“Richard” (not his real name) lives in northern Vermont, reads this column in the Caledonian Record, and his wife of more than 30 years suffers from major depression.

A National Institutes of Health website says a person has major depression if they exhibit, for more than two weeks, five or more symptoms, such as: feelings of hopelessness, fatigue, dramatic appetite change, sleep difficulties, agitation, and withdrawal from activities. The exact cause is not known, but major depression affects about 18 million Americans annually. And it increases a person's suicide risk.

As for Richard, his wife “Mary” has twice attempted suicide. “The first time was in 1997,” he said in a telephone interview. “She was driving over 100 miles per hour, wasn't wearing a seatbelt and wanted to be hit. But she got home. She was on the verge of a nervous breakdown and couldn't stop crying.”

At first, Richard felt a  potpourri of emotion, including anger, hurt, self‑blame and betrayal. Looking back, he realizes now that his wife was “self‑medicating” her depression for years with alcohol–until the alcohol no longer worked.

“The second attempt was in 2004,” he said. “A series of events triggered it, including, in a one‑week span, her mother's death, a blow‑up with relatives and a grandchild's birth.”

This time Mary tried overdosing on prescription drugs. Richard sensed something was wrong in a telephone call and rushed home in time.

“To a spouse the act of suicide can be perceived as the ultimate put‑down,” said Richard. “But unless having experienced depression, you can't fathom the pain and despair they must feel, to the point that they have decided the only way to make the pain go away is to die.” Fortunately, Mary's depression has since lifted considerably due to loving friends, medication, and a psychiatrist's “talk” therapy.

So how does Richard cope? “I have my own therapist,” he said. “As the spouse I became angry (after Mary's attempts) because I suddenly had to make sure she got to appointments and took her medication. I also had to send off the family bill payments, keep the family functioning, and work. The anger built and built. It also was a manifestation of not being able to process all my emotions, such as hurt and betrayal.”

Richard strongly suggests that spouses of people with depression should learn more about it and seek help for themselves.

For more, see danieljvance.com or www.nlm.nih.gov.