Helping a Husband or Wife Over Depression

By Diana Holbourn

Article Summary

Welcome

This article discusses some causes of depression, and suggests ways of trying to persuade a husband or wife to get treatment if they're not keen, as well as various things partners can try themselves to help lift their spouse's mood. It also gives advice on how they can try to cope with difficult or hostile attitudes the depressed person has towards them, and things they can do to look after their own needs.

It tells a couple of anecdotes about people who did manage to help their husbands get over their depression and how they did it.

Skip past the following quotes if you'd like to get straight down to reading the article contents and self-help article.


Quotes and Insightful Quips - Some Thought-Provoking - About Marriage and About Depression

Marriage is three parts love and seven parts forgiveness of sins.
--Langdon Mitchell

Do not brood over your past mistakes and failures as this will only fill your mind with grief, regret and DEPRESSION. Do not repeat them in the future.
--Sri Swami Sivananda

The longer we dwell on our misfortunes, the greater is their power to harm us.
--Voltaire

Concern should drive us into action and not into a depression. No man is free who cannot control himself.
--Pythagoras, BC 582-507, Greek Philosopher, Mathematician

Both optimists and pessimists contribute to the society. The optimist invents the aeroplane, the pessimist the parachute.
--George Bernard Shaw

Noble deeds and hot baths are the best cures for Depression.
--Dodie Smith

Through our willingness to help others we can learn to be happy rather than depressed.
--Gerald G. Jampolsky, American Psychiatrist, Lecturer, Author

Nothing else is needed to make you depressed, than to fancy you are so.
--Author Unknown

I want to help people with depression understand that there is hope, so that they can get the help they need to live rich, fulfilling lives.
--Tom Bosley

If depression is creeping up and must be faced, learn something about the nature of the beast: You may escape without a mauling.
--Dr R W Shepherd

Marriage is an adventure, like going to war.
--Gilbert Keith Chesterton

I cling to depression, thinking it a form of truth.
--Mason Cooley

How many pessimists end up by desiring the things they fear, in order to prove that they are right.
--Robert Mallet

If lawyers are disbarred and clergymen defrocked, doesn't it follow that electricians can be delighted, musicians denoted, cowboys deranged, models deposed, tree surgeons debarked, and dry cleaners depressed.
--Virginia Ostman

The Main Contents

The Self-Help Information in the Article

  1. Reminiscences
  2. The Causes of Depression
  3. Ways of Trying to Persuade a Spouse to Get Treatment for Depression
  4. Dealing With the Depressed Partner's Hurtful Attitude
  5. Techniques a Spouse Can Try to Help Lift Their Marriage Partner's Depression If They Don't Want Treatment
  6. A Few Insignificant Personal Musings

Background Information About This Article

This article is written slightly differently from most articles. It comes with a very short fictional story about someone finding out information to help someone with a depressed husband, - not a real person, but fairly typical of some others, - and it's presented as if it's what she's found out and what she's thinking. While the character is fictional, the anecdotes she tells about things she's seen and heard have all genuinely happened to others or the author herself.

This article is about helping husbands or wives, but a lot of it could apply to helping other loved ones, such as teenage children, and so on.

The character giving the information in this article is called Nicola, who's looking through notes she's made on a course she's been on to try to help people having problems in their marriages, and things like that, especially because she's due to counsel someone as part of the work experience she's doing as part of her course the next day.


Part One
Reminiscences


There cannot be a stressful crisis next week. My schedule is already full.
--Henry Kissinger

Work cure is the best of all psychotherapy, in my opinion.... As well might we expect a patient to recover without food as to recover without work.... The sound man needs work to keep him sound, but the nervous invalid has an even greater need of work to draw him out of his isolation, and to stop the miseries of doubt and self-scrutiny, to win back self-respect and the support of fellowship.
--Richard C. Cabot

Thinking

Nicola thinks:

These notes say that people with a depressed husband or wife usually start by trying to cheer them up and offering them sympathy; but if the depression doesn't go away after a while, it's easy to become annoyed and frustrated and unhappy, particularly since depression makes people forget positive things and think nothing's any good.

The Story of the Depressed Neighbour

Oh yes, my neighbour Barry was like that. He'd separated from his girlfriend but desperately wanted her back, and kept coming to me for sympathy and advice because he said I was a good person to talk to because I was a calming influence on him and training to be a marriage counsellor. His girlfriend would sometimes say she wanted to visit him and she missed him, but at other times she'd say they were better off apart, and then change her mind yet again a few days later and say she wanted to see him.

I would listen to him for some time and then make several suggestions as to what he could do, and he would say it was good advice, but then he'd go back home, and he said that as soon as he got in, he'd start brooding on his worries that he'd never see her again and go right back to square one, the heights of depression, where he thought everything was hopeless and he may as well not go on any more because there was no future for them together.

When he was depressed, it literally seemed as if a monster had invaded his brain and was stopping him from seeing things any other way, well, something big and powerful that was blocking out his power to see things from anything but the worst possible point of view. It was a real eye-opener. I didn't realise depression could be like that before. It was as if he could only see things from the worst possible point of view, that things were hopeless and would never get any better so he may as well not go on. Until he was calmed down, I couldn't help him to see things any other way whatever I said.

