How do I help my depressed DFil if he won't help himself?

[MsAdorabelleDearheartVonLipwig]

DSil and I are trying to help DFil manage his depression. He lost a much loved job a few months ago and on top of losing his wife two years ago. He's clearly depressed. He shakes, he can't eat or sleep very well, he's having paranoid delusions that the world is out to get him. He won't go out, he doesn't want us there, he's lost interest in hobbies.

She managed to get him to see a doctor and he's been on medication for about three weeks. He can't see the point in taking it but we have told him it takes a while to kick in, he's just got to learn to be patient.

Dh and DBil, his sons, work a lot and have families of their own. They want to help but are both also slightly frustrated at him not wanting to help himself. They say he's always been the centre of attention and felt sorry for himself. They have seen over the years how he's always put himself first, and been enabled by DMil who unfortunately was a bit of a martyr like that. She did everything around the home because it was 'women's work' and he hardly lifted a finger. Now he's struggling on his own. Whilst he had his job to keep him occupied he was fine.

They say he has to want to get better and I agree with them. Unfortunately he's so used to feeling sorry for himself that he can't see how to help himself. DSil and I are both sahm's so we do have the opportunity to go and help with stuff but she has a toddler and a baby and I have a puppy in the house at the moment as well as school run etc and am a bit tied up for a couple of weeks or so.

We have a lot going on at home at Dh and I aren't always able to just drop everything at his request. He does eat at ours once a week and DBil & DSil's once a week so he does at least come and see his dgc and we can see how he is.

I feel that we should do more but every offer of help is met with doom and gloom and is thrown back.

I would really appreciate some advice. I don't want to leave him like this. Dh is stressed enough with work as it is and I can't leave it all to him.

[NanaNina]

You sound like a lovely DIL incidentally. Loss of some kind (not necessarily bereavement) is almost always the root cause of depression. I'm slightly concerned about these "paranoid delusions" and him thinking the "world is out to get him" - I know this sounds like a delusion and maybe it is, but it may be just a way of him saying that everything is going wrong for him.

I suffer from intermittent depression which can be severe at time and it is an absolute torment and impossible to describe to anyone really. I honestly think you have to be unfortunate enough to have experience of this illness before you can understand it at all. The things you say about your FiL are all classic characteristics of depression - I know everyone's depression is probably different but most of us feel empty, flat, have no motivation/interest in anything, often feel worthless and it's almost like a stranger has taken over your mind and that's very scary. I think people who are frustrated that he "won't help himself" are unhelpful because the one thing that depression does is stop us from helping ourselves for much of the time. OK - some people can somehow find the motivation to go for a walk, try to distract themselves, eat healthily etc and this is of course "helping yourself" but there are times when I can barely get out from under the duvet and just want to hide away from the world and like your FIL at those times I don't want to go out or see anyone (only my DP) In fact I hate anyone seeing me when I am very depressed.

As for "wanting to get better" - depression has another trick up it's sleeve for us - it convinces us that we never will get better so it may not be a case of not "wanting to get better" who in god's name would want to feel such a wretch, may be more a case of just not believing it's possible.

I wonder if your FIL is actually taking the meds - many people feel they are a failure for taking ADs and men especially I think are reluctant to take medication, so it may be worth checking that out. They do take a while to kick in but he should be feeling some improvement 3 weeks in, but he's probably been started on a small dose and it will need to be increased and ADs act differently on individuals and sometimes you have to try different ones before you find something that suits.

Maybe it's best just to do things for him for the time being, rather than offering to help, maybe be a bit directive "I'll come and take you shopping on Thursday" or something similar, or try and get him out for a short walk. Offers of help will be met with doom and gloom because we can't see any hope in anything, "what's the point" - the whole thing is futile - we don't believe we will ever get better. What age is your FIL by the way. You say he "lost" his job - was he made redundant or was there another reason - is he depressed because he lost his job or the other way round - just wondered.

Maybe have a look at the MIND website - there's a plethora of information on there about depression. So glad he has a lovely daughter and you! Women are so much more compassionate than men!

[MsAdorabelleDearheartVonLipwig]

That's so lovely of you to say, thanks so much for your response. I have absolutely no experience of this at all. My parents died years ago and I only ever had one grandparent so I have no clue how to help a distressed older relative, let alone someone suffering from depression.

We can definitely be more proactive, and in fact DSil has been quite determined in her efforts to help him. I'll tell her what you said about how it really does seem so bad, she is beginning to get fed up of him not making an effort.

He lost his pheasant shoot. He had been gamekeeper on the farm for over forty years, for two different families. That farm was his life and his love and it kept him going after DMil died. Then it changed hands last year. The previous owner let him have the shoot for himself before the shooting rights transferred to the new owner. For the first time in his life he was in charge and he was overjoyed. He had his own birds, his own shoots and all his own friends and acquaintances over. We all assumed that it would carry on as we had been told that the new owner didn't want the shoot for himself. We made plans for leasing it from the new owner.

