My husband Matt wrote the following post about how challenging it can be to have a partner who is depressed. If you are at all technically inclined, you can check out his own blog, Quoth The Runtime, “Segmentation Fault”. He mostly writes about programming, but he also posts some pretty great stuff about the rampant sexism and misogyny in his industry.
LIFE AS A MOUNTAIN HIKE
I’ve come to the conclusion that the best metaphor I can conceive of for everyday life is that life is a mountain trail. Some days you have to work hard to make any progress, other days are simple, and some are nicely balanced. You can see beautiful vistas, or find yourself in the bottom of a dark valley. The weather can be reflective of your mood, a lot like what you see in movies (there’s a reason why it always rains during movie funerals). Some days the air’s become so thin that it’s a struggle to do anything of any great significance. You see your friends from time to time on the trail, and perhaps you’ve arranged to meet sixty miles up the trail in two days, and you only hope it’s downhill or level at worst, because you have a lot ground to cover in not much time.
So, given that life is a mountain trail, what is it like when your partner is depressed? It’s like hiking with someone with impaired lung function. They need to carry oxygen, and some cases are worse than others. Some patients need to basically have the mask on the whole time, while others can operate normally with a couple of deep breaths every once in a while.
How does this affect your relationship? You both have to take more load. Your partner has to carry the tank, so you offset that increased load into your own pack. But you’re also thinking about their oxygen supply. Sometimes it’s “do they have enough air in the tank,” but when you’re really paying attention, it becomes “do they have enough airflow”, and usually that only happens when their depression becomes apparent again. The big problem with depression, not just socially, but functionally, is that it’s invisible. Depression quite literally changes how the patient thinks, both on and off treatment. Enough airflow from the tank, and your partner is brought up to baseline.. except for the fact that they’re still carrying the extra weight, so you’re still taking some of what would otherwise be their load! With the right treatment, the patient can feel reasonably close to “normal”, but if they don’t maintain the treatment, for some reason–maybe a disrupted routine means not taking their medication for a few days, or maybe they’re feeling so good they self-moderate to a lower dose–or their circumstances change and now they just aren’t getting enough air (perhaps their brain chemistry has adjusted), then they can’t perform as well… and as their partner, it’s up to you to keep an eye on that. It’s not just your partner’s concern.
Living with a depressed partner is hard. In addition to everything that normally comes up in any relationship, you’re ultimately their partner in managing their depression, too. Whether it’s as simple as giving them some slack on the harder days, and letting them do their thing while you pick up the housework, or something as detailed as collaborating in their treatment plan, their depression will always be there, whether it’s forgotten, or it’s the elephant in the room, or it’s something than can freely enter the conversation as necessary. But remember, it’s invisible, and it’s insidious. Because it’s part of how your partner thinks (and not, say, an obvious but treatable impairment, like a significant limp) it’s all too easy to forget that it’s even there when it’s well managed.
It’s easy to become resentful that you’re doing more of the housework, because it’s easy to forget that it’s not that your partner is being lazy, they’re depressed. It’s easy to forget that depression manifests itself in more than just tears; it can also be lack of energy, lack of motivation, or lack of interest. When depression isn’t obvious, it’s all too easy to forget that it’s there, and then it’s all too easy to establish a mental separation between your partner and your partner’s depression, because you might only think about it when they’re well and truly despondent. While you and your partner may not want their depression to be a part of their identity, it’s critical to remember that it’s always there, in the same way that an amputated limb is always missing, even if it’s been replaced by a prosthesis.
And when you’re in a long-term relationship, you’ve been carrying the extra weight for as long as you have, it’s easy to forget that what you don’t see in your partner’s backpack is their failing lungs and their oxygen tank. If your partner’s been having an easy time with the hike–perhaps a couple of huffs on the tank a day is all they’ve needed for months–it’s easy to forget why you’re carrying more of the weight. It’s easy to forget that it’s so that they can simply keep up with the pace of every day.
But when the depression becomes apparent again, naturally, you respond with compassion and empathy. You encourage your partner to talk about it, or you give them their space, but if you forget, or don’t realise, just how bad their depression really is when it’s in force, then you may forget how your partner may really need you to respond when their depression strikes. Of course, the deeper problem with this is that your partner is an adult, or at least competent to make their own decisions. It’s very difficult to convince who a person who doesn’t believe they need air–they’re just a tired today, or the trail’s harder than they expected–that they really do need air… At least, it’s hard to do that without coming off as condescending and paternalistic (and, let’s be honest here, if anyone is liable to be offended, and rightly so, by paternalistic talk from her husband, it’s Anne) when you’re in a partnership of equals.
My own overwhelming desire to respect Anne’s agency and autonomy has meant that, on a number of occasions, I’ve dropped the ball badly, because I have a pretty significant mental block around telling anyone I love, “you need to do x.” Particularly so when I know that the thing I believe they need to do is something they would ordinarily object to. Anne has already told the story about how her postpartum depression drove her to pharmaceutical help; but I don’t think she mentioned in that story her difficult history with pharmaceutical treatment, or with psychotherapy. I had broached both ideas in the past during lesser episodes, and met with resistance on every occasion. I didn’t want to press the issue again (and I didn’t know had truly bad her depression had become until I read that post), and every time her depression has resurfaced since, I’ve had a hard time finding the strength to ask basic things like “have you been missing your medication,” or, “have you been using your blue lamp,” because I want to be able to trust that she has, and I don’t want her to think that I think she’s forgotten, or incapable of taking of herself. I don’t think that she can’t take care of herself, but I worry, at those times, that her depression will colour how she hears these things, or tell her that her treatment isn’t working, and that she should just give up.
But as her partner, she does need me to be able to say these things (whether she’ll admit it or not). She needs me to be able to tell the difference between herself talking and her depression talking. She needs me to be able to see that the trail’s too hard for her today, and figure out what needs to be done, whether it’s replace the tank, try to open the flow more, take more of the load (or straight out jettison some stuff, or find someone to help), or even just make her stop and sit for a while. Maybe she needs me to call for help, but I’ll never know–and she may never admit it, even to herself–if I can’t talk to her about her depression.
We’ve both recently started following TSN anchor Michael Landsberg’s Twitter feed. Landsberg, if you weren’t already aware, also suffers from clinical depression, and has written about it on his blog for Off The Record, particularly in light of Wade Belak’s death. Landsberg has been promoting a topic on Twitter, #sicknotweak, in the buildup to launching a website of the same name, in order to promote a change in how we, as a society, view depressed people–that they aren’t weak, but they’re sick, just with something that isn’t normally visible. It’s an important paradigm shift that I need to keep in mind, particularly when Anne’s depression comes to the fore again. Depression is, fundamentally, a disease like any other that needs to be managed.
Just like a hiker with a bad lung needs to manage their air intake.