Depression: The Silent Killer Of Marital Intimacy

Everyone longs for - and needs - intimacy. Intimacy in marriage exists when a husband and wife allow each other to experience everything they have to offer physically, intellectually, emotionally, socially, and spiritually without fear of criticism, judgement or rejection. In the absence of intimacy a marriage can not thrive and will struggle even to survive.

Prior to marriage, few couples give a great deal of thought to how they might prevent or deal with the potential roadblocks to intimacy in their marriage. In fact, few married couples address such obstacles until they find themselves in the middle of difficult times.

As much as every couple desires closeness, companionship and harmony in their relationship they cannot avoid the fact that there are a number of things in life that may keep them from enjoying true intimacy.

Some of the more common threats to marital intimacy include parenting pressures, financial stress, unresolved conflict, anger, unforgiveness, etc. But the "Silent Killer of Marital Intimacy" that often goes unaddressed is depression, especially when it strikes the woman.

It is estimated that over 18 million Americans suffer from depression each year. While both men and women are susceptible, women are twice as likely to suffer from depressive symptoms than men are. One out of every four women will experience at least one depressive episode in their lifetime.

Although the quality of a marriage can be impacted when either spouse is depressed, research has shown that women may experience greater relational difficulty when depressed. This is significant because they are more likely to derive a sense of well being from their roles in intimate relationships with others than men are (Jordon, Kaplan, Miller, Stiver & Surrey, 1991).

Studies on marriage and depression reveal that it can be both the cause and the result of marital problems and dissatisfaction. Highly stressed marriages can often trigger depression in one or both partners, often making a bad relationship even more challenging (Coyne & Downey, 1991).

Depression can also cause people in otherwise reasonably happy marriages to perceive themselves and their relationships in negative ways, often resulting in behaviors that sabotage positive marital interaction (see Dobson, Jacobson, & Victor, 1988). Let's consider, for example, a husband coming home late from work. His depressed wife interprets it as a sign that he no longer cares for her when, in reality, his boss simply detained him to finish a project. As a result of her assumptions, she avoids him when he arrives home. This causes him to feel isolated or rejected, and he, in turn, reacts by finding excuses not to spend time at home. Unless the silence is broken, the cycle of negative perceptions and rejection will undermine intimacy in the relationship.

It is normal to experience feelings of disappointment and discouragement for brief periods of time as a result of unmet expectations, like being turned down for a raise, or negative interpersonal interactions, like frequent criticism or disagreements. However, many people experience these symptoms, as well as others, for longer periods of time without recognizing it for what it really is - depression.

Symptoms and Causes of Depression

The severity and duration of depressive symptoms can vary greatly. They can range from mild to severe and last from a few hours to a few months and in some cases, years. Mild symptoms of depression include fatigue, irritability, sadness, decreased motivation and pessimism. More serious symptoms include feelings of worthlessness or guilt, emotional isolation, changes in eating and sleeping habits, a loss of interest in activities that were once enjoyable, difficulty concentrating or making decisions, feelings of hopelessness and helplessness, low self-esteem, negative thinking patterns and recurrent thoughts of death or suicide. When a person struggles with these more serious symptoms for at least two weeks they are experiencing what is referred to as a Major Depressive Episode. A mild but long-lasting or chronic depressed mood with symptoms similar to those of major depression is called Dysthymia. With this form of depression symptoms are present most of the day, more days than not, for two years or more.

Depression can be caused by a number of factors. It can be triggered externally by difficult and traumatic life circumstances such as the death of a loved one, a divorce, loss of a job or unresolved marital problems. It can also begin internally as the result of prolonged periods of stress, personality traits, heredity factors, and biochemical changes such as what may result from prolonged sleep deprivation or hormonal changes.

Regardless of what may trigger depression, it is ultimately the result of changes that occur in the brain's chemistry. A deficiency of certain neurotransmitters, such as serotonin and norepinephrine, is what causes a person to experience the symptoms of depression. Unfortunately, many people have been reluctant to seek treatment when symptoms develop because they have the mistaken belief that they should be able to "shake it off" without help. It is important to remember that the changes that occur in the brain are physical changes that affect emotions, much the same way as a broken leg affects the ability to walk. Depression is an illness, not a sin or weakness.

Who is Most Vulnerable to Depression?

Although women are more likely to experience depression in general, some women are more vulnerable than others are. A recent study revealed that women with exposure to one or more childhood adversity such as family violence, parental alcoholism, death of a parent, or parental discord or divorce are more likely to become depressed following less total stress than women without such adversity (Henry & Daley 2000). In other words, their emotional resiliency is lower. Cano & O'Leary (2000) found that women who experience what are referred to as humiliating life events, like infidelity on the part of their husband, threats of marital separation or divorce or physical violence, are six times more likely to experience a Major Depressive Episode.

Other facts:

* Women today suffer from depression ten times more often than their grandmothers did.
* Younger women are at a greater risk for depression than ever before. Nearly one out of three women eighteen to twenty-four will experience it.
* Women with siblings or parents who have suffered from depression have a 20 to 25 percent greater chance of becoming depressed themselves.

Marriage and Depression

Couples who report high levels of marital satisfaction and intimacy are those who are able to resolve conflicts quickly and effectively, are less hostile and argumentative, spend more time talking, perceive themselves and their environment more objectively and, in general, demonstrate behaviors that are more socially appropriate and inviting. Depression interferes with these healthy forms of communicating and relating.

Basco et al.'s (1992) study found that, compared to non-depressed couples, depressed individuals and their spouses (a) reported greater marital dissatisfaction, (b) demonstrated poorer communication and problem-solving ability, and (c) were more likely to have an impaired capacity for establishing and maintaining intimacy.

