UKC

Apologies for posting as a new user - I'm actually a long-term UKC user, but don't want to be identifiable for this topic. I'm really stuck at the moment, so where else would a UKCer turn... 

Long story short, my partner has been really down for several months, finding no joy in life and losing interest in most things. There are good days, but very few. This extends to our relationship getting cooler, I feel like I am being shut out and things are souring. My partner is terrible for just bottling things up and won't talk or communicate very much about things like this. To me, it seems obvious that this is more than just being a bit down. It's been going on so long and so relentlessly. When I broached this topic, it was met with anger as if I was accusing of some sort of terrible behaviour. The idea of reaching out for support or help was a non-starter. I've not mentioned it since (although I have had it thrown back in my face a few times). This was several weeks ago and things are getting worse rather than better. 

This is going to sound selfish, but I am finding it all really hard and am feeling a horrible mixture of helpless and miserable.  

Has anyone got any advice or suggestions for how to support someone in this situation? I just really don't know what to do for the best, but know that something has to change. 

Well done for reaching out, to use an Americanism I usually avoid.  Some basic things for you to do include keeping the basic support systems going - shopping, food, laundry and the like; keeping your other half (and by necessity, you) away from alcohol; encouraging exercise, no matter how small this may be.  Even a five minute walk is better than nothing; celebrating every small achievement with positive words; and the difficult bit of doing the support and challenge stuff.  

Look up thinking errors and see if you can identify any that apply.  Challenge those when you hear them with alternative outlooks.  Keep doing this until it becomes ingrained in you and, eventually, your partner.

Depending on how your relationship works, give them a hug and just be there in the moment, not talking, just being physically close.  Don't be the first one to pull away.

There's obviously much more, and other ways too, but these might help.  A site search will pull up past conversations about this and those will help shed some light too.

Good luck!

T.

I was in a very similar situation but from the other side, i.e. I was the one losing my head. Don't forget to look after yourself and your own mental health. Sorry that you are both going through a horrible time and I hope you manage to work through it. 

The pub is often a better place for these kinds of topics, for the same reason you have used a burner account.

Firstly, partner's of "depressed" individuals may become vicariously depressed. Indirectly, by finding the sufficient and necessary support for yourself, this may it turn be the optimum strategy for supporting yourself and your partner. There are many empirically supported 'treatments for depression: cognitive behavioural therapy (CBT), behavioural activation and pharmaceutical. An emerging field of research is a metabolic theory of depression, anxiety and enduring mental illness. This theory suggests a metabolic brain disorder and dysfunctional mitochondria is the root of such problems and is  supported by research. Before the advent of modern drugs for seizures over the last 100years the only available treatment was a ketogenic diet. Ketogenic diets stop seizures. In treatment resistant seizures where modern drugs fail ketogenic diets will not. If at all possible a diet low, or without carbohydrates (there are no essential carbohydrates) with animal protein and fat is an experiment worth considering for a short duration. I would recommend removing all ultra-processed foods, and especially industrial seed oils. 

Tough place to be….as others have said making sure you look after yourself is important!

I’d see if you could approach it again….and again but with a few days gap in between. Taking a ‘I’m concerned about you’ approach etc and whilst they may not appear on the surface to appreciate your thoughts it will give them a chance to reflect on it and mull it over a bit. If you think they are seriously depressed it’s worth a call to your local NHS mental health crisis service for some guidance….best wishes…

I've been wondering what on earth to suggest, as I have some relevant experience (unfortunately), but I know enough to know that every significant intervention and suggestion has to be absolutely personal; while anything else is bordering on common sense/platitudes (which are not necessarily a waste of time, but probably aren't significant.) 

First - tough gig. Good luck. Well done on the self-awareness and analytical thinking. That won't help with all of it, some of it's about feelings. 

I don't want to be dark about it, but as you tell it, it sounds like it might be months not days. So those are my only other bits of "advice"; get set for a long push, and, while your concern is about someone else, you're no use to them if you haven't got your own oxygen mask secured first. So it's not selfish to make sure you're OK - fit, fed, socialised, adventuring/self-actualising/whatever you want to do. That may be enough to give you the spare capacity to help and support. 

