How to support a partner with High-Functioning Depression or PDD

Living in an era where people can recognise their mental health struggles better and faster, instead of hiding them or not being aware of them (which was the case some decades ago), has brought us to a new reality in our relationships: we are often faced with the challenge of supporting a partner who struggles with their mental health.

I say it’s a challenge because:

• We don’t know the ropes of doing a good job in supporting them.
• We find ourselves completely drained in trying to come up with all the possible ways to help or feeling hopeless after trying for too long.
• We get confused by the mixed messages we receive from our partner: we don’t want to add more pressure, but we don’t want to stop caring for them either.
• We put aside our own needs, and as a result we may also end up struggling with our mental health.

It’s sad, confusing and frustrating to want to take care of your partner but not know how, and I hope that with this article, I can give you some ideas or a good starting point.

One of the most common mental disorders but also one of the most difficult to recognise and tackle in our partners is High-Functioning Depression.

What is High-Functioning Depression?

High-functioning Depression or Persistent Depressive Disorder (PDD; formerly called dysthymia) is a form of depression that typically lasts for at least two years. On the outside, people suffering from PDD don’t display many signs of a mood disorder. For the most part, they can work, maintain their household, manage interpersonal relationships, handle parental responsibilities, and to some extent, they seem to enjoy their lives.

But, with PDD, external appearances are deceiving. On the inside, individuals dealing with chronic, low-level depression feel empty and unmotivated. They manage to put on a good show, but they feel physically, emotionally, and spiritually drained by their unsatisfying and inauthentic existence. The depression they experience is as real as the depression of a person diagnosed with major depression. Still, their symptoms manifest in a muted form, sometimes detected only by people very close to them (e.g. their partners).

Symptoms of High-Functioning Depression

The primary symptom of PDD is a low mood for most days for over two years for adults and one year for children and adolescents. Other symptoms of dysthymia may include:

• Poor appetite or intense hunger.
• Getting too much or too little sleep.
• Low energy and feeling fatigued.
• Poor self-esteem and self-worth.
• Limited concentration and decision-making.
• Feeling hopeless or pessimistic about the future.
• Similarly to other conditions, these symptoms cannot be explained by another mental or medical condition. In addition, these symptoms must have an adverse impact on functioning.

How to support someone with PDD

So, how can you support someone with PDD?

1. Learn about depression

The more you know about depression, the more equipped you’ll be at responding to the potential changes in how your partner feels, thinks, and acts. If, for example, you know that procrastination is one of the symptoms of PDD, you will be less likely to judge your partner and label them as “lazy”, and more likely to be understanding and compassionate with them.

2. Ask how you can help

Being a compassionate and understanding listener is one of the most helpful ways you can support your partner. But other than listening to what is being shared, you can also openly ask your partner what they need or may find helpful. Each of us may need something different when we’re feeling down. Hence, open communication is crucial.

It’s important not to assume what your partner needs or doesn’t need. Try to avoid patronising them or overprotecting them; that will add to their already negative self-talk and helplessness. Instead, ask them directly. Also, understand all answers you may get.

For example, you can ask:

• How is your energy level today?
• Is there anything you would want to do right now?
• What activities felt good the last time you felt this way?
• How can I best support you? What do you need from me right now?
• Would you like to spend time alone today, or would you prefer to hang out with others?

3. Find activities to do together

Finding motivation is hard when struggling with high-functioning depression. Try to leverage any momentum your partner has and join them. Through a collaborative discussion, you can propose and arrange indoor or outdoor activities with them. Based on what you know they usually like or find meaningful, you can plan an activity together. Remember, you are a team and together you are working in order to get through this challenge.

4. Stay flexible

Depression can affect someone’s ability to participate in everyday activities. Someone experiencing depressive symptoms may intend to go out with you on Saturday night, but when the time comes, their mood has shifted. This mood shift reduces the motivation to even get out of bed sometimes. It’s not because they’re not trying hard enough!

Don’t blame or shame them for breaking plans; stay flexible and consider alternative activities within their comfort zone instead. Instead of going out for dinner, maybe you can spark their interest by suggesting cooking homemade food together. Instead of going to a party, stay in, drink some wine, and talk in a cosier atmosphere. Sometimes they may simply need some alone time; try to be respectful of their needs, remembering not to take it personally.

5. You are not there to fix them

We live in a reality of constant problem-solving. When an issue pops up, we feel very distressed by its occurrence. Unfortunately, there are no quick fixes for depression. Instead of pushing towards a “magical” resolution of the negative emotion, you can accept your partner’s feelings and confusion; ask them what their triggers are, what they do to cope, and what part they want you to play in their coping strategies.

See them as a human being going through a hard time in life, and not as a project that you need to manage or complete. Life is our journey through these struggles and not the absence of them.

6. Take care of yourself

I'm not saying it only to be nice to you; I mean it. You need support as well. Try to not overestimate your energy and your mental and emotional resources. You may feel stronger than your partner, but you are not invincible. It is possible that you may get burned out for trying too hard for too long, and there is a term for that: it’s called compassion fatigue.

So, make sure you engage in some self-care if you want to keep supporting your partner fully. Don’t forget the safety instructions we hear in the aeroplane: “Put on your own mask before helping those around you." Makes sense, right?

Professional support

Important: following the steps mentioned above is helpful but remember that you don’t need to go through this all by yourself. You are not your partner’s therapist, so encourage them to seek professional support. If they feel sceptical about this option, discuss their fears and concerns with them, but also the importance of stepping out of this negative cycle eventually. When they are in therapy, try to be supportive mentally and emotionally through this journey, as well.

Supporting your partner through depression can be hard, but it can also be an experience that deepens your relationship and helps you feel even more connected with each other at the end of the day.