Everyone’s entitled to a bad mood or a stressed out week here and there. But when you are intimate with someone who struggles with low moods, it can be hard to know when that line has been crossed and “just stress” is actually a diagnosable clinical depression. Understanding the difference between situational moodiness and serious depression can be subtle. How can you know when to suggest your loved one schedule that visit to the doctor, and what can you do to be supportive?
Depression is an illness. Just like any other illness, depression can be mild, moderate or severe and has a set of consistent symptoms that vary a little from person to person. These symptoms include:
- Low mood, sadness or irritability. This sad, cranky state is present nearly every day, for most of the day, and has been your loved one’s default setting for a few weeks. This sadness or irritability is not due to a life event, such as a death in the family, a geographic relocation or new job. There is no obvious or clear explanation for why your partner is suddenly sad or in a bad mood all the time, and nothing external (a nice dinner, a funny movie, a brisk walk) seems to help.
- Loss of pleasure. Your partner seems to have lost interest in activities he or she used to enjoy. Hobbies, evening classes or activities that used to be eagerly anticipated are now met with a shrug or that awful defeated sigh and the words “I don’t feel like it tonight.”
- Changes in appetite and concomitant changes in weight. Both weight gain and weight loss can occur and both are symptoms of depression. You may notice a lack of appetite; many people struggling with depression describe food as losing its appeal. It’s as if taste buds become dulled. Weight gain associated with depression may be due to emotional eating, but it may also be due to the slowing of the metabolism.
- Changes in sleep habits. Both insomnia and hypersomnia are common and both can be debilitating. In severe situations, fatigue and lethargy can be so intense as to interfere with employment, caring for children and other important tasks. Similarly, severe insomnia can lead to an increase in both depression and irritability. Either way, your partner will feel exhausted and “wiped out” every day, just from trying to manage daily activities.
- Changes in how your partner thinks. These changes can be disturbing for loved ones to witness, as they seem to indicate that deep personality changes are unfolding. For example, you may notice that your partner is thinking about death much more frequently. He or she may develop fixations or obsessive thoughts or feelings, most commonly feelings of worthlessness or guilt. And how your partner thinks will seem different – as if thinking itself is exhausting and too much effort. You may notice confusion, forgetfulness and that he or she struggles to concentrate.
- Changes in behavior. Called psychomotor agitation (or retardation if the opposite is present), you may notice agitated, fidgety movements and restlessness.
- Often depression and anxiety go hand in hand. You may notice that in addition to these new behaviors, thoughts and emotions that indicate depression, your partner is also struggling with free floating anxiety.
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Bad moods last a day or two. Talking it out, dealing with the issue at hand and enjoying a pleasant distraction can usually set someone back on track if it’s just stress and everyday life that is getting them down. When a true depressive illness is taking hold, none of these sensible and well-intentioned efforts help much.
How can you help someone who is truly struggling with a depressive illness?
- Get a diagnosis. There are a number of different depressive illnesses and different strategies for tackling each of them. Support your partner in going to a mental health professional and getting diagnosed.
- Support your partner’s efforts to follow through with the treatment plan. Often mental health treatment for depression involves doing new or different things to combat the low moods and exhaustion. At first these might include attending group therapy or meetings, or doing “homework” for his or her next therapy appointment. Understand and expect that treatment may take time and effort and that, while you can’t do these activities for your partner, your support makes a difference.
- Listen and support but don’t try to solve problems. Don’t fall into the trap of “helping” too much. Sometimes from an outside perspective, it looks like the depressed person’s problems are easy to solve: for example, “Just get up and take a walk; you’ll feel better.” While that might be great advice for someone in a bad mood, advice and solutions are often beyond the reach of a person struggling with depression. Be present and stay connected and loving towards your partner, but understand that when he or she is ready to hear and respond to solutions, they are probably also able to devise them themselves.
Depression is a serious but treatable illness, and a loving, committed partner is a significant protective factor. Remember to take good care of yourself as you stay present and support your partner through this challenging episode.