How do I help DP with his depression?

[ShalomToYouJackie]

DP has had ongoing mental health issues on and off for the last 10 years. He's been on medication (Citalopram and Propranolol) for a year and is now on the highest dose for both. Hasn't worked for two years as he was having panic attacks regularly at work and any interviews he's had since, he's had panic attacks on the way there or the night before. His anxiety is much better, when it was really bad he'd regularly be in hospital as paramedics would think he was having a heart attack and his heart rate would be 130bpm but that hasn't happened at all lately.

His depression has become a lot worse in the last month, he's lying on the sofa all day and not moving. Unable to hold a conversation because he forgets what he's saying or just doesn't care. Can't focus on anything. Keeps saying there's no point in anything or that life is meaningless.

I'm trying my best to help him and be supportive but I'm finding it very hard to live with him and the constant negativity, I get up, get him out of bed, make sure he eats and has breakfast, listen to his negativity, go to work, come home, he's not moved, make sure he eats and then he sits in silence all night. Everything positive I say is shut down. He refuses to leave the house, he will only go outside if I make him.

I'm at the end of my tether now and I'm not sure what to do. He won't engage with any services to help him, he's just full of medication and doesn't move all day. He says he's not suicidal but I'm not sure if I believe him. He's got a list I made of services to contact, small things to do to help him etc but he won't do it.

Has anybody been through similar? What do I do? Is there anything I can do or do I just wait for him to want to get better?

There's not much you can do in a practical sense, it's entirely up to him to realise that not only is he ill, but he's not going to recover from it by spending the remainder of his life lying on the sofa.

Pushing and prodding him verbally is likely to just be met with irritation and, having been through this myself, make him feel an order of magnitude worse at that specific point, but you don't need to put up with this indefinitely if he will not seek help, or will not accept that it's not realistic to just sit around waiting for a miraculous recovery.

Depressions, especially milder ones, often do lift of their own accord in time, but the symptoms and behaviours you're describing, along with his medications, suggest that he's really in a pretty deep and dark place. It also sounds as if he's accepting of the fact he's ill, hence compliance with medication etc, but he doesn't sound like he has a particularly keen insight into his own illness.

Has he any reading materials on Depression, it's causes, common symptoms, coping techniques, treatments, recovery etc? Sometimes it takes a new source of information for a light to go on and a recovery to begin. I've often said that my own experience felt like I had to totally bottom out, i.e. hit rock bottom, before I realised that the only possible route from that point on was to get better, but the problem with deep depressions is they totally rob you of your objectivity, including the ability to see that it actually is possible to get better.

Perhaps he's at that 'rock bottom' right now. The issue is what to do to switch that light on and make him realise that he can get better. The things you're describing, 'life is pointless' etc, is totally familiar to me. The thing is, he has to realise and accept for himself that not only is that untrue, but it's unnatural to feel like that, and he has to figure out how to go about getting better.

The other thing that occurs to me is to ask about his engagement with professionals. Presumably he has been referred to and is being prescribed by a Psychiatrist and not just a GP?

His depression is way past the point whereby you'd expect it to be managed by a GP, and also, if he's on the maximum dosage of Citalopram and his depression still appears to be deepening, perhaps it's time he looked at a different medication.

GP's dish out SSRI's like sweeties, and while I've seen countless people who swear they helped with mild and short-term depressions, I've also seen umpteen people, myself included, where SSRI's were entirely useless in preventing or treating a profound depression. There are loads of varieties of SSRI out there, and there are also dozens of different atypical and non-SSRI anti-depressants, so, I'd suggest that if he's not being seen by a Consultant and possibly also a CPN, that he needs to be referred to one urgently, and if he is in contact with one, then perhaps it's time to have a conversation about potentially switching to an alternative medication and stopping the Citalopram.

@XdownwiththissortofthingX

Thank you for replying, I really appreciate it and I'm sorry you've experienced it yourself.

You are absolutely right, I've stopped lecturing him because I know it makes him feel worse and he's now completely ignoring his parents who are telling him to sort himself out.

I have stopped hassling him but then he says I don't care about him enough. He told me he was going to bed at 9 and I said ok, I was going to stay up and watch some TV and he said "thanks for caring about me then" and walked off so I'm not sure what to do, I don't want to leave him to it and have him feel unsupported but there's only so many conversations I can have where I put a lot of time and effort into finding resources for him etc and he just shuts it down.

He definitely thinks he can spend the rest of the life sat on the sofa, he flat out refuses to look for a job, won't entertain the idea of coming off his medication (his Propranolol has turned him into a zombie but I think he likes that and doesn't want to stop it). He doesn't seem to want to get better, he won't try any techniques or anything. I have to call the GP and make him have an appointment to discuss medication because he won't do anything.

He's definitely educated on depression, he's helped me get through it when we first met. I feel like because he's in such a low place, he doesn't see any way out of it. He's gained about 7 stone and he's really unhappy but also seems to have just accepted this as his new normal.