I know of one big example of that. His girlfriend had bipolar disorder and one or two other big problems, and she hated changes in routine and travelling, especially on her own, and when he was with her before they separated, he'd booked holidays for them, but they'd ended up not being able to go because she'd panicked the day before and couldn't face it.

He knew all that, but that time when she said she was coming to see him and then got very distressed about having to travel the night before she'd been going to and so didn't make it in the end, the depression made him forget the significance of how hard it was for her to travel and make a break with her normal routines, and even though he'd been on the phone to her when she was panicking and crying about the journey, he thought that she must have decided not to come because she didn't want to get back with him. Never mind that with a bit of therapy, she might have been able to travel better so if he was patient, it might not have been that long before she could come and see him, or that the fact that she often changed her mind about seeing him meant that if it was true that she'd decided not to, she'd decide she wanted to get back together with him soon so all he had to do was wait. No. He sank down into this terrible suicidal depression, saying there wasn't any point in going on living, because everything was hopeless, and that was "reality".

Depression can obviously do terrible things to people.

Feeling hopeless And his depression didn't let him see that even if his girlfriend did finally decide she didn't want to get back with him, life could still get to be fulfilling and enjoyable. When he was in his depression, he thought that either he got back with her, or that life wasn't worth living, everything was hopeless, and he wanted to go to bed and never wake up. He could lie on his bed all day thinking thoughts of misery and hopelessness and suicide, just making himself feel worse. I was a bit worried.

He did have days when he cheered up and could see that it was possible that they'd get back together. But when he sank down into another one of his terrible depressions, it was as if he completely forgot all that. It was as if he'd become incapable of thinking of what might happen if he encouraged her and helped to get her some therapy. It was as if the thought, "Everything's hopeless; I may as well commit suicide" was preoccupying his brain so much that no other thoughts were capable of getting in, and it was impossible for him to see things any other way till his depression lifted. That's why it was as if there was a monster in his brain, stopping it from functioning properly, so he couldn't see things in their true perspective.

I'm ashamed and disappointed with myself now, but I got fed up in the end, because no matter how many times he agreed that there were ways forward when he wasn't so depressed, no matter what I said, he'd always go back to thinking things were absolutely hopeless when he sank into depression again, forgetting everything we'd said. If only I'd known how to help him more then, maybe things wouldn't have been nearly so bad.

And then I had to study for exams and so I was under pressure to spend my time revising, and I was trying to help someone else as well, so I didn't feel I could spend so much time with Barry. But he didn't seem to understand and just said I should organise my time better. He said it in a joky way, but it was still irritating. And then I put restrictions on the amount of time I was prepared to spend with him because I thought it was the only way I could cope with the amount I had to do, and he called me selfish. At almost any other time, I wouldn't have minded so much; but just then when I was feeling under pressure, it really annoyed me and I had a real go at him, and he got upset. I think it was the wrong thing to have done now. I shouldn't have done it.

Now I'm thinking that perhaps what he said was just a result of the same distorted thinking the depression caused that made him think everything was hopeless when it wasn't. So perhaps he would have felt differently when he felt better. So perhaps I should have just ignored what he said. If only I'd thought of that at the time, or known more about depression so I knew more about how it can distort people's thinking so they can't see all sides of a situation, I wouldn't have done it. It was a pity about what happened.

We didn't speak to each other much after that. He left the area in the end, and I think he moved in with his father. But that won't have done him any good, because they didn't get on well. I do think it's a shame he didn't find anywhere better.

I'd like to have been able to help him more, but I didn't know how to then. I'm glad I've learned a bit more about depression since then.

I have to stop this! Anyway, I'm being silly here, wasting time brooding on the past. I need to keep reading these notes so I can learn up about things I can talk through with the person tomorrow! Hopefully she'll remember what I say.


Part Two
The Causes of Depression


The greatest part of our happiness or misery depends on our dispositions and not on our circumstances.
--Martha Washington

I can feel guilty about the past, apprehensive about the future, but only in the present can I act. The ability to be in the present moment is a major component of mental wellness.
--Abraham Maslow

Rule your mind or it will rule you.
--Horace

Medications and Illnesses That Can Cause Depression

Taking blood pressure

Oh, my notes say that some medications and illnesses can cause depression sometimes. They say it can be caused by some diuretics and heart medications, blood pressure drugs, and some drugs used to treat arthritis and Parkinson's disease. They say that steroid medications and cancer treatment drugs can also occasionally cause depression.

I'd better tell my counselling client that tomorrow. Well, I'll ask her if her husband's on any medication, and if she says yes and he's got any of those conditions, I'll suggest they ask their doctor if his medication might be causing depression, and if so, whether his drugs can be changed.

I'll ask her if he's taking anything over-the-counter as well, and suggest he looks at the leaflets listing the possible side effects of any medication he's taking, whether prescribed by a doctor or bought over the counter. Or even illegal.

My notes say that other drugs that can sometimes cause depression include antihistamines, tranquillisers, sleeping pills, and narcotics.

My notes say that depression can also be caused by the body warning us about a serious illness it's got like some cancers that we might not know about yet.

