How can I convince my spouse to seek help for possible depression? I have reason to believe that he's struggling in this area, but he refuses to admit that this might be true or to take my concerns seriously. I'm not sure if it's pride, fear, or something else that's standing in the way, but I do know that this situation is really taking a toll on our marriage and our family. What should I do?
Since you're speaking in terms of "possible" depression, we're going to suggest that you begin by taking steps to figure out exactly what you're up against. Bona fide clinical depression (also known as major depression or major depressive disorder) is usually accompanied by some identifiable tell-tale signs. Watch for things like persistent sadness, fatigue, lack of energy, trouble sleeping or sleeping a lot more than normal, significant weight loss or weight gain, and loss of interest in work and recreational activities. Other signs might be indicators of depression. Is your spouse neglecting basic personal hygiene? Does he isolate himself (for example, does your spouse spend the entire day in the bedroom in his pajamas?). Does he seem to be angry a great deal of the time? Has he ever expressed suicidal thoughts? These can all be symptoms of depression indicating a need to get professional assistance. If suicidal thoughts are part of the equation, the situation is urgent and requires immediate attention, which might include a visit to the emergency room.
There are a number of causes of depressive feelings. Difficult life circumstances bring about feelings of sadness or helplessness in many people. Relationship struggles, or losing a close friend or family member can result in feelings of loss or grief. So can the loss of a job or experiencing financial hardships. Job loss and financial hardships can be especially tough on men, since they tend to find their identity in their work and their ability to provide for a family. Just because depressive feelings may be caused by life circumstances doesn't make them less significant, but the good news is that they tend to get better over time, especially if your spouse receives counseling and has the support of friends and family.
On the other hand, while clinical depression can be triggered by circumstances like those mentioned above, in some people it seems to arise from nowhere. This sort of depression has its roots in an imbalance of chemicals in the brain, and it appears to have a strong genetic component. If your husband has a close family member (such as a sibling or parent) who has experienced depression, his risk for this problem is increased.
In any event, the next step is for you to talk with your husband about your concerns. We're assuming that you've already attempted to do this (after all, you say that he "refuses to take your concerns seriously"). If this is the case, we recommend that you ramp up your efforts by expressing yourself as concretely and specifically as possible. Whenever you can, address the situation in terms of "I" statements. You may say something like, "I'm really worried about you because of what I see happening. I feel like things are out of control when you're sullen and withdrawn for days at a time, or when you haven't showered or shaved in a week. The kids become confused and scared when you snap at them, and it hurts me to see you this way. I'm afraid of what this is doing to our family. We need you to get help." Remember, it's not your responsibility to "convince" him of anything. Your number one job is to tell him the truth as you see it. (Of course, if your husband talks about committing suicide your goal is not merely to tell the truth about what you are seeing, nor is this the time to avoid being intrusive. In this case you must do what you can to ensure his safety. This might mean taking him to an emergency room or calling 911 for help.)
At this point you'll be in a position to propose a course of action. This is where you have to tread very carefully. Don't push your spouse too hard. Start where he's at. Try to find out what he's willing to do. Suggest that he go with you to talk to someone about his condition. It could be anybody in the beginning – a pastor, an elder of your church, a counselor, a trusted friend, or your family physician. Ultimately your goal is to set up a conference with a professional – ideally a licensed counselor or a psychiatrist – who really understands depression and the various therapies and drugs that are available to treat it. You might propose that he consider a number of sessions – for instance three or four – and then decide if he wants to continue. But don't try to jump too far too soon. In light of what you've told us, we're guessing that the very idea of a "psychiatrist" could spook your spouse and send him into retreat mode. The main thing at this stage of the game is to achieve some movement, however small, in the right direction.
Keep in mind that he may have all kinds of reasons for balking at your suggestions. As a man, he might consider it a sign of "weakness" to seek help with emotional issues. He may object that only "crazy" people need to see psychiatrists or counselors. If he's a serious believer, he might try and argue that faith and prayer are sufficient to deal with the problem (as you probably know, there's still a certain degree of stigma attached to therapy and medication for depression in some Christian circles). In that case, you might say, "It sounds to me like you're limiting God – you're telling me that He can't use drugs or counseling to help you."
If he still refuses to take action you might return to your use of "I" statements by laying it on the line as follows: "It's your life, and you have to decide how to live it most effectively for Christ. For my part, I can't continue as if everything were fine. I'm going to talk to the doctor about our situation. I'm determined to do this because I'm convinced that your attitudes and behavior are harming our marriage and our children. I'd love to have you join me. I know you're hurting right now, but this isn't just about you. I don't want to see your depression tear this family apart." You may be able to sway him by appealing to his feelings as a husband and father.
If you'd like to discuss your situation with a member of our staff, feel free to call Focus on the Family's Counseling department.
How to Help a Depressed Spouse: Barb Rosberg addresses what to do when your spouse is clinically depressed.