Above image found here.
My husband was recently diagnosed with situational depression. The symptoms are essentially the same as major depressive disorder:
- Feelings of hopelessness
- Lack of enjoyment in activities previously enjoyed
- Tiredness & trouble sleeping
- Feeling overwhelmed
- Avoiding social interactions
- Not taking care of important daily tasks, such as paying bills or working
As someone who has suffered from major depression on and off throughout my adolescent and adult life, I recognize these symptoms but it’s different when it’s a loved one experiencing them. At first I was confused and even annoyed. How can my strong, optimistic, functional partner be suffering from depression?
The answer is both simple and complex. As long as we’ve been together I have experienced both chronic and frequent acute physical health conditions. One of my diagnoses is intractible epilepsy, which means I have seizure that cannot be controlled by medication. When we met I was recovering from agoraphobia and had just gotten to the point where I could leave my house and venture out into the world. After both of our sons were born I experienced extreme post-partum depression, which included insomnia, paranoia and suicidal ideation. Through 11 years of on and off therapy, I have come to recognize that both my physical and mental health issues all stem from the same thing: trauma.
It would be simple to say, “well, duh, of course your husband’s depressed. Who wouldn’t be after dealing with that for 16 years?” It would be easy for me to believe it’s my fault, and in fact I did believe it for a short time. But, like I stated above, the answer is also complex. Yes, I have trauma that causes all kinds of personal and interpersonal problems and yes, that impacts our relationship in a big way. Thankfully, I have enough insight and self-esteem at this point to recognize that I don’t have to feel to blame for what my husband’s going through. It’s not as though I knew how challenging my conditions would be for us. Neither of us believed the water was as deep as it is until we realized about two years ago that we needed couples counseling.
My husband has spent the last 16 years taking care of me and being my emotional support through multiple years and modalities of mental health treatment. He often had to leave work or the house to come and pick me up because I was having seizures or anxiety and couldn’t get home. He was my lifeline as I woke with night terrors, experienced massive panic attacks and dissociation. Trauma has taken its toll on me and now I can see how it’s also deeply impacted my husband and our relationship.
So what can I do? First, I can recognize that he is just starting therapy to help him process his experiences and feelings and become educated about his mental health. I have been in therapy most of my adult life and I have two degrees in psychology, one of which focused on trauma and its effects. I need to give my husband time to learn the things I’ve known for many years. For once, I’m the expert and I need to practice patience.
I can also help him by finding other lifelines of support for myself. I can work harder in and out of therapy to learn and practice the grounding skills which can get me through panic, flashbacks and seizures without having to call on my husband. I can reach out to friends when I need to emotionally process, rather than turning to him for support. I can increase my distress tolerance skills so when something intense comes up between sessions, I can hold it until I see my therapist again.
Maybe the most challenging thing I can attempt to do is to not be so reactive. When I get worried or upset about something I generally have a huge response. It’s not as intense as it was 20 years ago when I would scream and hurl glasses at my partner but it still sometimes a confusing and hurtful experience for my husband. I react instead of respond because I’m most often living with my sympathetic nervous system turned on and amped up. In other words, in fight/fright/freeze mode where the amygdala is the part of the brain that is in control. Working with trauma has helped me reduce this activity but I need to work more consciously with the shift from react to respond.
In her article, Are You Responding or Reacting?, Debbie Hampton writes: Reacting is instinctual. Responding is a conscious choice. When something happens, our body is going to react automatically regardless. The trick is to become aware of this initial reaction, resist doing anything, involve your higher intelligence by considering options, possible ramifications, who you want to be, and what is going to be in your best interest, and, then, choose how to respond.
I need to work on that awareness moment so I can hold my reactivity at bay while I decide how best to respond. I need to allow my husband to finish his sentences when he’s expressing himself. I need to listen more mindfully. These days kids are learning mindfulness in elementary school and I can see how revolutionary this is, and yet how simple. I was introduced to mindfulness in the Dune series by Frank Herbert, and later learned and practiced mindfulness while doing my undergrad work at the Buddhist school, The Naropa Institute. 16 years later I was reintroduced to mindfulness while doing DBT, or dialectical behavior therapy.
With all this exposure to, and practice with, mindfulness, why I am still struggling to see the benefits of it in my relationship? That goes back to the brain, I think. For most of my childhood, and all of my adult life, my brain and nervous system were on high alert for danger. Research now clearly shows that when our amygdala is the prominently active part of our brain, we have little to no access to our reasoning and empathetic minds. I believe that practicing mindfulness as thought I were the hero from Dune, and later practicing active listening and tai chi, helped me to survive until I could have access to therapy which would focus on processing and resolving much of my trauma.
I’ve noticed of late that I am better able to track tasks, problem solve and experience empathy and that tells me that I’m no longer stuck in trauma response mode all the time. I’m actively working on further reducing trauma response by participating in CPT (cognitive processing therapy) and learning to identify automatic negative thoughts & beliefs and then challenge them with accurate statements. It is believed that automatic negative thoughts & beliefs trigger the trauma response and create a cycle of events that trigger negative beliefs, that then trigger fight/flight/freeze. All of this serves to activate symptoms such as flashbacks, night terrors, panic attacks, self-blame & shame, sadness and suicidal ideation. By changing the thoughts and beliefs, you can interrupt the cycle and reduce the symptoms to the point where they rarely interfere with daily life because they are either extinct or the survivor has learned to manage them. This means the brain can shift from amygdala to cerebral cortex much more efficiently.
Getting back to reactivity versus responsiveness, I believe I can now begin the practice of noticing when I feel reactive and then using mindfulness skills to intervene before I act on my thoughts and feelings. In the beginning this may simply mean noticing reactivity and telling my husband I need some time to settle my nervous system down before continuing a conversation. From previous skill building experiences, I believe I will soon be able to shorten the time it takes me to notice reactivity in myself and eventually be able to notice, intervene with skills and respond appropriately.
Like most challenges in my life, now that I’m assessing this one I can see that it offers a wealth of opportunity. My husband will learn a lot about himself, hone life and self-care skills, and have more insight into my experience. I will have move from self-blame to acceptance, create stronger bonds with friends and family who love and support me, and focus on doing the work in my therapy that will allow me to change automatic negative thoughts and beliefs and become a calmer person who can mindfully care for myself and respond to others. Pretty cool.