Supporting Her Without Running Yourself Into the Ground

Husbands, sisters and grown kids caring for a woman with depression need care too. Here is how to stay steady for the long haul.

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day. If someone is in immediate danger, call 911 or go to the nearest emergency room.

When a wife, mother or sister is struggling with depression, the people closest to her often pour everything they have into helping. They lose sleep. They cancel plans. They carry worry into work meetings and back home again. Over weeks and months, that can wear a supporter down.

This matters, because support helps most when it lasts. A woman between 38 and 54 going through depression, especially depression that includes thoughts of suicide, needs people who can stay steady over time, not just through one hard night. Often she is already the family's caregiver, for kids and aging parents alike, and the people now caring for her may be learning that role for the first time.

Signs you are running low

You feel numb, short-tempered or constantly on edge.
You cannot remember the last time you did something for yourself.
You are not sleeping well, or you are drinking more to unwind.
You feel resentful, then guilty for feeling resentful.

None of this makes you a bad partner, sibling or child. It means you are human, and you need care as well.

Share the load

No one person should be her whole safety net. Bring in others: a sibling, an adult child, a trusted friend, someone from her faith community. Divide tasks. If you are the main supporter, protect at least a little time each week that belongs to you.

It helps to know the warning signs so you are not guessing alone: talking about being a burden or wanting to die, withdrawing, big changes in sleep, giving things away, a sudden calm after a long dark stretch. Know, too, that you can ask her directly, "Are you having thoughts of suicide?" Asking does not plant the idea. If she is in immediate danger, call 911. Otherwise, call or text 988 together. The 988 line is also there for people who are worried about someone else, so you can reach out for yourself as well.

During a hard stretch, store medications and any firearms securely at home. It is one less thing to worry about.

Get your own support

Many supporters find it helps to talk with their own doctor or a counselor. Support groups for families of people living with depression meet in many communities, including around St. Louis, and online. Hearing from others in the same spot can ease the sense of being alone.

Basic care matters more than it sounds: regular meals, a walk, real sleep, a friend you can be honest with. You cannot pour from an empty cup, as the saying goes, and she would likely not want you to try.

Let her care team do their part

You are not her therapist or her doctor. Your role is to love her, notice changes, and help her get care. Clinicians handle the treatment. Letting go of the idea that you must fix this yourself can lift a surprising amount of weight.

One option her clinicians may discuss

Knowing what treatment can look like can ease a supporter's worry, and one option for depression with suicidal thoughts is this. Spravato (esketamine) is a nasal spray the FDA has approved, taken along with an oral antidepressant, to treat depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behavior. It is also approved for treatment-resistant depression. It is not a crisis treatment: it does not replace emergency care or a hospital stay when one is needed, and it has not been shown to prevent suicide or to reduce suicidal thoughts or behavior. It is given only in a certified clinic under a safety program called the Spravato REMS. The patient takes it there under supervision, stays at least two hours to be monitored, and does not drive until the next day after a full night of sleep. It is never dispensed for home use. Whether it fits is a clinician's decision after an evaluation.

Recovery from depression is common, and people who supported someone through it often say that looking after themselves was part of what made it possible.

If she is interested in that option, many clinics that offer it start with a free first conversation where she can ask whether an evaluation makes sense. She can bring someone with her, and that someone could be you, rested and ready.