Then they told us that not only were they not interested in running it for themselves, they didn't want any shooting there at all and he could pack his stuff and leave.

He was devastated. It meant so much to him. He knew that land better than anyone alive and he loved it. Now he can't go there anymore. I miss the place too but I can't imagine how he must feel.

Now he's got time to sit at home on his own and think about things and it's all got on top of him.

He's says he's taking the meds but we don't know for sure. If you think they should have had an effect by now I'll check with him.

DSil is speaking to the doctor this week. She couldn't really explain in front of him but he's convinced his neighbours are spying on him and have been in his house. He thinks they're going to take his shotgun licence away because he's ill. He thinks they're keeping a diary of his movements. His licence renewal has just come which doesn't help, he thinks he won't get it renewed. He thinks the firearms officer will arrest him because he hasn't filled in his licence application yet. This is all nonsense. And his neighbours are lovely and would be mortified.

This is all going round and round in his head whilst he sits up there in his house all by himself. Meanwhile we are miles away leading busy lives. I feel useless.

Gosh that was an essay. Thanks for reading.

[MsAdorabelleDearheartVonLipwig]

Sorry I mean DSil couldn't explain to the doctor about the paranoia when she took DFil to see him as DFil sat there with her.

[NanaNina]

Oh the poor man - that's some loss - small wonder he's conked out. I am quite concerned about your FILs delusions. I don't want to alarm you but to be honest it sounds like more than depression, as that is a mood disorder not a thinking disorder. It could be that your FIL is having a psychotic episode (as in being out of touch with reality) and will probably need to be referred to a psychiatrist for diagnosis and treatment. It's a bit odd if he's never suffered from a psychotic illness before in his life, but he is certainly having deluded thoughts isn't he. I'm not sure why your DSIL can't talk about the thoughts her dad is having with the GP with her dad being there. In fact I think it's the only way because the GP will need to assess your FIL to know whether he needs a referral to a psychiatrist. GPs can usually only diagnose depression and anxiety.

I think it's really important that your DSIL and her dad get to see a GP ASAP and she tells the GP about her dad's worrying thoughts. She doesn't have to use words like paranoid delusions, but she can say he seems to be having some strange thoughts and believing things that aren't true (about his neighbours) It could be that he has just become very confused and overwhelmed with the loss but I think he needs to be assessed sooner rather than later.

[NanaNina]

Sorry I should have said that it IS possible to have delusions of some kind when depression gets very severe but it still needs checking out with the GP.

[MsAdorabelleDearheartVonLipwig]

She's having a chat on the phone with the doctor on Wednesday and DFil has a follow up appointment on Friday. Sorry, probably didn't make it clear but he is her DFil too, her dp and my Dh are brothers - his sons.

If you don't mind I will show your reply to her. It's very kind of you to help. I'll paste it into a message so she doesn't know my username. She said she felt bad trying to explain that his - to him - very real fears are just paranoia, in front of him. She felt that perhaps by not explaining all her fears she wasn't being clear on it all so she wants to speak privately to the doctor.

I'm sorry if you're feeling like this. It's awful watching him. I hope you manage to feel better. Do you think you will overcome this?

[MsAdorabelleDearheartVonLipwig]

He's getting worse. When I went round on Tuesday he said he'd felt groggy that morning and it was because his neighbours had somehow got into his house and poisoned him.

I took him to the doctors myself yesterday. After him telling us his neighbours were trying to kill him, he told the doctor he was fine. I had to prompt him to be straight with her. In the end I had to tell her myself. She's upped his dose of ad's but I am worried he's not taking them.

The firearms officer took his shotguns away. Said he had to. He was ever so nice about it but it's another blow for DFil.

DSil said he's very bad today. Shaking, weak and confused. He clearly hasn't got any appetite an isn't eating. He's not doing any housework or washing his clothes. I think there needs to be an intervention. DSil is taking about getting him into hospital. Sounds a bit extreme to me. I was thinking of hiring him a home help of some sort. Not just a cleaner but someone used to people with health problems. He's like a demented little old man. I just can't believe it's the same man.

[MsAdorabelleDearheartVonLipwig]

Well nearly a month on and things are worse. The doctor changed him to Mirtazapine (sp?) as the previous stuff clearly had no effect. I wonder if he's even taking them. He won't drive now, he's too frightened. He thinks the police are watching him. He says he's done things in the past and he'll be arrested if he goes outside. It is an effort to get him to the doctors. He swears all the way there that it's a waste of time.

I'm struggling to be very sympathetic to be honest. He's always been a complete and utter narcissist and now he's got the perfect excuse to be self pitying and feel sorry for himself. He is bloody hard work at the moment. I wouldn't dream of saying anything but he is the worst person to be suffering with this. The world has always revolved around him. He is the most self centred, self important, opinionated, arrogant person I've ever met in my life and now we're all supposed to feel sorry for him? A friend of mine, not much older than me, married with two kids with SN, is dying of cancer. Him I feel desperately sorry for. DFil, not so much at the moment. I feel bad about it but there you are.