not just lazy or uncooperative, she (or he) may blame the partner for things he can't help at the time. This stirs up feelings of anger and resentment for the spouse.
The depressed spouse may be ashamed to admit that he (or she) can't handle the depression herself and thus refuse to see a physician. This feeling of shame reflects the belief of numerous people about depression. They may feel that they should be able to just "snap out of it," which is what family and friends may tell them, also.
In one research study, fifty-four percent of people surveyed believed that depression is a personal weakness. In reality, depression has nothing to do with personal weakness or will power or character.
A depressive disorder is an illness that involves the body, mood, and thoughts. It's not just a case of the "blues" that a person can "get over." Thus, common misunderstandings about depression can add to the problem.
It's vital for both spouses to have a thorough understanding of depression--what it is, what it isn't, what to expect, and what treatment options are recommended. It's also important to recognize that before marital problems can be effectively treated, the depression needs to be treated first. That means that the depressed spouse needs to see a physician or mental health professional for a depression assessment and treatment recommendations.
What can a spouse do when the depressed partner refuses to seek help? This is a common situation and there's no one answer that fits all situations. It's important to get the depressed partner to the doctor or mental health professional, even if the spouse has to schedule the appointment, take off from work, and accompany the partner to the appointment.
Sometimes the parents or siblings of a resistant depressed spouse can be enlisted to encourage him (or her) to take action and seek treatment. At other times, a close friend or minister can help to convince a depressed spouse to consult with his physician or see a therapist.
Another strategy that a concerned partner can sometimes use is to send a confidential letter to the depressed spouse's doctor, detailing the concerns and depressive symptoms observed. This only works when the depressed spouse has to see his (or her) physician for some other reason, such as a required annual physical, to get a prescription for medication, or on-going monitoring of some condition. The physician can't respond to the partner's letter due to confidentiality, but at least the information has been conveyed.
If all else fails, the partner can consult with a therapist herself (or himself) to get individualized recommendations on how to handle the situation. Together, they can create an appropriate plan of action while the therapist provides emotional support to the partner.