emtiness

Credit...Francesco Ciccolella

Jeff Zuckerman and his wife had been married for 30 years when she started battling bipolar disorder and depression. She had her first monthslong manic episode in the spring of 2015. Immediately after, she was thrust into a severe depression. The health crises rocked the couple’s marriage.

“You have to understand that for her, depression is not sadness so much as it is emptiness,” explained Mr. Zuckerman, 68, who is a freelance writer and editor in Minneapolis. When his wife’s depression was at its worst, she remained in bed, with the blinds drawn, for months. She stopped showering and hardly spoke.

“This is a woman who had been so active, who had run our family. She was a mom, she worked, all of that stuff, and then she fell into this depression that was so deep,” said Mr. Zuckerman, who wrote a book — “Unglued: A Bipolar Love Story” — about loving a spouse in the grips of mental illness.

Millions of Americans are in relationships with partners who are prone to depression. An estimated 21 million adults in the United States have experienced at least one major depressive episode, while in parts of the country up to 10 percent of people have seasonal affective disorder, or SAD, a syndrome that tends to kick in during the fall and winter as the daylight hours grow shorter.

When helping your partner weather a battle with depression, experts say there are ways to be supportive while also caring for yourself.

Learn more about depression.

Familiarizing yourself with some of the physical and emotional markers of depression may help you identify if your partner is simply in a bad mood, burned out or is living with depression. Common signs include loss of interest in regular activities, changes in appetite or sleep or unexplained physical symptoms, such as headaches or back pain that tend to last for at least two weeks, according to the National Institute of Mental Health.

Learning more about what depression is and how it affects people may also help you protect yourself emotionally, respond with more empathy and avoid taking your partner’s behaviors personally.

“If one partner doesn’t understand that their partner is suffering from depression, they may mistake things like a loss of interest in romance or sex as a personal rejection,” explained Xavier Amador, a clinical psychologist and co-author of “When Someone You Love Is Depressed.”

Cultivate curiosity about your partner’s experience.

When your partner is in pain, you may feel an urge to dive right in and tell them what you think is happening. But try to lead by asking questions, Dr. Amador said. Ask your partner how they are feeling. Tell them you’d like to understand more about what they’re going through.

If your partner is defensive, Dr. Amador recommends a strategy known as “reflective listening.” For instance, if you ask your loved one how they are feeling and they tell you they are fine and there is nothing wrong, you respond with something along the lines of: “What you’re telling me is that there’s nothing wrong, is that correct? Can I tell you what I’ve noticed?” Dr. Amador explained.

If you make an effort to lead with questions rather than rushing to share your opinion, your partner is more likely to feel heard and valued, not judged, he said.

Acknowledge your own limitations.

To help a loved one get diagnosis and treatment, you can call potential providers and set up appointments, or compile a list of clinicians for them to contact. But experts say it is also important to remember that you cannot force anyone to get help, and that pushing too hard can backfire.

“It’s a balancing act,” said Lily Brown, director at the Center for the Treatment and Study of Anxiety with the University of Pennsylvania’s Perelman School of Medicine. “Of course, you want to make yourself available to talk and to suggest how they can get help, but if you’re doing too much driving the boat, the person who is struggling with depression actually can start to feel a little more helpless and a little more hopeless.”

She added that partners who put too much care-taking responsibility on themselves are also often overcome with feelings of guilt and shame when they are unable to fix the problem.

You shouldn’t have to be your partner’s sole support, especially in situations where they may be in danger. Keep in mind that depression can increase the risk of self-harm and suicidal thoughts — and the 988 Suicide & Crisis Lifeline offers resources to find help for a loved one in crisis.

Prioritize your own mental health.

Romantic partners can affect each other’s health and health-related behaviors in ways good and bad, and Dr. Amador noted there is some research to suggest that depressive symptoms can be, in a way, contagious.

“If you’re living with somebody who is depressed and feeling helpless — and oftentimes doesn’t want to get help — then you can start to feel depressed and helpless,” Dr. Amador explained.

It is imperative that you support your own mental health, both Dr. Amador and Dr. Brown emphasized. If you are experiencing symptoms of depression, reach out to a health care provider for evaluation. But even if you are not, you may find it helpful to see a therapist or to join a peer-led support group.

Mr. Zuckerman is a volunteer facilitator of a National Alliance on Mental Illness, or NAMI, support group for families and partners of people with mental health conditions. And it has helped him connect with a community of people who understand what he is going through. Every other week, Mr. Zuckerman and 10 to 15 or so other partners discuss coping skills; help each other process feelings of grief or guilt; and offer a safe space to share their challenges and successes.

Make time for things you enjoy.

In addition to connecting with a therapist or support group as needed, it is also important to find other ways to prioritize self-care. It does not have to be time-consuming or complicated, Dr. Brown said. Simply getting out of the house for a bit and making time for the activities you enjoy can help protect your own emotional well being when your partner is struggling.

Spend time outside in nature, get involved in some form of advocacy or move your body. Research has shown, for instance, that jogging for 15 minutes a day, or doing less strenuous exercise like walking or gardening for an hour, may have a protective effect against depression.

And “socialize, socialize, socialize — whatever that looks like for you,” Dr. Amador recommended. “It is really important to get that social support and release.” You may encourage your partner to join you in your efforts to get out and exercise or connect with others, but keep in mind that loss of interest in normal activities or hobbies is a symptom of depression.

Mr. Zuckerman’s wife — who has given her husband her blessing to share their story, but only without disclosing her name — has been stable for three years, and said things between the couple are “great.” They go to movies, concerts and dance performances together. They cook, spend time with their grandchildren and attend synagogue.

But Mr. Zuckerman also continues to remind himself that it is not selfish for him to prioritize self-care.

“We fundamentally love our partners and our spouses, and at a gut level, we know it’s an illness. We know you can’t blame somebody for being sick,” Mr. Zuckerman said. “Yet what we go through as a result of it can be overwhelming.”