DEAR DR. JENN,
When my boyfriend and I first started dating, he told me that he struggled with depression. In retrospect, I think I was naive. I didn’t realize how much it would impact me and our relationship. What can I do to help him? What can I do do help our relationship when he’s struggling? —Down (Not Out)
You are not alone and neither is your boyfriend: According to the American Psychological Association, as many as 17 million adults in this country suffer from depression. Depression does not discriminate based on age, socioeconomics, fame or success. In fact, many celebrities have spoken openly about their own difficulties with depression, including Lady Gaga, Kristen Bell. Most recently, reports have come out that the newly married Justin Bieber, while thrilled with his marriage to Hailey Baldwin, has been struggling with depression and has undergone treatment for it. This really speaks to depression being an underlying issue and not a reflection of someone’s relationship. That said, it impacts a relationship enormously. Studies have shown that relationships where at least one partner suffers from depression have a divorce rate that’s nine times higher than the average. Understanding the signs and difficulties that depression can bring, and exactly how to get help, are crucial to keeping yourself — and your partnership — on an even keel when tides get rough.
The symptoms of depression can vary from upsetting and concerning to debilitating, and it’s obvious how this would impact a relationship. It is common to see sufferers struggle with apathy, hopelessness, loss of joy or interest in things that once brought pleasure, mood swings, exhaustion, obsessive thinking, sadness and anxiety. And in terms of lifestyle or behavior, depression can impact sleep (insomnia or sleeping too much), eating (loss of appetite or overeating), energy (low energy or restlessness), and cognitive ability.
Often, depression in men shows up up differently, in the form of agitation, irritability or anger. While anyone can experience depression related to a life event — a death of a loved one, loss of a job, trauma, divorce, e.g. — certain people are more prone to general depression. People who have one or both parents who struggle with depression, have experienced abuse, suffered from neglect growing up, and people who have drug or alcohol issues are among those who can be predisposed to depression. Whether your partner is dealing with a-once-in-a-while down mood, or has been diagnosed with a mental illness that will be part of your lives for good, here’s what you need to know.
It’s Not About You
Depression greatly impacts the way a person thinks. It creates a lot of negative filters when it comes to how a person views the world. Someone who is depressed tends to see the glass as half-empty and anticipate the worst a situation or person can offer. They typically do not feel worthy of love, kindness and care. They may appear lethargic or lazy when in fact they are just too physically exhausted from the depression to do much of anything. Many people who are depressed feel emotionally numb or sad much of the time.
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Keep in mind that his depression is not a reflection of you or your relationship. (Think of Justin Bieber and how over the moon he is for Hailey, even while he says he’s “struggling a lot” and asking for prayers and healing.) While it impacts you, this is your partner’s own struggle and it is important not to take it personally. Separating yourself from the “cause” or reason your partner is depressed can help you better support him. Understand that even if it’s hard for him to take action against depression, he does not want to be depressed. Depression is not a choice. Do not feel blamed or attacked for it “happening to” you or your relationship; and speak about it with empathy. Getting mad at someone for suffering from depression is like getting angry at someone for having cancer.
View Getting Help as a Sign of Strength
The single most important thing you can do to help your boyfriend is to encourage him to get treatment. In a more general sense, creating a judgment-free zone where he can be vulnerable and talk about his struggle can be very healing. Anything you can do to help reduce his stress and lighten the load while he is struggling can be helpful.
In order for you to help your partner, it is very important that he be open to help. Too many people who struggle with depression mistakenly think that getting help is a weakness. A woman recently wrote to me on Instagram saying that she had been “so weak” that she started therapy. The opposite is true. Getting help shows enormous strength. It is brave to be willing to face your pain, work on making things better, and be honest about your emotional state. Many people are too afraid to do the work. It is important that your boyfriend knows that you view this as a strength.
And the “work” shouldn’t be seen as insurmountable. Depression is extremely treatable. It is the common cold of psychotherapy, and something every licensed therapist knows how to handle. Psychotherapy can be very helpful treatment. For those who are experiencing depression that is more resistant to psychotherapy, the combination of antidepressants along with talk therapy can be extremely effective. Helping your boyfriend to utilize whatever support system he has is important. People who are depressed tend to isolate from those who love them, which only feeds their depression. In addition, encouraging him to take good care of himself is an important component of treating depression and even preventing it. Encouraging him to get enough sleep, eat healthy, get sunlight, exercise, and utilize stress reduction techniques can help.
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De-Stress Your Sex Life
Depression will impact your sex life together. It can kill a person’s libido, or simply challenge intimacy as it makes your boyfriend struggle to connect. If he is pulling away from you in bed, it does not mean he is not sexually attracted to you, it is the result of a chemical imbalance. And unfortunately, some antidepressant medications can lower libido, too. Do your best to work together to address these issues. You won’t want to put pressure on him to perform, as that could exacerbate the problem. Each person should have space to express their wants and needs, and the safety to know their boundaries will be respected. Proceed with care.
Look Out for You, Too
Men who suffer from depression often experience it as anger, meaning they have a short fuse and can be very moody. It is also not uncommon for them to self-medicate with drugs or alcohol which can have terrible results in terms of mood and temperament with their partner. It is important that you have good boundaries and self-care when it comes to how he treats you. If his illness manifests in poor treatment of you, or abuse of any kind, you may not be able to stay together. If someone is unwilling to get help and is consistently mistreating you — as hard as it can be to leave someone you love — sometimes you have to leave for your own well-being. You are allowed to do this, even if the other person is suffering from mental illness. You are not expected to endanger or harm yourself out of a sense of guilt for what the other is going through.
Call for Help
In some severe cases, people with depression may become suicidal. If your boyfriend expresses anything along those lines it should be taken very seriously. It is important to share with his therapist if he has one, family and support system, especially if it seems as if he isn’t addressing it how he needs to. Sometimes it is necessary to call authorities so they can determine if he’s a danger to himself, and needs to be checked into a hospital where they can monitor and treat him. (This is called “50150,” and can be a life-saving measure.) Another resource if you are concerned about suicidality is the Suicide Prevention Hotline (there’s a web chat, or you can call 1-800-273-8255). That can be a resource for you, for him, or for anyone else who is concerned.