Can You Be a Therapist for Your Depressed Partner?

A couple of readers have asked me to comment on whether it’s possible or advisable to try to act as a ‘therapist’ for your depressed partner. This idea came out of responses to one of the posts on relationships that has attracted the most attention on this blog: How Can You Communicate After Your Depressed Partner Leaves?

The word ‘therapist’ has to go in quotes because a non-depressed partner cannot and should not try to do what a professional therapist does. The more I learn about psychotherapy and the range of skills and training it takes to be good at it, the more respect I have for anyone who can fill this difficult professional role.

Quite apart from the specialized knowledge and clinical experience required, a partner has such enormous emotional involvement in a relationship that every word, intonation, gesture and silence is interpreted in the light of deep needs for connection. Depression threatens the bond that has existed in the past so every discussion, in a sense, is about the relationship more than it is about one person’s depression.

Present as Partner or Therapist

A professional therapist can be present with a client in a completely different way. Without the personal and intimate history of a relationship, the therapist brings concern and compassion but also detachment and a set of skills that are essential for helping a depressed person confront and cope with difficulties. The relationship of helper to client focuses on the need of one person to end suffering.

The therapeutic relationship is a testing ground for bringing out difficulties and finding ways to handle them. It can serve that purpose because it is not an intimate partnership. The therapist is constantly reminding the client of the boundaries that keep the focus on the need to deal with the client’s problems.

The differences may seem obvious, but we all talk informally about the sort of ‘therapy’ that can happen between intimate partners. Sometimes, the word refers to the healing discussion of feelings that are so sensitive that they can only be brought up when both partners feel especially open and trusting.

Sometimes, the word means the opposite of intimacy. A partner might come across as lecturing or applying pop psychology that isn’t really responsive to the depressed person’s needs. Or the non-depressed partner might resent being cast in the role of therapist when that means listening to a one-sided unburdening or venting.

The problem with both of these situations is that they are about one-way communication. It’s like being read to from a script, not talking together as partners who are present and responsive to each other’s needs.

Depression’s Filter on Relationships

I think a depressed person has needs that are very hard for a partner to meet because they aren’t about relationship. They come out of a narrowed perception of yourself and your partner.

Depression provokes a kind of soul panic. You feel a threat to your very being, but you’re not sure what the threat is. You don’t know how to deal with it so there’s a tendency to pull back, hunker down, withdraw. A survival instinct comes into play.

It becomes very hard to listen to other people. You sense the need of an intimate partner for loving reassurance. You hear their words intended to comfort or help. Yet most of what comes across is like an emotional demand that you simply can’t tolerate.

It can feel claustrophobic. You’re hurting too much inside, feeling too nervous about losing control of your own life to be able to listen to your partner’s needs. So it’s easy to tune out what they say or angrily reject it. There are times when I’ve been like that, and there was no talking to me.

Changing Expectations of Support

I think your expectations of your partner vary depending on your level of self-awareness and experience in dealing with depression.

Early on, when I had a poor understanding of what I was going through, I could blame everything on my partner, but these days I recognize the signs of depression right away. as does my wife. We both prepare for dealing with it. We’ve learned a lot about how to be thoughtful with each other during those times.

To the extent that we can participate in a two-way exchange, the relationship is holding up under the pressure.

Some commenters have used the word “therapy” to refer to quiet listening coupled with a deep understanding of the suffering that depression entails. The partner would be able to feel a lot of empathy and offer gentle encouragement that could help the depressed person get through a hard time.

I think most undepressed partners can manage that sort of responsive listening from time to time, especially if periods of depression are relatively short and not too severe. Knowing more about depression also helps. Understanding the illness makes it easier to react to its symptoms in a partner in a more detached way, without feeling you’re to blame or that the relationship is at fault.

Helping for the Long Term

When I think of depression that lasts for months and years, however, I can’t imagine any partner setting aside their needs to be the purely responsive listener all the time. It’s not possible, and a depressed person shouldn’t expect a partner to put life on hold for the duration. This isn’t an either/or problem. Sometimes, partners will be responsive and helpful, sometimes hurt and isolated from each other, sometimes struggling to connect and just survive.

