How to Survive Your Spouse's Depression

People often ask my husband Ken how he averted my suicide. His answer, short and succinct, speaks volumes. “I didn’t,” he’ll say. “We got lucky.”

After talking with literally thousands of people who lost loved ones to suicide since I published Struck by Living in 2010, I know the raw pain of those left behind. I always tell them this: What your loved one did was not out of lack of love for you.

This statement reflects my own experience, as well as by research by Thomas Joiner and many others. Once a mind gets on the track of suicide, luck plays a large role in survival. The seriously suicidal are often great actors who deceive their family and friends.

If we want to cause a quantum shift in the number of lives lost to suicide annually (38,500 suicide deaths annually as opposed to 40,000 lost annually to breast cancer), we must start far earlier. We need to be talking about brain health long before suicide is a consideration, to all people, not just those who show signs of mental illness.

Since Robin Williams’ death, the issue of mental illness has flooded the news. Phenomenal public forums, like this one by the American Foundation of Suicide Prevention: Robin Williams Movie Expert Screening Panel have created a way for the general public to ask questions and vent frustration.

Although this is wonderful, here is my frustration: Very rarely do I hear mental illness discussed as a possibility for anyone with enough stress, lack of sleep, and lack of proper support systems. In these forums, it is often the experts or family members pointing at the “mentally ill,” as though mental illness is only for the very few who are genetically stunted. Almost never do people discuss how all of us are susceptible and how we can protect our brains. With this approach, we will always chasing the disease—or reacting to, rather than preventing, mental illness.

I do talk about mental illness management and prevention however, not as a psychiatrist or psychologist, but just as someone who has managed my disease. Here’s my list, and I always encourage others to develop theirs: Adult Top Ten for Mental Health.

My husband, as always, is right (yes, this is an extremely aggravating characteristic, but I’ve learned to listen!). He was unable to stop my suicide attempts, and but for a well-ventilated garage and electroconvulsive therapy (ECT), I too would be a statistic.

What Ken often doesn’t mention however, is how he preserved himself during this stressful point in our marriage. That was the topic of his TED-like talk at his recent business school reunion. Because he protected himself, he was there for me. He was the one who pushed me to survive, to try ECT, without whom I’m sure I would not be here.

Here is his list for weathering my depression, one worth sharing:

1. It’s Not Your Fault. When a loved one goes off the rails, a spouse often feels responsible. Although it is always good to examine relationships and correct unhealthy tendencies, at some point, mental illness is an illness. We don’t blame ourselves if a loved one gets cancer, and we should not blame ourselves if a loved one develops mental illness. Often, mental illness is routed in genetic predisposition set off by something in the external environment. That “something” is often manageable, but genetics are the challenge with which a person has been blessed.
2. Depression is Real, and It's a Disease. Take depression seriously and seek professional health. Denying the disease and failing to take action does not make the problem go away. Most depression is manageable if caught early and corrected. If depression goes too far, often the depressed person can disguise his or her intent. Ken recalled being happy the day before I attempted suicide. I had cheerfully cleaned out the garage, one of the first positive changes he’d seen in months. He didn’t know I cleaned the garage as part of my plan for suicide. Ken also mentioned the early warning signs, right before the plunge. “It’s nice to have all cabinets in the house organized, and the top shelves in the closets cleaned,” he joked, “but now I try to bring it to her attention before the crash.” Today most manage mental illness by crisis, without the equivalent of a brain mammogram to catch problems early. If we let every breast cancer patient get to Stage Four before taking action, we would lose far more people to the disease. We need the same proactive approach to mental illness. The hard part is, mania often seems good and gets positively reinforced (e.g., you’re so amazing! How do you get it all done?). As I tell many of my friends — controlled mania is a beautiful thing. The person managing mania, however, often needs the barometer of family and friends to set boundaries and avoid flaming out.
3. Get Lots of Support. Ken evoked the “it takes a village” principle. Often family members hide depression or mental illness in shame. Family members are left to shoulder the burden alone – which wears relationships to a fine thread, ready to snap. Friends and surrounding community can be instrumental in bolstering the main caretaker. Our group of friends acted as a massive support force in helping Ken, at one point setting up a watch system where friends would sit with me to make sure I did not hurt myself. At the time, I didn’t like the idea of adult babysitting, but I am here today because of their efforts.
4. Take Care of Yourself. Ken was great at compartmentalizing and nurturing himself when things got overly stressful. When I had my first ECT treatment, he played golf. That may seem heartless and insensitive, but he was bolstering himself for when I really needed him. When I was having my first ECT treatment, there was not much Ken could do to help me. It was after the procedure, when I was conscious, when I needed his help. He came right over when I called him.
5. Be Open. Ken often says that he is the icebreaker about depression. Once he admits I had a problem, everyone else shares personal stories. I experience the icebreaker phenomena whenever I speak about this topic (which is daily). Often I wonder if all the discussion about “stigma” has only reinforced the fear of people sharing their success stories about managing mental illness. For every Adam Lanza, there are hundreds of thousands of us who have managed our illness and have contributed to our communities and world.

That’s my husband’s Top Five for Surviving Your Spouse’s Mental Illness. One of my other blogs might be of help for those grappling with helping a family member or friend: Convincing the Stubborn to Accept Mental Health Care. It is by far the most popular blog I’ve ever written.

Finally, if you are reading this blog and helping someone you love manage his or her mental illness, thank you. Sometimes this role is thankless, with a loved one cursing or condemning you, calling you a tyrant or dictator. As one who has been there and obtained a steady state, I encourage you to not give up the fight. Most of the time, your loved one can and will get well.

For those who lost the battle and lost a loved one to suicide, please remember: What s/he did was not out of lack of love for you. People die from cancer. They also die from mental illness. Our silence and shame only impedes our ability to understand and master these diseases of the brain.