Depression is the most common mental health problem in the world. According to some surveys, about 1 in 10 American adults will experience a major depressive episode in their lifetime. Many more will experience milder forms of long-term low mood, known as dysthymia.
Given these numbers, there’s a good chance someone you know and love will experience some form of depression.
When you see a loved one going through depression, you want to help them out. You want your spouse, friend, or parent to be happy and flourishing, so it sucks to see them struggle with the black dog. It’s not just difficult to watch them suffer; depression can also put a strain on the connection you share.
Today, we’ll unpack research-backed approaches for maintaining a healthy relationship with friends and family who struggle with depression.
Strained Connections: The Impact of Depression on Relationships
One of the things that makes depression so insidious is that it can cause a depressed person to sabotage or avoid the very things that can help relieve their condition. For example, exercise is one of the best things you can do to reduce depressive symptoms, but when you’re depressed, you find it hard to get motivated to even go for a walk, let alone pump iron.
Socializing can also reduce depression, but depressed people tend to withdraw and isolate themselves, which only worsens their mood. What’s more, many depressives engage in behavior that can damage relationships. Depressed people are more likely to lash out and manifest irritable, sulking, and hyper-critical behaviors, all of which can harm a relationship.
A study on college roommates found that when someone shares a dorm with a depressed person, they experience more conflict and arguing compared to when they share a room with a non-depressed person. Studies on marriages have found that when one spouse is depressed, the marriage is nine times more likely to end in divorce.
People aren’t just tempted to turn away from depressed individuals because they can be actively prickly; people also distance themselves because the melancholy vibe of a depressed individual brings down their own mood and isn’t something they want to “catch.” Folks aren’t just being uncompassionate; research has indeed shown that when people interact with a depressed individual, they end up feeling more anxious and depressed themselves.
These factors can create a downward spiral that unravels a relationship:
The depressed person feels low, and a non-depressed loved one tries to help.
The depressed person irritably rebuffs the help; the non-depressed person feels resentful, doesn’t enjoy being around the person as much, and starts to avoid interacting with them.
The depressed person lashes out at and criticizes the non-depressed person for not being more supportive, and the non-depressed person feels even more resentful and responds with harsh words.
Now the depressed person feels even worse, and the non-depressed person is even more apt to avoid them.
And on the downward, relationship-sabotaging spiral goes.
Writer Anne Sheffield calls the damage depression can have on a relationship “depression fallout.” In the forward to her book, How You Can Survive When They’re Depressed, journalist Mike Wallace recounts how his own severe, undiagnosed depression strained his marriage with his wife. He was constantly short-tempered and finding faults with her. It wasn’t until he started getting treatment for his depression that their relationship began to improve.
So when you have a loved one who is depressed, you not only have to worry about them, but you also have to keep an eye on the relationship you share, so that it doesn’t become irreparably damaged as the friend or family member passes through a dark season.
Strategies for Maintaining a Healthy Relationship with Someone Who’s Depressed
The following guidelines can help you maintain a healthy relationship with a loved one or friend with depression. Many are drawn from When Someone You Love Is Depressed: How to Help Your Loved One Without Losing Yourself by clinical psychologists Laura Rosen and Xavier Francisco Amador, who based their book on their clinical experience working with individual depressives and couples where one person has the disorder.
Learn All You Can About Depression
If you suspect a friend or spouse might be depressed, do some research on depression to learn as much as you can about it. Depression can manifest itself in a variety of ways; it’s not just crying and being sad all the time. Irritability, low motivation, anger, weight loss/gain, and diminished sex drive are all potential symptoms of depression. Learning about the different ways depression can manifest itself (here’s how it tends to show up in men) can put you in a better position to help your loved one.
Learning about depression can also help you take your friend or loved one’s depressive symptoms less personally (see below). If your depressed friend is more irritable, you’ll know that their depression is behind this behavior change.
