Relationships are hard enough without the added challenges of severe depression, but relationships are also one of the most powerful opportunities for individual and cooperative growth. With the right help and strategies to cope with criticism and self-doubt that stem from major depression, partners can navigate the recovery journey and thrive in a relationship.
Relationships can get dramatic, but, depression is less dramatic than physical pain or the drama that relationships bring in, but it is more common and also harder to bear. Less understood, however, are the ways in which depression can affect relationships and how your relationships can help you manage depression.
Take a look at some startling facts:
Depression affects one in five people in India. A study reported in WHO (World Health Organization), conducted for the NCMH (National Care Of Medical Health), states that at least 6.5 per cent of the Indian population suffers from some form of the serious mental disorder, with no discernible rural-urban differences. Though there are effective measures and treatments, there is an extreme shortage of mental health workers like psychologists, psychiatrists, and doctors. As reported latest in 2014, it was as low as ''one in 100,000 people''. The average suicide rate in India is 10.9 for every lakh people and the majority of people who commit suicide are below 44 years of age.
Severe Depression and Relationships:
Relationships have been known to turn people inside-out, uncovering shadows and challenging individuals to be vulnerable enough to trust another. When someone in a relationship has depression, it can intensify the experiences even more, making vulnerability and trust especially challenging. While it’s common for people in a relationship to have to work out problems and adapt for each other’s sensitivities, depression can introduce problems and sensitivities that are extreme, unpredictable, and resistant to reconciliation.
Major depression is a mood disorder that can alter a person’s moods in ways that don’t match the events and circumstances around them. When people get close to each other in a relationship and severe depression is present, emotions and conflicts can become volatile as the depressed individual tends toward self-doubt and criticism. But a relationship is not a lost cause even when depression is present, because major depression is manageable with the right help. And there are ways to keep things in perspective and grow even closer as partners through the challenges that arise.
Take a look at a client story who suffered with depression and saw his relationship erode while managing his mental health:
Please Note: The client story is presented as a case study withholding some confidential facts about the client's relationship and NO names have been cited to maintain our confidentiality.
"I'm a 30 year old man with severe mood disorder and I have suffered from a few panic attacks in the past 3 years resulting in my hospitalization. I have been under medication for the past 3 years and I have come to understand from Psychiatrists that I have depression because of which I suffer from anxiety and panic attacks. Mental disorders run in my family, with my mother, grandfather and uncle as Psychiatric patients.
Regardless, I am usually a very jolly person who attracts the company of many. I smile a lot and am passionate about my job. But, ever since I've had my first panic attack and understood that I have depression, my relationship has suffered majorly.
I feel responsible towards my beloved and her family. It is because I have committed to her that I would marry her, I feel it is only natural that she understands that I do love her. I don't fail in sending her gifts on occasions and I do talk to her over the phone when ever I get time. But, I am having a tough time managing this long distance relationship or this relationship at the most. I don't have the courage or the confidence. I don't even know if I should be with her.[sighs; breathes heavily]
I don't understand why she cries for me. I get frustrated when she says that my gifts aren't what she wants and that I don't fulfill her emotional needs, because I feel I do by sending her gifts, calling her, arranging for the wedding ceremony to take place and the like. [cries]
We have a lot of arguments. I feel I'm at fault. Sometimes I feel scared by her. I feel that she is very stubborn. I'm a very sensitive person and at times when she speaks to me about certain things, I feel hurt. It's all a blur and a big question for me. I'm under medication and it is getting very stressful for me. I don't want to feel this depressed. [cries; looks frustrated and irritated]
Everyday, I have to push myself for everything. I'm not getting sleep. I have a headache almost everyday. I do love her but I 'm unable to understand her and I feel that she doesn't get me. It's been more than a week that I have stopped talking to her. i tried explaining myself to her. I tried understanding her. She is scared that I would leave her. I want her to do well in life, to focus on her work and just speak to me as if we are friends. I don't want to talk to her about our relationship at the moment.
I've been in a loving relationship with her for 3 years. She is better off than I am. I'm not as good academically as she is. She's smart and beautiful. We are different- culturally. [starts listing other differences: states, gender, upbringing, thoughts, attitudes, education, profession, etc.]
Since the last 6 months we've been riding an unsteady boat. I don't know what to do. I want sometime. I tried postponing our wedding. There are certain issues. Now, my family knows about our difficulties. I've requested them to give me sometime. Nobody seems to get me. I feel lost and helpless. I'm more frustrated than I ever was.
My parents forcibly took me to meet a girl. I didn't even look at her face. Shockingly, the girl's family have agreed for the union. My parents have fixed my wedding with her and I am to get married in another month. I don't know what to do.
[cries with his head dug in his palms]"
Navigating the Symptoms of Severe Depression in this Relationship-Depression Case cited above:
Depression tends to distort one’s perspective. The individual (in the case above) will experience an interaction with someone (here, his beloved) through a filter of negativity that can inspire doubt, distrust, shame, fear, and many other discouraging reactions that may not relate directly to the truths of the interaction and the other person’s intentions (here, the girl's 'differences' as analyzed by the guy). Someone with serious depression may have a hard time not taking things personally, and pessimism and conflict (read: their arguments in the case above) can easily spiral out of control. The filter of depression can also distort feelings, thoughts, actions, and habits. When one doesn’t maintain awareness of this disorder and its power to distort, it can feel as if depression is in the driver’s seat and they are just along for the ride.
