When you hear about people suffering from depression, you may think that person has lost interest in activities they once found enjoyable for a prolonged period of time.  This may even come to mind:

While this is true, few of us understand that it is much more complicated than that.  Why would we know any better?  We still aren’t talking about mental health issues they way we’re talking about cancer, heart disease or diabetes.  We’re talking even less about how clinical depression affects loved ones of the person suffering from the illness.

Major depressive disorder (MDD) is a serious clinical mood disorder where feelings of sadness, frustration, anger and irritability interfere with a person’s everyday life for weeks, months or even years at a time (http://www.msn.com/en-us/health/medical/condition/8099794).  They are more likely to abuse alcohol or illegal substances, are at a higher risk for other mental and physical health problems and are at a greater risk for suicide than the general population.

People with MDD tend to have a distorted view of their lives and a chronic, negative attitude that makes it nearly impossible to imagine how problems or situations can be resolved in a positive way.  Other symptoms include:

  • Irritability, angry outbursts, even over minor issues
  • Trouble concentrating, remembering things or making decisions
  • Lack of energy, fatigue
  • Feelings of hopelessness and/or helplessness
  • Feelings of worthlessness, guilt or self-hate
  • Social isolation
  • Sleep problems (insomnia or excessive sleeping)
  • Significant changes in appetite along with weight loss or gain
  • Suicidal thoughts or behavior

(http://www.mayoclinic.org/diseases-conditions/depression/basics/symptoms/con-20032977)

What does this actually look like?

Irritability.  Flipping out when something triggers the underlying illness.  Examples could be: traffic, authority figures like cops, or money-related stress.  Multiple angry outbursts in public, like restaurants, over something so minor you can’t even remember what they were.

Trouble concentrating, remembering things or making decisions.  A task that is done on a daily basis (ie: making coffee) and not remembering that it goes on the dining table, not in the bedroom.  Being corrected every, single day and still forgetting the next day.  Not once or twice but twenty to thirty times in a row, and the person with MDD still cannot remember.  If you don’t realize they are sick and this is a symptom, it can be frustrating and misinterpreted as not caring.  But for the person suffering with MDD, this is a symptom of the illness.

Spending an entire day going store to store shopping, unable to make decisions on what to purchase despite knowing clearly what they like.  They cannot make the purchase without first receiving someone else’s approval on the item.

Feelings of hopelessness.  His job sucks and there’s no opportunity for anything better.  If he lands a better paying job then it will probably be in corporate America which is the equivalent of purgatory.  He will be miserable working long hours and will never get to see you.  This is the ONLY possible scenario, it will NEVER be possible for him to be happy elsewhere, so there’s no point trying to find it or trying to convince him.  (Oh, but you will try very, very hard to convince him of a positive outcome and get drained in the process).

Social isolation.  Having very few friends.  Not initiating contact with said few friends.  Being in very few romantic relationships because normal relationship issues trigger the underlying illness.  Despite wanting very much to be with his partner, the person suffering from MDD cannot really handle romantic relationships.  He makes his romantic partner the one and only person he socializes with, further stressing the relationship.  Avoiding activities that require interacting with groups of people or strangers.

How Depression Affects the Relationship

When one partner is depressed, the relationship is depressed.  You could be the happiest, most capable person but you will still get sucked into your partner’s depression with him.  The longer a non-depressed spouse lives with a depressed partner, the higher her own risks for depression (http://www.rd.com/advice/relationships/how-to-cope-with-a-depressed-spouse/)

You both can be so pulled into the fog of depression that you can’t even realize that this is what’s going on and that you need to get help.  If you’re unaware that your partner is ill, you may feel angry and resentful that he can’t just pull himself out of it.  If you’re newly married, you may feel alone and unwilling to tell anyone about what’s going on because people might brush this off as normal marital problems that need to be figured out.  Deep in your gut, though, you know it’s much more than that.

When you’re in a relationship with someone who starts to tune out and give up on life and struggles with making conversation or concentrating, it’s common to feel responsible for it and try to pick up the slack, becoming more of a caretaker than a spouse.  Over time, though, exhaustion and frustration will build up.  The person suffering with MDD may not enjoy doing things that the couple used to do together and the non-depressed person either has to learn how to do things on her own or also get stuck at home (http://www.webmd.com/depression/features/divorcing-depression?page=2)  The non-depressed partner may feel cheated because the relationship is no longer what it used to be or what they thought it was going to be.

Caring for a depressed partner can be lonely, overwhelming and emotionally draining.  You may grow pessimistic, lose your sense of humor and consider leaving.  You’ll get burnt out from the anger and frustration of dealing with an irritable and pessimistic partner who can’t help around the house, meet your needs or acknowledge how hard it has been for you to hold things together for months and years (http://www.rd.com/advice/relationships/how-to-cope-with-a-depressed-spouse/3/).

MDD is due to a chemical imbalance in the brain and tends to be hereditary.  A good indicator of a genetic link is if other family members are diagnosed or you can trace successive generations in the family with similar or identical symptoms.  In most cases of depression around 50% of the cause is genetic and heritability is 40-50%, probably higher for severe depression (http://depressiongenetics.stanford.edu/mddandgenes.html).  This means that if you have a child with your partner who is suffering from MDD, that child is 4 to 5 times more likely to develop depression than the average person (average risk of developing depression is 10%).

The combination of antidepressants with cognitive behavioral therapy or psychotherapy has proven to be effective in treating MDD.  It can take several weeks before people will start to feel better on antidepressants.  The average length of an MDD episode is nine months but most people will require lifelong treatment depending on severity.  About 80-90% of MDD patients will remit within two years (http://www.msn.com/en-us/health/medical/condition/8099794).

If you choose to stick with a partner suffering from MDD:

  • Find a mental health counselor for the both of you
  • Keep on learning about depression
  • Be alert for relapses
  • Understand that you cannot cure your partner’s depression
  • View depression as an intruder in your relationship – seeing it this way stops you from blaming your partner and treating it like a third party, an outside source, wreaking havoc on the both of you
  • Find support – via friends to confide in, preferably those who also have personal experience with depression, and by accepting help if you’re overwhelmed with the day-to-day
  • Monitor your own moods and thinking – and get help if you need it
  • Overcome the depression first before trying to work on the relationship.  Looking for major changes in your partner while they are still influenced by depression may just make things worse.
  • Respect your own needs.   You still deserve the right to a tidy home, regular meals and a calm family environment in addition to a social life, friendships and time to engage in meaningful interests.  You are just as susceptible to depression and pursuing your own personal pleasures can better prepare you to aid a depressed partner (http://www.rd.com/advice/relationships/how-to-cope-with-a-depressed-spouse/4/)

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