The problems often creep in slowly. Your partner may express unhappiness about work, or about your finances, or about the kids. At first, it seems pretty normal–after all, no one is happy all the time. Gradually–or sometimes not–you realize that the person you thought you knew is not there anymore.

That person now calls out sick from work frequently, sleeps all the time, lets chores and other responsibilities go by the wayside, doesn’t have any interest in a social life or sex, and is generally unpredictable. Maybe they even talk about how life would be better if they just weren’t around anymore.

Depression affects millions of Americans, and you are not alone if you are in a relationship with someone with depression. However, this situation can be lonely, especially when not only have you lost the partner you once knew, but you don’t know how or where to get help.

Anne Sheffield, author of Depression Fallout (and several other books about the impact of depression on partners), discusses the stages partners might go through when they are living with someone who is depressed.

As someone who both has suffered from depression and lived with family members with depression, Ms. Sheffield speaks from personal experience. Her website has a message board where healthy partners can receive support, and Depression Fallout contains material largely gathered from the topics raised on that board.

During the first stage of “depression fallout,” she describes initial confusion about the partner’s changes in behavior, then a stage of self-doubt, where the healthy partner begins to question whether they have done something to bring on the change in their ill partner.

What can you do if this is what you are experiencing?

Next comes the time of feeling demoralized, where the healthy partner feels as if nothing they do is right, and that the ill partner is blaming them for everything.

What can be done during this stage?

  • Seek your own therapy, join a support group, or use online forums to receive support and get information about how best to handle the challenges of having a partner with depression.
  • Allow yourself some self-compassion for what you are going through. It is truly difficult to live with someone who has depression…and it’s okay to feel that way, too.
  • Continue to talk with your partner and set boundaries. Boundaries are good for everyone: your partner will know what you expect of them, and you will have been honest in how far your limits can be pushed. And just like with teenagers who want to see whether their parents will really enforce the rules, expect that your partner will test you as well. Remaining firm about the boundaries is important.

The next stage is when the healthy partner feels resentment towards the ill partner, placing blame squarely on the person, not the illness.

Strategies for this stage:

  • If you haven’t implemented some (or any) of the previous suggestions, try those first.
  • By this stage, the depression has probably been a member of your relationship for quite some time. You may want to take time to evaluate your relationship, as well as your life as a whole, and look for places where you have the power to make some changes. Depression sucks the life and energy out of everyone in its radius, but as the healthy partner, you have choices.

Some questions to ask yourself:

  1. Are you feeling resentment towards your partner because you want your old life and relationship–the ones you had prior to depression, that is–back?
  2. Are you expecting your partner to do things or act in ways they simply are not capable of right now?
  3. What would it mean to you if, when your partner recovers, your relationship looks different from what you had expected and the person you love is not the same as before?
  4. What needs to happen for the relationship to survive? What’s your role in making that a reality?

Finally, she describes the last stage as the time when the healthy partner considers whether to leave the relationship. She claims that this stage can be avoided, but it takes conscientious work.

What to do if it gets this far:

  • Even as a therapist who works with clients with depression, I do not have an answer for this one. I agree with Ms. Sheffield that this stage can be avoided, which is one of the primary reasons I started this blog in the first place. If you are at this stage, again, I recommend you seek professional counseling in order to get a neutral perspective on what is ultimately the decision that feels right to you. For some people, that does mean leaving the relationship. For others, there may be things that have not been tried that can improve the situation.

No matter what you decide, being the partner of someone who is depressed is life-changing. Your relationship will never be the same as it was before depression entered it: it may turn out better than you expected, or it may be irrevocably damaged.

If only it were as easy as reading a blog post to fix.

How do you cope with depression in your relationship? What tips do you have for others?