It takes a lot of energy to sustain a relationship in the first place—physical, mental, and emotional energy (read: how stressful the man feels in the case study above). Major depression tends to drain a person’s energy and leave them feeling unmotivated, discouraged, and fatigued. So, in addition to moodiness and irritability, an individual with depression may simply lack the energy and the interest to participate authentically. Without regular connection and intimacy, it becomes even harder to generate trust and appreciation for each other.
When someone with depression struggles to feel confident in themselves (as the man feels in the case study above), it can be very difficult to have confidence in another. Self-doubt leads to doubt about their partner, and often criticism follows. When conflict arises as a result—either because a depressed partner is critical of the other or because the depressed partner is ceaselessly critical of themselves—a person may see the reasons to doubt even more, and it becomes a slippery slope for severe depression and relationships. It often takes an outside perspective to help wake a couple up from this depressive slide. The good news is that, typically, the real circumstances are not as bad as the depression lens makes them out to be; the relationship may be a truly positive support system through the recovery journey from depression (unfortunately the couple above cannot seek this positive change as they didn't seek professional help).
Identifying Strategies to Cope with Criticism and Self-Doubt in Relationships
Major depression is a very serious disorder that can have devastating consequences if not properly treated. But all of the negativity and pressure that one with depression perceives is not a reflection of who they truly are. Treatment for depression is about caring for the whole person and guiding them back to a clearer perspective of who they really are and of the opportunities they have before them, including their relationship.
It’s important to make space for the experience of depression—for acceptance and for healing. Simply resenting and pushing against the disorder day after day will perpetuate the symptoms and increase self-doubt and criticism. Committing to residential treatment may be one of the best opportunities for someone with major depression, as they can put recovery first while setting aside common triggers that heighten stress and cast further shadows on the lens of depression. In this setting, clinicians can help clients to find the best medications and dosages to minimize depression symptoms. Plus, experts know how to cultivate a balance between making compassionate space for the depression experience and also directing focus to the empowering moments and positive situations that are accessible for a client—especially the challenges that they are able to overcome despite the depression.
A critical benefit of caring outside perspective, such as that of a counselor or therapist, is that it can help someone with major depressive disorder to see the filter of depression for what it is: a distortion, not an honest representation of what’s really going on around them or an honest representation of their own self-worth. When a therapist helps a client to step back and see the disorder for what it is and how it operates on their mind, thoughts, and emotions, they can begin to take some of the power away from that depression filter. The more someone can remember that it is the disorder weighing down their view and experience of the world, the more they can be aware of alternative perspectives and have hope for a future of recovery.
Along with comprehensive treatment for the individual, couples therapy can help ground partners with tools and coping strategies to manage the presence of pessimism, doubt, and criticism. Spending regular time in therapy together can also serve to refresh partners’ perspective and to maintain an awareness that the filter of depression is a challenge they face, not an actual reflection of either of the partners’ value. With the support of therapy, a couple can identify needs of both partners and develop strategies for balancing and fulfilling those needs. A therapist can help them to create reasonable expectations and actionable steps, especially when criticism or other conflict arises. Both partners can feel more secure, knowing that they are not alone and that they have accessible tools for managing the sometimes overwhelming effects of depression.
Someone with depression—indeed, all of us need to feel secure within ourselves and in the context of a relationship. The keys to a confident connection are open communication and a productive balance between space and togetherness. A relationship is always evolving, as are we as individuals, as is depression. Honest communication and respect for expanding interdependence will support all of the dynamic elements at work. Long-term support must come not just from within the relationship when a partner has severe depression, but also from outside to ensure the best outcomes for individual and relationship recovery.
How can counselling help?
We see a lot of couples affected by depression. While EduPsych counselling is not a treatment by itself, it can really help to work with someone who understands how depression can impact on a relationship.
They can help you begin to unpick what’s happening so you can get a better grip of the situation and how you might begin to address it. The idea is to help you feel like everything isn’t hopeless – that, actually, there are ways of managing what’s happening.
Here are some of the specific techniques used:
Open communication. This is something we encourage in any form of counselling, but it can be particularly important when it comes to depression. The kind of pressure that mental health issues can place on a relationship can be eased by talking openly and honestly about what each person is finding difficult. The counselor will enable this process, making sure that each partner is able to speak and be heard.
Externalizing. This means detaching the condition from the person so you’re able to see the depression as the problem, not the person suffering from it. This could even mean giving it a name or referring to it in the third person. The idea is to help the person with depression see it as a separate entity, rather than being part of their personality.
Breaking down the details. This means identifying the exact nature of the depression so we can see if there are any triggers and get a better idea of its severity. Lots of people come into counselling feeling like depression affects them all the time, but when you look at things in more detail, they begin to realize there are times when it’s not such an issue, or that there are times when it’s particularly bad. Acknowledging what might be contributing to the depression and whether there are any specific sources of stress can be really useful.
Making a timeline together. This is where we look at positive and negative events throughout the relationship. This helps to pinpoint when the depression first intruded itself into the relationship and looks at what else was happening around that time. Depression can often be linked to a loss of some kind (death or separation from a loved one, loss of identity, loss of job/status, loss of health/mobility, loss of purpose). Doing a timeline can also give each partner a better idea of how the other is feeling. We often find that some events feel more or less significant to one partner than the other.