Depressed people not only feel different from those who are not depressed, but they behave and think differently as well. Depressed persons speak less often and more slowly, with lower volume, more silences, and greater hesitancy. They also take longer to respond to the remarks of others. In addition, they make less eye contact, don't smile as often and often prefer to isolate themselves from others (Segrin & Abramson, 1994). These behaviors can be misinterpreted by spouses and others as a lack of interest or affection, and create barriers to communication, which is essential to relational intimacy.

Depressed people also tend to view their environment more negatively, critically and with more skepticism and they are more likely to communicate a higher percentage of negative messages. Because of the depressed person's impaired social skills and negative perceptions and communications, they often experience an increase in interpersonal conflict, stress, and rejection resulting in a vicious cycle of marital problems.

Whether marital problems are the cause or result of depression, they cannot be effectively addressed and resolved until the depressive symptoms are successfully treated.

Keys to Overcoming Depression and Keeping Your Marriage Strong

As is true of any illness, prevention is the best medicine for depression. When struggling to climb out of the depths of sadness and despair, altering your behavior is nearly impossible. However, when you realize you are beginning to slide into depression, you are in a much better position to avoid some of the pitfalls. Here are some strategies for preventing and/or defeating depressive symptoms while keeping your marriage strong.

* Keep an open mind if people who care about you express concern about your mood or behavior. Comments like, "You don't seem like yourself lately," or questions like, "Is everything okay?" may indicate that others are seeing a change in you. Be courageous enough to look honestly at yourself and explore how you really feel. If you realize that you have been experiencing symptoms of depression for more than a few days, you may need to take some action.
* Exercise regularly, maintain a sensible diet and get plenty of rest. Your body is designed to release natural mood elevators called endorphins when you engage in physical activities such as walking, swimming, or biking. Eating in moderation and maintaining a balanced diet containing fruits and vegetables can help keep your mind and body healthy. Substances such as caffeine, alcohol and refined sugars are depressants and can negatively impact your mood. It is also critical that you do not deprive your body of the sleep it needs to function properly. Fatigue stemming from a lack of sleep can alter your brain's chemistry resulting in depressive symptoms. The key is maintaining a consistent sleep schedule, not depriving yourself of sleep and then trying to "make up" the lost hours.
* Balance your life responsibilities and minimize your stress. Learning to say "no" to activities and responsibilities that have the potential of creating overload is the first step to creating balance in your life. Over commitment is highly counterproductive and often leads to emotional burnout. Living life at a slower pace, getting plenty of rest and allowing yourself to enjoy free time will help you stay on track.
* Confide in your spouse or close friend. It is important to let someone know exactly how you are feeling. An understanding and supportive spouse or close friend can serve as a valuable source of encouragement. One study suggests that close, confiding relationships may help to buffer the emotional impact of stressful events (Lin, Dean & Ensel, 1986). Support of an intimate relationship may help to prevent or minimize depression.
* Educate yourself and your spouse about depression. Having an awareness of the signs and symptoms, understanding its potential impact in your life and knowing what treatment options are available to you can greatly help to minimize its negative consequences. Read articles, visit Web sites and ask your doctor questions.
Journaling your thoughts on a regular basis will help you to express your feelings, frustrations, joys and dreams. Having this outlet of expression can help prevent your emotions from bottling up and taking control.
* Address problems in your marriage or personal life as they arise. Avoiding or ignoring personal or marital problems will not make them go away or easier to cope with. An honest assessment of your relationship and personal wellbeing, and a willingness to make appropriate changes, will help you to maintain a more stable and satisfying life.
* Seek professional help as early as possible. When you are depressed you don't want to go it alone. Begin by talking to your family physician or a licensed psychologist or counselor about possible treatment options. Numerous studies have demonstrated the value and effectiveness of individual and marriage therapy for both depression and relational problems. Therapy combined with anti-depressant medication has been shown to be the most effective treatment for Major Depression. Anti-depressant medication helps to stabilize a person's brain chemistry much the same way insulin works to help maintain a diabetic's blood sugar.
* Take one-hour "vacations" at least three times a week. Give yourself permission to spend at least three separate hours per week doing something that you really enjoy. It may be reading a book, gardening, making crafts or emailing a friend. It is important that you not allow non-emergencies to distract you from taking this time out.
* Take personal and marriage weekend retreats. At least once a year, get away by yourself for a personal weekend retreat. Spend your time sleeping in, reading, taking walks and identifying and/or reviewing your personal goals and dreams. It is also important to "escape" with your spouse for the weekend at least once or twice a year. This will give you an excellent opportunity to assess the strengths and weaknesses of your relationship, review goals and dreams and to celebrate your mutual love without distraction. Attending a weekend marriage conference on an annual basis is also an excellent investment in your relationship and family life.
* Place your focus on others. When we begin to feel discouraged or sad it is easy to dwell on the circumstances we believe are responsible for our negative feelings. This is the time to take the focus off of yourself and place it on someone in your life that would benefit from your time and attention. This exercise will help you maintain a more healthy and realistic perspective of your life. It has been said that generosity and emotional health go hand in hand. Giving of yourself can increase your sense of well-being and combat depression.
* Pray and meditate regularly. The ultimate key to guarding your marriage and your emotions is to strengthen your relationship with God. Expressing your gratitude and sharing your needs will help to renew your strength and increase your hope.
* Create a "Blessings" list and review it regularly. Never let a day go by without identifying the blessings you have been given. Developing a thankful attitude will help you keep your focus on what is truly important.

Maintaining companionship, affection and harmony in your relationship will not only provide you with personal fulfillment and satisfaction, but it will also strengthen, guard and preserve your marriage. By understanding the potential impact of depression and knowing how to effectively address its symptoms, you will be better prepared to combat this silent killer of marital intimacy.