Beyond that, the that prompted me to do "Oh, I can suggest something" was looking at my podcast playlist. "Conversations" with Annalisa Barbieri. I am suggesting it may be of interest/relevance/help for some clear reasons. I have been through a certain amount of psychotherapy (including the possibility of going and getting a training in it) and an important part of that, for me, has proven to be kinda basic psychological education. I have found the podcasts DO align with the things that I learned (slightly expensively in paid sessions but that's OK) and AREN'T full of woo-woo that conflicts (which is important to me as an analytical thinker.) I have found them very helpful for insights or context or worked examples or reminders. Stuff about couples - stuff about anger and what it's for and why it matters - stuff about counselling, when and how. Big list of old episodes, maybe choose a few that look like they might stick with you. 

There are a lot of ways you can go or suggestions that can be made. Smells and bells, ear candling, three sessions of CBT, whatever - that's why I make the comment that it's kinda hard to identify the right/accessible intervention for you/yours. If you listen to any of the Gary Lineker podcasts you'll get a bunch of adverts for Betterhelp, about which I know little but I suspect lead off into the £30-60/hour therapy sessions for... weeks ? Months ? A year or two ? For one/two/both of you ? That might not be right or accessible for you. But having seen a bit of that, I don't think you'll go too far wrong with the Barbieri stuff. 

Assuming of course it's not all far too basic, or you can't stand her, or something.... 

Enough from me. Go well. 

Y

Just wondering, can you bring your partner's family in to help? Or best friend / good friends?

Sorry to bother you if you've already done this

Best of luck in any case

As someone else said, it’s hard not to just post platitudes or state the obvious, as it’s so person specific beyond the top level.

If someone doesn’t want to deal with their problems, you’re going to burn bridges trying to get them to take help.  Perhaps you need to step back a bit from where you weighed in.

Can you focus on ways to help them realise they need to seek help?  If they come to that realisation “themselves” it’s so much more powerful, and you can help them from there on.

It’s so specific to the individual I can’t offer any specifics, but when dealing with a few clearly depressed people I had an advisory role to, I found that asking a leading question, listening to their first answer and then asking the question again could prompt some progress. 

me: How do you think XYZ is going?
them: (lots of stuff about how well it’s going)
me: Is that really how it’s going?
them: (a more accurate take on things)

Good way to open some dialog perhaps?  This way you’re listening and not suggesting they have specific problems but encouraging them to reflect on things.

It’s not selfish.  If you can’t look after yourself you can’t help anyone else.  You’ve got to deal with that.

This is what has to happen but can be the hardest thing to do. It might be best for you both to separate either for a spell or for good. I speak from experience and it was difficult. I get on very well with my ex and she is my best friend and I'm sitting on her settee now stress free. The sun usually comes out after the rain.

Speak to your GP.  They will be able to direct you to help and suggest approaches. You are and will be an important cog in any future interventions/help etc. so you need that advice as well as the sufferer.   

Are you my wife because this resonates with me very strongly... She's an amazing woman. Some of my relevant experience with depression-

The only times I've accepted help or talked about my mind is when I've been the lowest of the low, possibly during what I think may have been psychotic episodes. So then I probably make no sense anyway. Every other time its a hard no, dont want to talk and I definitely feel angry when its brought up. I feel like it might be a defense mechanism? - I am well aware routinely not accepting help is essentially shooting myself in the foot, sometimes your head just doesnt make sense even though its blindingly obvious.

The biggest help for me is being gently pushed to get out and DO stuff, because doing stuff helps alot, and getting motivated to do stuff is hard. Medication and staying busy keeps me mostly on a level heading now, which I guess was what CBT was all about anyway.

Appreciate this is all about me but maybe it gives an insight into the mad and nonsensical world of mental illness and maybe why your partner doesnt talk about it. But I entirely agree with others, you have to put yourself first, if you don't look after yourself you can't look after anyone else. If you can get your partner to get a phone appointment with GP that would be a good start, and they would likely get priority appointment, the assessment they do is very straightforward and nothing to worry about. For me it took alot of very gentle persuasion to get me to take that step.

