Depression

Can Depressed People Have Long-Lasting Relationships?

New research shows there may be hope for the relationships of the depressed.

Posted Oct 19, 2019

Pexels/Pixabay
Source: Pexels/Pixabay

Your closest relationship should be the one that offers you the most support by providing you with emotional gratification. For people who experience significant symptoms of depression, that support would seem particularly important. In the best of cases, your sad mood and low self-esteem could be offset by a partner who allows you to feel good about yourself and helps propel you back to an emotional even keel.

Over time, that continued emotional buffer against the world could perhaps help to reverse even your darkest moods. Your depression may ease as your partner provides a stable base of love and affection. By the same token, a chronically miserable relationship could lead you to feel despondent and hopeless. Although you began your relationship with an optimistic and hopeful frame of mind, you’ve grown instead to feel that your life is doomed by the mistake you made in committing to remaining with this individual over the long haul.

These scenarios raise the thorny theoretical issue of cause and effect when it comes to long-term relationships and depression. People who are depressed can be made better or worse by their relationships, to be sure, but can’t a poor relationship create its own source of depression? Furthermore, if one partner is depressed, might the ensuing conflict and unhappiness create a similar despondency in the other partner? Translating the theoretical problem into the research needed to evaluate causality would seem to be almost impossible.

Fortunately, some possible answers emerged from a comprehensive review of the available literature on married couples by the University of Quebec’s Maria Goldfarb and Gilles Trudel (2019). Many studies on the depression-relationship quality link take a cross-sectional approach that produces correlations on a single occasion. These studies by themselves don't allow causal connections to be discerned.

However, there are some investigations that follow couples over time, making it possible to determine if the depressed have worse outcomes in their relationships than the non-depressed. Indeed, the most sophisticated approaches trace bi-directional patterns, determining whether depression at Time 1 affects relationship quality at Time 2, and vice versa. Furthermore, as Goldfarb and Trudel were able to uncover, studies that examined these patterns in older adults provide even better answers to the causality question. Taken together, cross-sectional and long-term (longitudinal) studies, involving younger and older couples, make it possible to start to see patterns in the depression-relationship quality connections. 

The contrast between the younger and older couples, according to the Canadian author team, is important. Newly-formed couples operate under different dynamics than their older counterparts, due to the varying pressures on couples at the earlier and later stages of relationship development. Although the authors don’t acknowledge the role of self-selection in who remains together and who breaks up, this division of studies along age lines would suggest that the longer-persisting relationships somehow managed not to end in divorce despite the strains that depression could place on the couple.

With this caveat in mind, consider these three paths proposed by Goldfarb and Trudel that can characterize the relationships of people who are depressed:

1. Interpersonal theory predicts that depressed individuals seek support from their partners when they are going through difficult times. However, the relationship may worsen if the partner becomes resentful and hostile and, at the same time, feels guilty over having these feelings. The depressed individual eventually becomes resentful, which unfortunately serves to alienate the partner even further.

2. Stress generation theory, also an interpersonal approach, emphasizes a known feature of the lives of people with psychological disorders to create, inadvertently, some of the stress in their relationships by virtue of their own symptoms. As their stress levels leak out into the relationship, conflict increases, and relationship quality goes downhill. 

3. The discord model begins with low relationship quality, not depression, as the starting point of the cycle. As described by the authors, “discord or dissatisfaction, manifested in decreases in various types of adaptive behaviors and increases in negative behaviors, leads to subsequent depression, which is then manifested in further maladaptive types of interpersonal behaviors and, ultimately, further [relationship] dissatisfaction” (p. 740).

Both versions of interpersonal theory regard depression in one partner as creating conditions that lead to conflict, compared to the discord model whose starting point is the development of conflict leading to poor relationship quality and, in the end, depression in one of the partners. Even so, in all three approaches to understanding depression and its connection to relationship quality, a vicious cycle develops in which, whether as the origin or the result, the depressed individual’s symptoms put a strain on the relationship, almost guaranteeing the further development of depression.

After evaluating both cross-sectional (one-time) and longitudinal approaches to the depression-relationship quality connections, the Canadian authors concluded that, among young adults, the discord model earns the most support for the discord. Thus, a young couple begins their relationship on a positive note, but problems develop when they begin to engage in destructive methods of conflict resolution and poor communication. The personality trait of neuroticism may further contribute to this unfortunate pattern, as was tested in several studies.

However, as the authors point out, the discord model was not consistently supported, and some findings emerged that were actually the opposite of what the model would predict. Once again, consider the problem of studying over time what in this study were marital relationships. Marriages ending in divorce were not included, meaning that the unhappiest couples are no longer part of a study’s sample. The weaning-out process could begin very early in a relationship if the couple decides they can't tolerate high levels of conflict and so part ways, leaving them out of any possible analyses.

Looking instead at older couples, who, by definition, have managed to remain together even in unhappy relationships, the findings could become somewhat clarified. Unfortunately, very few of the studies the authors reviewed involved longitudinal designs. When they did, the timelines tended to vary, and often there were only two times of testing, which further clouds the direction of the relationships.

For example, one study may track participants between 10 and 20 years of marriage, but another between 8 and 15. The long interim means that much can happen in the dynamics of the couple’s relationship, but also that some changes may occur at 12 years and others at 16 or 17. As a result, in some cases, a relationship in the direction of depression to poor marital quality was observed, and in others, the opposite. In yet other studies, the relationships were truly bi-directional, meaning that no clear pathway emerged. Finally, to complicate matters further, one of the partners may have been depressed early in adulthood; in the words of the authors, most of the older couples “have been in their actual marital relationship for a very long time, and the depressive episodes have probably occurred in the past” (p. 753).

Despite these logistical problems, there is some good news from the studies of older couples. The fact that there are couples who remain together into later life, despite the fact that one of the partners was depressed, suggests that chronic feelings of sadness in a partner do not have to spell doom for a relationship. Couples can remain together throughout the difficult times involved in handling a period of depression. Successful couples find a way to avoid that self-perpetuating cycle of lack of constructive conflict resolution, negative emotional states, blame, resentment, and guilt that can accompany depression in one of the partners. The longer the couple is together, the more they figure out how to adapt to these emotional tribulations.

To sum up, the Goldfarb and Trudel study suggests that depression best be understood in an interpersonal context rather than solely as a quality of the individual. A good relationship can serve as a buffer against depressive symptoms over the course of time. From a practical point of view, regarding individuals as part of a couple can help suggest treatment approaches that take this interpersonal context into account, making both individual therapy more effective while also providing the basis for longer and more fulfilling relationships.

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References

Goldfarb, M.R. & Trudel, G. (2019) Marital quality and depression: A review, Marriage & Family Review, 55 (8), 737-763, DOI: 10.1080/01494929.2019.1610136