Using the vivid, poignant and personal stories of the members of a website support group she founded (www.depressionfallout.com), Anne Sheffield, the author of two highly acclaimed books on depression, provides an honest record of what happens to a love relationship once depression enters the picture, and offers solid advice on what the nondepressed partner can do to improve his or her own life and the relationship. Of the millions of people who suffer from a depressive illness, few suffer in solitude. They draw the people they love spouses, parents, children, lovers, friends into their illness. In her first book, How You Can Survive When They're Depressed, Anne Sheffield coined the phrase 'depression fallout' to describe the emotional toll on the depressive's family and close friends who are unaware of their own stressful reactions and needs. She outlined the five stages of depression fallout (confusion, selfdoubt, demoralisation, anger, and the need to escape) and explained that these reactions are a natural result of living with a depressed person.

Introduction	p. xi
The Deadly Duo: Depression and Depression Fallout	p. 1
Unraveling the Mind-Brain Mysteries of Depression	p. 26
Overcoming Denial: The Art of Persuasion	p. 56
Drawing a Line in the Sand	p. 77
A Partnership Approach to Treatment	p. 107
The Virtues of Being Selfish	p. 143
I Love You, I Love You Not	p. 170
Mending or Breaking the Bond	p. 194
Life Beyond Depression Fallout	p. 225
A Guide to Internet Resources on Depressive Illness	p. 255
Selected Bibliography	p. 261
Notes	p. 263
Acknowledgments	p. 271
Index	p. 273
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Depression Fallout
The Impact of Depression on Couples and What You Can Do to Preserve the Bond

Chapter One

The Deadly Duo: Depression and Depression Fallout

Love and depression speak different languages. Every manand woman in a relationship touched by depression comesface to face with this unpleasant truth. Although eachbelieves that he or she is living through a unique situation, the behavior of both parties conforms to a predictable pattern. One participant acts according to the dictates of his or her depression: Be critical, unpredictable, sullen, illogical, angry, touchy, put-upon, distant yet occasionally tender, and deny there is anything wrong with you. The other follows the rules governed by depression fallout: Be confused and bewildered, blame yourself for the relationship’s problems, become thoroughly demoralized, then get angry and resentful, and, finally, yearn to escape.

Few people are well informed about the dynamics ofdepression and its companion, depression fallout, despitethe unhappiness they cause. Ask most people to conjure up the image of someone who is depressed and they willenvision a huddled figure sitting passively in the cornerand murmuring about how sad he or she feels. No wonder,since most lists of depression's symptoms begin with "apersistent sad, 'empty,' or anxious mood," followed by"loss of interest or pleasure in ordinary activities, including sex." While these symptoms do describe how depression sufferers feel, they are not matched by the expected passive behavior. Indeed, the depressed often become unpleasantly aggressive, argumentative, and faultfinding without provocation. This disconnect causes innumerable depression-clouded relationships to unravel and become mired in conflict and misunderstanding. When previously attentive, warm, demonstrative partners turn irritable, distant, and thoughtless, mates are unlikely to attribute the change to a psychiatric illness, even though they may have read about depression in the abstract. Instead, they jump to what seem to be more likely explanations: a waning of affection, dissatisfaction with the marriage or love affair, a clandestine liaison with somebody else, a selfish preoccupation with work, or a reluctance to share deep, dark secrets that concern both partners.

Since the true culprit is an illness that afflicts no less than nineteen million Americans at any given moment,why don't depressed partners speak up and explain what isgoing on in their minds and hearts? Surely anyone whoselife has turned inexplicably gray and hopeless wouldchoose to talk about it with his or her intimates, thuspaving the way for answers and solutions. But that is notdepression's way. Indeed, depression's most insidious trait is the ease with which it seduces its sufferers into blindalleys signposted Lousy Relationship, Bad Karma, WeakCharacter, Stress Overload, and other misleading names.

All those battered by depression fallout are convincedthat their situation is unique and their reactions to it aberrant. Having enjoyed a gratifying and seemingly solid partnership beset by no more than the usual ups and downs,they find themselves living with an unwelcome strangermasquerading behind a familiar face. Not only does thisnewcomer no longer behave as expected, but he or sheappears to have undergone a personality change for theworse. Tenderness and support have been traded in forgrumpiness and irritability; sharing for secretive distance; patience and reason for volatility and antagonism; and good habits for bad ones. Threatening though this is, fall-out partners do not seek solace or advice from family and friends. Convinced that they are somehow responsible for the transformation, or that its explanation is perhaps embarrassing and best kept hidden from others, they guard their secret. This extracts a costly price.

Isolated in self-imposed solitary confinement, unableto coax explanations or apologies from their mates, falloutsufferers start shelving their lingering suspicions of personal responsibility and take to building protective ramparts in the form of negative reactions to and feelings for their partners. Loosening the knot of love, loyalty, and companionship formed over time takes a toll, and that toll is at least partially paid by fallout partners in guilty self-recriminations for being a "bad" or selfish person who can be counted on for support in good times but not in rocky ones. They indulge in tit-for-tat, parrying criticism with criticism, and although this temporarily relieves their feelings of frustration, it brings them no closer to an understanding of what is happening to the relationship.

The first gift the Message Board delivers to new arrivals is assurance that they are neither malcontents nor misfits. They quickly learn that even those Board posters whose partners have been diagnosed and are being treated for depression share the same problems and are subject to the identical negative thoughts. Even in the presence of such empathetic company, first-time Board visitors often lace their posts with "I know you won't believe this, but ... " or "He [or she] said the strangest thing to me ... " and are instantly welcomed and reassured that what they hadthought unbelievable and strange is commonplace. Whenoldtimers respond like a well-rehearsed chorus -- "Oh, yes,we know, we've been there, too, and we understand" -- thedam of reticence gives way, allowing pent-up emotionalturmoil to flow freely. In short, the single most importantfact for a depression fallout sufferer to grasp and take toheart is that his or her particular brand of misery, far from being unique, is shared by a minimum of nineteen million others in the United States alone, and so are their far-from-aberrant emotional reactions.

Depression Fallout
The Impact of Depression on Couples and What You Can Do to Preserve the Bond. Copyright © by Anne Sheffield. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.

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