When Someone You Love Has Repeated, Intense Episodes of Depression

Without the tools to manage it, recurring and intense depression often breaks up relationships. The truth is, depression is hard to handle. One way to help make it through depressive episodes is by preparing a depression plan when the partner who experiences depression is not depressed. The aim of the plan should be to create a shared understanding about the changes in thoughts and behavior that depression causes, as well as a commitment to “stretch” to get through the difficult period of depression.

Separating the Person from the Depression
It takes a great deal of effort, on the part of both the depressed person and their partner, to separate the person from the depression. Yet doing this can be very important to maintaining the relationship. Try thinking of “Depression” as a third party in the relationship: an entity with its own unique thoughts and actions that it expresses through your loved one’s body. One way to do this is to establish the difference between how the depressed person acts when they are depressed and how they act when they aren’t.

For example, during an episode of depression, the depressed person may get much more sensitive to criticism. If both people know that, it can help them to remember that that behavior is the depression, not the person. The partner may want to be more careful not to be critical, or to not react to the depressed person’s overly sensitive reaction to criticism. “That is Depression speaking (yelling, crying, acting insecure, calling me names), not my loved one,” can be a useful mantra.

This doesn’t mean the partner should take abuse. Partners still need to set limits—calmly, firmly and before accumulating resentment—about anything the depressed person does that doesn’t feel respectful. This may sound something like, “I know you’re in a lot of pain right now, but I won’t allow you to call me names under any circumstances. I’m going out now; let me know when you are confident you can treat me respectfully and I’ll come back.”

For the depressed person, it can also be helpful to remember that no matter what terrible things the depression is telling them (she doesn’t love me, she thinks I’m disgusting…), those thoughts are the depression interpreting what the partner says and does through a filter that turns everything to the worst possible scenario. If the depressed person can identify that this is the way Depression causes them to think before the depression happens, it can help them to remember that those feelings are likely distortions of reality, even though they may continue to seem real in the moment.

The depressed person can also prevent damage to the relationship by attempting to translate what they want to say (“You’re a skank”) into their own fears and sad thoughts (“I’m scared you’re going to leave me”) before saying it out loud.

Identifying Depressed Belief Patterns
Try making a list of messages that Depression gives, in general and/or for the specific person, in order to be able to look at it when depression hits. If every time the depressed person gets depressed, they become certain that their partner is having an affair, put that on the list. A list can be written from the point of view of the depressed person or the partner, or each can have their own. An example from the depressed person’s point of view could look like this:

“When depression hits, I see things differently and characteristically believe:

• My partner is having an affair
• I am ugly and undesirable
• I will never feel better
• I am a burden to everyone and would be better off dead
• I am inadequate in any number of ways
• I fail at everything I do
• My life is cursed
• Nobody loves me, or even likes me

“When I’m not depressed, all of this looks different. When I am depressed, I believe the depressed point of view is reality and the nondepressed point of view was distorted. This is not true and not helpful to my desire to feel good.”

Setting Boundaries for Caretaking
While it can be helpful for the depressed person and loved ones to define reality, loved ones can get burned out on reassuring the depressed person. They should do it only as much as it is possible to do so without resentment. They may need to pace themselves—can they do it once a day? Once a week? Give what support is possible without getting burned out or resentful, or starting to agree with the distortions (maybe I don’t love him, maybe he is disgusting). The rest of the time, the depressed person needs to do their own work: some alone, some in therapy, and some with other friends and people they feel comfortable talking to in order to soften the distortions.

Many years ago, a mentor of mine talked about how she coped with taking care of her partner who was dying of cancer. She wanted to be there, but not to feel resentful and burned out. She told her partner that she expected her to do everything she could possibly do on her own, and then my mentor would do the rest. So if her partner could get up and get a magazine for herself but didn’t feel like it, my mentor wouldn’t get it for her. This left her available for the kind of caretaking that her partner absolutely needed and allowed her to sustain her energy over a long period of time even as her partner’s needs increased. I thought this was a brilliant way of thinking about caretaking for loved ones. It’s so easy to want to rush in and do everything in the beginning and then burn out. Pacing oneself and seeing the other person take as much responsibility as they can helps the caretaker so much.

It is important for the depressed person to commit to “stretch” as far and do as much as they possibly can—as much as they would be able to do if they were alone. Then, if the partner is willing to act in a caretaking role, they can do what the depressed person absolutely can’t do. With depression, this can be tricky to identify. Only the depressed person knows where that line is, and it can be difficult for even them to establish. It also may change from day to day or minute to minute. A depressed person may have to spend a whole day psyching themselves up to get up and take a shower or to make a phone call—but then they may be able to do it, whereas earlier in the day they absolutely couldn’t.

It is also important for the depressed partner to “stretch” by giving expressions of love and gratitude to the caretaking partner. It may be very difficult for the depressed person to do this, but it is usually possible if the depressed person commits ahead of time and the caretaker reminds them that the relationship needs it.

Caretakers need to consciously keep their own life going as much as possible. If they can’t expect to be emotionally nourished by their partner when they’re depressed, they need to be sure to be “fed” by other family and friends, activities they enjoy, work, or whatever is available. They might consider going to Co-Dependents Anonymous for support with keeping boundaries and not giving too much. This can, ironically, free people up to be more available to the person who needs their care.

Maintaining Balance
Most depressive episodes do pass, and the person who experiences depression returns to their nondepressed personality and functioning. Both depressed people and loved ones have to try to remember this fact as they do everything possible to get through and resolve periods of depression. The most important thing to remember is that neither person should make big decisions about their relationship, or judgments about how things will be, until the episode is over.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.