Major depression: how to deal with it

How I talk to others about it
December 5, 2022
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By Deborah Serani, PsyD, as narrated by Hallie Levine

When it comes to talking about how depression affects relationships, I’m the expert. And not just because I’m a psychologist. I’ve been living with major depression since I was 19. Not only do I work on this topic with my patients, I encounter it every day in my own life.

There is no doubt that strong relationships can help provide a buffer against depression and reduce the severity of depressive episodes. One study, for example, followed American adults ages 25 to 75 for 10 years and found that people who reported having bad relationships with their spouse or other family members had a higher risk of depression.

But it can be difficult to maintain relationships when you’re so hurt yourself. Here’s what I tell my patients and want everyone who suffers from depression and those who care for them to know.

Depression can be difficult to understand because it is an “invisible” illness. This is especially true if you are struggling with it yourself. Most of us “understand” that a broken leg, for example, is an injury and that we need a cast and crutches to get around. But if you have symptoms of depression, such as When you’re feeling moody, having trouble concentrating, having trouble sleeping, and just generally feeling sad and uninterested in anything, it can be difficult to resist the temptation to just tell yourself not to.

But if you don’t accept the fact that your depression is real and just as much a chronic illness as high blood sugar or arthritis, you will set yourself up for relationship problems. Why? You set unrealistic expectations of yourself.

Your loved ones want to help you and make your life easier. They need you to tell them what you’re up to and when you need help or a break. Spouses and other family members tend to worry too much. You can make her and your life easier if you just openly say how you feel.

Make it clear that depression is not your everything. It’s easy for loved ones to mistake real, authentic sadness or irritability for depression. You might be upset about the situation in Ukraine or worried about COVID-19, and a loved one will mistake those genuine emotions for just a relapse of symptoms.

Again, they only pay attention to you and your health. I encourage you to be upfront with them and say, “No, it’s not that I missed my meds or that my depression is getting worse. I have a really legitimate reason to be upset and it’s X, Y or Z.’ Then talk to them about it. They will feel better sharing your thoughts, and they will feel better knowing that you are managing your symptoms.

This is especially true when it comes to children. My daughter, who is now in her 30s, is used to having a depressed mother. When she was little, I noticed that if I seemed calm or moody, she worried about me. Sometimes I had to reassure her that Mom was fine.

Children whose parents have depression tend to feel like they have to walk on eggshells, that they don’t want to upset that parent. They want to be caretakers and renounce their own needs because they want to make sure they don’t set up a row of toppling dominoes for their chronically ill mom or dad.

It’s important that you and your partner reassure them that they don’t have to feel this way. Let her know that you’re fine, but you might need some time in the sun or a walk outside to regroup and feel like yourself again. Just as it is important for you to check your own sanity, check theirs.

Be selective about who you share your depression diagnosis with. It may seem that you “should” be open about your depression and “should” let your boss and co-workers know about it. But think carefully before doing so. Yes, we’ve come a long way in understanding mental illness, but it’s still stigmatized. Employers view depression differently than other chronic conditions, such as heart disease.

I have found this to be true in my own professional life. Yes, I have found that it helps patients to know that I also have days when I have trouble getting out of bed or that I am well acquainted with the side effects of certain antidepressants. The stigma I faced surprisingly came from other therapists who felt I shared too much.

As a result, I’ve learned to be very careful about who I share personal struggles with. You can have depression and be a wonderful parent and have a stellar career. But there is still this misconception that if you have this disease you are flawed as a person. It’s very sad, but unfortunately it’s a reality.

Check in with yourself regularly. Not only will it help you; it will help your relationships. I ask patients to ask themselves these three questions at least every few weeks:

  • Has your partner commented that you seem moodier, sadder, or irritable lately?
  • Have you fought in more than one situation every day for at least 2 weeks? (For example, if you feel overwhelmed by both your work and your children.)
  • Do you find it difficult to do things with family and friends that you usually enjoy, such as watching a movie or going out to eat?

If at least one of your answers is yes, consult your therapist. And if you don’t have a therapist right now, consider getting one. A medication check may also be due, whether it’s changing medications or increasing your dose.

Make it a priority to have some time for yourself as well. It may seem like a luxury that you cannot afford either financially or in terms of time. But if you take just a few minutes a week, whether it’s going to the gym or taking a relaxing bath, you’ll feel better and more willing to give in to your relationships. Trust me. Your partner, children, friends and other family members will thank you.


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Major depression: how to deal with it
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