Well, hopefully that's only a rare cause of depression. I'm not sure whether to tell my counselling client about that. I wouldn't want to scare her. I think depression's usually caused by mainly psychological problems. But I think it would be a good idea to suggest that she advise her husband to go to the doctor's for a check-up just in case, especially if they try psychological methods first and nothing works.

I know underactive thyroid can cause depression.

I heard someone once say he'd tried different techniques for twenty years to get over his depression but he still had it, but then it was found that he had an underactive thyroid, and when he started taking medication for that, his depression went away.

Yes, I'll advise that the woman tomorrow suggests to her husband that he gets a few medical tests.

Then again, I've spoken to so many depressed people who went to their doctors, and they said all their doctors wanted to do was to put them on antidepressants, no questions asked, so they were unhappy with their doctors. I'll have to suggest that if he goes to his doctor, he's very specific that he wants physical problems to be ruled out, but if he isn't that happy about going on tablets if the doctor says his depression's got a psychological cause, he tells the doctor he'd like to try self-help methods first.

Then again, it depends partly on how willing he is to try other methods.

My notes say that alcohol and nicotine can also cause depression. They say it used to be thought that depressed people just used them more, but now, it's thought that they actually cause depression.

Eating and Drinking Healthily Can Help Keep Depression Away

Fruit

They say certain vitamin deficiencies have also been linked to depression.

so I'd better ask the woman a bit about how healthily the family eats.

They say that a well-balanced diet can help guard against stress. And they say it's also important that people do eat regularly, since when people don't, the blood sugar gets low, and then people are more likely to get mood swings. And people can get anxious or irritable as well, because the body releases adrenaline to compensate for there not being enough sugar in the blood, and that boosts energy, but it can also give people symptoms that make them feel edgy, since it's designed to put people on the alert in case they're in any danger.

My notes say that as well as eating regularly, it's best not to eat too much sugary food, since that can make the body release insulin so it can cope with more sugar than the body wants, and insulin can turn the sugar into energy, so when it has, that makes the blood sugar level drop a lot, so people can get edgy again.

So the notes say it's best if people can eat foods that make the blood sugar level rise slowly, rather than eating too much sugary food. Wholegrain foods are good.

They say foods containing vitamin C are also helpful for depression, as well as oily fish. And they say a deficiency of the B vitamins might contribute to depression, particularly B6 and B12.

Also, I've heard some mineral deficiencies might cause it, such as magnesium deficiency. I've read that magnesium's found in green leafy vegetables and nuts, among other things.

I think I'll suggest the woman I see tomorrow does some research into what kinds of food it's best for depressed people to eat. It's not something we covered on the course in detail, but there's probably some good information about it out there. Then again, I don't think research is all that well developed yet. But if her husband does go to the doctor, he could perhaps ask to be referred to a dietician who could tell him more about the kinds of foods it's best for depressed people to eat.

Exercise Can Help Lift Depression

Exercising with others for fun and companionship

It says in my notes that exercise can relieve depression and keep it away. They say it's recommended that people do five sessions of vigorous exercise a week, provided they're fit enough, and they can build up to that in stages if they're not. They say that among lots of other health benefits, exercise releases the body's "feel-good" chemicals, endorphins.

Psychological Causes of Depression

Feeling dejected

My notes say that people can spiral themselves down into depression by the way they think. This can happen especially after a big event in someone's life that's made them unhappy, but some people regularly think really negatively.

My notes say people can drag themselves down by being pessimistic a lot of the time, and then wonder why they're so miserable, and end up making themselves feel a whole lot worse by searching for the reason, brooding on bad childhood or recent experiences in their minds that just upset them more, making them sink deeper into depression, till they think that everything's bad, so everything's hopeless, and things will never improve because they're so bad. They forget all the good things while they're depressed, and might even deny they ever happened if they're reminded of them.

My notes say that people who do that can be helped if they try to pull themselves back from their thoughts a bit, recognise them as depressive thinking and not balanced thinking, and realise that the depression's fooling them into only seeing the bad side of things. The notes say there are methods depressed people can be taught to help them do that.

My notes say that the thoughts that can make people spiral down deeper and deeper into depression won't just be about the past, but could be to do with worries about the future, confusion about where their life's going, feelings of anxiety and worthlessness because they're not getting what they want from life or they have low self-esteem, and lots of other things.

They say that unhappiness in a marriage can cause someone to think more and more negatively until they spiral down into depression, especially if they feel hopeless because they've tried to change things for a long time without achieving anything.

I'm going to have to speak to the woman tomorrow about any parts of her relationship with her husband that could do with being improved, and talk through ideas with her about how she could go about improving them.


Part Three
Ways of Trying to Persuade a Spouse to Get Treatment for Depression


That terrible mood of depression of whether it's any good or not is what is known as The Artist's Reward.
--Ernest Hemingway

This is my depressed stance. When you're depressed, it makes a lot of difference how you stand. The worst thing you can do is straighten up and hold your head high because then you'll start to feel better. If you're going to get any joy out of being depressed, you've got to stand like this.
--Charlie Brown

A positive attitude may not solve all your problems, but it will annoy enough people to make it worth the effort.
--Herm Albright, (quoted in Reader's Digest, June 1995)

The tragedy of life is not that it ends so soon, but that we wait so long to begin it.
--W. M. Lewis

Not Being Too Insistent They See Things the Way You Do

My notes say there isn't any sure way to persuade a husband or wife to get treatment for their depression if they're reluctant to get any kind of help. But there are things people can try. It recommends in my notes that people try various things till something works.

