Co-winner of 2005 Canadian Mental Health Association Gold Media Award

(© Bonnie Schiedel. Originally published in Chatelaine, November 2004.)

In a white bungalow on a quiet, tree-lined street in Saskatoon, eight-year-old Robin demonstrates how his computer game works while three-and-a-half-year-old Annie shows off her ballet moves. Their mom, Carmen Perret-Smith, tops yogurt with fruit salad and their dad, Rob Smith, tries to calm Daisy, the family's tiny, hyperactive black dog. At first glance, you'd never know that depression dwells here, too, but it does. Rob, 47, has fought depression for his entire adult life - and that means his family is battling it too.

This is Carmen and Rob's story. It's a romance—with a twist. They light up when they look at each other; they use phrases like "deeply in love" with simple sincerity. "We've always been the couple where people say, "'Wow, you are so in love; I can only hope for a relationship like yours.'" Carmen shakes her head. "After a while I found myself thinking, 'If only you knew.'"

Carmen and Rob's experience with the crippling darkness of depression is not
unique. According to the Canadian Mental Health Association, fully two-thirds of Canadians have experienced depression or anxiety, either their own or a loved one's. And while the stigma around mental illness is starting to abate and treatment options are better than ever, depression is still incredibly hard on relationships. As Carmen and Rob discovered, Rob's illness affects their lives as parents, providers and, most of all, as partners. But after years of hard work, yelling and tears - including a barnburner of a fight where they tossed their wedding rings over a bridge - this couple is starting to heal and to cope.

Carmen and Rob's romance began in Calgary 14 years ago when they both stopped
to listen to a street busker play a Sesame Street tune. They started chatting and ended up hand-in-hand in a coffee shop, talking all night about their plans and dreams. "It was an instant connection," Carmen, 32, remembers. "We fell madly in love, and moved in together three weeks after that." They'd go running together, or walk through parks for hours. When Carmen, then an art student, had to stay up all night to do an assignment, Rob would read Trivial Pursuit questions to keep them both awake. (He was working as a real estate agent in between stints with the Canadian military.) She loved his sweetness; he loved her strength.

Then, a few months after moving in together, Carmen recalls coming home to find Rob still in his shorts and T-shirt, staring at the computer when he was supposed to be at work. "There were days and days and days where he wouldn't leave the apartment or wouldn't get out of bed, dotted between drinking sprees," she says. This was her first encounter with what she would come to call "the beast with no name," and Carmen didn't recognize it as depression. "I was concerned, but I thought his mood was a temporary thing, and that when he got back into the army, he would be okay."

In fact, Rob had all the hallmarks of clinical depression. He'd experienced it
before, starting when his grandfather, who raised him, suffered a debilitating heart attack. "I remember being incapable of doing my homework. I was frozen," he says. Family history: his mom suffered a nervous breakdown in her twenties. Rates for major depression and panic disorder in the Canadian Forces are also significantly higher than in the general population, according to a 2003 Statistics Canada report, although the reasons aren't clear. Rob's drinking was another red flag, as studies indicate that people with mental illness often use drugs or alcohol to make themselves feel better, if only for a little while. "At the time, I didn't think anything of the drinking," Carmen admits. "I was 19, and he didn't drink any more than some of my friends."

Rob's increasingly frequent - but still undiagnosed - bouts of depression didn't stop the couple from marrying between Rob's military tours. Carmen had her career as a graphic designer, and she hoped that the military life would take care of Rob's moodiness. Even after Rob left the army and embarked on a few different careers, the couple didn't acknowledge his depression or the financial havoc triggered by Rob's (understandable) inability to hold down a steady job. "I dealt with it by ignoring it," says Carmen. "I was confused: how could he be so outgoing outside the house, and so completely withdrawn and quiet when we got home?"

Rob's diagnosis in 1998 came too late for Carmen, and they separated shortly afterwards. "I was so tired of following Rob through this path of up and down and up and down," remembers Carmen. "I still didn't realize what depression meant and I didn't understand the disease one bit. I just felt like I was too young to be hooked up with someone who wasn't going in the same direction as me." Carmen was also concerned about their toddler son. "I was worried that I was going to slip into depression, too, and that just wasn't an option. I needed to take care of Robin."

