One in five people will experience a form of depression at some point in their lives [1]. If your partner is depressed, you can play an important role in helping them get better. Depression is more than just a low mood. It’s a prolonged illness, whose symptoms include a lack of energy, a loss of interest in things you might normally enjoy, feelings of low self-worth, and changes in sleep and appetite [2]. A sudden onset of depression in your partner can have an impact on your relationship. You may have to take on a temporary caring role, which can put unexpected strain on you [3]. Some of your partner’s symptoms can affect you too: Low mood. When your partner is feeling down most of the time, it can feel like you don’t have access to the person who is most important to you. Loss of interest and energy. Your partner may lose interest in the things you like doing together, like going out, cooking, and even sex. Concentration. Depression can affect concentration, even to the extent that your partner struggles to stay involved in a conversation. Sleep and appetite. You may notice changes in your partner’s eating and sleeping patterns, which can affect their mood even further. It can also disrupt your own eating and sleeping as established routines get lost. Low self-worth. You may notice your partner being more critical of themselves and possibly lashing out at you too [2]. You may also wonder if you are responsible for your partner’s mental health problems. While there are sometimes external causes, including relationship problems, depression can often come along out of nowhere [4]. You can play a positive role in your partner’s recovery [3]. One of the first things you can do is notice the signs of depression and encourage your partner to seek help. Often, the quickest route to support is through your GP, who can make a diagnosis and refer your partner to appropriate support. There are many forms of mental health support, but it’s likely that your partner will undertake some form of talking therapy. They may be given exercises to take home. You can offer support by encouraging your partner to complete the exercises or, if appropriate, by getting involved directly. Your partner’s doctor may recommend couples therapy, which has been shown to be effective for people with depression [5]. If this is recommended to your partner, it doesn’t mean that your relationship is in trouble; it just means that you are being asked to get involved in your partner’s recovery. Attending sessions together means you can be better informed and more involved. Whether you are directly involved in your partner’s treatment or not, there are many ways you can be supportive: Encourage them to seek support. Getting your partner into professional support is one of the best ways you can help. Learn about depression. Read up on depression and its symptoms. A good place to start is the OnePlusOne and NHS guide, ‘Depression and low mood: A guide for the partner’. Set aside blame. Accept that the illness is happening, and don’t blame your partner or yourself. It’s here, and it’s treatable, so just focus on recovery. Notice the signs. Be aware of your partner’s symptoms and the things that can set off an episode of depression. Get support if things seem to be getting worse. Solve practical problems. When someone is depressed, problems can be magnified and may seem insurmountable. You can help your partner by solving practical problems, which could be as simple as doing more than your share of housework for a little while. Listen more. Clear communication and active listening can help your partner to feel better supported and more in control. Do some exercise. Help your partner to get some gentle exercise, even if it’s just a walk around the block. This can have the added benefit of helping with sleep problems. Get your partner out of the house. While it might seem easier to avoid social situations, it’s often best to try and turn up to things that they would usually enjoy. Even if you plan just to go out for half an hour, you can help your partner break out of the loop of depression and inactivity. Notice what helps. What usually makes your partner feel better – a morning walk? Cooking a healthy meal? Make a note of what works, and encourage your partner to do more of it. Keeping a mood journal can also help you to show your partner that they have been making improvements, as they may find it hard to focus on the positives [6]. Seeing a partner go through depression can be upsetting but, with the right support, even the most severe cases can be treated. As with any illness, you should seek professional help if you are worried. Recovery is likely to be gradual, but it is possible, and you can play an important part. This article gives just a quick overview of how you can support a partner with depression. For a more in-depth look, we recommend reading, ‘Depression and low mood: A guide for the partner’, co-produced by OnePlusOne and Northumberland, Tyne and Wear NHS Foundation Trust. References [1] Bolton, J., Bisson, J., Guthrie, E., Wood., S. (2011) Depression: key facts. Retrieved from http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/depressionkeyfacts.aspx [2] NHS (2015). Low mood and depression - NHS Choices. Available at http://www.nhs.uk/conditions/stress-anxiety-depression/pages/low-mood-and-depression.aspx  [3] Crowe, M. (2004). Couples and mental illness. Sexual and Relationship Therapy, 19:3, 309-318. [4] Hickey, D., Carr, A., Dooley, B., Guerin, S., Butler, E., & Fitzpatrick, L. (2005). Family and marital profiles of couples in which one partner has depression or anxiety. Journal of marital and family therapy, 31(2), 171-182. [5] Bodenmann, G., Plancherel, B., Beach, S. R., Widmer, K., Gabriel, B., Meuwly, N., ... & Schramm, E. (2008). Effects of coping-oriented couples therapy on depression: A randomized clinical trial. Journal of consulting and clinical psychology, 76(6), 944. [6] NICE (2009) Depression: The Treatment and Management of Depression in Adults (Update). NICE clinical guideline 90. Available at www.nice.org.uk/CG90.

