Depression Takes Toll on Spouses and Loved Ones, Too

Dec 30, 2014, 9:00 AM

Mieke Beth Thomeer, PhD, is an assistant professor of sociology at the University of Alabama, Birmingham, and Debra Umberson, PhD, MSW, is a professor of sociology at the University of Texas at Austin and a 2011 recipient of a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research. The authors received the 2014 American Sociological Association’s Best Publication Award from the mental health section for an article on marital dynamics and depression that was published in Society and Mental Health.

The Centers for Disease Control and Prevention (CDC) estimates that one in 10 Americans is experiencing depression at any given time.1 Depression is a frequent topic in the media: news reports highlight the toll it takes on the diagnosed person;2,3 celebrities publicly discuss their debilitating experiences with depression;4,5 and researchers investigate biological markers of and cures for depression.6,7

Overwhelmingly, depression is depicted as an individual-level problem, a burden and difficulty for the person with it. Little attention is given to what depression means for her or his loved ones, especially for spouses. Because depression is rarely experienced in isolation, we argue that it is important to ask:

  • What is the mental health impact of having a depressed spouse?
  • What factors lead to the spread of depression from one spouse to the other?
  • How can both spouses be supported during episodes of depression?

In our study,8 we found that having a spouse with depressive symptoms increased one’s own chances of developing depressive symptoms. However, this was not the case across all couples. A key factor in whether depressive symptoms would spread from one spouse to another was the gender of the person with depression. In our quantitative analysis of 2,601 couples, we found that women’s depressive symptoms had a larger negative impact on their husbands’ mental health than men’s depressive symptoms had on their wives’ mental health.

In our in-depth interviews, we interviewed many couples in which one partner was depressed. We found that it was common in couples in which the husband had depression for the husband and wife to work together to combat his depression. For example, the wife would make her husband’s medical appointments and remind him to take his anti-depressants.

Conversely, in couples in which the wife was depressed, the wife tended to experience her depression as an isolating condition. This occurred either because the wife actively worked to shield her husband from knowing about or helping with it, or because her husband dismissed its seriousness. For example, one of our respondents said:

“Before I was diagnosed with the depression, but I felt like there was something wrong, [my husband] kept saying, ‘There is nothing wrong with you. It’s just fine . . . you’re just stressed out or tired or sad,’ or things like that. So, there was a lot of discord because I felt like he was discounting ... I knew there was something really big that was wrong.”

Tackling depression as a team seems to be beneficial for the spouse with depression and protective for the spouse without depression. Indeed, the finding that husbands’ depressive symptoms had little impact on wives’ mental health may reflect the benefits of the team-based approach to depression—the approach often used by couples in which husbands had depression.

Treating depression by focusing solely on the depressed person is detrimental to her or his family members. When treating a person with depression, it is imperative also to monitor the mental health of her or his loved ones, especially depressed women’s intimate partners. Clinicians should be aware that women with depression may be especially likely to exclude their spouses or have their depression dismissed by their spouses. Clinicians should actively work to include spouses in treatment plans.

Moreover, it is important for policymakers to go beyond a focus on individuals and their spouses to consider the broader social contexts in which depression emerges and how such contexts can be modified to better support individuals and couples affected by depression. As important progress continues on pinpointing the causes of and treatments for depression, our study and others9,10,11,12 highlight the contribution of the social environment and of relationships, including the risk factors associated with being married to someone with depression.

Depression, in short, should not be viewed as an individual-level issue, but as a mental health concern that can easily spread through social networks—and a problem that can be alleviated through social relationships. 

1 Center for Disease Control and Prevention. 2010. “Current depression among adults --- United States, 2006 and 2008.” Morbidity and Mortality Weekly Report (MMWR), 59:1229-1235. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5938a2.htm?s_cid=mm5938a2_e%0D%0A. [back to text]

2 Rivas, Anthony. 2014. “Depression comes with a lack of intuition, hindering decision-making processes.” Medical Daily, November 9. Available at http://www.medicaldaily.com/depression-comes-lack-intuition-hindering-decision-making-processes-309980 [back to text]

3 Tartakovsky, Margaret. 2014. “Cognitive distortions: The lies depression tells.” PsychCentral, November 12. Available at http://psychcentral.com/lib/cognitive-distortions-the-lies-depression-tells/00020607[back to text]

4 Sarkari, Karishma. 2014. “Katy Perry opens up about the depths of her depression after split with Russell Brand in Australian TV interview.” Daily Mail, November 10. Available at http://www.dailymail.co.uk/tvshowbiz/article-2828334/There-thoughts-never-actions-Katy-Perry-opens-depths-depression-split-Russell-Brand-Australian-TV-interview.html[back to text]

5 Hare, Breeanna. 2014. “Wayne Brady reveals battle with depression.” CNN, November 4. Available at http://www.cnn.com/2014/11/04/showbiz/celebrity-news-gossip/wayne-brady-depression[back to text]

6 Kaplan, Rebecca. 2014. “Changes in single gene can control addictive and depressive behaviors.” Tech Times, November 11. Available at http://www.techtimes.com/articles/19976/20141111/changes-in-single-gene-can-control-addictive-and-depressive-behaviors.htm#ixzz3Is75u2NG[back to text]

7 Keilman, John. 2014. “Magnetic stimulation gains in treatment of depression.” Detroit Free Press, November 2. Available at http://www.freep.com/story/life/wellness/2014/11/02/magnetic-stimulation-depression/18192989[back to text]

8 Thomeer, Mieke Beth, Debra Umberson, and Tetyana Pudrovska. 2013. “Marital processes around depression: A gendered and relational perspective.” Society and Mental Health, 3:151-169. [back to text]

9 Ross, Catherine. 2000. “Neighborhood disadvantage and adult depression.” Journal of Health and Social Behavior, 41:177-187. [back to text]

10 Rosenquist, J. N., J. H. Fowler, and N. A. Christakis. 2011. “Social network determinants of depression.” Molecular Psychiatry, 16:273-281. [back to text]

11 Evenson, Ranae J. and Robin W. Simon. 2005. “Clarifying the relationship between parenthood and depression.” Journal of Health and Social Behavior, 46:341-358. [back to text]

12 Frech, Adrianne, and Kristi Williams. 2007. “Depression and the psychological benefits of entering marriage.” Journal of Health and Social Behavior, 48:149-163. [back to text]

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.