The Couple Who Medicates Together
Could a pill be the key to marital bliss?
Leslie Greenspan, a psychiatrist in Madison, Wisconsin, says couples sometimes come to her when one has urged the other to get help after circumstances (trouble at work, struggles with a child, a major marital disagreement) pushed him or her to a new low. If that person meets the criteria for depression and chooses medication, Greenspan generally waits about a month—the time it typically takes antidepressants to kick in—to see the couple again. By then, the unmedicated spouse often (gratefully) reports "a huge difference" in his or her partner's level of irritability, while the one taking a pill every day has yet to notice a thing.
Many standard measures of depression focus on mood-based symptoms such as sadness, withdrawal, and loss of appetite rather than on how respondents are getting along with spouses, coworkers, and kids, which Greenspan thinks may be a mistake. As she and other therapists I spoke to assured me, anger, often simply the unpleasant by-product of stress, is common in depression—and spouses tend to bear the brunt of it. Indeed, scientists' failure to appreciate this could be one reason studies suggest antidepressants don't work terribly well—the data doesn't capture their ability to reduce volatility because researchers don't ask about it in the first place. "It's the kind of thing where something like 'He left the top off the toothpaste tube' just grates," Greenspan says. But for the person on meds, the toothpaste cap becomes a mere bother rather than a roadblock that prevents her from hearing about her spouses day.
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