How depression affects couples – in their own words

Depression has been called a "we-disease" because when the dark clouds arrive, it's not just the depressed person who is affected, but all those close to them. A new study in the Journal of Social and Personal Relationship explored these spillover effects in the context of romantic couples, where one or both individuals have a diagnosis of clinical depression. The US study broke new ground by asking both partners in each couple to provide their perspective on how depression had affected their relationship. Liesel Sharabi and her colleagues said their results show how "the experiences of both partners should be considered when treating depression."

In all, 135 couples, most being heterosexual and white, provided open-ended answers online. The average age of the participants was 40 years, and just over 70 per cent of the couples were married or in a similar life-long commitment. The researchers identified several key themes, the most commonly mentioned was the emotional toll of depression on the relationship. Other themes included: problems with romance and sexual intimacy, over dependence on the relationship, and feelings of uncertainty about the relationship.

The study provides striking examples of the impact of depression on the non-depressed partners. For example, many of them spoke of the support they were required to give to their partner: "Raising a child in our household poses its own challenges since many times I feel like a single parent. And many times I have to parent my spouse such as making certain he wakes up, stays motivated … eats, exercises and baths" said a 34-year-old woman. Another participant with a wife who has psychotic depression, described the contagion effects of depression: "If my partner is sad or depressed, it makes me feel sad and helpless". And the wife of a man with major depression described her loneliness: "I feel like my husband's depression affects our sex life. He always seems to be not in the mood, like he is sad."

The answers given by depressed participants (with a non-depressed partner) also illustrate how the dynamics between the couple can sometimes make life extra difficult or complicated for the depressed person, including the frustrations they can feel at the lack of understanding. "He doesn't understand what depression feels like, that feeling of being at the bottom of a deep, dark hole with no way out," said one woman. "When I am feeling depressed, I feel guilty for not acting like my 'normal self'," said another. "I feel sometimes he thinks I can just 'get myself out of it' so to speak," said a 33-year-old woman with postpartum depression.

There was a silver lining in that some couples – more often those where both partners were depressed – described feelings of enhanced intimacy that were fostered by depression. "It brings us closer at times by supporting one another," said a woman with depression who's husband is also depressed.

Another approach the researchers took was to see how often partners in a couple mentioned the same issues. In fact, 80 to 100 per cent of the time, partners described different effects of depression on their relationship – a potentially useful insight for clinicians working with couples.

Overall, the researchers said their findings show just how "difficult it is to disentangle the effects of depression on the individual versus the relationship." For example, their participants' stories show how: "When a depressed person's sex drive is suppressed, the sexual needs of his or her partner go unmet; when a depressed person goes into isolation, his or her partner is shut out; when a depressed person refuses to leave the house, his or her partner must face the world alone. Thus, our findings provide poignant illustrations of how depression ripples beyond individuals to reverberate within couples."

Further reading

Sharabi, L., Delaney, A., & Knobloch, L. (2015). In their own words: How clinical depression affects romantic relationships Journal of Social and Personal Relationships, 33 (4), 421-448 DOI: 10.1177/0265407515578820