They say it shouldn't matter whether a spouse is willing to admit that they are depressed. They might prefer to call it something else, like just feeling down or stuck in a rut or whatever. So people shouldn't insist their spouses admit to being depressed. They might still find an effective treatment without doing that.

And they say it shouldn't matter if the depressed husband or wife decides to go for a treatment that isn't the one the person who wants them to go for treatment would prefer them to go for. If they're doing something, it'll hopefully be movement in the right direction whatever it is.

Within reason, presumably.

I'll try to remember to say all that to the woman tomorrow.

Gently Expressing Concern

These lecture notes say that a good thing for someone to do to start with is to wait till they have their spouse's full attention, and then say something like,

"You know, I'm really concerned about you. Your behaviour's changed towards us recently."

Then they can give specific examples of the way it's changed. If they do it gently enough, their spouse hopefully won't get defensive. They could use phrases a bit like, "You hardly say a word at home to anyone. That's not like you", or, "Yesterday evening when you snapped at me at dinner, I was really concerned, because you seem really angry lately, as if you're feeling really down".

The notes say it's important not to be vague, but to phrase things in such a way that the person you're talking to will be sure to understand exactly what you mean. So, for instance, instead of saying to them, "You've seemed listless lately", they could say, "You haven't left the house for five days in a row; this isn't like you."

My notes recommend that people then tell their spouse they believe they're depressed and that it's been influencing the way they think and feel about things, and then they say they think there are lots of things depressed people can do to feel better, and that if their spouse likes, they'll investigate some with them.

They say people should stop then, and pay attention to the way their spouse is reacting. If their husband or wife is positive about the idea, they can go on to discuss various treatments with them and see if they like the sound of anything.

If they do like the sound of something and decide to go for it, in the coming weeks, the spouse who raised the concern about them being depressed should see if they follow up what they said by getting any kind of treatment. If they do, the concerned spouse should support them and praise them for it. If the depressed one's feeling rewarded for what they do by that, they'll be encouraged to carry on with it till they hopefully feel better.

The notes say that if they don't seem to be bothering to get any kind of treatment, maybe a gentle reminder would do. They say that sometimes, people are more open to suggestions after they've thought about things for a while. And maybe if a bit more time goes by with nothing happening, another gentle reminder might work.

But they say that if those don't work, it can be safely assumed that the spouse doesn't actually want to get help. So then other tactics can be tried.

Varying the Wording Used

My lecture notes say that if a spouse gets defensive when the word depression or depressed is used, such as saying they don't have a problem or refusing to discuss treatment, it might just be because they feel threatened by a word that sounds as if they have a mental illness, like depression. But they might be more comfortable if words are used that make what they've got seem more usual, like suggesting they might be moody or down in the dumps or stuck in a rut or something. The language doesn't matter, since the treatments for all those things will mostly be the same.

If the depressed spouse still refuses treatment, there are other things that can be done.

I'm going to read through these notes several times to try to get all this stuff into my memory so I hopefully won't forget it when I'm discussing it with my counselling client tomorrow.


Part Four
Dealing With the Depressed Partner's Hurtful Attitude


Men are more prone to revenge injuries than to requite kindness.
--Thomas Fuller

In these times you have to be an optimist to open your eyes when you wake in the morning.
--Carl Sandburg

People who look through keyholes are apt to get the idea that most things are keyhole shaped.
--Author Unknown

The real act of marriage takes place in the heart, not in the ballroom or church or synagogue. It's a choice you make -- not just on your wedding day, but over and over again -- and that choice is reflected in the way you treat your husband or wife.
--Barbara De Angelis

There is no feeling, except the extremes of fear and grief, that does not find relief in music.
--George Eliot

I'm going to rehearse saying this stuff, imagining I'm saying it to my counselling client, to try to get it more firmly into my memory. I could say to her:

If the Depressed Partner's Blaming You for All Their Misery

Depressed

Some depressed husbands or wives forget all the good things about the marriage, and their thinking becomes so one-sided in their emotional state that they blame the person they're married to for all the problems in it, which they probably blow out of proportion as well. Do you think that's happening to you?

(If the answer's yes) It might be totally unfair of him to be blaming you for all the problems in the marriage, but if he is, then maybe he isn't listening to what you say about him needing treatment because he thinks you're the last person qualified to make comments on his behaviour and what he needs, since yours is supposedly so bad.

If you've been saying that it's his behaviour that's been causing the problems and that it hasn't been all your fault, he might be refusing to seek help because if he did, it would feel to him as if he was admitting that you're right after all and he was wrong. It's a silly way to think, but that's the way people can get when they're in an emotional state.

