April 6, 2005

About Shokooh

Signs of depression

Dear Shokooh,

I know that this might be a loaded email, but any help would be wonderful. I am married to my wife of 6 years and as of the last two years, I have noticed my wife being down. Lately, the last 6 months, the frequency of her being "down" is more often and even more lately, last 2 month, her symptoms are more severe. She is crying a lot. Feeling of despair and hopelessness, and a lot of signs of depression… I have talked with her about the possibility of her being depressed and have tried to get her to go and see a trained professional such as a psychiatrist. She does not want to go, and actually reacts very negatively towards that suggestion.

I am starting to worry about her more and more. She is starting to lose hope that she will once again be happy the way the she was. I love her very much and want to see her get better. I am wanting to know what I can do for her and how to help her break away from her present situation and start feeling better. The ultimate help will have to come from within her (be it by the guidance of professional help or other means), but what I can do to avoid more severe depression and/or other illness setting in. I want to be as supportive as I can be.

Anonymous (letter has been shortened and personal details omitted)


Dear Anonymous,

While I have not met you or your wife, the symptoms you have shared and the tone of your letter lead me to offer you a simple statement: I am concerned for your wife.

I cannot tell you whether or not your wife is depressed. Only a trained and licensed professional, after directly meeting and assessing your wife’s situation, can make a diagnosis. However, the specific symptoms you have shared make me think that she is suffering and needs assistance. Before I delve further into your letter, I must share a vital warning: If, at any time, you feel any fear that your wife may hurt herself, seek urgent medical assistance. If you fear for her safety, call 9-1-1. I do not wish to frighten you, but I want you to be aware that if things become dangerous, you may need to take urgent action to get her immediate medical help.

From what you have shared in your letter, it sounds like you being a supportive and loving husband. You are communicating openly with your wife (by bringing up your concerns about her mood), you are directly addressing the issue at hand, you are sharing potential paths for her recovery (encouraging her to take time off work and to seek professional help), you have spent time researching the topic, and you are reacting with love and caring. Your wife is lucky to have you.

However wonderful you may be as a husband and partner, you are not a trained professional equipped to handle an illness as serious as depression. You are right to encourage your wife to seek help. Depression is an illness that requires treatment. Her symptoms, particularly the feelings of despair and hopelessness, must be addressed. The good news is that there is a plethora of treatment options for depression. There is every reason to have hope that your wife will respond to treatment and feel better. She can absolutely recover and return to happiness and good health. The key lies in connecting her with some form of treatment.

You have shared that your wife has reacted negatively to the suggestion of seeing a psychiatrist or psychologist. It may be difficult to get her to accept help -- but do not give up! Have you asked her why she doesn’t want to seek help? Starting with this topic -- in a gentle way -- may be helpful. Can you think of a friend or family member who might be able to gently talk with her about this topic? Saying something as simple as “I love you and I am worried about you” can be a wonderful way to start dialogue with a loved one. Perhaps there is someone she is close to that can make the suggestion gently? Does she attend religious service? Is there a spiritual figure, such a priest, who could talk to her or act as a neutral third party as you discuss these issues with her? Would she be wiling to see a medical doctor? This is often the first stop -- your family physician may be able to discuss her symptoms, offer her information on treatment options, and make referrals. Another option can be a good book -- I highly recommend “The Feeling Good Handbook” by Dr. David Burns, a Stanford professor and psychiatrist who specializes in cognitive-behavioral treatments for depression and anxiety. Perhaps asking her to join you for couple’s therapy may be an option. Then, with the guidance of a neutral third party, you could discuss your concerns and ask her to consider seeking professional assistance.

There are many avenues for connecting your wife to treatment and help. I realize that it is difficult and I appreciate how worried you are for her well-being. You know your wife best -- use your love and caring to find a creative and gentle way to communicate your concern for her. At the same time, remember that self-care is critical. How are you doing? I can imagine that the situation has resulted in a great deal of pain and upset for you. It is important that you assess your own feeling. Are you open to seeing a professional even if your wife will not? The benefits of you seeking individual therapy are twofold. First, you will have the opportunity to share your experience and feelings with a caring and experienced therapist who can offer your more specific suggestions and on-going help. Second, you can model for your wife that seeking professional assistance is a positive experience, one that can alleviate suffering, end negative symptoms, and inspire growth.

You sound like a truly loving and supportive husband. I hope that you will take care of yourself as you take care of your wife. I wish you both all the best and hope the New Year brings a return to health and joy for you both.

Be well,



This column is for general educational purposes only-- it is not a substitute for medical attention, counseling, or therapy of any kind. The Couch and the staff of this website urge you to seek immediate medical attention if you are in an urgent, harmful, or potentially dangerous situation. Psychiatric emergencies or urgent matters should be handled by calling 9-1-1 or going to the nearest emergency room.   Please note that your emails will not be answered on an individual basis and your confidentiality cannot be guaranteed. Top

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