In our particular case - she was a horse girl and earned a veterinary degree. When she started seeing our wonderful collie as a burden, she finally realized som

In our particular case - she was a horse girl and earned a veterinary degree. When she started seeing our wonderful collie as a burden, she finally realized something was seriously wrong. That understates what happened. She started wishing the dog would just go die. That finally brought home to her that her thinking had dramatically changed and that it wasn't just situational, e.g. it wasn't that I was lazy. This is incredibly specific to our situation and I'm sure it doesn't help anyone else. But the takeaway for us was that she had a come-to-Jesus moment that made her realize this was her problem, and she needed outside help. She did not realize she had clinical depression until that moment. It helped that I was in graduate school and had a very supportive set of people around me. They valued me and let me know it. As stated elsewhere on this thread - there aren't a lot of support options available for men in this situation.