"Love is important, but cannot cure depression"
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Trigger warning: This text is also about suicide.
If the partner is depressed, love is not always easy. Often the relationship is overshadowed by anger, sadness, despair, but also feelings of guilt. What can a relationship withstand? How to help the person with depression? And where should relatives draw their own boundaries? Gabriele Pitschel-Walz, senior psychologist at the Department of Psychiatry and Psychotherapy at the Technical University of Munich, explains this in a telephone interview.
now: Ms. Pitschel-Walz, how can I tell that my partner is suffering from depression??
Gabriele Pitschel-Walz: Everyone has mood swings. But if someone is constantly depressed for two weeks, withdraws, lacks drive and perhaps can’t get out of bed at all, we assume that they are depressed. He loses interest in things that are otherwise fun to do.
How should one react when the other person withdraws more and more??
If it happens, let him or her rest. But if it goes on for at least two weeks, you should really bring up that you are concerned. It is also important to ask what the other person wants: Should I stay out of it, or is it okay with you if I take care of it?? Often people do not talk about what their needs are. Yet this is often relieving for those affected.
Many people are afraid of saying the wrong or inappropriate things when talking about the illness. What helps and what is counterproductive?
It is counterproductive to build up pressure: "Now get up at last, the weather is nice, don’t be so lazy". These are direct attacks, which should be avoided. Nevertheless, it is important to keep at it and to keep making your partner offers that motivate him or her: "I’m going for a walk now, would you like to come with me??"But if the partner says, "No, I can’t at the moment," you shouldn’t insist.
How can you still support in everyday life?
Often it is difficult for those affected to do things that are otherwise quite easy to do. This ranges from personal hygiene to household chores. Sometimes it helps to hand over small, concrete activities. When cooking together, you can ask, "You cut the tomatoes, I’ll do the rest?" Then the person is involved, but is not overwhelmed. The other danger is that you take over everything from the tasks and the person feels totally useless or useless, which in turn can increase the depression.
"There are always several causes for depression – a relationship can also be a risk factor"
Relatives often blame themselves for the depression. Rightly so?
There are always several causes for depression. Genetics, what experiences one has had in one’s own life history, other illnesses, or acute stress. This stress can also be relationship stress. For example, when you fight again and again and there are certain relationship patterns that do not do any good. Then the relationship is a risk factor.
And if the relationship is actually going well?
Then they often ask their partner what’s going on. The person affected then experiences this again as pressure, because he usually does not know himself what is happening to him. Men in particular tend to react to this in an annoyed way, saying "leave me alone" or "don’t keep asking". As a partner this is not easy to bear at all. And if one is rejected, the thoughts come up again that maybe it’s my fault after all.
A friend told me that her partner often explains his misbehavior in a quarrel by saying that he is depressed. He therefore no longer feels like discussing things with her. How much consideration do you have to give to your partner’s illness in this situation??
This is a frequent question when talking to relatives: Can’t or won’t? How much is convenience and what is actually the depression? Therefore, this should be clarified with professional help. As a relative, you can be more supportive and are not the main culprit. Many think that with love and affection alone I can help to overcome this depression.
And that never works?
Love is important, but it cannot cure depression. Depression is an illness.
What helps instead?
First of all education and advice about depression and what you can do yourself. This can be done by family doctors, psychotherapists, psychiatrists or self-help organizations. In the case of severe depression, a combination of medication and psychotherapy should be used.
"You don’t have to talk everything out at the moment when everything is boiling up."
Can I make a doctor’s or therapy appointment for the person affected if he or she does not take the initiative themselves??
You can of course make something up, but then the question is whether the person will take advantage of it. And it may increase the pressure. So one should first of all point out. Perhaps also put appropriate literature on the table.
And when everything is useless? Should or can one be compulsorily committed in case of emergency?
No, that is not possible. Relatives are not authorized to do this. But if the depression is severe and suicidal tendencies are imminent, you can call the emergency doctor or a crisis service. Then comes a specialist nurse who is specialized in this and talks to the person concerned. If it is necessary, one can involve a psychiatrist who is on call. He can decide: Is it already so threatening that hospitalization is necessary?? Many affected persons then voluntarily go to a clinic. In the case of compulsory hospitalization for acute self-endangerment, a judge must come to the clinic and assess the situation.
If one comes back to the argument situation in which no acute professional help is available: How do I end the argument??
You don’t have to talk everything out at the moment when everything is boiling up. For a partner conflict it is always good if one of them says: Now let’s take a break from talking. We part and everyone does something for themselves. Then perhaps we can talk about this topic again at another time.
Being out and about with friends and having fun when your partner is sitting at home – this often feels wrong, but at the same time you need this time to switch off from time to time. How much can and must one take care of oneself in a relationship??
That guilty conscience comes automatically. But if a partner is depressed, he is usually not able to give love. This is also a difficult situation for the healthy partner. It helps to realize: I need to do something for myself to recharge my batteries so I don’t develop burnout or depression myself.
Do you think it is justifiable to break up with a depressed partner?
That is a difficult thing. Usually it welds the partners together if they get through the depression together. But I have also experienced that the partner simply does not have enough energy. Or someone is very empathic, suffers thereby very strongly with and wants to separate for self-protection. Then you can say: We pull each other down and it might be better if we split up.
Even if the person concerned is very unstable?
One would then perhaps not accomplish straight in the illness phase the separation, but see to it that the concerning is at least in treatment. That one does not leave him alone in a difficult situation.
So that means together until the end?
Yes. If you can do that.
Editor’s comment: If you find yourself affected by depression or suicidal thoughts, please contact the telephone counselling service or U25 immediately. Under the free Hotline 0800-1110111 or 0800-1110222 there is assistance of advisors, who could already point out ways out of difficult situations in many cases.