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April 30, 2014 5:47 AM   Subscribe

I think my spouse has chronic depression and it is badly effecting our relationship. He has agreed to attend a couples counselling session tomorrow but is very reluctant to admit to depression. I've never done couples counselling. How do I raise the issue of his depression in the session?

He is only going to the counselling because he knows I am reaching the end of my endurance with the current state of our relationship. I have had one on one sessions with counsellors before and attach no stigma to it. He does attach stigma and may be resistant to any suggestion that some of his behaviours, or lack of behaviours, indicate depression and/or anxiety. The session tomorrow is with a woman whom neither of us know.

His depressive behaviour and daily dourness are at close to deal-breaker stage in the shorter or longer term from my perspective but I can't give up on us until I try everything. How can I best approach this session with the goal of him moving toward acknowledging his depression and, hopefully, choosing to do something about it?

also, if I am approaching this the wrong way, please let me know that too
posted by anonymous to Human Relations (17 answers total) 2 users marked this as a favorite
It's a start. Your counselor will probably ask you why you're there and when it's your turn you can say, "I believe that Lionel has some sort of depression. These are his behaviors and they affect me in the following ways (it's okay to make a little list.) I am willing to work with him on this and I believe that a trip to the doctor, where he is 100% candid is the first step."

From there, he can say what he thinks and the counselor can help mediate between the two of you.

But, if your husband refuses to get treatment, or if it turns out that he's not depressed, he's just a moody asshole, then what? Have the counselor walk you both through your feelings. Ultimately, it may be that you're disassembling your relationship with her help.

Either way, good first step.
posted by Ruthless Bunny at 5:56 AM on April 30, 2014 [2 favorites]

with the goal of him moving toward acknowledging his depression

I suggest changing your goal. Your goal is to improve the relationship and your satisfaction with it. Avoid the diagnostic term. It's not something you or a couples counselor can diagnose anyway.

Discuss the specific behaviors, how they're different than usual/before, how they affect you, what your needs and expectations are. That's what couples counseling is for.
posted by headnsouth at 5:56 AM on April 30, 2014 [21 favorites]

This was the situation my mother found herself in- a husband whose dourness and anxiety were not only making the house funereal but putting a lot of emotional strain on her personally. (She doesn't know this but it affected her kids quite a bit too as we were growing up).

The bad news is that it took failed couple's therapy and two serious threats of divorce before he came to the stage where he started making active changes. There was a stage in-between where he admitted his problems but didn't do anything to help himself. They both tried couple's and individual counselling and while I think it was good for them to have a neutral party to rant to, it didn't necessarily fix my dad's problems.

The good news is that my mother decided she wanted to keep trying, and he made a big effort to make the changes that needed to happen. He's much better now. It took: moving to a new area, changing up his career a bit, getting a better social life, losing weight, cutting back on drinking, exercising more and putting back into the community through volunteering.

So from my experience: he has to WANT to change and do things to make his life better. My mother deciding she wasn't going to stick around was what made my father want that change. I wouldn't say I'd advise that way of doing it, but it did work. And therapy/counselling might not be a magic cure, necessarily.
posted by mymbleth at 5:59 AM on April 30, 2014 [5 favorites]

The therapist will ask why you're there. This is your opportunity to say "Lionel's dourness and X, Y and Z are affecting me in the following ways. I don't know if this is unacknowledged, untreated depression or something else, but it has driven me to the deal-breaker stage."
posted by DarlingBri at 6:12 AM on April 30, 2014 [1 favorite]

I agree with headnsouth. Avoid diagnosing. Talk only about the deal-breaking behavior, let him explain the causes. He might be depressed, unhappy with his life and/or the state of the relationship, maybe a combination of both. He'll need to speak for himself. By diagnosing him before he has a chance to explain his behavoir you cut him off and frame the conversation around whether he is or is not depressed, which could put him on the defensive. He might have legitimate concerns and forcing him into a "you need to be fixed" conversation can brush those aside.

Like mymbleth says, he has to want to change and fix things. It's great that you're working on this with him and that he's willing to try counseling.
posted by AtoBtoA at 6:52 AM on April 30, 2014 [2 favorites]

I'm going to stick my neck out here and say that I think you're being a little presumptuous, diagnosing your partner as having depression. I'm not you, and I'm not a fly-on-the-wall in your house, but could "it's depression" not be a convenient get-out for other issues in his life and in your relationship, something for you to say to avoid other difficult questions? Depression is a medical condition and should only be diagnosed by a professional - it's not something that should be thrown around as a vague guess.

I know what it's like to have a miserable bugger around the house - I faced similar issues with a particularly dour relative while I was growing up, and you're right, it's not pleasant. But constantly badgering him to go to therapy, to go to the doctor is likely to be exacerbating the problem. It's also perhaps making him feel like this is a shortcoming of his, a constant criticism of you towards him, rather than a medical condition that's no-one's fault in particular.

