There’s a great piece by Fiona Millar, a journalist and political adviser, on coping with her partner’s long-term mental health problems. “How I Learnt To Live With Alastair Campbell’s Depression” is the original article, if you have a Times subscription. Here’s a comparable piece if you don’t.
Society is opening up about mental health, destygmatising something that affects a huge number of people. But you don’t hear about their lovers and supporters, their family members or their best friends. There must be millions of people out there supporting and coping with seriously depressed loved ones. Weirdly, Millar’s piece is the first article I’d ever seen about it.
Loving someone with depression is a common experience. Talking about it isn’t. Here’s what I’ve learned from loving a depressive partner – it may sound familiar to you.
Alexis, my fiancé, is a professional writer. He’s eloquent, loquacious and fiercely intelligent. But when he’s depressed he can barely communicate. It seems to cause him physical pain to talk about his feelings, and anhedonia makes him bored and disinterested in the world. So he can’t tell me, his fretting girlfriend, how bad he’s feeling, and it’s difficult for me to judge how worried I should be.
He can rate the severity of the episode on a scale from 1 to 10. 1 is ‘having a bad day’. 10 is ‘suicidal’. Or he can tell me where the Black Dog is: at the far end of the garden; prowling around the front door; glaring down at him, right next to the bed. This sort of communication helps connect Alexis to the world and helps me understand what he’s going through. One of the nastiest parts of depression is that insulating isolation that descends around the sufferer, separating them from the love and support of the people around them. Our odd couple’s language stops that isolation from taking over completely.
When our relationship was new, I tried to ‘fix’ Alexis’s depression. Trying to cheer up a depressed loved one is a natural response, but it’s also – I know now – naïve. Being particularly nice to someone isn’t going to rewire their brain. Tea and chocolates can’t dismiss a pervasive existential sense of hopelessness. You can’t ‘fix’ mental health.
You can help, though. One of the most useful things I do is anticlimatically boring: I just stay near him. His worst moments usually last no more than twelve hours, when he’ll stay in bed, curled up in the fetal position with his back to me. Sometimes his depression is so severe that his skin hurts if you touch him, so I can’t even rest a reassuring hand on his arm. Sometimes it helps to put music on. Other times that hurts him, too. But however bad the episode, he always says afterwards that it helped not to be alone. It breaks that crippling depressive isolation. These days, when it gets bad, I just sit next to him in silence and read.
I’ve also encouraged him to seek external help. I’m not a doctor or a psychiatrist, so I’m woefully underqualified for anything other than unconditional love. Depression makes people less likely to seek help or reach outside their comfort zones. So encouraging your loved one to look after themselves, see a therapist or consider anti-depressants can really change their life for the better. It also takes the pressure off you – you don’t have to be lover, parent and therapist. You can just be you.
Alexis’s depression is for life. I know that part of being with him is accepting that three or four times a year he’ll have a serious depressive episode, and I will be correspondingly miserable. This is what it means to love a depressed person.
Over time, depression can ruin relationships. We spoke early about the effect it might have on us: his biggest worry was that it would eventually drive me away. Six years later, I’m confident it won’t. But I can absolutely see depression being the end of many otherwise lovely relationships, and don’t blame the partners of depressives for getting out. I’ve thought about it myself, and I suspect if you gave a depressive the option of a total cure at the cost of ending their relationship, many would leap at the chance.
Our more alarming discussions were about depression and suicide. Alexis’s brother killed himself when he was twenty-one, and Alexis has had several periods in his life where he’s been in the final stages of suicidal ideation (planning the method, carrying around a suicide note – the end-game things). I knew nothing of the disease when I first met him, so worried that every time he was depressed he might want to die.
I know now that your suicide risk from chronic depression is much more like metal fatigue, where small fractures over time build up to a breaking point. Alexis often talks of ‘wrestling the angel’, referring to the active effort he has to put in to thwart a depressive episode. You really have to rage against it, time and again, like battling your way through dense jungle. Over time you get tired. I can imagine that many sufferers who find themselves in an acute depressive crisis after years of wrestling the angel just don’t have the energy anymore. I can see the attraction of making it all stop.
Alexis struggles to talk about suicide when he’s very low. So like the Black Dog, suicide has a nickname: the Salesman. In particularly horrible moments, the Salesman comes round and tries to sell Alexis death. The Salesman’s vilest feature is he’s as smart as the person he’s trying to convince, and he knows his weak spots. It’s difficult to win an argument against yourself. But the moniker makes it easier for Alexis to mention it, and I’ve made him promise on everything he holds holy (his mother; freedom of speech; gin) to tell me whenever the Salesman appears. It gives me a sense of security to know that even if my partner is fleetingly thinking about ending his own life, I’ll know. One of the most common regrets I’ve heard from people who’ve lost loved ones to suicide is not seeing the signs in advance. If Alexis keeps his promise, I will.
The brilliant nineteenth-century poet Gerard Manley Hopkins suffered from chronic depression. He wrote a number of poems – the ‘Terrible Sonnets’ – during particularly black moods, and this always stuck with me:
“O the mind, mind has mountains; cliffs of fall– “No Worst, There Is None”
Frightful, sheer, no-man-fathomed. Hold them cheap
May who ne’er hung there.”
I have never hung there, in depression’s frightful chasms. But I don’t hold depression cheap. I’ve watched it closely for six years. It’s fantastically malign and brilliantly coercive. I respect and despise it equally.
But this leads me to my final, painfully simple conclusion. You, the partner or family member or friend, matter too. Depression is a proper illness. It has physical symptoms. It can change the person you fell in love with so much that, for a time, you hardly recognise them. And it’s contagious. It affects everyone around it. So you need to look after yourself.
The cosmic roll of the dice which decides which brains misfire and which don’t is unfair. So I like to think I’m evening the odds, even a little, by supporting my partner through his black moods and loving him in spite of them. I wish he didn’t have to suffer, and I wish I didn’t either. But you have to treat reality as it is rather than you’d like it to be. There are millions of couples living with the Black Dog, just like us. The ones that stay together develop their own individual coping strategies. It’s hard work, but so is living together, long-term relationships and having kids. “Nothing worth having comes easy”, and a good relationship with a person you love is the thing worth having most of all.