Since I am a Couples Therapist, this article is focused on depression and the impact it can have on a relationship. If you think you may have depression, this doesn’t just impact you. A relationship is fluid so when one person feels down, the partner will react to this – this reaction will vary, of course. It doesn’t mean they will have a negative impact, but we don’t know until we talk about it.
This article is for you if you have depression and want some solutions for you and your partner. Or maybe you think your partner might have depression, and you are feeling the impact and want to know more. Research shows that depression is highly responsive to effective treatment – what a relief if this has been your battle!
National Suicide Prevention Lifeline
1-800-273-8255 or text HOME to 741741
I have every disorder of the DSM-V. Before we get to the diagnostic criteria, let me tell you a little bit about my time in graduate school. When I was studying the diagnostic criteria for mental disorders, I either had every disorder or knew people who had every disorder. “Oh shit, I have depression”, or “Am I going through caffeine withdrawals”, or “I have Hypersomnolence Disorder”.
That last one, yeah, I was just tired – easily understood when I acknowledged I was in grad school and working at the same time. I analyzed my behavior to the point where it was over the top, so please take this information with that in mind.
This is only the tip of the iceberg, so if you are wondering if you have a mental disorder, please contact a mental health professional to get a true diagnosis and (if applicable) a treatment plan. This is in no way supposed to act as a way to get a diagnosis, just as a tool for information and awareness.
Diagnosis. When discussing a diagnosis, mental health professionals refer to a book titled Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association. The book is currently in its 5th edition and is often referred to as the DSM-V.
This book has been updated as the field grows and understands people and our mental capacities through the use of research. In this edition, there is a chapter on depressive disorders that contains diagnostic criteria for multiple conditions.
The common features these disorders include are: “the presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function. What differs among them are issues of duration, timing, or presumed etiology” (DSM).
So, in short, different disorders could be classified as overall use of the word “depression” that is characterized by sadness, melancholy, lack of energy, hopelessness, and loneliness which may be on a spectrum of being chronic to acute and mild to severe. In addition, (as with all mental diagnoses) these have to cause actual impairment in life. If I like to take naps or sleep longer than the average person, but I don’t need to wake up until noon anyway, I may not meet the diagnosis for depression.
Another common mistake is to confuse depression with grief. If you’re crying because of a loss in your life, that is different than having depression.
Genetic or family pattern? Depression is often seen in more than one family member – not always, but sometimes when one family member has depression, there is a higher likelihood that one or more other family members have symptoms of depression. There is a debate in the field as to whether depression is developed genetically or through a family pattern.
More research tends to support an environmental factor that allows family members to “learn” or “pick up” depressive behaviors. In a way, this means it is passed within a family; however, no “depression gene” has been found.
Solutions. As a Couples Therapist, I can work with a couple to identify patterns, behaviors, or risk factors that may impact the success of treatment for depression. In couples therapy, we can work together to set real goals for your relationship that can exacerbate or improve depressive symptoms. Here are some potential examples of solutions.
· Couples Therapy. Some therapeutic approaches are more effective in treating depression – one of which includes interpersonal approaches. Yes, this means we can address depression’s symptoms and get some solutions through couples therapy. For a lot of people, depression can be exhausting; therefore, how do you get more energy? Does spending time alone tinkering in your garage help you feel more recouped? Or staying in for a movie night? Maybe a date night out is what helps you feel refreshed? We can talk about this in therapy.
Yes, we want to be mindful of your needs in your treatment, and we need to be mindful of your partner’s needs, too. What is going on for your partner when you are having more depressive symptoms? A solid balance can help build the relationship and help with the treatment of depression.
This balance may include together time, alone time, effective communication skills, coping skills, work/life balance, defining needs, increasing connection and intimacy, etc. Building effective tools for one aspect of your life can impact other aspects of your life. So in this example, building up your relationship may decrease your depression.
· Individual Therapy. Depending on your needs, individual therapy is most likely a solid step for those with depression. As stated above, we can work together in couples therapy to have real tools to apply, at the same time, individual therapy may be a good addition to this treatment. If you are a current client, we can work together and see how the symptoms are adapting and a referral may be of assistance. Couples therapy may also give you all the tools to tackle your relationship distress and your depressive symptoms simultaneously.
Your treatment will be more focused on you instead of on your relationship. If you choose individual therapy, I would still recommend touching base with your partner as you are going through treatment. As stated above, what happens to one, happens to the other. This will be a change for them, too, so at least check-in. I wish I had a more definite answer for you; however, your treatment should be customized to you.
· Medication. I’m not a psychiatrist, and I do not prescribe medications. A psychiatrist can be of assistance to provide medications as they see fit. I believe that trying other means before medication is ideal. Of course, there are exceptions to this rule; however, if treatment is successful in therapy, medication may not be needed.
The opposite is true for some as well, if treatment in therapy is ineffective, a solid referral to a psychiatrist may be a beneficial next step. When in doubt about your next step, contact a mental health professional or even talk to your primary doctor.
You are more than any diagnosis!
Language. Let’s talk about the difference between saying someone is “depressed” versus someone “has depression”. Sometimes, people online or in social situations throw around clinical terms as if they are clinicians. I often hear “I’m depressed” or “I have OCD” (maybe we’ll make another post on obsessive-compulsive disorder – let me know if you’re interested).
If you meet the clinical diagnosis you have a form of depression. There is a difference and the language matters because one is more negative and one is more positive. Saying you are “depressed” implies it is a part of you – it is tied to your identity; therefore, you are stuck being depressed. Instead, someone “WITH depression” has a level of separation aka a level of moving toward a solution.
You are more than any diagnosis you may or may not have. You are who you are and you may have a diagnosis. You aren’t just your diagnosis! Let’s change the way we talk about it.
Let’s all move towards solutions! If you have depression, there are some solutions available for you and your partner – you just have to find the right fit!
Suicidal Ideation. If you have thoughts of suicide, then please take action. You can call the national suicide prevention lifeline at 1-800-273-8255, chat on their website, or text HOME to 741741 for free and confidential help.
When in doubt, please visit your nearest emergency room as another option. The Couples Workshop is not a crisis center, nor is it open all day, and would not be an effective solution to you for suicidal ideation.
Sources Mentioned:
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. www.psychiatry.org.
National Suicide Prevention Lifeline. http://suicidepreventionlifeline.org
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