When depression strikes, it can take a heavy toll on even the most loving relationships. Yet while antidepressant medication is often seen as the go-to treatment, research shows that for mild to moderate depression, drugs alone are often not effective.1 The good news is, couples therapy has emerged as a powerful tool for not only lifting the cloud of depression, but also revitalizing the relationship in the process. By working together in therapy, couples can gain insights, learn coping strategies, and forge a deeper connection that enhances both mood and marital satisfaction.

The intertwined nature of marriage and depression

Mental health professionals recognize that the state of one’s marriage and depression are often closely linked. Being in a distressed relationship is a major risk factor for depression, with studies showing that people in troubled relationships are three times more likely to be diagnosed with major depression.2

At the same time, depression itself can fuel marital strife, leading to a vicious cycle. For example, a depressed spouse may withdraw emotionally, leaving their partner feeling isolated and resentful. The non-depressed partner then feels caught in a no-win situation – criticized for not being supportive enough, yet pushed away when they try to help.

The power of couples therapy

This is where couples therapy can break the impasse. By providing a safe space for open, honest communication, a skilled therapist can help couples gain a new perspective on their relationship dynamics and how they may be contributing to depressive symptoms.

One of the key insights couples gain is that many of their problems are actually quite common and solvable. In fact, renowned relationship expert Dr. John Gottman found that 69% of relationship conflicts are perpetual – stemming not from a lack of love, but from differences in personality or lifestyle needs.3 Just knowing this can be tremendously relieving for couples who felt their situation was hopeless.

Equally, even having a Gottman assessment to examine your relationship strengths and struggles was proven effective in one recent study.4

Specific interventions used in couples therapy for depression include:

  • Learning communication skills to share feelings constructively without blame or criticism
  • Behavioral changes to show affection and break patterns of withdrawal and hostility
  • Gaining greater acceptance and appreciation of each other’s strengths
  • Creating shared goals and a vision of a more supportive, fulfilling relationship

Remarkably, these strategies have proven effective even for severely depressed individuals, particularly women. One study found that the more severe the wife’s initial depression, the more her symptoms improved with couples therapy.5

Small changes, big impact

While healing a relationship and overcoming depression is a gradual process, small shifts can spark a positive cycle. For example, something as simple as a daily 10 minute conversation focused on understanding and appreciating each other can increase emotional intimacy. Or scheduling more shared activities the couple enjoys can provide an uplifting sense of connection and fun.

As couples feel more supported and satisfied in their marriage, depressive symptoms often naturally start to lift. At the same time, a stronger relationship provides a crucial source of coping and resilience when the next wave of depression hits. Research5 has also found that a woman’s satisfaction with her romantic relationship is linked to depression levels in both partners. This connection seems to be influenced by how much the woman feels her partner is accessible, responsive, and engaged in the relationship. In other words, when a woman perceives her partner as being more present, attuned to her needs, and actively involved, she tends to be more satisfied with the relationship. This relational satisfaction is in turn associated with lower depression levels for both the woman and her partner.


In the face of depression, there is hope. By equipping couples with insights and skills to build a more loving, accepting relationship, couples therapy offers a pathway to both alleviating depression and preventing relapse. Rather than just treating symptoms in isolation, it empowers couples to tend to their own mental health and that of their relationship. With compassion and commitment, spouses can emerge from depression as a stronger, more united team, ready to face life’s challenges hand in hand.


  1. Kirsch, I., Deacon, B.J., Huedo-Medina, T.B., Scoboria, A., Moore, T.J., & Johnson, B.T. (2008). Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration. PLoS Med, 5 (2), 45.
  2. Whisman, M.A. (1999). Marital dissatisfaction and psychiatric disorders: Results from the National Comorbidity Survey. Journal of Abnormal Psychology, 108, 701–708.
  3. Gottman, J.M. (1994). Why marriages succeed or fail. New York: Simon & Schuster.
  4. Gray, T D., Hawrilenko, Cordova M., J. V. (2020). Randomized Controlled Trial of the Marriage Checkup: Depression Outcomes. Journal of Marital and Family Therapy 46(3): 507–522.
  5. Novak, J. R., Sandberg, J. G., Davis, S. Y. (2017). The Role of Attachment Behaviors in the Link between Relationship Satisfaction and Depression in Clinical Couples: Implications for Clinical Practice. Journal of Marital and Family Therapy, 43, 352–363. doi: 10.1111/jmft.12201