Dear Therapist:

My wife suffers from major depressive disorder and has for many years. Most of the time it is kept under control with medication but every so often will flare up into a severe depression. She has currently been suffering from a depressive bout for the past month and a half. She is working with a psychiatrist and therapist to get better. Part of her depression is that she doesn't want to do anything but sit at home all day. Sitting at home and thinking all day just makes her depression worse and I know that she needs to get moving again in order to get better. I am not sure how hard to push without it backfiring on me (and our relationship). The therapists are working with her but say it's slow going. Do you have any advice as to how to get her moving in the way she needs to? Is my role just to be unequivocally supportive? But the therapists are only with her briefly; who can give her the nudge she needs but me?

Response:

I don’t believe that someone who has never been clinically depressed can truly understand the impact that depression can have on those who suffer from it. Often, people believe that someone who is depressed simply feels down in the way that we all have—only more severely. Feelings of sadness are only one symptom of depression. In fact, children can be depressed without feeling overly sad. In children, anger can replace the sadness. 

When someone is depressed, they are typically sapped of their energy, drive, and interest in activities. It can be extremely difficult to focus and to perform daily activities. You mentioned that doing things can help your wife’s mood to improve. This is likely true, and the reverse holds true as well; feeling a bit better will make it easier for her to do things. 

You mentioned the notion that pushing your wife to get out might negatively impact on your relationship. You may be referring to anger that can be easily triggered when one is depressed. I wonder whether any anger that your wife has exhibited in the past has bled over into your general relationship—or whether it only affects your relationship while she is actively depressed. Though it can be hurtful when an otherwise good relationship undergoes a trying time, if the overall relationship is not significantly affected, the ends may justify the means. If, however, resentment tends to build up—leading to future ongoing issues—it may make more sense to support your wife through her depressive episodes until she is able to accept your overtures. 

Coaxing someone to do something is often a question of timing and of feeling the person out. Sometimes, even someone who is deeply depressed can recognize when they can be receptive of the type of help that you’re trying to offer. If you recognize that pushing your wife to do things is not the way to go, you can try having a frank conversation with her. You can let her know that you’re fully supportive, and that you want to help her in any way that you can. You can ask her if it’s ok for you to urge her at times to get out, and let her know that you will respect her wishes when she tells you that she will not (or cannot) comply. In this way, she can feel that she is a part of the process, and that you’re not simply trying to impose your will on her. 

If your wife has close friends or family members who are willing to cajole her into doing things with them, encourage them to do so. Usually those types of relationships are not negatively affected in the same way in which a marriage can be. Hopefully, with your support and that of others in her life, your wife will have a quick recovery.                                                                                            

Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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