Dating is an emotional minefield under the best of circumstances. For someone dealing with depression, that minefield can become even more explosive. Depression disrupts many aspects of daily life, and romance is usually near the top of the list.
Depression interferes with dating and romantic relationships in a number of ways, says Dr. Sue Varma, a psychiatrist and clinical assistant professor at the NYU Langone School of Medicine. “Decreased libido. Decreased interest in sex, relationships, talking. Indecisiveness. Lack of motivation. Lack of pleasure in life,” she says. In addition, depression brings with it lower self-esteem and confidence in the ability to meet and attract someone. “With increased self-doubt, people take less chances,” Varma says. Pessimistic thinking leads to the perception that any move toward intimacy will inevitably lead to rejection, which adds to the inability to take a risk in romance, she says.
And there seems to be a vicious cycle when it comes to depression and problems in romantic relationships, says Amanda Rose, a professor of psychology at the University of Missouri. “The most common precipitating event of an individual’s first episode of clinical depression is the breakup of a romantic relationship,” she says. This usually happens in adolescence or early adulthood, and it can set an unconscious link between romantic disappointment and future bouts of depression.
[Read: Are Depression Naps a Harmless Internet Meme or Concerning Sign?]
On top of that, people with depression also have characteristics that make it more difficult for them to have positive dating relationships, Rose says. For example, she notes one consistent finding in the research is that depressed people are especially likely to do something called “excessive reassurance seeking,” which is repeatedly asking for assurances that he or she is loved and cared for. “Unfortunately, this tends to be aversive and creates problems in the romantic relationships,” she says.
In another area of research that Rose conducted, she found that adolescents with depression often engage in a construct that she and her colleague, Rebecca Schwartz-Mette, a former doctoral student who is now an assistant professor of psychology at the University of Maine, called “conversational self-focus.” “Probably in part because depression makes people have a very narrow focus on themselves and their problems, adolescents with depressive symptoms tended to repeatedly turn conversations to focus back on themselves, especially when the conversations were about problems,” Rose says. “In our studies, their friends were especially likely to see the relationship as poor quality and also reported that they would engage in behaviors to avoid or minimize contact with the friend. We have not studied conversational self-focus in romantic relationships, but I suspect that the same dynamic would occur.”
[See: Am I Just Sad — or Actually Depressed.]
Getting Into the Dating Game
How can those with depression participate in the dating game? Online dating may seem like an easy answer, as it avoids the difficulty of getting out into the world and meeting people face to face. But Varma is skeptical it’s the best option for someone dealing with depression. “When [anxiety and depression] is high, [online dating] just becomes more fodder for negative, pessimistic thinking,” she says.
She suggests counseling instead to build self-esteem and self-image. One of the best, most empirically validated treatments for depression is cognitive behavioral therapy, she says, and when needed, combining CBT with antidepressant medications can be effective. “I use CBT techniques with my patients to challenge negative, pessimistic thinking and that the depression and negative features of their life are not pervasive or permanent,” she says. But the challenge of distorted thinking makes assertiveness and risk-taking hard, and progress may be slow. “Dating is further down the road,” she says.
Dating someone who is depressed can also be challenging, but there are ways to help a romantic partner. One way to do that, Varma says, is to boost his or her activity levels. Plan rewarding activities such as getting together with friends, going out for a walk or engaging in some other pleasurable activity — “anything that they feel capable of doing at the moment and less of the low-rewarding behaviors such as watching television alone passively,” she says.
Another way to help is by not blaming your partner for his or her depression. “Avoid telling them it’s all in their head, avoid telling them that it’s going to be OK, avoid anything that would minimize it,” she says. “Spend time with them, get them engaged back in their own lives, hobbies, interests and friend circles. Pleasure helps get people better. Encourage them to do the things that would bring them pleasure and would make them feel good about themselves.” Most important, seek counseling “for the two of you, if necessary,” she says.
[See: Apps to Mind Your Mental Health.]
Is Honesty Important?
Once an individual with depression begins dating, another issue arises: Should he or she be honest with dates about the disorder, and how? Many people don’t understand depression, Varma says, so addressing the issue can be tricky. “You can feel it out,” she says. Rose suggests that individuals with depression not bring their depression diagnosis up immediately. “However, if the relationship becomes more serious, this is an important issue to discuss with the partner,” she says. “Hopefully, this will help the partner be understanding and allow him or her to serve as an important source of support.” If you do choose to talk about it, Varma suggests describing it as you would any medical issue. “Be brief and to the point,” she says. “I don’t know if it’s always relevant to go into too many details.”
One important detail to consider is the side effect of some antidepressants: lower libido and lack of interest in sex. “It may be necessary to explain this so a sexual partner doesn’t think it’s their fault,” Varma advises. Rose also recommends that depressed individuals be aware that they may feel compelled to engage in behaviors like excessive reassurance seeking and conversational self-focus that may actually make the relationship worse. “Once they are aware of that, it might be easier to substitute these behaviors with more adaptive behaviors, such as asking the partner about his or her day, that might make the relationship stronger,” she says.
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The Struggle of Dating With Depression originally appeared on usnews.com