One in ten pregnant women experience mental health problems, and often go undiagnosed until after the baby is born. The pregnancy and parenting charity Tommy’s has produced a video encouraging pregnant women to seek support if they feel anxious or depressed. The short clip follows the story of a woman’s journey through pregnancy as she realises she’s not coping and finds someone to talk to. Around 10-15% of pregnant women experience mental health problems like anxiety and depression [1] but, despite antenatal depression being very similar to postnatal depression, many go undiagnosed and untreated until after the baby is born. Symptoms of anxiety and depression can include feelings of sadness, hopelessness, irritability, and losing interest in activities that used to be fun. Most women feel more emotional than usual during pregnancy, but the video urges you to seek help if you notice that you’re unhappy more than half of the time, or if feelings linger for more than a couple of weeks. When you’re pregnant, it might seem like there’s a pressure on you to feel happy all the time, or to be flushed and glowing with the joys of impending motherhood. If this doesn’t describe your experience, it can be quite distressing and you may even feel guilty for not living up to the expectations of those around you. Your midwife or health visitor will understand. Speak to them and let them know that you need support. You partner, family, and friends can also offer support, by talking things through with you and offering practical support. Let them know you’re not feeling yourself and that you might need some extra support. If you can, hand some of your regular chores over to your partner, or ask someone to help out. Friends love to feel like they are helping, but sometimes need to be given specific tasks like popping to the shops or watering your plants when they come over. Try to eat as healthily as possible, take some gentle exercise, and rest whenever you have the opportunity. Getting regular sleep can have a positive impact on your mood. Take time out to focus on yourself and do something you enjoy. Allow yourself a chance to relax and ease some of the pressure. If you are worried about other areas of your life, such as finances, housing, or your relationship, look into the support available for these specific issues. If you can keep external factors under control, you may find it easier to cope with whatever feelings you are juggling. Keep talking to your partner. Help them to understand what you’re going through, what you’re doing to try and make things better, and what kind of support you need at home. References [1] National Institute for Health and Care Excellence (NICE) (2014). Clinical guideline 192: Antenatal and postnatal mental health: clinical management and service guidance https://www.nice.org.uk/guidance/cg192 (Accessed July 2018) [2] Howard L.M, Molyneaux E, Dennis C et al (2014).  Non-Psychotic mental disorders in the perinatal period.  Lancet 384: 1775-1788.

When people on Facebook list their relationship status as “it’s complicated”, you may wonder what could be so complicated about it. You might think someone's either in a relationship or they're not but, for many young people, it’s not necessarily so straightforward. Although monogamy – an exclusive relationship with one partner – is still considered the norm, more casual relationships are increasingly common for adolescents. When someone says “I’m in a relationship”, there’s a good chance you’ll picture two people in a steady, sexually exclusive relationship. And you wouldn’t be alone with that assumption. One study showed that, despite Western society becoming ever more permissive and accepting, monogamy is still considered to be the most desirable and ‘normal’ way to engage in a relationship [1]. So, what’s the problem? Well, monogamy being placed as ‘the normal thing to do’ can mean that anyone choosing a non-traditional form of relationship, such as polyamory (multiple partners) or an open (not sexually exclusive) relationship may feel marginalised by or excluded from sex and relationship advice and education. They may feel stigmatised; and many experience rejection or bullying from peers, and disapproval from parents. It can be confusing for people who don’t know how to classify their relationship, which could be a problem for an increasing number of young people today. Even though monogamy remains the ‘ideal’ for many in society, other relationship types have become much more common over the last 20 years or so. One study [2] states that ‘recent research on adolescent sexuality finds that casual relationships appear to be gaining acceptance among heterosexual emerging adults’. An example of a casual relationship would be a ‘friends with benefits’ setup. This is when two friends agree to have casual sex with no strings attached and continue to define their relationship as friends rather than a couple. A study from New Zealand [3] into how young people define a relationship showed that definitions are just not that clear cut. The researchers discovered that it depends on a vast multitude of factors including: How much time the couple spend together. Emotional investment in each other. Decisions made about whether it is OK to sleep with other people. These considerations all contribute to defining a relationship in different ways. Boundaries can be blurred, making many relationships difficult to categorise – even for the couples themselves. Categorising or labelling your own relationship could be an even more daunting task in a society which holds monogamy up as the right way to be. Should we be concerned about the increasing informality of young people’s relationships? While young people are not necessarily having more sexual partners than previous generations, they are revealing a very different, more informal approach to relationships. One sociological study [4] describes how these casual arrangements can be a stepping stone for young people who are exploring what it means to be in a relationship. They suggest that young people often progress steadily from short, casual relationships towards a single long-term relationship. So, although young people are taking a less traditional path, they tend to end up at the same destination as the generations who have gone before. In the meantime, these young person will still need support dealing with their current, more complicated relationships. After all, relationships are confusing at the best of times, even without all these extra factors to consider. Communication is essential to understanding and navigating these shifting types of relationship. A professional supporting young people with sex and relationships should remember that relationships can be more complex than they first appear. And couples should feel able to talk to each other about their relationship: Where is it going? Are we exclusive or not? Do we present ourselves to others as a couple or as friends? Being able to talk about the boundaries of a relationship can remove some of the uncertainty from more casual encounters. As non-traditional relationships become more common, these conversations become more important. Accepting that relationships can be diverse, and being willing to talk about different kinds of connections beyond monogamy could prove instrumental in helping young people navigate the ever-shifting boundaries of what it means to be in a relationship. References  [1] Moors, A. C., Conley, T. D., Edelstein, R. S., & Chopik, W. J. (2014). Attached to monogamy? Avoidance predicts willingness to engage (but not actual engagement) in consensual non-monogamy. Journal of Social and Personal Relationships, 32(2), 222-240.[2] Williams, J. C., & Jovanovic, J. (2014). Third Wave Feminism and Emerging Adult Sexuality: Friends with Benefits Relationships. Sexuality & Culture, 19(1), 157-171.[3] Allen, L. (2004). ‘Getting off’ and ‘going out’: Young peoples conceptions of (hetero)sexual relationships. Culture, Health & Sexuality, 6(6), 463-481[4] http://onlinelibrary.wiley.com/doi/10.1111/j.1533-8525.2009.01142.x/abstract;jsessionid=23182CC55EC031A3A0759B75F9A48731.f02t02