Few people would be surprised to hear that couples in troubled relationships can also be depressed — certainly not those of us who’ve been in such relationships and know how depressing they can be.
Frequently, the conflict in these relationships and distress that results can become so overwhelming that any other problems, like depression, are typically hidden from view. A couple I’m presently treating, Jim and Stacey (not they’re real names), are engrained in an attack-withdrawal routine (i.e., she criticizes him and then he avoids her and doesn’t talk to her for days). This pattern is common in troubled relationships, but their hostility deftly masks, to all but the trained eye, depression’s underlying influence.
But does it really matter if one partner is depressed — especially when couples like this are constantly at each other’s throats? Yes, it does. To understand why, let’s look at some research on the effects of depression on partners within troubled relationships.
Researchers have found through more than two-dozen studies that relationship dissatisfaction accounts for 44% of a depressed partner’s symptoms1 (such as loss of interest and motivation, hopelessness, changes in appetite and sleep). Shockingly or not, partners in distressed relationships experience a 10-fold increase in risk of depression.2
In a recent study, researchers examined couples in troubled relationships where one partner was depressed. They wanted to find out if depressed individuals and their partners differ in their behavior toward each other compared to those without a depressed partner.3
This study examined 61 couples in troubled relationships, a third of whom had a depressed partner. Researchers videotaped couples responding to the following prompt: “Please identify and discuss the three best things in your relationship.” Trained coders observed the couples’ responses and rated them using the Structural Analysis of Social Behavior (SASB) coding system. The SASB system evaluates partner’s behavior toward each other in terms of the level of connection. For example, an “I focus on you” response shows connection, “I react to your focus on me” indicates interdependence, while “I focus on myself” demonstrates independence.
Not surprisingly, the study replicated prior findings that show that relationship distress is associated with increased interpersonal hostility — such as a husband telling his wife, “You never do anything right.” It’s helpful to understand that the SASB coding scheme defines interpersonal hostility in two ways, as either other-focused or self-focused. Other-focused hostility is aimed at the partner and takes the form of actions like blaming, attacking, or ignoring; while self-focused hostility is a reaction response, such as sulking, withdrawing, or shutting down.
The researchers found that relationship distress produces interpersonal and other-focused hostility in all couples (depressed and non-depressed). However, the partners of these depressed individuals displayed more partner-directed hostility (e.g., a wife telling her depressed husband, “If you don’t shape up right now, I’m leaving you.”)
Partner’s of depressed individuals seemingly subtle behavior distinction is important. For the researchers it shows just how interconnected relationship problems can be, with one problem multiplying the affect of another. For therapists, such as myself, it shows how both partners’ actions are pivotal in understanding their behavior within distressed relationships, especially when depression is present.
Given these findings about partner hostility toward a depressed partner, it should not be surprising that the couple I described earlier initially came to see me because of Stacey’s desire to “fix” Jim’s anger toward her. Men’s anger is often a symptom of underlying depression.4 Just like this couple, many distressed couples enter treatment mistakenly focused on one partner and one issue (i.e. Jim’s anger), while ignoring other problems (i.e. Jim gets some anger management tools, but still has an anger management problem because his depression and interactions with Stacey were not addressed). Fortunately, in therapy many of these couples begin to learn how complicated and interconnected their relationship problems actually are.
Some of the layers of interconnected problems within this couple’s relationship are Jim’s anger problem, which partly originates from his depression, but also out of his interactions with Stacey. The couple’s communication routinely involves her demanding him and his withdrawing.5 His withdrawal, both driven as a way to cope with her demands and by his depression, makes her feel that he “shuts me down” and thus fuels her attacking him even more. Stacey’s poor view of herself complicates things further. She soothes these feelings by blaming Jim for parts of herself she is unwilling to accept, such as her own perceived anger and feelings of worthlessness.
Depression in distressed couples really matters because relationship problems are never as simple as just one partner or one issue. For therapists this means examining and simultaneously addressing how partners interact in order to effectively treat the original problem, but must also explore other potential coexisting problems. For couples to improve either depression or their relationship, and hopefully both, they must be willing to examine the whole relationship context with an open mind to the possibility that there is more than one problem coming from a single partner.
1Whisman, M. A. (2001). The association between depression and marital dissatisfaction. In S. H. R. Beach (Ed.) Marital and family processes in depression: A scientific foundation for clinical practice (pp. 3-24). Washington, DC: American Psychological Association.
2O’Leary, K. D., Christian, J. L., & Mendell, N. R. (1994). A closer look at the link between marital discord and depressive symptomatology. Journal of Social and Clinical Psychology, 13, 33-41.
3Knobloch-Fedders, L.M., Knobloch, L.K., Durbin, C.E., Rosen, A., & Critchfield, K.L. (2013). Comparing the interpersonal behavior of distressed couples with and without depression. Journal of Clinical Psychology, 69(12), 1250-1268.
4American Psychological Association. Men: A different depression. Website retrieved June 30, 2014: http://www.apa.org/research/action/men.aspx Washington, DC: American Psychological Association.
5Eldridge, K., Sevier, M., Jones, J. T., Atkins, D. C., & Christensen, A. (2007). Demand-withdraw communication in severely distressed, moderately distressed, and non-distressed couples: rigidity and polarity during relationship and personal problem discussions. Journal of Family Psychology, 21, 218-226.
Kurt Smith, LMFT, LPCC, AFC – Website
Kurt’s research specializes in understanding men, women, and the issues they face in relationships together. His daily experience as a practicing clinician provides a unique window into examining the challenges facing today’s couples while applying present-day research to gain new insights. 