A heartfelt thank you to everyone who has replied. I'll look into the various suggestions, thank you. I take the point that every situation is different, but it means a lot just to have people offer advice - I'm in a lonely place at the moment.  

Hi, long term UKC user but for reasons identical to your own I'm posting as a pseudonym.

First, well done on bringing this up and talking about it. It's an incredibly personal thing to talk about, not just if it's about you personally but in some ways it feels more personal to discuss these things about your partner.

I was in a similar situation to yourself, didn't know where to turn to, didn't have any support around me and didn't know what to do. I basically tried to just be caring and compassionate but as things escalated I also needed to get outside help. Unfortunately when I broached the subject my ex-partner told me if I talked to anyone they'd leave and take the kids and I'd never find them. I'm guessing such reactions are not uncommon as it sounds like your partner didn't take the suggestion well either.

For me the whole thing continued with me not knowing what to do, feeling like I should just try to do my best and enduring the whole situation which escalated into me getting constantly emotionally and verbally beaten up until I was in a really bad emotional and mental state myself. So, don't do that. If you're posting on UKC for help then yes, you need help, it's not a good idea to try to deal with it yourself.

Things that helped (although we are ex-partners we still have a good relationship).

 - The last bit of your message, that something must change is really important. Don't necessarily force your partner to get help (I mean how could you?) but ask them what steps they are going to take to change their situation. It's not all on you, you don't have the power to 'fix' someone with depression, it's got to come from them and it's not fair for them to expect you to deal with it by yourself indefinitely. 

 - Get help for yourself. I ended up going to various sorts of counselling until I found something that fitted. Just talking to someone in a confidential situation gives some relief and some perspective on the situation. I was so isolated in the situation I couldn't work out what was acceptable behaviour from my partner and what wasn't, a good counsellor won't tell you this but they will facilitate you to work this out for yourself.

Do not beat yourself up about being selfish. It's not selfish to have emotional needs yourself. It's incredibly mentally draining to care deeply about someone with depression but have no agency to fix the situation.

Good luck with it.

As everyone else has said, it's so hard to advise without platitudes, but I feel for you.

I've been the depressed one, but not the partner. I can only imagine how hard it is if they seem to not want help. It can be so difficult to try to help without seeming like you're passing judgment. Do they know how you're feeling? 

I'd just add the obvious point that often those closest to us, particularly partners or parents, are the hardest to talk to, so please don't take that personally at all. It can feel like there are so many more consequences to those conversations.

As others said, be there for them on the little things, and support them spending time with friends and family - it may be that they feel able to talk someone even if it's not you.

When they do want to reach out, they may be able to self refer for basic NHS therapy (used to be called IAPT, now Talking Therapies, at least where I am). Or if it's wider health stuff (I don't know their sex or age), a decent GP ought to listen. They can write down how they're feeling, and importantly how it's impacting them, in a letter and hand it to the GP. 

Look after yourself.

I understand how difficult this situation must be for you both. As others have said, don't forget to care for yourself as well through this. Your partner is lucky to have someone who wants to support them. Remember that seeking help is a personal decision, one your partner will make in their own time. For now, small acts of care and understanding can help. Try not to lose hope - this too shall pass.

I've been on both sides of this, and I'd say your main job is to look after yourself. 

Let them know you are there for them when they are ready to talk, but make sure you are getting out and living a fulfilling life, not getting sucked into the depressive vortex.

When I'm low, I close down from those around me and people knocking on the door of my cage makes things worse - I'm much more likely to run than open up.

I find that I have to sit in that space for a while, figure out what my depression is trying to tell me, and find my own motivation to start a self care routine and start climbing out.

Obviously that's a personal thing and your partners responses may be very different, but just be careful about pushing someone who's not ready to open up.

If you don't look after yourself, you may not have the mental energy to repair your relationship when your partner gets through this spell to a better place.

