Supporting a partner with depression

Look for changes that last, not one bad day. Health organisations list many signs, and they may be present for at least 2 weeks: feeling sad or hopeless, losing interest in things your partner usually enjoys, sleeping too much or too little, and low energy¹. Others include irritability or anger, trouble concentrating, changes in appetite, slower speech and movement or more restlessness, poor hygiene and self-care, and pulling away from other people².

Depression can come on gradually, so it can be hard to notice. Many people cope without realising they're unwell, and it can take someone close to say that something seems wrong³. Even if your partner hasn't said they're struggling, subtle changes in mood or behaviour can show it's a hard time: they stop joining in on things they enjoy, or seem distant and hard to reach⁴.

Signs can look different from person to person. Behavioural signs listed for men include withdrawing from friends and family, escaping into work or sport, relying on drugs or alcohol, and reckless behaviour⁵. Around a partner's pregnancy or the first year after a birth, depression in fathers can be "masked": alcohol or drug misuse, risk-taking such as speeding and gambling, and more aggression and irritability than in depressed mothers⁶. These are averages, not a description of your partner.

Signs aren't proof. Only a qualified health professional can say whether someone is depressed, so treat what you notice as a reason to check in and talk. A rough note of what you've seen, and for how long, can help you describe it calmly.

Listen, stay calm, and let your partner keep a say in how you help. Health organisations give this same basic advice for depression and for supporting someone with a mental health problem more generally^1,7.

Here is how it can look:

• Pick your moment. Check that you're in a good headspace, have time, and have chosen a comfortable moment¹.
• Open gently. Tell your partner you're worried, and use open questions that start with "how", "what", "where" or "when"⁷.
• Reassure. Starting the conversation may be difficult. It can help to stay calm and say they don't have to deal with things alone⁷.
• Listen without rushing. Give them a safe space to talk, and hold back from quick advice or judgement¹.
• Ask before helping. Then your partner has a choice and isn't being told what to do¹.

If your partner turns down your help, keep showing care. Offering support and care can still make a difference¹.

If you're wondering about couple therapy, it may work as well as individual therapy for depressive symptoms, and may improve the relationship in distressed couples. The evidence is low quality, so no firm conclusion is possible, and it mostly covers people with moderate depression in Western countries, so it may not apply to severe depression⁸.

Say you're worried, listen, and suggest seeing a doctor or finding another source of support as a first step. Your nudge matters: people are more likely to seek help if someone close to them suggests it⁹, and a partner is often the first to realise that help is needed².

Be patient, because several things get in the way. Worry about telling anyone, and about confidentiality, is the most prominent stigma-related barrier to seeking help¹⁰. Shame, embarrassment and stereotypes that mental illness means weakness also deter people¹⁰. On average, men, young people and some ethnic minority groups are deterred more¹⁰. Stereotypes of masculinity can lead depressed fathers to suffer in silence rather than ask for help⁶. So your partner's hesitation may be about fear of judgement, not about you.

One way to go about it:

• Choose a calm, private moment when neither of you is rushed.
• Start by saying you're worried, then ask open questions and listen. Don't argue them out of how they feel.
• Suggest seeing a doctor, and ask whether they'd like help with it, such as finding a time or going along.
• If they say no, leave the door open and keep showing care. It isn't clear yet that any one way of raising the subject makes help-seeking more likely, so go at your partner's pace.