With the way you've written this - with the goal of him moving toward acknowledging his depression - it's almost as if you've already decided what's wrong, what needs to be done, and how it's going to be resolved without allowing him to feed back or have any input into the situation at all. "His depression" may not even exist, but you've already made up your mind, it seems.
posted by winterhill at 6:54 AM on April 30, 2014 [3 favorites]

Agree with the suggestions above - if your goal is "get him to acknowledge he has depression", then you may be setting both you and him up for failure. A more realistic goal might be "get him to understand how you perceive his behaviors/actions and how they affection you; talk together with the therapist's help about what might be driving those behaviors."

That might very well get you to a place of "okay, let's look at whether there could be any underlying medical or psychological stuff" and maybe with the therapist's help, a future step may be "go to a doctor, rule depression in or out." That's not going to happen on day one, if he's that resistant to even approaching the idea.

Day one, stick strictly to the behaviors, how you feel in response to the behaviors, how that dynamic between the two of you affects your relationship. And it's totally okay to ask the therapist's help in figuring out where to go from there! You don't have to go in with a full plan of attack; the therapist is there to help you both figure out how to improve things.
posted by Stacey at 7:08 AM on April 30, 2014 [3 favorites]

I suffer from depression and it does, on occasion, negatively impact my marriage, so I can relate to your situation, but from the other side.

Agree with your goal not being quite right. You goal shouldn't be to get him to admit that he is depressed. If you go in there with the goal to "get him to acknowledge his depression" how do you think he will feel? He thinks you're going in to this to work together on the relationship, and you're running the risk of having the couples counselling turn in to an intervention type thing entirely focused on him and what he is doing wrong. It will come off as an attack, that all of the relationship problems are his fault. Success lies not on this path.

Your goal is to improve/save your relationship. Your goal is to identify the elements in your relationship that aren't acceptable and work to correct them. Your goal is to identify things that BOTH of you can work on and change to help to save your marriage. Your goal is to figure out what both of you would need to be willing to continue in this relationship. Your goal is to understand how his behaviours affect you and how your behaviours affect him. Having his (undiagnosed and up for debate) depression treated may very well play a part in the repairing of your relationship, but you cannot come at this as that being the only cure.

Your post read very much as though you place the fault entirely on him for why your marriage is struggling. You said your goal is for HIM to acknowledge that HE has depression and that you want HIM to choose to do something about it. It is entirely possible that he *is* the reason behind all of your difficulties, but if you are serious about repairing your relationship then you need to come at this much more as a WE and US. Things both of you are doing that is contributing to the difficulty. Things both of you can do to work to fix it. A marriage is a partnership, a co-operative effort. Don't make this entirely about him and don't make it out like he is the soul cause of your marital difficulties. Your relationship and how to work together to save it should be the focus, not him and his depression.

Does he have depression? I don't know. If he does, having him admit it won't magic wand away all your relationship problems. He can admit it but that doesn't mean that he will necessarily improve. Like others have said, he will have to want to get better himself, and acknowledging/admitting isn't the same as curing. The other reality is that your relationship could still be on rocky ground even if his depression was improved. It is very easy to attribute all the problems in the relationship to his depression, and I get why you seem to think that curing his depression would cure everything else, but that isn't necessarily the case. And (sadly) if he is chronically depressed this is always going to be a part of him and his life in one way or another. There will always be times when he struggles with this. Keeping depression in check can be a constant battle. It simply is a "thing" that is always part of my marriage. 90% of the time my depression is well in control, but sometimes I totally tank out for no particular reason.

I'm also very curious how long you have been married, and if this behaviour of his is new, or if he has always been this way.
posted by PuppetMcSockerson at 7:26 AM on April 30, 2014 [4 favorites]

He may or may not have depression, but I think that going to a couples therapist to pursue a diagnosis of your partner is not a good idea. A good therapist would probably pick up on this early on, and may call you out on it. You sound as if both of you have unmet needs in this relationship, arising partly from issues with depression. One goal of couples therapy is to have both partners commit to addressing these issues in the relationship, and not to pathologize the relationship from one person's perspective.
posted by carter at 7:41 AM on April 30, 2014 [1 favorite]

chiming in to say that I think Ruthless Bunny really has it here. While you aren't able to diagnose, you are able to share your observations and the counselor might provide feedback as well as your spouse. If your spouse isn't ready to face it, he won't... but at least you will have shared your thoughts... and again Ruthless Bunny has a wonderful way to phrase what you are thinking/feeling. It's a very common feedback model for a reason, it works and it generally takes the sting out of messages.

