- Couples often don't realize that depression is at the core of their relationship problems.
- Depression prevents couples from addressing and resolving conflicts.
- Depression accentuates a couple's differences and can lead to substance use and infidelity.
- Once depression is treated, a marriage can often be saved and even become stronger than before.
I’ve seen it over and over. Couples come see me and begin recounting a litany of complaints about each other. They share painful experiences of feeling hurt, jealous, ignored, and unvalued. They complain that their spouse has been irritable, withdrawn, short-tempered, impatient, and unsociable. They say they are fighting over money, childrearing, in-laws, balancing work and family, sex, friendships, housework, and leisure time. For many of these couples, it can be hard to remember when they last had a good time together or even what they originally found so attractive about each other. Everything about their relationship seems hopeless. And that is usually a telltale sign.
An underlying condition that can be toxic to a relationship.
Depression can be so toxic to a relationship that when couples come in for therapy I always screen for depression. Yes, the problems and conflicts they are experiencing are real. Yes, there are differences that need to be reconciled, bad habits that need to be broken, and empathy and communication that need to be cultivated. But what is often a key dynamic in a couple’s misery–and too frequently ignored–is that one or both partners may be depressed. While their challenges may be significant and need to be addressed, they are being exacerbated by a depression that may be biologically or hormonally based and must be treated.
In some cases, it's depression that leads to infidelity or substance use, which then further exacerbates couple conflicts. That is what happened with Jim*, an actor, and his wife Julie*, a publicist for a large company. They had been married for 15 years, had children ages eleven and nine, and said their relationship had been “great” until about six years ago.
It began subtly. First, Jim lost his sense of humor. Then his patience. Then his ability to work because it took a lot of energy. He stopped going to auditions and was around the house all day. Jim’s self-esteem plummeted. He felt guilty about not earning money but was unable to summon the effort to do anything about it. Frustrated by Jim’s souring mood and disappointment with himself, Julie found herself engaged in shouting matches, screaming, “why don’t you just go out and work?” Their sex life became nonexistent. Jim began drinking to calm his nerves. When Julie announced she was leaving the marriage—she'd grown up with an alcoholic father and wasn't going to tolerate even early warning signs of deterioration—Jim crashed. In despair at the thought of losing Julie, he recognized he needed to seek help from a mental health professional.
When Jim entered my office for a consultation, his first statement was, “I’ve ruined my life. I haven’t worked for five years, and my wife is leaving me. I think I’m beyond help.” Jim went on to describe his symptoms: he couldn’t sleep or eat, he had little energy, he couldn’t focus on his career, and was preoccupied with feelings of failure and guilt. Jim had never considered all his symptoms related to one condition. But they were.
This was a clear case of depression, and, as I told him, he had an excellent chance of being treated successfully. Jim was willing, actually eager, to start taking antidepressant medication. He responded so well that when an actor friend invited him to accompany him to an audition, Jim not only went along, but the director, who recognized him from his old days in the theatre, asked him to try out for another part. Jim was offered a role. His life got back on track. Fortunately, his marriage did as well.
Blaming unhappiness on your partner.
People often think of depression as a mood disorder. And it certainly does impact mood, But depression doesn’t just make people feel sad and irritable. It can also affect cognitive thinking. When one is depressed, it’s hard to make decisions, problem solve and see anything in a positive light. When people are depressed, they feel hopeless. Many depressed people blame their unhappiness on their partner. And they feel certain that there is no way to improve the relationship.
It often surprises couples when, during a marriage counseling appointment, I say I want to assess both spouses or partners for depression. They have been sure that there is nothing ”wrong” with themselves and that it’s just their partner who “is the problem.” I explain that depression makes everything seem worse. And so, while the problems they face need to be resolved, they will be much more difficult to address if they are stuck in a depression.
As in Jim’s case, depression can manifest in various ways. Those who suffer from depression often don’t realize that varied symptoms are tied up in one condition. Symptoms can include ones that are physical (problems with sleeping and eating); emotional (feeling sad, impatient, irritable, and/or suicidal); cognitive (problems concentrating, having difficulty making decisions, experiencing problems with memory); somatic (having headaches, stomach aches, or other physical pains); and social (unable to enjoy engaging with friends and/or colleagues). Before diagnosing depression, a health practitioner must ensure that no other medical conditions, like sleep apnea, dementia, Parkinson’s Disease, or drug reactions, may contribute to the symptoms.
Assuming no other medical complication exists, the frequency and intensity of the symptoms will determine if someone is experiencing a major depression or has a more low-level depression known as Dysthymia or Persistent Depressive Disorder. What can be so confusing about this latter, milder type of depression is that it is more subtle. It generally doesn’t fit the classic picture of someone who wants to stay in bed all day with the window blinds closed. Some people live for years with it. They are often described as seeing the “glass half-full.”
Sullen, withdrawn, and irritable moods can be difficult to tolerate.
Yet, even though it is less extreme, persistent depressive disorder can be just as devastating to a relationship. People with mild to moderate depression can go to work or school and assume parenting and other responsibilities. But their sullen, withdrawn, or irritable mood makes them difficult to tolerate. And because the condition is probably not interfering with day-to-day functioning, it’s often not clear to a couple that the angry barbs and accusations are the depression “talking.”
This milder form of depression may also have more of an off-and-on rhythm so that one day a person seems agreeable, and the next day is unbearable to live with. The partner who is depressed often blames their change in disposition on their partner, who, in turn, feels hurt and angry at the accusation. It’s easy to see how quickly a couple can get into a vicious cycle of anger, blame, hurt, and hopelessness. By not recognizing that depression is a key component in the ruination of their relationship, too many couples consult with a divorce lawyer when they really need to first meet with a mental health professional.
Treatment for depression can help heal a relationship.
While the bad news is that depression can destroy a relationship, the good news is that effective treatment for depression can heal a relationship. When I identify depression in one or both partners who come in for couples counseling, the treatment for depression is given priority. Once the dark cloud of depression is lifted, relationships “lighten up.” There is less blame and frustration. Instead of channeling energy into accusations, it can be directed to tackling relationship problems and identifying and implementing solutions.
In our book The First Year of Marriage: What to Expect, What to Accept and What You Can Change, we share our findings that newlyweds who "sweep problems under the rug" are the most likely to get divorced. When signs of depression are addressed early on, before too many ugly accusations are hurled back and forth, relationships can be saved. They may even be stronger than before. And, in cases where marriages are not salvaged, having had depression treated will enable partners to transition out of the relationship with a healthier, more positive, and constructive mindset. Depression is never inevitable nor should it ever be ignored.
*Not their real name
To find a therapist near you, visit the Psychology Today Therapy Directory.