Arguing

If you're going to be able to convince him to get help eventually, it's important that you stop defending yourself, since that'll just make him more determined to prove he's right about you being the cause of all the problems rather than his depression, and the whole conversation will keep getting side-tracked into an argument about how much you're to blame for the problems. He might bring up everything he can think of that's ever made you look bad, and say more and more hurtful things to try to prove his point. Depressed people remember bad things far more than good things, so he might end up convincing himself that you've destroyed his life. I know that sounds horrible, but it's just because depressed people don't think clearly. They have a distorted impression of things where they can only think of the bad things. So it's best not to argue with him, but to try to change him more subtly.

One thing you need to bear in mind is that it might take a lot of patience, since it might be a while before he changes, if he's been that determined not to. So try not to get exasperated with him and start insisting he needs help. If you're patient with him, he'll hopefully come around in the end, since he'll probably get fed up of the way he is and want to change eventually.

Try Not to Take the Depressed Partner's Accusations Personally

Complaining angrily

In the meantime, every time he says something horrible to you, try to remember he's saying it because his thinking's all clouded and he isn't thinking of things in a balanced way. Miserable people often say things they realise were unfair when they stop being miserable. So he might do that.

It'll probably be difficult, because his accusations are bound to be hurtful or annoying, but it'll be best if you can resist the temptation to defend yourself against his accusations, since if you do, he'll probably disagree and come out with worse ones. So a calming thing to say instead might be something like,

"I'm sorry you're feeling so bad about us. I wouldn't have done anything intentionally to upset you."

People often find that the better they feel about themselves, the less likely they are to let hurtful accusations get to them. So it might be a good idea if you do things that'll make you feel good about yourself, and also things that'll help you de-stress yourself. It might help if you do the best you can to spend time without your husband, around people who are supportive of you and your efforts to get your husband to change, and who you can be yourself with.

It's best not to spend time with people who ask you why you're putting up with him, people who think that leaving him would be in your best interests. If you've got any hope that your husband will change and that your marriage will get good again, you'll only get discouraged by being around people who are well-meaning but who are trying to convince you to chuck it all in. People who divorce often regret it later. If you think he's still worth keeping, in the hope that things will improve, then try and spend time around people who'll support you in that decision.

If the people who ask why you stay with such a person are good friends of yours so you want to spend time with them, you could perhaps say to them something like,

"I appreciate your caring, but I want to try to make my marriage work".

Then it's best to stop complaining to them about your husband, since they'll only encourage you to give up on him some more, and it might make you feel like giving up on him yourself. But the fact that you've got here today proves you care about him and your marriage, so it would be a shame if that happened.

If he starts getting back to the way he used to be, you'll be glad you stayed in the marriage after all.


Part Five
Techniques a Spouse Can Try to Help Lift Their Marriage Partner's Depression If They Don't Want Treatment


The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.
--M. Scott Peck

I believe there are more urgent and honorable occupations than the incomparable waste of time we call suffering.
--Colette

Treat people as if they were what they ought to be, and you help them become what they are capable of being.
--Johann Wolfgang von Goethe

There are quite a few things you could try.

Suggesting Enjoyable Activities Known to Lift Depression

Exercising

Is your husband into healthy living at all? Or I wonder if you could get him interested, or at least in doing something energetic. Research has found that exercise helps lift the mood. Is he fit enough to do some energetic exercise? (If the answer's yes) Perhaps you could ask if he'd like to join a health club or gym or go swimming or for walks with you, or to go for some other exercise that you think you'd both enjoy. Actually, even if he's not that fit, he could go for walks with you.

It's best not to tell him that the reason you're asking him to come with you is because you're trying to make him feel better, since if he doesn't want help, he might just think you're interfering and get annoyed. But you might be able to talk him around to liking the idea if you say you're going yourself and act as if you'd like his company or something.

What kind of exercise do you enjoy? Can you think of an exercise you both enjoy, or might both enjoy? After all, you might feel better if you do more exercise as well. It can give people more energy and make them feel more lively. So you might both find you feel better.

Getting Someone Else to Speak to the Depressed Spouse

Talking

If your husband's blaming you for all his misery, he might not think you're a good person to be giving advice; but maybe he'd accept it from someone else. It might be that if someone else had a talk with him where they expressed concern about him and suggested he get some kind of help, he might be willing to do something.

So maybe you could ask someone you know your husband loves or respects if they'd do that.

But the idea is risky. If your husband suspects you put them up to it, he'll probably be annoyed and refuse to do something about his depression even more. Even if he doesn't think you put them up to it but still thinks you must have been talking to them about his depression, he'll still be annoyed. So it would have to be done carefully and seem as natural as possible, with the other person giving examples they've personally noticed of ways your husband's behaviour's changed.

Writing a Letter

Writing a letter

It's possible that you might find that writing him a letter finally convinces him that he needs help. I don't mean one you post, but one you just leave somewhere where you know he'll find it. It might work especially well if you're out at the time when he finds it so he has some time to think about it before he sees you again.

Writing letters doesn't always work. But it often can, perhaps partly since if you're not there when he reads it, he's not going to be busy thinking of what to say to defend himself, so he's more likely to take what you say in. Also, people have more time to think through what they say in a letter, so they can explain themselves in more detail. I've heard that lots of people have found that writing letters works when their attempts to talk through their spouse's depression with them have miserably failed.

