When one spouse has depression, it can put a strain on a marriage. Living with a depressed partner who is often unhappy, critical and negative isn't easy, and at the same time, it may also be hard to persuade a husband or wife to get help.
"Depression varies tremendously in severity, but it has many behavioral impacts that can profoundly affect all significant relationships," said Dr. Jay Baer, a psychiatrist and director of ambulatory services in the department of psychiatry at Brigham and Women's Hospital in Boston.
Depression results from shifts in brain chemistry that influence mood, thoughts, sex drive, sleep, appetite and energy levels — all factors that could affect a marriage, as well as disrupt home and family life.
"Have marriages been broken up by depression? You bet," Baer said. But the condition can also be uniting: There are plenty of instances when a couple faces the illness together, and it becomes another one of life's many challenges, he said.
Here are his tips and advice when one spouse has depression.
Try to stay on the same team. "The enemy is the illness, and not the spouse with depression," Baer told LiveScience. Team up to tackle depression rather than allowing it to drive a marriage apart. Actively work to help your spouse get better, whether it's taking a daily walk together, providing a ride to a doctor's appointment or ensuring that medication is taken.
Don't get bogged down in stigma or angry feelings. Dealing with a partner's depression can provoke anger and resentment, especially if one spouse is often making excuses for a loved one's social absences, or if some household responsibilities might need to temporarily shift.
When a spouse acts withdrawn and unaffectionate, a couple's sex life and level of intimacy will suffer. There is also a sense of shame attached to having a mental health disorder, which can prevent a depressed spouse from seeking help for a treatable illness.
Help your spouse get a proper diagnosis and treatment. The illness might prevent a depressed person from recognizing they need help or seeking it out, so it's often the non-depressed spouse who will express concern and suggest an action plan.
To broach the topic, say, "I love you but I hate watching you suffer. Depression is a common problem and you shouldn't be ashamed of having it, so let's find out more about this illness together," Baer suggested.
Show receptivity. Encourage a depressed spouse to talk about the way he or she is feeling, thinking or acting, and listen without passing judgment. If someone is in a bad depression, you might hear things that could freak you out, Baer said. For example, a depressed spouse might question their love for their partner or interest in staying together. Defer decisions about your marriage until after a depressive episode.
Offer to go to a doctor's visit. "It's incredibly helpful to see a depressed patient along with their significant other," Baer said, because the spouse is often a wealth of information and observation. A non-depressed spouse may be the first to notice behavior changes in a loved one and these insights are valuable during treatment.
Give children and teens age-appropriate information. Depression not only affects a marriage, but it also impacts the entire family. Kids can often sense when something is wrong.
In a sensitive and honest way, talk about the illness with kids so they don't feel afraid or worried. Some depressed parents say that feeling an obligation to their children, for example, to get up early in the morning and take them to school, helps them to function better.
Be patient with the treatment process. A certain amount of trial and error in treatment is to be expected, Baer said. But the good news is that doctors can often help people with depression feel better and function better with a combination of medication and talk therapy, he added. With time and treatment, depression can lift.
Understand that depression is usually an episodic illness. When a spouse has depression, that person goes through bad periods and good ones. There is sometimes a role for couples therapy, Baer said. "You may have work to do as a couple to improve your relationship, but this should be done at a separate time, when your spouse is feeling better," he said.
In the meantime, the non-depressed spouse might need to turn to a trusted friend or therapist for emotional support when feeling overwhelmed or aggravated.