Carmen's concerns are shared by many. Anne Sheffield, author of Depression Fallout: The Impact of Depression on Couples and What You Can Do to Preserve the Bond (HarperCollins) coined the phrase "depression fallout" to describe the enormous impact depression has on loved ones. "The non-depressed person can't believe there's such a change in her partner. She assumes she must have done something wrong, or that it's an affair or money trouble," Sheffield says. "Then when she realizes she's dealing with depression, she wants to help. When her help doesn't work, she becomes even more demoralized and distressed. And then she gets resentful, and she wants out." Indeed, studies show that marriages where one partner is depressed are rockier - with poorer communication, greater conflict and fewer expressions of affection - than those of healthy couples. The well spouse may even slide into depression, too.

Shortly after the separation, Rob drove to the beer store after drinking a
case of beer. Although he wasn't caught, the realization that he could have killed
someone prompted him to quit drinking and join Alcoholics Anonymous. Seven years later, he's still sober. "It was like being on a merry-go-round - then putting your foot on the ground long enough to slow things down, and see that living this way isn't working," he says.

Rob and Carmen decided to give their marriage another chance, and Rob started seeing a counselor and taking anti-depressants for the first time. The initial round of medication wasn't a success: "Horrible sexual side effects," says Carmen ruefully. "And I was drowsy all the time," adds Rob. The next prescription was more effective, although Rob wasn't always faithful about taking it. "I just wanted to be like everyone else," he says. Carmen didn't like Rob's cavalier attitude about his medication: "It pissed me off. When he's off his meds, his moods become far more erratic and he's very edgy and temperamental." (Now, partly because he's clicking with a new counselor, Rob is committed to taking his antidepressants regularly.)

Most of us associate depression with sadness and lethargy, but the chaos-creating mood swings and irritability Carmen talks about are an all-too-common part of the disease, according to experts. Skipping medication or stopping it altogether isn’t unusual either, often because of frustrating side effects, says Dr. Elyse Dubo, a University of Toronto psychiatrist. "Going on and off medication means you may not respond as well to medication the next time you need it," says Dr. Dubo. "And the longer depression is untreated, the more chronic and severe it becomes."

Withdrawal from family life is another typical symptom of the disease. "When Rob's down, there's this great tension around the house - a lot of yelling," says Carmen. For example, when their son Robin was a toddler, they went to a campground about three hours drive away. They had trouble finding a campsite, the mosquitoes were awful, and it was tough to get their excited little boy to bed. To a depressed person like Rob, that was an intolerably stressful situation. They ended up packing up at midnight and driving home. "I'd sooner be out in a Serbian minefield than deal with the kids on a bad day," admits Rob. "When you pack everyone into the car and then hear, 'I have to pee,' that drives me nuts."

Still, Rob does do "dad" stuff. He zips remote control cars up and down and the hallway with Robin, reads with Annie, and takes them fishing with Carmen's dad in the summer. When the kids were younger, Carmen and Rob weren't convinced that the kids were affected. "Rob tries not to make this a part of the kids' lives," she says. "And I give them as much love, stability and comfort as I can." Now, however, they're considering telling eight-year-old Robin about his dad's illness. "We want to make sure we look at this positively with him, and say 'this is what happens when your dad gets down, and this is why,'" says Carmen.

That kind of frank approach works, says Linda Conn, a social worker at Sunnybrook Regional Hospital in Toronto, who helps families cope with depression. "Explain, in an age-appropriate way, that depression is an illness - you haven't done anything to made Mom mad or sad. And be upfront: if Mom is hospitalized, don't say she's on a trip," says Conn. Maintaining a good relationship with the kids is crucial, adds Josephine Tan, a psychologist studying the impact of depression on families at Lakehead University in Thunder Bay. "A depressed parent can be withdrawn, angry or irritable, or in extreme cases, abdicate parental responsibility altogether," says Dr. Tan. "Children are walking on eggshells. They need reassurance." Honesty can dispel the anxiety and fear created when kids feel that they can't talk about what's happening.

