Like many modern American families, Robert and Sally are busy. Very busy. Married now for 11 years, both partners work full-time jobs, tend to their three children (and their ongoing schedules of miscellaneous activities), and pitch in with their extended families when needed. So when Robert first started withdrawing at home, saying he was too tired to participate in many things the couple usually shared and enjoyed, Sally did not think much of it. “I knew he was really stressed out at work—there was a big project going on and he was in the middle of that,” she says. “I just assumed that he needed some breathing space and did my best to give it to him.”

As it turns out, Robert was experiencing an episode of depression. And that initial withdrawal ultimately evolved into deeper feelings of sadness, apathy, and worthlessness that later required hospitalization.

“It got really bad, really fast,” says Sally. “At the time, I felt a little blindsided by it all. I didn’t realize how bad it was for him. But by the same token, I also felt like I knew something was really wrong, and I knew it for a while. But he just kept telling me he was fine.”

How to Support a Partner Who is Struggling with Depression

It’s not an uncommon feeling. You want to think you know your partner better than anyone. But depression can sometimes be lurking under the surface. Madeleine Wilson, a psychotherapist based in Albuquerque, New Mexico, says this is why it’s really important for couples to be open to discussing mental health issues.

“It’s a matter of normalization. Talking about mental health issues should be a part of communication within the family structure,” she says. “But it’s hard—because of the stigmas and taboos around mental illness.”

“But we need to find ways to have conversations with our partners about how we feel,” she added, “and ask our partners how they are doing when we suspect something might be wrong, and asking Socratic type questions that can get a deeper conversation going about what’s happening.”

Wilson also suggests that partners trust their guts and not automatically listen to the “fines” that family members who are struggling may give us.

“We typically know when there’s something up with our family member or our partner. But we often ignore those nagging feelings out of our own fears or apprehension or discomfort about talking about mental health issues,” she says. “But if you feel like something is up, point it out! Find a way to talk about it. Because your gut feelings about your family members are usually pretty accurate.”

Wilson says that starting a conversation with your partner about mental health isn’t always easy. Especially when your partner may be brushing off your concerns.

“If you’ve tried to talk and nothing is shifting, then you can say, ‘Look, I see you struggling. I’m really concerned about you. I see how hard this is on you. And it’s something that is also becoming hard for our family. I need you to consider finding someone to talk to about this and getting yourself some help.'”

She suggests using “I” statements that help make your own feelings clear as well as outlining clear, achievable goals. And making sure you clearly voice your support for your partner finding some help. Of course, if your partner is already so depressed that they’ve completely withdrawn from life, or are talking about suicide, it’s probably time to take your partner directly to the emergency room for treatment.

Sally wishes she had been more open to talking to Robert when she first started suspecting that he was having trouble coping—but now she makes sure they have regular conversations about his feelings and his mental health state. And they discuss her feelings as well.

“We check in with one another about how we’re feeling,” she says. “It gives me a better idea of what’s going on with him—and when I need to suggest that he check in with his therapist. Hopefully, it will keep us from getting to the point where things get really bad again.”