‘Therapy’ doesn’t seem to fit the way partners can relate to each other when one of them is in the midst of depression. It seems to set up the wrong expectation. For the depressed partner, expecting your mate to help guide you through depression is a very limited way of thinking about your own treatment.

Your partner can be a knowledgeable, loving and supportive helper in a program of recovery, but the primary source of change is within the depressed person. I guess I’m sensitive about this because I spent so many years expecting therapists, doctors and, to some extent, my wife to bring me out of depression. That was a long delusion that got me nowhere.

Sure, partners nurse and care for each other when they’re ill, but when depression is a life condition, both partners have to prepare themselves for long-term changes in the relationship as they deal with the illness. Expecting one partner to act as therapist for the other seems like the wrong idea.

What do you think?

25 Responses to “Can You Be a Therapist for Your Depressed Partner?”

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  1. Alexander says:

    Hello, I met my girlfriend online in February. We really hit it off and before we even got together she explained to me that she was depressed and it would probably be very difficult to be with her. Not only that, she is extremely anxious and fears and hates humans which makes it very difficult for her to get a job and function in society. I live in England and she lives in Germany though surprisingly the distance between us isn’t so daunting, of course we miss each other greatly, even more so after i have visited her twice. There have been some rough patches with her depression and i am slowly coming to grips with how it can make her act towards me and though it can hurt at times i realise it isn’t her fault and she doesn’t want to act this way towards me or anyone, she is a good girl and tells me when she is feeling really bad to just leave her be so she doesn’t hurt me. When she is like that she doesn’t want any affection at all and will distance herself. But over the course of the 6 months we have been together it feels like she is growing less and less interested in me, whether that is the depression or not I do not know, i just feel I am saying the wrong things or just responding to her feelings in the wrong way. I’m really trying to understand her and I dont want to ruin our relationship because I am unable to respond properly to her depression. I try to talk to her about my feelings as much as possible but im afraid she will start to resent me for always complaining about little things, and it feels like she doesnt tell me anything about her feelings, i dont think she likes to talk about it. I really truly love her and want to be with her but it feels like this relationship is slipping through my fingers and there is nothing i can do to stop it…

    • Khari says:

      Hello. I’m in a similar circumstance with my fiancé. Did you figure out how to cope/respond? Please let me know.
      -Khari

  2. Joana says:

    Hi, my boyfriend is a psychology graduate and he admitted to feeling depressed and that he doesn’t know who he is anymore. I really want to help him and I offered to release him from our relationship but I’m scared and I don’t know what to do. I want our relationship to stay but I don’t know how to help him and how to make it still work. I love him so much to let go…

    • Evan says:

      If you don’t know it may help if he can get to a doctor or psychiatrist or psychotherapist. And then you can support him doing what he decides in consultation with them. In the meantime letting him know you love him and think he is a worthwhile person should be worth doing.

  3. anonymouth says:

    I have stumbled onto this wonderful website, by sheer luck, and it has opened my eyes to a pandoras box of issues. I am at once thankful for all the insight on this blog and daunted by the enormity of the problems my husband and I in the middle of.

    My husband and I have had a difficult relationship for 2 years, during which he has told me his depressed. He is also an alcoholic. Both things he has suffered with for over 15 years. He stopped drinking recently after a major fall out with his mother and I over christmas. We resolved to tackle this head on together.

    Unfortunately, since then he has not sought professional help to cope with the effects of not drinking. Now he is in denial there is anything to address and just continuing as normal, he is using other drugs to support is lacking of drinking. He is creating distance, and disappearing into a fantasy with a women he has met online. Although he is unaware I know, deep down he probably knows I know. Its all happening too fast for me to see what is going on and know how to deal with. I was about to walk our before I read this website.
    I recognise so much in what is written on this website and it has helped me so much to understand and manage my own emotions. Now I am just trying to figure out the best way to address the problem before it does any more damage. this maybe something I cant stop, I dont know maybe I will just have to step out of the way to limit the effect on meyself. I just need the courage to say something.

