I’m one of those people who researches things instead of just complaining that I have a problem and chugging drugs. I like to try things until I find something that works. If the experiment doesn’t get you results research and conduct another experiment.
In my life I have found that there are some very important life skills that no one can teach you. Anyone can love someone, but to learn how to do so in a healthy way takes time and patience. Knowing when to leave and when to stay, how to give in a healthy way and how to take in a responsible manner are some of the building blocks to a healthy relationship. In an optimal relationship both parties are providers. There is no bread winner. There is no happy house wife.
As you read this guide keep in mind that I am not a doctor; you should talk to your doctor before you start any exercise program or change your medication or your dose of medication. Also keep in mind that these suggestions are based on my own experience and research. None of the suggestions are cited (except one) with references to empirical evidence. In other words, your mileage may vary.
These are the things I discovered about living with a companion who is depressed:
Don’t crowd them.
Give them enough space to deal with the problem.
Put yourself first.
Even though their life is on the rocks, yours doesn’t have to be. Don’t let them use you to relieve their own frustration. Keeping yourself happy is as important as keeping them happy because if you’re both depressed it’s miserable all around. Don’t go down with the ship.
Be ready to listen to the same problems incessantly.
People who are depressed aren’t magically depressed because of the depression fairy. They’re depressed because of life factors that they refuse to change or think they can’t change because they are settled into a comfortable depression zone. One of the ways depressed people deal with their problems is complaining about them. When you’re depressed everything you do is ten times harder and when you get frustrated it’s twice as frustrating and the resulting misery when you fail lasts five times as long. That’s a lot to complain about. Hear the complaints but don’t listen to them. After the second or third time just nod your head and move on. If they ask why you’re not listening to them, repeat the problem they’re complaining about back to them and ask them if the way you are explaining it is correct. This is the way to end irresponsible complaining.
Know when enough is enough.
If they tell you it’s your love and/or companionship that keeps him going it might be time to reconsider. Even if you want to help them more than anything else in the world you can’t carry them. Parasitic relationships eat away at your mind until you become depressed too. If you are noticing that people want to spend less time with you since you started living with your partner’s depression this might be why. If you’re living with your partner’s depression instead of your partner it might be time to break up with it.
Find out if you’re actually needed.
Sometimes no matter what you do you’re not going to help. Sometimes your partner doesn’t even want your help. It might be that he wants you to be there for him to use as a punching bag. If he’s not listening to your offers to help or he makes no effort or not enough effort to improve his condition you might be wasting your own happiness. There’s no point trying to help someone who won’t help themselves, or who is actively resistant to help.
Don’t promise your partner you’ll fix their problems.
You’re setting yourself up for taking the blame for his condition. Even if you could completely fix their problems, people who are depressed tend to relapse. If you’re in it together, you’re really in it together for a lifetime. They will go through periods of depression in the future. Healthy practices can reduce the weight and length of phases of depression over time.
Remember that depression is a medical condition.
Depression isn’t a matter of being “happy” or “sad.” You can’t just spring out of bed one day and “snap out of it.” Our bodies are made of squishy juices that mix together in different ways to make us feel one way or another, and those feelings often mix in confusing ways. You can’t just reach in and untangle them, you have to use tools from outside your body to gradually wiggle them into the right solutions.
Depression is caused by chemical imbalances in the brain and body that causes lethargy, mental confusion, physical pain and other symptoms. While depression can be fixed in most people with a combination of medication and lifestyle changes, you can’t just wake up one day and decide to be happy. It takes a lot of work. For others, depression is a natural disposition. If you’re unsure which is the case, ask yourself if you’ve ever known your partner to experience a period in their life when they were not depressed.
If you want your partner to rise out of depression, find out what causes their depression and point it out to them. Ask them if they’re willing to take medication and make lifestyle changes to improve their depression. Make sure they’re aware that medication isn’t a magic bullet that fixes depression; that only with a combination of medication and lifestyle changes can you rise out of it. Also, for some people medications for treatment of depression are not meant to be taken forever.
Don’t let your dependency on your partner prevent you from saving yourself.
It is neither safe nor responsible to depend entirely on someone else to fulfill your financial, emotional or carnal needs if they are using your dependency to hurt you.
If you are depending on your partner for living space, financial security, sex or for any other reason, find alternative ways to fulfill those needs. Establish a firm backup plan. Once you’ve put that plan into place, tell your partner about it.
- “I know you’re giving me money, but I’d rather default on my school loans than let you ruin my life.”
- “I do enjoy having sex with you but if you’re going to use that to keep me here you should know that many other people find me attractive.”
- “Even if you tell me to leave I have friends and family I can stay with.”
If your partner is using you, neither of you is any more or less guilty. You share the blame equally. His guilt is using you and your guilt is letting him.