Moreover, learning what your friend or spouse is going through mentally and emotionally will help you better empathize with them. If you haven’t experienced depression, you might think it would be helpful to tell your depressed friend to look on the bright side and think about all the great things they have going for them.
But while faulty thinking is one cause of depression, changing thinking patterns isn’t easy, and there are typically other factors at play as well, like genetics, that are outside someone’s control. Understanding the intractable difficulties a depressed person is facing will help you be more patient with and sympathetic to their struggle.
Affirm Your Support
What a depressed person needs the most is to know that you’re with them during their low times. This doesn’t mean you have to bend over backward to help them get out of their funk. Just acknowledging that they’re going through a hard time is enough. Regularly affirm the durability of your relationship and that you’re going to be there for them.
Offer Suggestions Respectfully and Judiciously
If a friend or loved one’s depression is getting so severe that it’s interfering with their life, encourage them to get help from a licensed therapist.
If someone’s depression isn’t so serious it requires therapy, or they don’t want to see a therapist, it’s okay to suggest some of the many lifestyle changes that can help alleviate depression: getting exercise, improving sleep, eating a healthy diet, meditation, etc. But follow these guidelines when you offer advice: 1) Only offer one suggestion at a time. Think about what behavior change might have the highest ROI for the person and only mention that one idea. 2) Don’t be offended if the depressed person rebuffs your suggestion. It may be an idea they need time to come around to and will decide to try on their own timetable. 3) Don’t nag them about the idea. Bring it up, and if they don’t follow through on it, wait an appropriate amount of time to resurface it. “Have you thought any more about trying X?”
Set Realistic Expectations About the Persistence of Depression
When you know someone who is depressed, you’ll naturally want to help them. You’ll want to “cure” them so that they’ll always be happy and upbeat.
But as we highlighted in our guide to managing depression, expecting to be able to “cure” depression is a recipe for frustration. There isn’t a cure for depression. Once someone’s had a major depressive episode, their chances of experiencing another one go up significantly. There’s also a chance the person has a melancholic temperament, and no amount of therapy or medication is ever going to change that. If you think depression can be permanently overcome and that once a loved one is over an episode of it, you’re forever out of the woods, you’re apt to feel disheartened and even angry when they become depressed again. Ironically, accepting that someone’s depression will likely be a lifelong struggle and that it can only be managed rather than cured, will help you be more zen about it.
Set Realistic Expectations for How Capable Someone Is of Managing Their Depression
There are many ways to manage depression, from getting more exercise and sunlight to quitting alcohol and spending time in nature to therapy and medication.
But, as already mentioned, depression sets up a catch-22 where it saps the motivation to do the very things that would alleviate it.
One of the most difficult questions around mental disorders is figuring out the degree to which they compromise someone’s agency. How much are they still responsible for their actions, and how much can you expect them to choose health-promoting behaviors despite the psychological constraints they’re under?
There are no easy answers, and it will vary on a case-by-case basis.
But unless someone is suffering from a depression so severe that it’s left them essentially incapacitated, it’s reasonable to expect a loved one to make some kind of effort toward getting a handle on their depression. Often, all it takes to maintain a good relationship between a non-depressed person and a depressed person is for the former to see that the latter is trying; even if the depressed person’s attempts at managing their disorder don’t bring about big results, the effort still shows the non-depressed person that they care and are cognizant of the way their depression affects the relationship.
At the same time, it is reasonable for your loved one to expect that you will be very patient as to the consistency and success of their depression-managing efforts, exercise a high degree of compassion in acknowledging how difficult it is for them to get going and stick with these practices, and understand that, again, even when such habits are implemented, they will not cure, but only mitigate their depression.
Let your depressed loved one know you do expect them to make an effort, but you don’t expect their efforts to be perfect.
Don’t Take It Personally (But Set Boundaries)
As mentioned above, depressed individuals will tend to be angrier, more critical, and more negative all around. They’ll also socially withdraw.