Also, don't beat yourself up if you decide to change things for yourself. Remember that if you are unhappy and you make yourself happy, you've made the world a happier place.

I've been the depressed one in our relationship, I can remember well my wife offering advice on things I could try, and me then getting angry in return. However for me, once I had stewed on my wife's advice for a few weeks, I did come around to the idea of seeking help, and things gradually got better for both of us... hopefully something might spark in your partners mind in the near future, and may seek support from you or others.

In the mean time, if they are in the angry phase, a hug and a 'I'm here for you' is usually a good bet.

Also, perhaps a bit of an acquired taste, but I found a fair bit of help on the various reddit subforums relating to mental health... r/depression, r/anxiety, r/anger etc... they can be a bit overwhelming with the level of misery being evident in the world, but they're also a bit of a gold mine of shared experience and support, even just writing your feelings down on a throwaway account can be really helpful I found.

If your partner is perimenopause/menopausal, then GP may be able to assist on that angle 

A possible different strategy, how do you suspect your partner react to the following:

Open up and say you're struggling and that you personally feel like you need counselling, but you don't want to do it alone. Would your partner likely attend  a session to support you?

I know it's dishonest, but it may get you both sat in front of a professional, and your partner may be more open to hearing things from a professional than you.

THAT is not a bad idea (at least it resonates for me) and is only dishonest for a pretty strict definition of honesty. The OP is struggling and looking for change. Alternative is "OK, I will go alone then..." and hopefully gains value and inspires curiousity. 

It would not be surprising or disturbing if things develop to three counselling arrangements (for reasons of confidentiality.) One each plus one couples. 

That's partly why I was cagey around cost earlier. I suspect/believe if one is talking UKCP or BACP talking therapy then you're looking at £30-£60/hour for multiple sessions. Which is NOT the same as 3 x CBT (not better or worse, different.) The truth is these things can get costly. 

Y

I have been on both sides of this situation, and there isn't an easy answer.

First time round, OH had severe reactive depression after a serious injury. I recognised that he was depressed, but he refused to acknowledge the idea. I had to wait until he was so unwell that he simply couldn't drag himself out of bed to go to work: at that point he had no resistance left, and he didn't push back when I dragged him to the doctor (amazing GP who was on-call that day, who saw him same day and followed him up for months). The months leading up to that point were very difficult. I endorse what others have said about keeping yourself well, so that you can look after your partner. There's a fine line between trying to encourage your partner to seek help, and crowding them to the point of them pushing you away. As others have said, sometimes they will respond better to someone who is NOT a close friend or family member... but finding that person could be tricky.  Do enlist the support of friends and family: let them know your concerns, and ask them to proactively arrange to see your partner for whatever activities etc they would normally do. This helps take the load off you, as well as being good for your partner.

Second time round, it was my turn to suffer with depression. It took me a while to realise what was going on, but I think the tipping point was when I was sat on the sofa crying about absolutely nothing. I got myself along to the doctor, then burst into tears when I realised I'd lost the piece of paper with my list of symptoms & how it was affecting me. They prescribed medication and encouraged me to attend a course through IAPT, both of which were helpful in their different ways. Having been through that and come out the other side, I'm much more aware when I think I'm slipping into depression, and have been able to take action before I get so bad that I need medication. I have a daylight lamp to use in winter, and am better than I used to be about trying to maintain social connections which I know are crucial to me staying well.

I hope some of that is vaguely useful. Good luck.

OP; I know this sounds intuitively like a good way forwards, but only consider this if you genuinely plan to use the appointment to talk about yourself and how you are coping with the situation. If you go with the intention of your partner becoming the client by stealth or being talked into getting help then it will likely be a very short appointment. 

It’s possible that a therapist might give some brief advice to your partner if they came to an appointment with you, but they may well not. Your partner wouldn’t have consented to being assessed or treated so the focus would very much be on you and not them. 

I had a black dog, his name was depression:  youtube.com/watch?v=XiCrniLQGYc&
Living with a black dog:  youtube.com/watch?v=2VRRx7Mtep8&

These videos are great, regardless of which side you are on. The "dog" can be a useful framing for some people, because it's a reminder that depression is a thing that you have, not a thing that you are.