But if you write a letter, it'll be just as well not to try to prove your point that he's depressed and needs help if that might just antagonise him. I think the best thing to do is to express concern, love and caring in it that he's feeling down. You could ask him what he'd like you to do to help him feel better. If you can think of any qualities of character or problem-solving abilities he's had in the past that have helped him improve something, and you think there's a possibility he could use them to help himself get his life back on track now, let him know.

I think it's best if you don't say anything about the letter, but just wait to see if he responds. Don't get frustrated if he doesn't, since he might still have taken in what you said and be planning to do something about it without telling you. I think some men feel awkward about discussing their feelings with people. So he might just feel awkward about bringing the matter up. And he might feel awkward if you do. So don't mention it unless he does.

But watch his behaviour in the coming days to see if anything happens that seems as if it could be progress.

If nothing happens, you can probably conclude that letter writing doesn't work with him, and move on to trying something else.

Take Special Notice of the Times the Spouse Isn't Depressed

Oh dear. This is sounding far more like a lecture than a counselling session! Well, I don't suppose it'll really go just like this. I'll just try to bring in these points at times during the conversation.

There are more things I'd like to say to her as well. I'd like to say:

Depressed people often have hours or days when they're not so depressed, or not depressed at all. But like I said before, when people are depressed, they only think of the bad things and forget the good things. So your husband might think he's depressed all day every day without a break. So that thought might make him even more miserable.

So it might help cheer him up if you make efforts to notice when he seems a bit happier, and compliment him on what he's doing. When people are complimented, it can cheer them up a bit, and since they feel rewarded for what they're doing by the compliment, they can feel like doing it more. And if what they're doing is something that cheers them up, when they do, that'll mean they cheer up some more.

I heard about a woman whose husband had been depressed for a few months. He was withdrawn, always blaming her for things, and didn't pay any attention to the children. She'd tried everything she could think of to persuade him to go for therapy or at least admit he had a problem, but nothing worked. She was beginning to consider divorcing him, since she didn't think she could live the rest of her life with someone who showed so little interest in and care for the family.

But before she started to consider divorce seriously, she decided to try helping him again. She went to see a therapist herself, who advised her to watch out for times when he seemed to be feeling a bit better and was a bit more like his old self, showing a bit more interest in things, and to compliment him every time she caught him at it, expressing gratitude to him for any acts of consideration.

Over the next few days, the woman noticed that her husband was doing some things for their children like giving them baths and reading them bedtime stories, and he seemed to talk more than he had for some time. She didn't think there was anything special about him giving the children baths and reading them bedtime stories really, since she thought that's what dads are supposed to do. But she realised that since he was depressed, it probably took extra effort for him to motivate himself to do that.

So she decided that instead of just taking what he'd done for granted, she would compliment him. She said,

"The kids really seemed happy that you read them to sleep last night. It means a lot to them. I know that you're not always in the mood to do that, but I'm glad you pushed yourself because they love having you be part of their lives."

She left it at that.

A few days later, she came home one afternoon and heard him playing his guitar. He'd often played it when he was his old self. But he hadn't played it for weeks. She wouldn't normally have thought much of it. But since her meeting with the therapist, she realised it was part of his good old self and something she wanted to encourage. So she simply said, "It's nice to hear music in the house again." He thanked her.

Three days later, he started playing his guitar every day.

The woman decided not to try to persuade him to seek help for depression any more. She decided instead to help him realise he wasn't depressed all the time, by continuing to compliment him when he showed he wasn't. Doing that not only helped him, but it also helped her. She realised, as well as him, that he wasn't depressed all the time, and it helped her to think of him as a person who had occasional bouts of depression, rather than as a depressed person.

As she grew more optimistic, she started being more cheerful and less cautious around him. And his mood improved, which might have had quite a lot to do with that.

So complimenting your husband for things he does when he isn't so depressed sounds like a good strategy. I think it's best not to talk about depression at all if you try it, but just watch out for when he's more like his old self or doing things that please you or the children, and compliment him for them.

Behaving as If the Depressed Spouse Wasn't So Depressed

I heard that the woman I've just been telling you about had been in a bad mood herself for some time because of her husband's depression. I heard she'd been feeling hurt and resentful, and she was cautious around him, since she worried that the smallest thing might send him into one of his blaming moods. She'd been defensive around him for weeks. She hated coming home because of the feeling of doom and gloom around the home.

It's quite possible that he was getting more depressed because of her cautious and defensive behaviour. She didn't think her behaviour had anything to do with it. But then when she started behaving differently, he became happier. So it seems that her behaviour did have an influence on him.

Things changed when she started looking for good things about his behaviour and expecting to find some. So it may be that your husband would do the same. You might not realise it, but if you expect him to be miserable, that might be reinforcing his idea of himself as a miserable person so he'll go on being miserable; and if the atmosphere's bleak in the house, there won't be anything to inspire him to cheer up. But if you start expecting good things, you'll be more cheerful, and that might rub off on him.

So have a go at asking yourself,

"If I thought my husband wasn't depressed but was in a really good mood, how would I approach him differently? What would I do that I haven't done for a long time because I've been nervous about his mental state?"

