Helping Your Spouse

Living with a depressed person is difficult under any circumstances. When the person is your wife or husband, the problems escalate. The role of spouse carries with it expectations of love, companionship, parental partnership, economic support, and all-round helpmate. But depression reduces sexual desire, energy levels, sociability, and productivity. It can destroy a relationship.

Even if the depressed spouse is getting treatment, the situation can be stressful. Depression can cause people to become withdrawn, rejecting, and irritable and to say hurtful things to those they care about. If nondepressed spouses realize that the illness muses these behaviors, they may find it easier not to feel ‘hurt and to respond in a nonrejecting and reality-orienting manner. For instance, if the depressed spouse says something like, “You never loved me,” or “I don’t love you anymore” the nondepressed spouse might respond, “That’s your depression talking. Your illness is hurting both of us, but when you get better, you will feel differently.”

Until symptoms are alleviated, depressed people need patience, understanding encouragement, and assistance; however, they should not be made to feel totally helpless or inadequate. Sometimes it requires walking a rather fine line, and nondepressed spouses may find it useful to get counseling to learn more about depression and how best to help their depressed spouses as well as themselves.

In fact, counseling may be even more useful for the nondepressed spouse if the depressed spouse refuses treatment. For one thing, counseling can help the nondepressed spouse avoid becoming depressed. . It is all too easy to be overcome with feelings of isolation, helplessness, and hopelessness if you are living with a depressed person, particularly one who refuses help. Also, counseling can clarify alternatives, offer solutions, and “stiffen spines”-for it is time to get tough when a depressed spouse refuses treatment.

Although more women than men get depressed, getting tough with a recalcitrant, depressed spouse is more often a wife’s problem, because men are often less willing than women to seek treatment for any health problem, including depression. It requires a challenging combination of sensitivity and self-confidence to be caringly forceful with a man-or woman-whose self-esteem has already been undermined by a depressive illness.

Sometimes it pays to ask others to intervene. For example, close relatives or friends, who understand that depression is an illness and not a weakness, can often convince the depressed spouse to seek treatment. A family doctor or religious leader knowledgeable about the symptoms and treatments of depression may also be helpful Sometimes, if enough people say often enough, “We care about you, but you need professional care to feel better,” the message gets through. In some cases, it is most helpful to have several people speak privately to the depressed person, and in others, a group approach is more successful.

If all efforts to get the depressed spouse to seek treatment have failed, nondepressed spouses will need to consider how well they are coping and, if there are children, whether they are being affected. Consultation with a mental health specialist may be particularly useful in this situation.

But depressive illnesses are not always recognized. In fact, it is not unusual for families to be unaware that a loved one is suffering from a depressive illness. They may react inappropriately or suffer unnecessarily as a consequence. Such was the case with Alice and Charles.

Alice and Charles

At first, Alice couldn’t believe what was happening. Her once considerate and loving husband had changed dramatically over the past year. She kept expecting him to get over whatever was making him withdrawn hostile and antisocial but on the rare occasions that Charles was willing to discuss his feelings with her, he just kept saying that he was tired of everything and everyone-his job their kids and especially her.

Initially, Alice attempted to placate him, but nothing she did made him happy. In fact the harder she tried, the angrier and more withdrawn he seemed to get. Eventually, she lost patience and returned his anger with her own. Their relationship deteriorated, and Alice contemplated leaving Charles.

Before taking such a desperate step, Alice confided her feelings to a friend, who suggested that Charles might be ill and should see a doctor. Alice then began to take a different approach in dealing with Charles. She spoke to him about her feelings of frustration and concern about their relationship. She told him that she still cared about him very much and was worried about his health. Eventually, she convinced him to visit their family doctor.

The physician listened carefully to Charles, asking him questions about his life and symptoms. Following a complete physical examination and several tests to rule out other explanations for his symptoms, the doctor suggested that Clarles might be suffering from depression. He explained that Charles’ symptoms we real and not “in his head.” Depression, he told Charles, is a disorder that can and should be treated. He referred Charles to a psychiatrist for an evaluation, explaining that it was his practice to send patients to practioners he thought were expert in a particular azea. For instance, if Charles had a heart problem, he would refer him to a cardiologist or if he had a bladder problem to a urologist.

He also reassured Charles that he was not pushing him off onto another doctor, but that he needed a psychiatrist’s expert opinion about Charles’ condition and whether he needed therapy, antidepressant medication, or both.

Charles’ depression was confirmed by the psychiatrist and successfully treated. Within several weeks, he was feeling much better. He also gained insight into some of the problems in his relationship with Alice. For ample, he realized that his behavior was due to his depression rather than her inadequacies. He also realized that while he could not control the pain of depression, he did not need to accept it either. Best of all, he recognized that his symptoms were not his fault and that he deserved to feel well again.

Charles had a lot going for him. He had a sophisticated family doctor and access to medical insurance that covered mental health treatment But even if Charles didn’t have these advantages, he could have found help. Community mental health clinics and some private clinics and therapists adjust their treatment fees in accordance with a patient’s ability to pay. Consumer organizations offer mutual support and assistance. Religious organizations provide social groups and day care, and local governments offer many kinds of help.

Unfortunately, many depressed people lack the energy and motivation to seek the services they need. Here again, friends, family members, religious leaders, and others can help get needed information and provide transportation and encouragement.