Dear Lori and Jeff,

I think my husband is depressed and don’t know how to help. He says he’s fine, yet some days he has trouble getting things going in the morning choosing to stay in his pajamas or just wear sweats and not shower or shave. Other times he is irritable and snaps at me for things that don’t seem like they should be a big deal. He’s always had a difficult relationship with his mother and his dad passed away about a year ago and I don’t think he’s ever really dealt with it. His mood is significantly affecting our marriage and I walk around on eggshells. When I’ve suggested he get help, he becomes defensive. What should I do? 

Signed, On Eggshells

Dear OE,

Lori and Jeff: It’s estimated that 10 percent of Americans are currently experiencing depression and 15 percent of Americans will experience it at some point in their lifetime. While the symptoms and struggles of depression are commonly talked about, the impact on relationships often receives less attention. Couples in which one partner is depressed can experience significantly decreased connection, higher feelings of loneliness and isolation, increased conflict, increased stress and decreased fulfillment. There’s no question that you’re in a tough position. However, many couples survive and come out stronger when partners learn how to support while creating clear boundaries.

Jeff: While the statistics show that nearly twice as many women are likely to be diagnosed with depression as men, the numbers are greatly skewed due to the vast underreporting by men. Whether men don’t know that they are depressed or are more reluctant to admit it, men who need support are struggling. Men, like your husband, are likely to have been socialized not to talk about their feelings, which makes it hard for you to know what he is experiencing and for you to start a conversation with him.

In his book I Don’t Want To Talk About It, author and therapist Terrence Real describes the experience of men with depression by highlighting two components: Covert Depression (internalization and repression of feelings) and Overt Depression (externalization of feeling through anger and action). Covertly depressed men are often emotionally paralyzed, endlessly ruminating on their pain, despair and regret. Overtly depressed men turn to action in order to soothe. They desperately try to mask their pain, building up their tenuous self-esteem through achievement or acquisition, or by inflicting their pain on others. This construct seems to fit your husband’s behavior, both in his emotional paralysis and his anger, irritability and aggressiveness toward you.

Real goes on to say that, because of our society’s gender biases, the relational needs of most boys were never attended to. The need for connection, for nurturing support and the invitation to express vulnerability were all assumed to be too feminine and therefore not necessary for the male experience. As a result, men were taught that these needs were not legitimate and it became very difficult for men to navigate the realm of emotion. Because it often goes undiscussed and unresolved, depression in men tends to be passed along from generation to generation. To help, you must first let go of any assumptions that your husband knows how to express his feelings, if he’s even able to identify them. Then, work toward minimizing the shame he may carry for not knowing how to help himself. Create nurturing, relational support by accepting that a lot of what he is going through may not have anything to do with you or the marriage even though it is having a significant impact on it. 

Lori: As the supporting partner, it’s fundamentally important to gain awareness of your own internal experience in the presence of your partner’s depression. It’s common in these circumstances to feel powerless, frustrated, anxious or resentful. Start by naming your feelings and exploring the stories you have that are driving them. Are you resentful for having to give more or not receiving what you need? Do you feel the responsibility to fix the situation? Is your own emotional energy becoming enmeshed with or overcome by his depression? Recognize that while his depression may be front and center in the relationship, you are still responsible for your own emotional experience. For example, your tendency to walk on eggshells is likely a protective pattern that you adopted well before your marriage. It may be helpful to access your own support in lovingly asserting yourself. 

The role of the partner is to bear witness to the pain and discomfort and hold safe, empathic space. The impulse may be to direct him to therapists, give him books and articles or tell him what he needs to do. This is analogous to jumping into his hole with him and trying to drag him out. The outcome is often losing your own energetic grounding. Instead you want to remain rooted in your own foundation and create invitations and support for him to climb out. What is often most helpful is being willing to listen and validate his felt experience. At the same time, as you become more clear about your stories and needs, set concrete, behavioral based boundaries. “I love you and I know you're going through a hard time, and snapping at me is not okay.” If time continues without change, you may need to delineate for him specifically what you need from him as a spouse to remain married. Don’t focus on his time in pajamas, but rather your specific unmet needs in the relationship. This could include the need for connection and support yourself, equal help in managing life’s responsibilities, and being treated kindly. 

Lori and Jeff: Have empathy for his experience and understand that change doesn’t happen overnight. However, that doesn’t mean that you abandon yourself in the effort to support him. Clarify your specific needs and acknowledge his efforts as progress. Lastly, if you’re concerned about his mood, don’t be afraid to ask about suicidal thoughts. Research has consistently shown that asking will not cause someone to become suicidal, but can create the awareness needed to help save a life.