Candid discussions with your partner are a very important life skill for both of you that you develop together. A discussion about the material components of your relationship is essential to preserving your relationship and helping your partner to recover. If you’ve never talked about why one of you is supporting the other financially, or why one of you is supporting the other emotionally, it is essential to do so as early in the relationship as possible. At first you may feel uncomfortable talking about things you’ve previously made assumptions about. It can feel wooden and awkward. But the more you do it the more natural it feels. In time you’ll wonder why you ever made assumptions instead of talking to one another.
Use remedial behavioral conditioning to get your partner to help himself. If he does something he’s supposed to do, reward him with something he wants. For example, if he takes his medication on time for a week, take him out to dinner at a restaurant he likes. If he does something he’s not supposed to, take something away. For example, if he accuses you of being responsible all or in part for his depression, don’t have sex with him and tell him that’s why he’s not getting any.
Do not use negative or accusing tones, posture or words to punish bad behavior. You are not responsible for punishing your partner. When you use reinforcement, do so matter-of-factedly and explain why.
- “I don’t like it when you make me feel responsible for your anger or depression.”
- “We’re not having sex today because of that.”
- “I like it when you eat healthy because I think it helps you to be happier.”
- “We’re making your favorite desert today because of that.”
It’s important to enforce verbally with your partner every time you use a remedy that you’re doing it to help him and to get verbal confirmation that he knows the specific behavior that you do or do not approve of each time.
- You must be consistent in your behavior.
- Every time there is a bad behavior, use negative enforcement.
- Every time there is a good behavior, use positive enforcement.
- Match the enforcement to the magnitude of the behavioral variation.
- Positive enforcement can be something as simple as a smile and/or a hug.
- Negative reinforcement can be something as simple as a stern look or walking away from him when he’s using attention getting behavior.
If this sounds familiar, it’s because the same operant conditioning strategies are used to treat behavioral problems in human children, human adults and pets (and this will be the only citation in this essay, G.S. Reynolds, “a primer of operant conditioning” 1975) because this type of conditioning works consistently for everyone. Conditioning is said to be effective only when the operant results in the same respondent consistently.
Reinforcers should consist of wants, not needs. For example, you can deny your boyfriend the right to a conversation with negative vibes but you shouldn’t tell him he can’t go to the bathroom.
The pattern of conditioning works like this:
1. Tell them what they did wrong/right. Explain if needed, repeat if needed.
2. Get verbal confirmation that your partner understands what they did wrong/right.
3. Use the reinforcement.
4. If the behavior recurs go to step 1.
Understanding Fields of Medicine Involved
Psychiatrist – Responsible for prescribing medication. Your psychiatrist and your psychologist should read the same medical records and they should interact with each other. If they don’t, tell them to. If they refuse, talk to their superior about the problem or see a different psychiatrist.
Psychologist – Responsible for providing applied mental health assessments. This doctor’s job is to help you find out what is wrong and recommend a course of treatment. If they tell you that you need to go get some drugs and then rush you out of their office, you’re seeing the wrong psychologist. You’ll encounter this problem with doctors provided by your health plan. It might be worth paying the fees to see an independent and noteworthy “pay for talk” psychologist.
Physician – A physician’s job is to diagnose your body. Make sure your partner’s physician understands that your partner is depressed. Depression can cause physical problems such as excessive stomach acid, lethargy and chronic pain. Talk to your partner’s physician and your physician before beginning any exercise program. If your partner is seeing a psychologist and/or psychiatrist make sure he tells his physician and discusses his treatment with them. If your partner’s physician is covered by an insurance plan and doesn’t seem to care about his condition, consider changing doctors or paying a doctor directly.
Course of action:
1. Discuss the material and emotional aspects of your relationship.
Tell your partner about the effect his behavior is having on your life. Enforce your independence. Make him aware that there’s nothing he can take away that will keep you there if he’s not willing to commit to a healthy life and a healthy relationship. Use your serious tone. Don’t use emotional words and reserve use of analogies. Listen and respond to everything your partner says. When the conversation is over, use major positive reinforcement.
It doesn’t have to be a hard conversation to have and it’s the first step toward recovery.
2. Re-assess your partner’s interactions with his psychiatrist to fit yourself into his improvement plan.
Go with your partner and talk to a psychiatrist about a course of medication suitable to your partner’s condition. If he’s already on medication, have them re-assess their condition in your presence.
3. Enforce an iron-clad schedule of taking medication.
Make sure he takes the medication on schedule every day or as directed by the psychiatrist. Positive reinforcement when he takes his medication, negative when he doesn’t.
4. Go with your partner to see his psychologist, psychiatrist and physician.
Talk with them about the problems in your relationship and tell them about your plan of action. Ask them for help in reinforcing the plan.