Good luck. I wish you success in your relationship counseling!
posted by Draccy at 7:49 AM on April 30, 2014 [1 favorite]

Yes, just talk about specific behaviours that affect you. The least helpful thing would be if you were the one to present your theory, and the counsellor agreed with you; he'd likely feel ganged up on and reject the effort.

If depression's there, the counsellor should be able to pick up on it enough to probe further, based on your descriptions of behaviours, things he says, and maybe how he comes across (people in the middle of a depressive episode tend to have a certain way of holding themselves and speaking that's fairly evident to someone trained in recognizing it).
posted by cotton dress sock at 8:09 AM on April 30, 2014

I don't think it needs to be forbidden to use the d-word in the room. I think it's fine to say you are concerned that it's depression or it reads to you like depression. You're allowed to say what you think and you're allowed to voice your concerns. Don't withhold information in order to make the therapist guess.

I say this because, as a person with depression who can't always identify when I'm in a downswing, it would save everyone a lot of time if someone else was able to say "yeah, her sleep schedule is a mess and she's bingeing" rather than having to bring that out in discovery.

Also, if how you feel is that he has a problem and he needs to fix it, end of story, then the therapist should know that's where you're at as well. There are some feelings that maybe should be explored there.
posted by Lyn Never at 8:31 AM on April 30, 2014 [2 favorites]

And (sadly) if he is chronically depressed this is always going to be a part of him and his life in one way or another. There will always be times when he struggles with this. Keeping depression in check can be a constant battle. It simply is a "thing" that is always part of my marriage. 90% of the time my depression is well in control, but sometimes I totally tank out for no particular reason.

This is a very important point. If he does turn out to have depression, and it turns out to be chronic rather than situational, finding an effective treatment plan in the first place can take years. There's unfortunately still a lot of grasping in the dark in that field. And since the human body is susceptible to all kinds of changes, a course of treatment that works great for a while can lose its effect over time and need adjustment and change.

DISCLAIMER ABOUT THE FOLLOWING PARAGRAPHS: I say this as the child of a marriage that couldn't - and shouldn't - have been saved by any amount of counseling, individual or joint; but which an extremely polite, overly optimistic person looking in from the outside and determined to gloss over the harsh realities of abuse might have described in a similar way to your post. I am in no way saying or hinting that you are not representing your situation less than accurately; I'm just disclosing my own background so you can adjust your grain of salt accordingly.

So, even if this session goes exactly as you hope, and the therapist says, "Mr. Anonymous, I suspect you may have clinical depression and I'd like to refer you to Dr. XYZ," that's probably not the end of your work as a couple if you want to continue the marriage. Odds are it's not going to be as simple as here's a pill, the bad times are over, and there's no need to learn to cope together.

And even if it is situational depression, that's something a couples counselor might help you with in addition to solo therapy. She may be able to convince Mr. A. to pursue therapy on his own, but if you get stuck in a certain pattern of argument, couples therapy might then give you the tools to say, "Remember what Dr. ABC said to do when this happens?"
posted by The Underpants Monster at 8:31 AM on April 30, 2014

He may or may not have depression, but I think that going to a couples therapist to pursue a diagnosis of your partner is not a good idea.

I agree that you should use the majority of the couple's sessions to focus on relationship problems rather than individual diagnoses, but a competent couple's counselor should absolutely refer one or both partners to other therapists or MDs as needed. Individual diagnoses should not be off the table in couple's sessions, but I agree that the therapist/counselor should be doing the diagnosing and you should be focusing more on what specific behaviors affect you and how they do.
posted by jaguar at 2:42 PM on April 30, 2014

When Mrs. TacoDave and I went to a counselor, she had us each fill out paperwork before we started to let her know why we were there. I mentioned my wife's depression in the paperwork, but didn't bring it up verbally.

Maybe yours will do something similar.
posted by tacodave at 3:34 PM on April 30, 2014 [1 favorite]

Yeah, I once was convinced a boyfriend of mine was depressed. It turned out to be a whole confluence of other things. I was all "you do X, Y, and Z -- you must be depressed!" then we debated Depressed: Yes or No. I would've saved us a bunch of time if I'd just said "you're doing X and I don't like it." "Y bothers me." "Oh hey, that's Y again." "Would you mind not doing Z?"

I don't think it's "against the rules" to explain your theory to the counselor. But I suspect that he or she will try to have you back up and give examples of things that are bothering you and why. You've built up your theory: X + Y + Z = Depression. I think you'll most likely end up analyzing X, Y, and Z separately. Perhaps from there, you will together build back up to a theory based on a clear and shared understanding of these items.
posted by salvia at 11:06 PM on April 30, 2014

Don't go in with your diagnosis, just start with your issues.
The doc is trained and educated to do diagnosis.
Don't use the terms of depression and anxiety, just your actions, feelings and the reactions
posted by edtut at 6:25 PM on May 1, 2014

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