I have been through this, but on the other side. Disconnecting feels a lot safer than admitting there's something wrong. If your partner hasn't come to terms with the change in their mental health, then it's going to be a scary thing to hear other people try to diagnose. Interventions are tricky at best and dangerous at worst.

Avoid (if you can) explaining how it is making you feel (to your partner) initially. That might sound counter-intuitive when it comes to communication, but one of the worst things about being down in a hole is that you know that it affects other people and that hearing that feedback makes you feel worse about yourself, which begins a vicious cycle.

Some people will need to be encouraged very very gently into talking about it. Some people will need to be shocked into it. You may have some idea of which would be more appropriate. Watching the end of my relationship and realising how much deeper the hole goes when you don't have someone watching out for you was enough to realise that I needed professional help, which ultimately kicked things into a better direction. I suspect that if there had been a "we can't live like this" ultimatum earlier in the process, things could have turned out differently.

I'd highly recommend "Living Better by Alastair Campbell" if you want to read a more involved exploration of what it's like to acknowledge depression and maintain a relationship and a fulfilling life in spite of it. Whether or not you agree with his politics is irrelevant, the book is about mental health.

The last piece of advice I would offer is that unless this period of low mood was caused by an event or a change in perspective, you may never understand or fix it, just manage it. The relationship will take more work, but it can be stronger for it.

Look after yourself.

It's fairly common for sufferers of depression to bottle stuff up and to get angry at those innocently trying to get a glimpse of possible causes or triggers. Depression seldom follows logic or conventional behaviour. The nearest and dearest are the ones who bear the brunt of the intense emotions and outbursts associated with 'held in' depression and anxiety - and like Becky above I speak from experience on both sides.

Perspective from someone who has depression:

• There's a strong desire to not be a burden on anybody else, so social, physical and emotional withdrawal is a common solution.
• If I feel like talking in some depth about what's bothering me, the obstacles are: a) sometimes I don't even know what it is myself and can't articulate it; b) even if I did know, talking about it feels like weakness or inadequacy. Feeling inadequate can make the depression worse if I perceive that the other person (perhaps unknowingly) is lacking in empathy and understanding; c) I'm acutely aware that the things that trigger a depressive episode in me, may not be as overwhelmingly disabling in others - so best to keep quiet about it.
• Maintaining an acceptable social facade despite feeling like sh!t is probably the most energy-sapping of all. It requires Bafta winning performances to bamboozle others into thinking I'm just fine. Even though by now I'm good at that with 55 years of practice, it is nonetheless the root of crippling social anxiety - especially the catastrophising 'what if' period beforehand.
• Then there's the stigma surrounding poor mental health. I've decided that those who stigmatise, or are themselves scared of it, aren't worth the bother and waste of energy.

Perspective from a supporting role:

• Sometimes silence, a dependable physical presence and gentle attending to needs is enough support.
• If the person wants to speak, listen intently and paraphrase what they have said to demonstrate your understanding. They might then want to go deeper and offload some more if they know you are interested in what they are saying.
• Self disclosure of similar issues that you may have experienced yourself can be a good leveller and might encourage them to open up a bit more about their problems.
• Trust is a big thing. Always do what you say you are going to do with no triggering surprises.
• Avoid being judgmental, even when you are asked a 'fishing' question that would normally require a judgmental answer. Inhabit their world as much as you can because depressives are often profoundly 'turned inwards' on themselves.
• Avoid telling them what they should be doing. It may not seem like it at first, but deep inside they do have most of the answers; depression just suppresses them all in a fog of pessimism.
• Observe facial expressions and body language, which are more telling and immediate than words.
• Take great care to look after yourself and your own mental health. Maintain your own resilience as much as possible because looking after someone is physically and emotionally draining. Don't dismiss the idea of professional help for yourself.

Apologies for the length of this post. I felt it might be useful to see both perspectives from my personal experience. 

I wish you all the best.

Thanks for sharing those perspectives…appreciated!