糖心Vlog

Medical sociologist supervised a research team who interviewed partners of people with long-term depression. Their findings have been published in a paper called .

鈥淭he impact on couples seemed incredibly important,鈥� explains Dr McPherson. 鈥淪o many adults with long-term depression are in a relationship or have been in the past, and that relationship (whether it survives or breaks down) is a key part of the context within which any individual experiences depression.鈥�

The research found that people suffering from depression who are in a relationship are rarely 鈥� if ever 鈥� offered couples therapy, and partners of patients feel excluded from their care.

The research team is calling for greater awareness of the emotional impact on partners among frontline health service staff and for increased accessibility of couples therapy.

Partners鈥� experiences

One of the key findings was that the participants had all gone through a similar process as their partners became unwell.

Pre-diagnosis, people tried to explain the changes they could see in their partner鈥檚 behaviour. While diagnosis gave them a concrete explanation and a hope that it was 鈥榮omething we can fix together鈥�, the realisation that there was no simple cure then sank in and the depression started to dominate their life. They then had to learn to navigate their new day-to-day reality.

The impact on relationships

Crucially, on top of the burden on partners as individuals, the relationship between the couple was affected at every stage.

• Participants felt they no longer received emotional support from their partner, leading to feelings of resentment and a struggle to reconcile those feelings with ones of loyalty.
• Pre-diagnosis, conflict about seeking professional help often placed strain on the relationship.
• As participants realised that depression may be a long term problem with an uncertain trajectory, they had to adjust the assumptions they鈥檇 previously made about what their futures would look like.

This is where couples therapy comes in. As partners find depression coming between them, joint therapy could help partners work as a team again. Couples therapy has the potential to prevent relationship breakdown which in turn could help avoid further depressive episodes induced by relationship loss and so save health service resources in the longer term.

Current UK provision

As of November 2017, say that couples therapy should be 鈥渃onsidered鈥� if a relationship might be contributing to an individual鈥檚 depression. Draft new guidelines propose that it should also be considered if involving the partner may help with the individual鈥檚 treatment.

鈥淣ICE judges treatments on a very narrow basis,鈥� says Dr McPherson. 鈥淣ICE focuses on short-term outcomes, looking only at symptoms in individuals, which doesn鈥檛 give the full picture of the wider and longer term burden on those individuals, couples, families and communities. NICE is failing to treat depression as a long-term condition on par with physical conditions 鈥� a supposed NHS principle known as 鈥榩arity of esteem鈥�.鈥�

None of the people interviewed by our researchers had been offered couples therapy, and most felt excluded from their partner鈥檚 care and treatment. They felt medical professionals didn鈥檛 acknowledge the significant impact that living with a partner with depression can have.

Looking ahead

鈥淲e obviously want to see couples therapy offered more widely for depression, but it goes further than that,鈥� says Dr McPherson.;

鈥淲e hope our research will highlight the link between past and present relationship difficulties and depression and show that couples therapy could also be used as a preventative measure 鈥� an intervention before depression develops.鈥