This month Douglas Holwerda, American trained and licensed mental health counsellor, answers the problems of friendship and being an expat wife

 

Dear Douglas,

 

I need some advice about what I can do with my husband, who is depressed and shows no signs of improvement. We have been together for sic years, married for the past four, and have lived in Ho Chi Minh City since 2012. I have a regular job as a teacher and he had planned to do some writing while teaching English on a part-time basis. I see that he is in a state of depression and I have tried to be supportive and understanding of his inability to do or enjoy much. I’ve listened to him and waited for him to feel and act more like the guy I knew before, but now I find myself quite angry at him and feel myself withdrawing. He doesn’t want to go to therapy because of the cost, even though I have told him I will pay for it. What can I do?

 

— Charlotte (not real name)

 

Hello Charlotte,

 

The advice we all get when given safety instructions on a plane — to put on our own oxygen mask before assisting others — is applicable when trying to support someone who is chronically depressed or otherwise ill. It is very important to keep tabs on our own emotional wellbeing, especially under the stress of compassion fatigue. If he won’t go to therapy, maybe you should go for a few sessions to develop a clear plan of how you can deal with your own challenges and be a support to him.

 

Here are some ways to think about depression and its effect on people.

 

In the same way that a person who has pneumonia is not responsible for being sick, depression is not the fault of the person who has it. That said, a person who has depression is responsible for the care of their own emotional wellbeing and there are things that they can do to improve the likeliness of feeling better.

 

These things usually fall into two categories. One is the mechanics of living daily life. We know that when persons activate themselves to participate in things that formerly gave them pleasure or satisfaction, even when they don’t feel like it, they often feel better. It can feel like walking uphill — effortful and laborious in the beginning and eventually engaging and satisfying. Sometimes we say you have to “fake it until you make it”. It is the same with participating socially. Of course, this is more difficult as a person becomes more depressed.

 

The other category has to do with the inner life of a person. Our low moods might be a reflection of unresolved inner conflicts and beliefs that are self-limiting. Socrates said, “An unexamined life is not worth living”. Our inner worlds can be full of doubts, fears and messages about who we are which undermine our ability to live confidently in the world. Often people learn coping strategies to deal with circumstances that are beyond their control. This works for a while — maybe even years — but is eventually ineffective. We are meant to do more than cope with life, and we have to go through the process of understanding what it means to live the way we are meant to. All of this is the terrain of therapy.

 

So, Charlotte, recognise your limits and that you are not doing him a favour by sacrificing more than you really can (the point at which you start to resent it). The duration of his depression and the effect it is having on your relationship strongly suggests that he needs therapy to find his way out of it. Push him to do it. Maybe he has to know that you will pay for it now, but he will have to pay you back sometime in the future. It tells him that while you support him, he is responsible for himself and that you are optimistic that he will overcome this depression.

 

— Douglas

 

Do you have a question you would like Douglas’s help with? You can email him at This email address is being protected from spambots. You need JavaScript enabled to view it.. Personal details will not be printed

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