5. Participate in and enforce a daily healthy diet.
Look at his diet and observe what he’s eating. People who are depressed are more affected by whether or not they eat a consistent, balanced diet than people who are not. Eating a healthy, balanced diet is the most important component of fixing the problem. Use the website choosemyplate.gov to choose a balanced diet. Prepare meals together as a relationship building tool. When possible, prepare healthy meals in advance. When he eats bad food, negative reinforcement. When he eats good food, positive reinforcement. Preparing food with and sharing meals with your partner is one of the oldest and best ways to build a healthy relationship. You also must eat a healthy diet every day. It’s not fair to expect him to eat a healthy diet when you’re not. If both of you are eating healthy foods on a daily basis it will be less expensive because you don’t have to buy separate foods.
Get a copy of Martha Stewart’s Cooking School. This book tells you everything you will ever need to know about cooking from boiling water to french cuisine. You don’t have to buy all of the utensils and dishes mentioned in the front of the book at once. You can gather them over time as you find that you need them, or use suitable replacements. For example, instead of buying a colander you can poke holes in a coffee can. Make learning to prepare food together a special occasion by planning to make and share a meal together when time allows.
Start off with little things. Make pancakes for breakfast (or dinner!) from pancake mix or stir fry some veggies. If you make mistakes use them as learning opportunities. Buy some food with the intent of using it to practice cooking so that if you ruin it you don’t feel as if you’ve lost anything, and if it comes out alright that’s a bonus.
6. Engage in healthy activity.
Get a physical and talk to your physician before starting an exercise routine. A healthy lifestyle that is two parts healthy eating and daily healthy activity not only builds a sound mind and a healthy body, it serves as a distraction from depression. When you’re depressed one of the worst things you can do is sit around all day thinking about it.
Getting active after being sedentary for years takes a lot of building up muscle mass and getting used to a more active life style, so do it at a healthy yet careful pace. Plan simple activities like walking to the store to buy groceries, picking up the mail together or going for a daily walk in the park. Once he’s used to that (give or take six weeks to two months), get him into a walk/run program and even if you hate running it make it look like you love it. If you can’t run because of a health condition, jog slowly. If you move to the next step of your walk/run program and you experience chronic symptoms of over-exertion, wait a couple of days and then move back to the previous step in the program. Positive reinforcement when he follows the schedule, negative reinforcement when he doesn’t. Exercising together with your partner is an excellent way to engage in positive interaction. You’re feeling the burn together. Talk up the positive aspects of exercising: It’s a distraction from being depressed for a while, it’s exhilarating, you can brag to your friends.
7. Practice mindfulness meditation with your partner.
Mindfulness meditation is the practice of learning to experience what is going on around you as it happens without any internal dialog. There are lots of books and videos available, but the activity itself is pretty simple. Sit in a quiet room in a comfortable position, close your eyes and pick one thing to focus on. You can focus on the air going in and out of your lungs, the light coming through your eyelids, or any other simple thing that is local to your body. Do not think at all. Turn off your brain. Allow what is happening around you to happen without questioning it. It’s okay to make mistakes. If your mind wanders and you find yourself thinking about what you’re going to do tomorrow, or something from your past, gently guide your focus back to your focal point. Don’t feel bad when it happens, let it happen and guide your mind back each time.
Start with just a few minutes and work your way up. Use a timer to help keep track. Mindfulness meditation does not support any goal. It doesn’t help you to achieve anything, but should be done simply for the act of meditating itself. You may experience positive side effects, but don’t make them a primary goal. Mindfulness meditation is for its own sake. But great minds and many doctors over the course of human existence have spoken of its benefits.
7. Help your partner to consider gradually stopping his medication over time.
Antidepressants do not work forever. They work for some time, but then their effectiveness wanes and their dosage has to be increased. Eventually the maximum therapeutic dose might not be effective. This causes the person taking the medication to have to switch between medications, looking for one that works. In some people antidepressants don’t work at all, and can make symptoms worse. Some people think they are depressed but actually have other conditions, and are being treated for the wrong condition. Only your partner and his doctors can determine the correct course of medication. But only your partner and his doctors can also decide when it’s time to stop them.
Some people require medication for most or all of their life. Only your partner with the help of his doctors can decide whether or not he needs medication forever. However, some people can stop taking antidepressants once they have built a healthy lifestyle. Once he has implemented diet and lifestyle changes, he can begin to reduce the medication dosage with the help of his psychiatrist. He should do this very gradually. Some people can stop taking medication in a few months. For others, it takes years. The change can be as tiny as shaving a little bit off of one pill or as big as cutting the dose by a third. Always talk to your doctors before changing your dosage and discuss your desire to move away from dependency on medication.
To summarize everything I’ve said here:
- Have a conversation with your partner about the material and emotional aspects of your relationship.
- Assess whether or not your partner is willing to be helped.
- Use behavioral conditioning consistently to enforce correct behavior.
- Assess your partner’s condition with his doctors.
- Participate with your partner in healthy lifestyle changes.
- Participate with your partner in a healthy diet.
- Consider an assessment of the feasibility of reducing medication use over time.