When You Love Someone Who Is Depressed: 4 Core Themes

What do caregivers experience when a family member struggles with depression?

Reviewed by Jessica Schrader

Key points

• Limited information is known about the impact on family caregivers of those with depression.
• For family members, caring for someone with depression can be a time of uncertainty and distress.
• Despite the challenges, family members are often unwavering in their goal to live well.

Depression is a serious public health issue, afflicting some 260 million people worldwide. While there has been exhaustive research to support those who are struggling with the condition, less is known about the impact on family caregivers of those with depression.

What is it like to be a caregiver for a family member struggling with depression—and how would they define living well? These were the main exploratory questions of a study led by Dr. Amanda Cole of Edith Cowan University in Australia.

In order to pursue this inquiry, Dr. Cole and her team began by recruiting individuals who were at least 18 years old and lived with someone who had been formally diagnosed with major depression. There were eight participants, between the ages of 31 and 63 years—and on average, they had been living with a family member with depression for 18 years. From there, Dr. Cole and her team had the participants recount personal stories of “living well” while living with a majorly depressed family member. The participants' narratives were then analyzed for themes.

The results were striking. The narratives yielded four overarching themes, all with sub-themes, which are summarized below.

Theme 1: A time of uncertainty and distress

Participants shared that living in anticipation of unpredictable actions or reactions of their family member with depression was distressing. This theme yielded two sub-themes.

Walking on eggshells. Participants were highly cautious and measured when relating to their family member with depression, in efforts not to make things worse.

The fear does not leave you. Participants expressed anxiety, fear, and anticipation that their family member might hurt themselves or commit suicide.

Theme 2: A time of change and adaptation

This theme captured the idea of change in three ways: (i) alteration and modification (small but meaningful change; (ii) accommodation (compromise, adjustment, and concession); and (iii) transformative change (profound or major adjustment). Participants’ stories referenced alteration, accommodation, and adjustment in order to better ‘fit’ their family member with depression, with particular respect to goals, roles, and family dynamics. This theme broke down into three sub-themes.

Things are not always as they seem. Participants changed the way they related to others in order to keep up positive appearances and mask what was really happening at home. This was done to protect both the family member and the family unit. This was an important aspect of living well—how they shared what was happening beyond the family.

Something surrendered, something gained. All participants adapted in concert with their changing needs. All of the stories referred to making sacrifices, whether it be role changes, goals, and future plans. In making these changes, the participants discovered a benefit that improved their lives.

A new journey can begin with a single step. This sub-theme refers to events, situations, or moments that gave rise to transformative change for participants. This transformation altered the path forward with their family member with depression, and led to positive change. For example, one participant shared that he had a stroke roughly a year prior to the interview, which caused a role reversal with his wife who struggled with depression—and who then became his caregiver, creating a profoundly different dynamic between them.

Theme 3: A time of perseverance and endurance

Participants expressed that living with a family member with depression can be difficult, and cause suffering and pain for the family. Despite this, participants were unwavering in their goal to live well. This theme was comprised of two sub-themes.

A heavy load to carry. Participants' "weight" of responsibility and their sense of duty toward their family member with depression was accompanied by copious worry and exhaustion. One participant reflected: “I think you feel a responsibility as family, acknowledging that you don’t have control over that other person, and trying to understand the illness.”

This is going to make me or break me. All participants stated that their experiences were extreme. They had to shore up all of their psychological strength to cope, and at times summon every ounce of grit to get through daily life.

Theme 4: A time of hope and healing

Participants referred to their personal ingredients for their individual recipes for living well. They described being strength-based and active in their approach, adapting and adjusting as needed, staying hopeful, and remaining resolute in the face of challenges. This theme had three sub-themes.

Accepting it for what it is. The narratives suggested that accepting their family member’s depression was an intentional and resolute act. Over time, they called depression “it,” to distinguish between the condition and the person living with it. Moreover, many participants arrived at the realization that they couldn’t “fix” the condition or the family member.

A crack of light through the darkness. This theme evokes imagery representing the positive change that can happen despite the storm. Participants’ stories pointed to a shift from surviving, to “living a life,” to coping and surviving.

Tomorrow is another day. In spite of the challenges, participants’ narratives were hopeful about the future and living well with a family member with depression. Words related to hope, such as faith, belief, expectation, and care surfaced repeatedly in their stories—and with an emphasis on looking forward.

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