Once again, the tricky question of how mental disorders interact with agency arises. To what extent is the depressed person still responsible for their behavior, and to what extent is it being dictated by the disorder?
It’s possible to both give a depressed person extra lenience in the ways they might lash out or withdraw, while also not allowing them carte blanche to treat you like crap. While a person might not be to blame for having a mental illness, they are responsible for managing it so that it doesn’t harm others. Set boundaries on what isn’t acceptable behavior. You might put up with some daily irritability, but you don’t need to accept extreme anger or abusive criticism. Let your loved one know what your boundaries are and stick with them.
Communicate Effectively
Depressives tend to filter pretty much everything in a negative light; in fact, research suggests that this negativity bias may not only be a consequence of depression but a cause of it. So communicating with a melancholy person can be tricky because something you say that seems innocuous will likely be interpreted by them in the least charitable way.
Rosen and Amador offer the following suggestions for communicating with a depressed person:
- Speak calmly, clearly, and slowly. Depressed individuals often experience slowed thoughts and difficulty comprehending information. They can feel overwhelmed and have trouble paying attention. Conversations may seem too fast and loud, making it hard for them to keep up with the flow. When speaking to someone who is depressed, it is crucial to be calm, clear, and speak slowly. Not in a patronizing way, of course, as if you think the person is dumb or disabled. Rather, your tone should simply be composed and mellow, even if expressing negative feelings, and you should avoid ambiguity; again, anything that’s not spelled out clearly is apt to be interpreted negatively.
- Don’t talk down. A depressed person is capable of having opinions and should be respected as such. Talking down to them may cause them to become angry and lose patience. Don’t assume to know what’s best for them.
- Don’t generalize. If you are upset about something, be specific about the thing you’re upset about. Don’t use words like “always” and “never,” like “You’re always a mope!” That will just make the depressive defensive and put them deeper into a funk.
- Express your needs directly. If the depressed person’s behavior is adversely affecting you, let them know. Again, indirect communication will just be interpreted in a negative light. As you express your needs, don’t blame the person! Acknowledge that the depression is a factor and that you want to figure out a way to help your loved one and also maintain the relationship. Follow the above guidelines as you express your needs.
- Listen. When your depressed friend or loved one talks to you, listen closely. Acknowledge you’re listening by repeating back what they’ve said in your own words and asking if you’ve correctly understood them. Let them know you understand that it sucks that they constantly feel hopeless and down.
Keep in Touch
As mentioned, depressed people tend to socially withdraw and isolate.
If your depressed friend has withdrawn from you, don’t take it personally. And don’t decide, “I guess they don’t want me to bother them,” and drop your communications. Be persistent and stay in touch. You never know when they might feel up for responding, and just knowing they have resources in their life, even if they’re not yet up for taking advantage of them, will strengthen their psyche. Send a quick text to check in. Continue to invite them to social outings. Rather than asking the person what they want to do, plan an activity they’ll enjoy and tell them you’ll swing by to pick them up; all they’ve got to do is shuffle out the door.
Take Care of Yourself
While you want to be there for and support a loved one with depression, you can’t neglect your own physical and mental needs while you do so. Having two people end up in a pit doesn’t help anyone. You need to continue to take care of yourself so that you don’t get burned out.
Keep up your own health-promoting routines. Maintain your workout habit. Carve out times of space, peace, and solitude while still being there for your loved one. Keep socializing, too. Your spouse might not want to go out, which will tempt you to stay home to support them. But Rosen and Amador recommend that you stick to your social routines as much as possible for your own sake. Let your spouse know you understand that they don’t want to go out, but that you need to for your own well-being. If you’re empathetic and direct, they’ll hopefully understand.
Depression is tough. It’s really hard for the person going through depression, and it can also be hard on relationships too. With a bit of prudence and a lot of love, you can help your family members and friends leash their black dog while not getting bit yourself.