  4. Therapist says:

    I think the one who is not depressed can help in the process of healing of the depressed one by moral and spiritual support.It is best to exercise to silent communication.You can also support your partner without saying a word.Thanks.I learned a lot from your post.

  5. Donna-1 says:

    This feels like a very emotional subject to me. I don’t know how to respond. When I was married I felt like I required so little from my husband, and he was unwilling or unable to give even that. Like Judy, I really think my husband contributed to my depression because he was so controlling and demanding and unforgiving (and denigrating and belittling.) You can see how that would be depressing. So I blamed him. We had zero communication skills. Maybe that’s what could be improved in relationships — not that a partner needs to play the role of therapist, but there definitely needs to be a way for each to talk about what he or she is experiencing without assessing blame.

    And to be honest, now that I look back, I had depression long before I ever met my husband, so he wasn’t totally to blame. But problems in a relationship are never one-sided. It seems to be a mix of love and ignorance…and the goal should be to decrease the ignorance and increase the gifts of love and the application of love. We never got that far. Our marriage was 13 years of denial of the obvious and being generally oblivous.

    • John Folk-Williams says:

      Hi, Donna –

      You do have a way of getting to the heart of things – decreasing ignorance, increasing love – the application of love – that’s a great summary. I doubt that it’s possible for two people to be together without communicating, although much of the time the “talk” is too loud and totally nonverbal, as in visibly turning away to avoid saying anything or even eye contact, disappearing in plain sight, etc. I think blame has so much to do with the fear of being vulnerable and buried shame. There are times when people get so hostile or indifferent that it’s just not safe to trust them – a very hard call to make.

      John

  6. Nancy says:

    I found this post to be both encouraging and enlightening. I have the ability to be detached, but only for so long (as you pointed out), especially when my needs haven’t been met for soooo long, and my partner hasn’t been able to empathize or even been able to be concerned with what is going on with me for months or years at a time. This post help me realize that I should not feel guilty for that. Up until now I have felt that I should be able to put myself aside and help him, but recognizing what why I can’t. I have been feeling like I’m just up on a shelf……..because he can’t meet my needs, but I am not his therapist, and my needs are just as valid as his. It is not my responsibility, nor is it good for me, to ignore myself for so long. As I said, I am able to do it for short stints, or here and there…….but being that he is supposed to be my partner, but has checked out for a few years now, the amount that I am able to give is fast dwindling.

    I have battled depression myself since I was a teenager, but I haven’t really sought “therapy” from my partner, because I never felt like he truly understood anyway, besides either I haven’t had too many therapist that were very good, or “talk” therapy only benefits me so much. The worst part for me was always the lack of energy or motivation to do anything, rather than “self contempt”. The worst it ever was for me was after being put on medication for anxiety/depression, we found out that my thyroid was actually off. I experienced a period of time when I could feel absolutely no positive emotions. Nothing gave me security, I constantly felt like I was standing on the edge of a precipice looking down into the deepest/darkest cavern imaginable. Christmas music helped…….I listened to it a lot. I did some soul searching, did some research, did some visualization. At one point when I would be overwhelmed by the ledge I would picture it filling with earth and flowers growing out of it. A lot of what I went through was because I was living a life based on fear, I have since then learned the diffference in how life is from that center and living from a center of love, and even though fear still creeps in, I am able to keep it at bay. I do sometimes wonder if the medication didn’t exacerbate my depression, but with my thyroid under control I slowly weaned off of it all, and although I have “days” that may turn into a week, I haven’t had weeks that turned into months……

