Living with someone who's depressed
By psychologist Angie Willcocks
Living with someone who is depressed is difficult. It's hard to know what to do: push them to get better by 'tough love' or opt for a gentle and easy-does-it approach?
The most common words I hear about living with someone who is depressed are "walking on eggshells". If you have every lived with a parent, friend, partner or child with depression you will know what this phrase means. It means constantly watching your every word and move, for fear of further upsetting the person and sending them deeper 'into their shell'.
It's my opinion that walking on eggshells around someone who is depressed not only doesn't work, it can make things worse for the whole household. Walking on eggshells happens when people are not sure what to do - they become overwhelmed, scared and worried. I have written this column for those of you living with someone who is depressed. I've used the term 'partner' throughout, but of course the advice applies whether the person with depression is your husband, wife, child, friend or parent.
The role of the partner varies, depending on what 'stage' of the diagnosis and recovery stage the person with depression is at. The stages I use are diagnosis, treatment planning, early recovery, recovery & maintenance and relapse prevention.
Diagnosis, or figuring out what is going on, is the first stage. It can be hard to know if someone is depressed, stressed or maybe anxious. Last year I wrote a column about the difference between depression, stress and anxiety. (Click here to read it!) In my opinion the role of the partner of someone who might be suffering depression is to educate themselves about symptoms of depression and to raise the topic. Start by asking the simple question: "Do you think you might be depressed?" and discussing specific symptoms you've noticed. If the answer comes back as 'yes', the next question is "What should we do about it?" in a matter-of-fact and positive way.
Depression is a treatable illness, which is hard to believe when you're in the thick of it. Common symptoms of depression are difficulty making decisions and an overall sense of negativity. It's typical for someone who is depressed to have trouble making the decision to get help and to genuinely not know where to start. Unfortunately it's also likely that a strong sense of negativity might have them thinking that nothing will be helpful anyway. It's here that the partner can play a very important role. Finding out about treatment options and collecting this information is useful. I think it's ideal to engage the person who is depressed in this exercise, but if they can't find the motivation to do it, go ahead anyway and provide what you have found to them to look at in their own time. Talking about the information you have found in a matter-of-fact but optimistic way is good. Printing off information from the internet is helpful, as is going along with your partner to the GP (if they want you to of course!) Simple and practical tasks like finding telephone numbers, offering to drive the person to an appointment or picking up a prescription can be helpful.
Early recovery is the next stage. This can be a hard time with a few steps forward and then some back. Finding the right medication (if appropriate), the right psychologist, psychiatrist or other health practitioner can certainly take some time, persistence and patience. Finding the energy and motivation to do things that need to be done even when you are low is very tough for someone who is depressed. This is a stage where being patient and recognising even small steps forward is important. Educating yourself on what it is like to be depressed (by reading books about depression or talking to people who have been there) can help at this point. It's now important to supporting the person with depression in practical ways: providing healthy meals or temporarily taking on more of the 'stressful' parts of life (organising the household finances or dealing with that difficult neighbour, for example).
Recovery and maintenance is the stage where the treatment plan is established, working well and the person's mood is improving. In this stage it's important for the partner to remain supportive and optimistic and also realistic. There may still be some evidence of low mood and some symptoms of depression at times, but sticking to the treatment plan will keep things on track. Getting back to normal life is part of this stage, and gradually expecting the person with depression to pick up their usual duties is ok here.
Relapse prevention is the final stage where the person is fully recovered and focussed on taking care of themselves to prevent further episodes of depression. The role of their partner here is to generally support a healthy lifestyle and to keep an eye out for early signs of low mood.
I'm aware that breaking down depression into stages and offering advice at each stage makes the whole process seem much more straightforward and simple than it really is. Living with a depressed partner is tough, even when all the 'right' steps are followed. The very nature of depression makes depressed people difficult to live with. They are sad, disinterested, often withdrawn, lacking in energy, easily upset and negative about almost everything. It's hard to not become depressed yourself! It's really important to look after yourself by doing things that you enjoy and making sure you seek support for yourself. This could be through a counsellor, GP, friend or family member. Think about what keeps you positive and focus on that.
It's also important to keep in your mind that there is a difference between the person and the symptoms. Try to think that it is symptoms that are hard to live with, rather than the person. It's normal and expected that you will sometimes become frustrated or fed up with the situation. It's a good idea to explain to your partner that you are fed up with 'depression', rather than fed up with him/her.
On a final note, please understand that depression is not a free pass to treat people badly or to be horrible person. At any stage of depression, the sufferer is responsible for their behaviour. Their partner should not be expected to put up with nasty criticisms, put downs or other hurtful behaviour. You can be supportive and loving while still having some clear limits around what is ok and what is not ok. I recommend being very clear about what behaviours are not ok. Examples of behaviours that I hear about and I think are not ok include: behaviours that unnecessarily cause worry to the partner (like deliberately not answering the phone for long periods of time); kicking the cat; drinking and driving; totally ignoring the children; eating away from the family (every night); not showering for days; or saying nasty things to people.
Speaking up about specific behaviours that are not ok can reduce the impact depression has on the household as well as encourage the person with depression to move towards recovery.
To read other columns written by Angie Willcocks during her six years with Mining Family Matters, please click here. And remember that we offer a free email Q&A service with our psychologists, so just click here to ask a question about relationships, parenting or your career. All advice on Mining Family Matters is for general information only and should never be regarded as a substitute for professional health services or crisis services. To talk with a trained volunteer telephone counsellor at any time of the day or night, call Lifeline on 13 11 14. To contact the info line at beyondblue: national depression initiative, phone 1300 22 4636.