But what about the couple? Mood swings, diminished desire, strained family life and money troubles can all spell disaster for a marriage. "The breakdown in communication and the irritability can be very destructive, so support and treatment are very important," notes Dr. Dubo. For Rob, guilt is another part of the equation. "I am deeply in love with Carmen," he says. "But I often feel like I'm not letting her get on with her life. The guilt of dragging her down with me is probably half of the depression." Carmen knows their marriage has suffered, too. "I'm getting better at not doing this, but when Rob is having a down day, I can get bummed out. I think, 'What a rip off!'" she says, smacking her thigh for emphasis. "Days will go by where we talk and talk, and everything seems fine, and then it's like he's gone, you know? And I'm on my own."

Anger, frustration, guilt and grief are all normal reactions to depression within the family, says Conn. Partners and kids may sometimes feel that the depressed person is lazy, self-absorbed or not trying hard enough. That's why it's so important to reach out for help and support. It was also a huge epiphany for Carmen when a counselor said, "Look, this man is sick." As Carmen says, "It's helped me immensely to really understand that this is a disease, because it's taken the focus off feeling angry at Rob for his behaviour. If Rob was dying of cancer or dealing with MS, I would not turn my back."

So, how is the Carmen and Rob story going to turn out? "We've been to the brink of divorce more than once, but we don't consider it anymore," says Carmen. (With mock solemnity Carmen says, "I am not divorce material!" She and Rob erupt into laughter, then turn serious again.) "We're kind of up and down in a wave pattern - I'm surprised we've hung on this long," says Rob, adding, "but I still have lots of hope for the future." Carmen agrees. "It is not easy. This disease has damaged our relationship, and we need to heal. But we celebrated our tenth wedding anniversary last November, and our love for each other is deeper than ever before. I know we're going to have a happy ending."

SIDEBAR: Coping with someone else's depressionOver the years, Carmen Perret-Smith of Saskatoon has found positive ways to deal with an often-turbulent home life and take care of herself. Mental health experts, such as Dr. Josephine Tan, professor of psychology at Lakehead University in Thunder Bay, Ont., agree
that she's on the right track. Her strategies:

1. Find a listening ear. "When you start to open up to people, you realize how common depression is," says Carmen. "The situation is not so scary or embarrassing anymore." In addition to talking with her family, Carmen created an informal support group of friends in similar situations. They get together and talk about what's been going on with their depressed spouses. Carmen and Rob also rely on their church, faith and prayer. "When I remember to pray to God, my outlook does get better," says Carmen. (You can also find an organized mental-illness or support group. Al-Anon groups can be helpful if alcohol or drugs are involved, as in Rob's case. Check with your doctor or local hospital.)

2. Find the right counselor. Talk to your doctor or contact your local branch of the Canadian Mental Health Association (www.cmha.ca) or your local mood disorders association (look in the Yellow Pages under "Mental Health Services"). Consider visiting several mental-health professionals to find the one you're most comfortable with (some may charge a consulting fee). Carmen and Rob have sought counseling with mixed results - the experts didn't always seem to understand what living with depression was really like. But now they see a psychologist who sees them separately and as a couple, and who gives
them tools to cope.

3. Educate yourself. Learning about depression is a key coping strategy, too. "Through counseling and reading, I have learned that this is not my fault, and I have learned that I can not fix Rob's depression. That alone is a lifesaver," says Carmen emphatically. For information, download the booklet, All Together Now: How families are affected by depression and manic depression from Health Canada's website (go to www.hc-sc.ca and enter "All together now" in the search engine). Or, read Anne Sheffield's Depression Fallout: The Impact of Depression on Couples and What You Can Do to Preserve the Bond (HarperCollins). This book hit Carmen like a lightening bolt. "I never dreamed that the stories would be so close to mine. I realized there was hope."

4. Care for the caregiver. Carmen makes sure she looks after herself, too. She gets more sleep, heads to a counseling session, gets a massage or takes a weekend getaway with girlfriends when she needs to. She also loves to lose herself in her job as a graphic artist. "Get the help you need because if you're not strong, you can't be strong for that other person."