    My partner on the other has always avoided conflict at all costs (didn’t realize this for a long time as he simply rephrased my “stance” so I thought we were in agreement. The problem was that his actions never lined up with what we had discussed (because he never really agreed or made a commitment but pretended to). For the first couple years I had no idea that he was just agreeing to agree, pleasing so that I would like him. I have talked to him about these things, but it seems that is the only way he knows how to “talk” (I purposely didn’t use the word communicate). There has been very few times where we genuinely connected, and those have been the times I have held on to. It has been my pushing and prodding to establish a “healthy” relationship in which two people communicate in truth that has put more pressure and stress on him, I think. He seems to do okay as long as he can live in a life of denial, as long as I don’t confront him when he lies, or get frustrated because we haven’t truly connected in weeks (non-sexually). That added to the stress of my stint while sick, and my son who was diagnosed with Aspergers a few years ago. He, my partner, says he has struggled with depression in the past, but drinking, or being with other women (mainly cybering), playing lots of video games, etc…. This is the longest relationship he has ever been in, they always ended before the actual “problem” was recognized.

    I was able to encourage him, that along with the effects of some very poor choices this summer, to speak to a therapist. He has now admitted to me that he has lied most of his life, something he never admitted to before and something I had no idea was so pervasive. He says he wants to be healthy, and that he wants our relationship to be healthy, but he is still stuck in the, “but I don’t know if I can do it, and I don’t deserve it anyway.”

    I have, as I said until now, felt guilty for “asking too much”, or getting frustrated with him for not engaging in the family, and not connecting. It has become a way of life almost. I even feel guilty for being jealous of his therapist…..because he actually shares things with her, things he doesn’t want me to know about. I sat in the waiting area during one session just reading, and since he has adamantly stated that he doesn’t even want me to do that, because he is afraid I might overhear………. So, now I want him to get help, but I feel even more out in the cold. I DO understand it is easier to talk to someone who you can’t “hurt”, but it still hurts.

    Anyhoo, I will no longer try to be his therapist (although me being detached is almost the only times he shares anything of an intimate nature…) and stop feeling guilty for having my own needs. Thank you!

    • John Folk-Williams says:

      Hi, Nancy –

      Thanks for telling this difficult story here. It reminds me how much two people learn about themselves and grow from the friction of trying to get along with each other. It’s hard to make the relationship work when you try to get fixed elsewhere and only want to open to your partner when you feel OK. There is so much risk and vulnerability in trying to be close to someone over a long period of time. The only way I could learn to take those risks of being open with my wife was to weather many stormy crises but with the help of a good couples therapist. It sounds like the two of you are making progress, each in your own way, but I wonder if working together with a different therapist would be a good thing for you too. Just a thought.

      All my best to you — John

  7. Evan says:

    “Most things that are therapeutic aren’t therapy”. I think partners will usually want to contribute to healing. It is good to talk to the depressed person about how they would you like to do this. And how they want you to fit in with (or not) what their therapist is doing.

    I don’t think that in long-term therapy the therapist and client can avoid becoming friends to some extent. For the relationship to stay healthy I think the process of the relationship needs to be made conscious – suppressing awareness is unlikely to help therapeutically in my view (I am aware that many people do not share my view).

    • John Folk-Williams says:

      Hi, Evan –

      I agree that talking with the depressed partner about how to fit in during treatment is critical. I think treatment as a whole should be approached as another dimension of the relationship, with constant discussion. I can’t imagine my wife not being a part of such a life-changing process. As to the relationship with the therapist, I’m sure that can be as variable as people are. For me, I’ve always been friendly with therapists but not friends. I’m sure it’s an ongoing problem for therapists, given how differently they would tend to react to each client on a personal level.

      John

  8. Judy says:

    John, I had to smile when I saw the title of this post. You are so right about a partner not being able to be a therapist. You really do need that caring detachment of a professional – someone who has no personal agenda in helping you or in expecting certain outcomes from you, etc. I remember in the worst days absolutely hating it when my husband would try to “fix” me. I felt like I needed too much and that I didn’t deserve it, anyway. Besides, he had a role in it, as well. We were terrible communicators, because of fear, and his behavior and attitudes were contributing to the depression, besides the fact that I was seeing him as the cause of it, although it felt like it was much deeper than that but I couldn’t name it.