Then, whatever you'd want to do, or have done in the past when you were getting on better together, have a go and see what happens. Behave as if you're more confident that the depression is a temporary thing and he'll get over it soon.

I heard about a man who was scared about his marriage when his wife became depressed and withdrawn from him. There was a history of depression and failed marriages in her family. Before she became depressed, they'd often communicated about their feelings with each other. But he was scared of putting any pressure on her, so he left her alone to sort her own feelings out instead. But she just got worse.

Her husband didn't know what to do, but when he heard about the technique of behaving as if he was confident that things would turn out allright, he decided to try it. He realised that talking about their lives and feelings had been a very important part of what they'd done together before. It had always helped her when she'd been upset before. He hadn't done it this time because he'd been scared things would go wrong and she'd want to leave the marriage. But when he asked himself how he'd behave if he was more confident that the depression was only a passing phase and that their marriage wasn't in danger, he realised he'd express concern for her and ask her about her feelings, and if she didn't want to talk at first, he'd continue to do that. It had always worked in the past when she was upset.

So he did that, and it worked. She started talking about her feelings, and seemed relieved that he cared and was concerned about their relationship.

After a while, she agreed to go for counselling; and in a short time, she was feeling much better and their marriage improved.

Doing the Opposite of What You've Been Trying to do to Help the Depressed Spouse

Hey, I'm going to tell my counselling client that story about the woman who left those leaflets about old people's homes around the house and it scared her husband into proving he could be more active and he stopped being depressed. I like that story.

There's that thing in my notes with the story that says that trying to cheer a depressed person up often has the opposite effect, because they think you just don't understand how bad they feel and you seem to think it's easy for them to cheer up when it's not. So sometimes, doing the exact opposite of what you've been unsuccessfully trying can work.

This story's good. A man got depressed after he'd had to retire from work early with a back problem.

... OK, that bit's not good. The good bit comes later when he gets better.

He hardly did anything all day, but just sat around feeling sorry for himself.

He saw a therapist, and complained about being unhappy, but didn't follow any of her suggestions about getting a job that was less physically demanding than his old one had been, or doing other activities that might make him feel better. He stayed just as depressed as he was before.

The therapist asked him about his wife and what she thought of what was going on. He said she was a nurse and she was very concerned about him. He said she'd tried to get him to chat to the neighbours and relatives, but he just didn't feel like it. She'd tried to persuade him to get a job that didn't involve anything physically strenuous, but he didn't feel like doing that. He knew she loved him and that she was frustrated at his lack of progress.

The therapist asked him if he'd mind his wife coming in on her own one day without him, and he agreed.

His wife was a cheerful sort of person, but she was very upset that her husband wouldn't come out of his depression. She'd tried everything she could think of to cheer him up and get him involved in life again. She said that even the neighbours noticed he'd changed; he didn't talk to them any more like he used to.

The therapist complimented her on her efforts. Then she said that sometimes, the more a person tries to cheer a depressed person up and get them involved in things, the less they'll want to know. But if it seemed as if she was giving up on him, he might start wanting to prove he was capable of doing those things after all and make an effort to do them.

So the therapist suggested that when she went home, she told her husband that she realised she'd been expecting too much from him. She had wanted him to go back to the fun-loving, cheerful and sociable person he used to be, but now she realised that because of his back injury, he might never be like that again.

The therapist advised her that she tell him she needed to find enjoyment and fulfilment in life on her own without him, and apologise to him for having not realised this before and put too much pressure on him to join in. The therapist suggested she tell him not to worry, she wouldn't be pushing him any more, because she was committed to becoming more realistic about his condition. Then she should end the conversation.

The woman loved the idea. She laughed, and asked if the therapist had any other ideas as to how she could make her husband think she'd given up on him.

The therapist suggested she go to a few nursing homes in her area and pick up brochures, and then leave them scattered around the house in places where he was bound to see them. If he asked what they were, she was just to give some vague reply, perhaps saying they might come in useful when deciding where to place clients who were under her care. If she said she was thinking of putting him in a home, it would obviously cause a big argument. So she wouldn't do that.

Then the therapist told her to make lots of plans for herself to go out with friends and so on, without consulting with him or asking him to join her like she had before.

The therapist said it was important for her to pay attention to the way he was responding.

Two weeks later, the woman came back and told the therapist what had happened.

She said that when she apologised to him for trying to push him into things, he was speechless. Then, he told her it was only natural for her to want him to feel better. She said she understood what he was saying, but said she now realised that what she'd been doing hadn't been in his best interests so she was going to stop completely.

He seemed confused, and even a bit put out.

A day or two later, she noticed he'd picked up one of the brochures she'd left on their night stand. After that, his behaviour changed quickly. He immediately started looking for a job, and already had several interviews lined up! She noticed he was talking to the neighbours again, and he even invited one of them around for dinner, which really surprised her. He started talking more at home, and his attitude seemed to have improved a lot. She was astonished.

The woman was tempted to compliment her husband on his positive changes, but the therapist warned her that if she started being all positive again too soon, he might well go back to being negative again, since he wouldn't think he had to make any effort to get his life back on track any more if she was going to be accepting of him again and try to plan everything for him.

