Six years ago, Stephen’s relationship changed fundamentally. At the time the COVID-19 pandemic began, Stephen’s wife, Jessica, was in poor health and has since struggled with depression. For privacy reasons, the couple have asked to be referred to by pseudonyms.
Jessica was placed on sick leave and was unable to work for three years. She spent several months in hospitals, receiving outpatient treatment and trying various medications.
“After about three years, we came to the conclusion that things would never be the same again,” said Stephen, a 44-year-old software developer. “That carefree, comfortable togetherness is no longer there.”
Early warning signs of depression: feeling overwhelmed, withdrawn
Stephen said it started with Jessica becoming afraid of people and developing social anxiety. She even became isolated from her close group of friends. Grocery shopping became difficult; It was impossible to call doctors or take care of bureaucratic errors.
Jessica also felt overwhelmed by Stephen. The worldly thoughts he shared with her – for example, about things he had read or seen – had now become too numerous.
Depression is difficult for those who suffer from it. But loved ones also suffer. Things change in a romantic relationship.
“There were times when I didn’t have a wife, but there was another child,” Stephen said.
The less Jessica could do on her own, the more she took responsibility for it.
Setting boundaries for your mental health
Birgitte Asch helps family members of people suffering from depression. For many years, she worked as a nurse with people suffering from mental illness. One thing she noticed: Only when family members are involved can those affected really recover.
Today, she is a systemic family therapist at a mental health clinic in Bonn, Germany, and the point of contact for people like Stefan. She offers courses in which family members spend three evenings learning about depression – and how their own feelings and experiences matter.
“Most of the family members go through about four weeks of hell before the affected person is hospitalized,” Asch told DW.
At this stage, family members have often tried everything, are exhausting themselves, and are stressed, anxious, and full of worry about their loved one.
“‘How are you really?’ This question is asked [family members] “Very rare,” Ash said.
Asch emphasizes that it is extremely important that family members learn to take good care of themselves and set boundaries, so they can stay healthy themselves. Only then can they truly help their sick loved one.
‘No help without request’
When family members take on more and more daily tasks without asking, Asch explained, it reinforces the person suffering from depression’s passivity, which in turn promotes depression.
Self-sacrifice by family members also intensifies feelings of guilt and shame for the depressed person. Stephen had to learn this the hard way. The more he did housework for his wife, and the more often he called her, the more he felt she was becoming a burden.
Jessica said to him one day, “It would be better for you if I weren’t here anymore.”
Asch likes to say: “No help unless requested.”
This preserves the depressed person’s sense of self-efficacy, and, importantly, gives family members a chance to say “no” and prevent their own burnout.
“Setting boundaries doesn’t mean I’m rejecting the person, but I’m just giving the depression a certain amount of space,” Asch said.
separating the person from depression
According to Asch, it becomes easier to set boundaries when family members manage to separate the depression from the person. Jessica is often frustrated because she cannot meet her expectations due to illness, and quickly loses her patience.
“The isolation, irritability, and emotional distance come not from the person, but from the depression,” Asch said. “In a relationship, it is important to accept that the couple is living in a love triangle with this disease.”
Communication becomes particularly important – and at the same time, it is particularly difficult, especially when it comes to potential sources of conflict.
Stephen said, “I always have to step back and assess the situation first. It’s very tiring.”
At the same time, he is always afraid that things might go wrong. So Jessica and Stephen have agreed that he will communicate certain concerns — for example, if he feels she’s criticized him unfairly — via text message. Stephen can express himself, and Jessica can respond at her own pace.
Dealing with Depression: Appreciating Small Steps
Jessica has been back at work for over a year now – four hours a day, four days a week. That’s all she can manage right now. But Stephen is happy; After all, this is more than has been possible for a long time.
“Now she can even go grocery shopping after work,” he said.
Ash said it’s important to appreciate small steps, like going shopping, washing your hair, taking out the trash. “Dealing with the disease is a difficult task for the affected person,” he said.
As Jessica becomes more and more withdrawn, Stephen moves into isolation with her. It’s not unusual, Ash said, but it doesn’t help anyone.
“We don’t pull anyone off the couch by the hair,” he said. But family members have the right to say, “I’m not going to sit here and be sad with you.”
Help family members through therapy, support groups
In the fourth year of his wife’s depression, Stephen began complaining of anxiety and an unknown itch that kept him awake. Psychosomatic disorders – possibly caused by the stress placed on him by his wife’s illness.
He searched for a doctor and also found a way to reach Ash. Apart from courses on various mental illnesses, she also offers individual counseling and support groups.
All this helped Stephen find his place in the triangular relationship with his wife and her illness: to withdraw more and do more for himself.
“It’s also important to stay productive,” Stephen said.
The itching and tics have since disappeared. Stephen is often out, sometimes with Jessica, but also alone. He wants to meet new people and try new things. He also wants to reduce his working hours to devote more time to sports.
Isolation is advised when depression is at the center of everything
Stephen and Jessica have found a way to communicate that works, but not all couples do. Ash has also supported people through breakups. Isolation is advisable when depression becomes an excuse for everything, Esch said.
Reasoning like “I’m sorry, I can’t be nice to you – I’m sad” does not contribute to a healthy relationship.
This article was originally written in German.
If you are suffering from severe emotional stress or suicidal thoughts, do not hesitate to seek professional help. You can find information about where to find such support, no matter where you live in the world, at this website: https://www.befrienders.org/