    The thing that helped change this the most was couples therapy, in addition to my individual therapy. We had an objective person who could see what was going on and get us to push past the fear. I have to give my husband a lot of credit for being willing to do that because it totally went against his nature! But I think he at least felt like he had somebody who could be HIS ally, too, and see that a lot of it wasn’t in his control, nor was it his fault. Kind of a relief, I would think! I think couples therapy can also make the depressed person realize when your behavior and attitude are inappropriate and that you don’t have a license to act like a jerk, just because you’re depressed.

    I just got reminded, in writing this, of how my grandson acts when he’s unhappy – he starts crying and says, “I don’t know what to do!” That’s how depression can feel, too, and sometimes we need somebody who can non-judgmentally show us that there IS something we can do.

    • eve says:

      Judy,

      Thanks for your post here too!

      Really good to hear from someone on the ‘other side’ of the equation.

      When my ex and I attended couples therapy I felt like your partner, ‘Kind of a relief….someone who could be my ally too and see that a lot of it wasn’t in my control’. The therapist could also tap into my ex and challenge her thoughts. You sound very aware of your emotions and the affect of depression on your thoughts.

      Latest with me – my ex and I had a good chat on the phone last night. Still very early days in terms of building up trust etc to reconcile. But already I’m thinking that attending couples therapy would be important if things get back on track with us.

    • John Folk-Williams says:

      Hi, Judy –

      It’s so encouraging to hear about you and your husband doing couples therapy and being able to confront all the embarrassing and difficult truths with a trusted pro. That takes incredible courage as well as a highly durable bond of love. That thing can take a lot of kicking and abuse but is amazingly tough and resilient. Sometimes, I feel like a raging kid who knows it’s safe to boil over once in a while because there is something safe and enduring between the two of us. We stretch the bond, but it brings us back again.

      My best to you —

      John

  9. Wendy Love says:

    I agree. Partners should not attempt to be therapists, nor should they be expected to.

    My husband plays a key role in my support system and if he is away, I don’t do as well as when he is home. But, having said that, he is not my therapist. He plays a key role but in small snippets. For instance, one silly thing that really seems to help me is that when I wake up and attempt to start my day and realize it is NOT one of my good days, it helps me tremendously to have a five minute pity party with my husband listening. He seems to be able to hear it without needing to fix or comment and after five minutes of telling him how sorry I am for myself, and how tired I am of this wretched illness, I feel just a wee bit better and am able to face, or endure the day. Without that little outlet, it is not as bearable.

    Another way that he is helpful is to give me permission to do nothing. When I am in a bad state he might say ‘well, I guess you know what you have to do today right?’ ‘Yup, nothing’ I answer and he makes my doing nothing sound quite noble. He checks on me throughout the day to make sure I am still doing my job – nothing! Without those small things that he does I cannot imagine enduring depression.

    But, having said that, to be a therapist, when he has no training, is just plain silly. And to put our partners in the line of fire of our emotional garbage on a regular basis, when they already have to endure so much of the aftermath of our emotional illness, is just plain unfair.

    Think of it this way. Would we, the mentally ill partner, like it if our spouse said to us “I need you to listen to me tell you how hard it is to be married to someone with a mental illness”? Don’t you think that would be a little hard?

    Once again John you have raised an important point.

    And some of your descriptions of our depressed emotions are so amazingly accurate and articulate. Today’s favourite for me was “Depression provokes a kind of soul panic. You feel a threat to your very being, but you’re not sure what the threat is. You don’t know how to deal with it so there’s a tendency to pull back, hunker down, withdraw. A survival instinct comes into play.”

    Keep up the good work John. You are providing a great service as you share tips, advice, support and amazing insight into this complicated illness.

    • John Folk-Williams says:

      Hi, Wendy –

      Thank you for this beautiful comment. It’s so wonderful to hear about the way your partner and you can relate to each other when you’re having a hard time. I can’t tell you how often I have blown those moments when my wife just needs to say how she’s feeling and I cut her off with the solution to a problem. How emotionally balanced and loving he must be.

      And thanks so much for your kind words about the post.

