I think medication is a HUGE part of the equation. Possibly more so in some than in others. For my dh, it is huge! D runs in his family. There is definitely a biological component there. It is amazing the change the right meds made!

I think for fallout sufferers though, we need to figure out how to live with our spouse or partner when d is in the picture. We need to focus our energy on ourselves during their d. We shouldn't spend all of our time trying to "fix" them. Support them yes..."fix" them no. They need to do that themselves. Chances are that d will be a recurrent part of our lives. We need to acknowledge their feelings. I'm not sure it is denial that keeps them from getting help, it is just that their view of life is so different now. My dh can't remember ever being happy when he is depressed. He thinks the way he feels during d is how he has always felt. He is confused when I tell him he was happy before...he just can't remember any happiness. He thinks his anger & unhappiness is a personality flaw or someone else's fault. He does seek help, but doesn't always believe he can be happy or ever feel better. He seeks help on the off-chance that the books, doctors & I just might be right. I think he feels he has nothing to lose & even as irrational the thought of him finding happiness is to him, he figures if we are right, he has a lot to gain.

My dh has had bouts of d for over 20 years now. His most recent MDE is ending...but I am realistic...it will most likely recur. When it does, I will focus on myself. I will also support him in his attempts to feel better. I will remind him of his past struggles as well as his past happinesses & successes in battling d whenever he needs it. BUT he will need to take whatever steps needed to get well...I learned long ago that I can't do that for him. I actually told him this time I certainly could do all the work for him...make the appointments, read the articles, make sure he takes the meds, do whatever it takes for him to get well...but that if I did everything, it wouldn't work anyway. He needs to do these things & want to feel better...for himself, not for me or anyone else.