Your Health

Treating individual depression with relationship counseling

Depression. Just the word can cast a pall even if you are not depressed. To a person suffering from depression, life may be colored by a gray or even black cloud.

Depression is an enormous health problem. It is a common and serious ailment with a wide spectrum of degrees of severity, causes and characteristics. In the United States, approximately 7 percent of the population experiences major depression in a given year – and the frequency of mild and moderate depression is even higher. We are still learning about this debilitating and isolating condition. Although much has been written about causes and treatments, the vast majority of attention focuses solely on the individual suffering from depression.

What is often neglected is depression’s impact on our closest relationships. This column addresses the effects and treatment of depression in the context of a committed relationship.

Recent studies highlight three key facts regarding depression and relationships. Depression can be devastating to intimate relationships (including a higher divorce rate), discord in a relationship can cause depression and the nexus of depression and relationship discord can reinforce each other.

In other words, depression and relationship distress often are intertwined.

But it is not all bad news. There are a variety of treatment options depending on circumstance and severity. In cases of severe, debilitating depression, the treatment gold standard is a combination of antidepressant medication and talk therapy. Research has shown that couples therapy can help not just the relationship, but also a partner’s depression. Healing includes reducing the common feelings of loneliness, not being valued by others and low self-worth.

Emotionally focused therapy

Many issues may block repair. One of the most common is that one partner is reluctant to participate in therapy, usually the male partner. And let’s be clear, couples therapy is no panacea – nothing is. However, an empirically validated couples therapy treatment known as emotionally focused therapy (EFT) has been shown to be effective in treating depression by harnessing the power of the bond between two people.

In EFT, therapy begins for couples with a de-escalation of tensions and negative emotions such as anger and withdrawal. Because the depressed patient can be hypersensitive to negative emotions, the therapist works to establish a safe and calming environment, helping each partner to regulate his or her emotions.

Relationship discord in EFT is called the “negative cycle,” where, specific to each couple, a reinforcing negative pattern of interaction hijacks the relationship. One common form is the “pursuer” and “withdrawer,” though it’s important to deeply understand the specific triggers and responses of each partner. Often the depressed partner feels lonely and hopeless, while the other partner feels frustrated and helpless, unable to “fix” the other. Once this cycle is identified, the therapist helps the couple to see it as their common enemy instead of blaming the partner, and to see themselves working together as a team to defeat it. Through this work, the couple strengthens their attachment bond, which in turn impacts a partner’s depression.

Healing relationship discord is not easy and, depending on the degree of difficulties, a skilled couples professional offers the best solution to realizing long-term harmony and love. In cases where one of the partners is depressed, a self-help approach is not recommended. EFT has a high success rate, helping three of four couples move out of the danger zone of contemplating divorce, and 90 percent report improvement. For couples with a depressed partner, EFT offers a two-for-one: treating depression and strengthening the relationship.

For more information on EFT and depression, two books worth reading are Sue Johnson’s “Love Sense” and “Hold Me Tight.”

Nancy Andersen, licensed Marriage and Family Therapist, provides emotionally focused therapy for couples in her Loyola Corners office in Los Altos. For more information, call 833-9574 or visit

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