So the therapist suggested she didn't say anything, and if he asked her if she'd noticed the changes in him, she was to say she had, but she was wondering if they were going to last. That way, it would be up to him to prove to her that he was getting better, rather than her trying to prove to him that he could manage it.

The therapist saw the woman once more, and the woman said things had improved a lot more.

My notes that go with that story say that when people have been trying something over and over again, even when it seems the logical thing to do, sometimes, the thing that will work best is the exact opposite, so it can help to do that.

They say that often though, people are scared to do that, in case it makes their husband or wife worse. People might worry, for instance, that their husband or wife will think they've really given up on them and get even more depressed. But the notes say that the worst thing anyone can do is probably more of what doesn't work. So it's worth changing tactics.

They suggest several ways people could try changing:

People who've been patient and understanding up until now could try becoming firm and setting limits on the way they'll tolerate being treated.

People who've been refusing to tolerate inconsiderate behaviour could try showing more patience and understanding.

People who've been making sacrifices to do everything they can to please their husband or wife could try pleasing themselves instead.

People who've been trying to get their husband or wife to tell them what's wrong on a regular basis should probably stop behaving as if they're so concerned.

People who've been trying to cheer their spouse up with positive comments such as, "You'll get better", should probably stop doing that.

Basically, any behaviour that's been tried for some time but hasn't worked should be changed, and possibly totally reversed.

Looking After Your Own Needs for Enjoyment in Life

There's something else I'd like to say to my counselling client tomorrow, based on what I learned in one of the books I read. I'd like to say:

Don't lose heart if nothing you do seems to work. Sometimes, people with problems need to feel really really bad before they'll think they can't stand it any more and they'll be motivated to change. So people around them just have to wait till that happens. Trying to help them just stops them feeling bad enough to want help. So if nothing you try seems to work, strange though it might sound, it might be kindest for him, and best for you, to stop worrying about him, and pay attention to looking after your own well-being and making your own life enjoyable.

Happy

So you can ask yourself what you used to enjoy doing but that you haven't done recently because you've been so concerned about your husband's well-being or the state of your marriage. It can be good to make a list of everything, and then start doing all the things again, even if it means doing them without your husband. You have to think of yourself and your own enjoyment. There might be new activities you'd like to take up as well.

It's especially important that you start making an enjoyable life for yourself if you have children. For them to have one depressed parent is bad enough, but it's much worse for them if both their parents are unhappy. But if the children can experience laughter and happiness in the home and in their lives, they'll feel more cheerful and secure.

And if they learn that it's possible to enjoy yourself in several ways and be happy often, they'll know that life can be happy. Your husband might even learn or remember that life can be happy, so what you're doing might rub off on him.

You don't need to feel as if you're abandoning him. Think of it as you being a role model for him. You're proving to him that life can be happy, so it might get him interested.

If the Spouse is Suicidal

Having advised you to make a life for yourself without him if nothing else you try works, of course, that's only if you think it'll be safe to leave him alone. If he's feeling suicidal or talking about death or hurting himself, or threatening to hurt someone else, or anything like that, then it's important that you contact a local mental health centre or suicide crisis centre or somewhere like that.


Part Six
A Few Insignificant Personal Musings

Embarrassed

Actually, thinking about it, I don't suppose I'll have time to say anywhere near that much to my counselling client tomorrow! She might do most of the talking anyway. Hopefully I'll have more than one counselling session with her so I can say everything over the next few weeks, or at least the amount that I remember. I'll just have to think of what the most important things are and say those tomorrow.

And we might get right off track anyway if I ask her a question and we start talking about other things. Oh dear! She might ask me questions about things I haven't revised so I don't know the answers! Even if I learned up about them recently, I might have forgotten them. Maybe that's why counsellors like their clients to do most of the talking! I'm not sure I'm planning to do this counselling the way you're supposed to. I hope I don't fail my course because I've been doing too much talking!

Well, if my counselling client does ask me questions I don't know the answers to, at least if I have more than one counselling session with her, in all but the last one, I can find the answers out in between sessions and get back to her the next week, ... unless they fail me before I've even finished my work placement because I've given far more advice than you're supposed to in this type of counselling, of course!


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The Backstory

The Way Things Are Before They Begin to Improve

Trying to think

Nicola is coming to the end of a marriage counselling training course, and is on work placement, counselling couples in a nearby centre, for practice and to show she can make a success of it.

She hopes to do well enough to pass her course, but she's finding it difficult, because the couples she's counselling keep asking questions she doesn't know the answer to, because she's forgotten what she learned about those particular topics, if she learned about them at all on the course, and didn't realise they were going to come up in the conversation, so she didn't prepare for them.

She's thankful that she does have the opportunity to prepare for most things though, because she gets to know a bit about the circumstances of each couple she counsels before she does, so she can read up about the particular issues she knows will come up.

She knows she's got an appointment to counsel a woman whose husband's depressed tomorrow, so she looks through her old course notes to find some information about how to help a spouse over depression. She thinks it might be a bit of a challenge though, since the woman has said her husband isn't very keen on getting treatment himself, and so she's hoping for some new ideas on how to persuade or help him.

She does find things she hopes will be useful.


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