      All the best — John

  10. jim says:

    No, partners can’t be expected to be your therapist. It isn’t fair. I can’t tell you how many relationships/friendships etc I have damaged by my expecting them to make me better.

  11. eve says:

    Hi John,

    This post above was very insightful for me.

    Your comment you make here is key , ‘A professional therapist can be present with a client in a completely different way. Without the personal and intimate history of a relationship, the therapist brings concern and compassion but also detachment and a set of skills that are essential for helping a depressed person confront and cope with difficulties.’

    I think you’re helping me understand how important it is to leave the real therapy to a professional.

    Over the last few months, (since the break-up with my ex) I have been learning about different ways to correspond with her without applying pressure. For example, the need to sit in silence hold hands, be a passive presence when she is feeling low. And not put any demands/ask for help at these times. And possibly expect some negative/moody feedback from the depressed partner. At these times non-depressed partners need to remind themselves it’s not personal.I think this is all fine for short periods of time, but the real issue is the depressed person needs to seek help and look after their own well being.

    Thanks John for being honest with your own admission – that you spent much time expecting your wife or therapists to help guide you out of your depression when really it was you that was able to do this for yourself. I like what you say that a partner can be a supporter in the program of recovery.

    One question I have is if depression comes and goes – does a non-depressed partner need to always expect to not have their needs met at times when their depressed partner feels low? For example, should we not expect the depressed person to help around the house, be able to engage in conversation, be physically affectionate etc.

    Or should this be a point where both partners keep a check on the depression and the depressed person look at seeking help. Thereby allowing the needs of the non-depressed partner to be met too?

    • John Folk-Williams says:

      Hi, eve –

      I can’t imagine that any non-depressed partner could set aside their own needs for a long time. I think the difficult periods can be more bearable if you know that your partner is getting help, but it’s important to be open about what you’re going through. If two people are working together, they can hopefully discuss how hard it is for one to be out of commission, even if it’s not their fault. People with depression can go through the motions of helping out and being present, even if they don’t feel like it. Keeping up even a minimal level of activity is important as part of getting better. Learning small steps of self-activation has always been helpful to me. It’s part of the process of getting more control over the focus of your attention – you wander away in a fog but then pull yourself back to some task in the moment, however trivial it might be. Talking is always important so long as it is done with understanding rather than anger.

      John

  12. Cheryl says:

    Although my depressed partner has now left, I understood quite well that my attempts to be there for him were interpreted as an emotional demand from me. In some ways they were, as I was feeling quite desperate just to get it across to him that I was more than willing to stay by his side no matter what he was going through. But I did not need him to give anything, do anything, I just wanted him to be aware and accepting of my presence. But what he saw, interpreted was “NEED” .

    For this reason I also believe that there is no way a partner can act as therapist. Our roles can be to support, comfort and celebrate progress, but we cannot facilitate deep discussion as there is too much at stake for either to open up freely without consequence. What we can do is hold hands, remain connected in a silent and accepting way, and listen when they talk of their own accord.

    Nothing I did or said would convince my ex that I just wanted to be there if/when he needed me. Perhaps in time he will come to realize that, especially now that we are not together and less attached. I feel a lot less anxious about the situation, and may soon be able to offer my support without projecting the sense of “NEED” that threatened him before.

  13. John Folk-Williams says:

    Hi, Cheryl –

    It sounds like your partner never got the help that could enable him to see around his depression and tune in to the reality of your loving presence. Remaining connected in a silent way can certainly be a wonderful form of communicating, and is often extremely helpful to a depressed person. Not having to explain anything – and feeling understood. But anger at the expression of love is a strong sign of depression you can’t quite face as your own internal problem – at least that’s the way it was with me. Then there are also, often, deep patterns of behavior linked to that anger that go way back in one’s life and can only be uncovered with the help of a therapist. I hope your partner can come to realize the value of your support, but it seems he will need help to get there. You know he should be able to handle the part of you that does really need him and need something back from him from time to time. The need for his presence is important for you and can’t be pushed aside altogether.

    Thanks for sharing your story.

    John

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