I'm very sorry, but you need to leave him before he completely destroys your life and your mental health. There is nothing you can do for him, and he clearly refuses to help himself. You can't fix him, op. You don't have a marriage, you are merely his caretaker.

He is only under the care of his GP and is on a 2 year long waiting list for psychotherapy. Unfortunately I can't afford to pay to go privately for any counselling as we are both living off my salary. He has a long history of mental illness, he was diagnosed with alcoholism, depression and anxiety 10 years ago and was prescribed Benzos at the age of 21 when under the care of his doctor in another country but became addicted and stopped those. He's been under the care of our GP but they just seem to chuck prescriptions at him and leave him to it.

He had a telephone appointment with a GP last week who made noises about switching him to Prozac but DP said he didn't want to change and the GP just accepted that. I'm not sure if I can ring the GP to discuss my concerns about him and get a plan put into place without the consent of DP?

Again, a lot of familiar themes in your reply.

I recognise the hostility in his manner, but I don't think you just have to sit there at take it because he has the excuse that he is ill. It means a lot to people with depression to hear that they are not being judged, they don't have to feel ashamed, and that their loved ones are there to support them, but at the same time, I think perhaps you might need to have a conversation with him about what he thinks is the likely outcome if this continues indefinitely. You need to be careful not to present it like a threat, or an ultimatum, but he needs to realise that he can't expect you to just sit around forever being his verbal punchbag and a target for his frustrations while he's totally unwilling to seek a recovery for himself. Perhaps you need to put it along the lines of 'what do you think will happen if this just goes on and on?', and if he simply shrugs or says he doesn't care, then that's perhaps the point to spell it out?. Everyone obviously wants to support their loved ones, but you have your own life and your own mental wellbeing to consider also. Again, you are under no obligation to put up with this forever if he continually refuses to try anything to change the situation.

I do not have any personal experience of taking propanolol, but my partner does use it for anxiety, and I can see that it changes someone quite profoundly. I certainly wouldn't want to be with someone who is using a significant dose every day of the week, so perhaps that's as big, if not more, of an issue than whether the Citalopram is actually doing anything or not.

I'm sure that you realise that it's utterly pointless to expect him to go job-hunting while he's in the grip of a profound depression. It's highly unlikely he'd be able to hold down any job for more than two minutes even if he were to find one, but I can totally understand if you are frustrated at his inactivity and feeling like your own life is on hold as a result. Again, that's perhaps something that you can feed into a conversation about what he thinks will happen long-term if he continues to refuse to try and recover. Just make it clear to him, as subtly as you can, that you have ambitions, needs, etc that aren't ever going to be fulfilled if he spends the remainder of his life lounging around on the sofa.

Been there. With someone who did all the ‘right’ things, medication, exercise, therapy. And it was so so hard to live with. I wouldn’t have stayed with him if he hadn’t. It was that simple. My health mattered too.

I tried to make sure I exercised, I did my thing, I kept on working and we got through it. I used a counselling service at work so I had somewhere safe to moan and rail.

But the best advice I got was on here. You have to take care of yourself as it’s bloody hard work

I'm not sure if I can ring the GP to discuss my concerns about him and get a plan put into place without the consent of DP?

There's nothing a GP can do without your DP's consent, and of course, they will not discuss particulars of your DP's health with anyone he hasn't given them prior permission to. That's absolutely no reason why you can't still contact them though to express your concern that his mood has taken a significant turn for the worse, that his medication appears to be insufficient, and although he hasn't expressed this himself, there's no reason at all to hide from them that you are also concerned that he might be at risk of harming himself.

You could possibly put this in a letter if you know which GP he sees regularly, and it might prompt them to call him and have a discussion over the telephone or something. If you are expressing concern about a potential suicide risk, that might also serve to prompt them into a MH referral. From what you are describing, I genuinely do not believe a GP alone is adequate to meet his needs, and I think he really should be talking to a Psychiatrist ASAP. If he's being referred for Psychotherapy, are you certain that he hasn't already been in contact with a Psychiatrist?

XDownwiththissortofthingX - completely agree. Depression can make people incredibly self-centred and selfish and this takes its toll on those around them, who get very little in return for their support. We do it because we love them and feel we can't be critical in case it makes things worse, but it can take its toll on your own mental health, so take care of yourself.

@XdownwiththissortofthingX@

I've tried to have conversations about the future, what he thinks will happen if he carries on sitting at home on the sofa not getting dressed but he shrugs are changes the topic. I've told him it's not fair on me, that he can't expect me to spend the rest of my life working to pay for us both, not see a penny of it and not ever do anything together because he won't leave the house. He just tells me "break up with me then" or "kick me out then". Sometimes he says OK, tomorrow I'll do X but will then put that off for weeks.

His Dad lives abroad but has also contacted him saying it can't go on and what does he think will happen if it carries on and he just ignores him. He's completely unwilling to think about the future and I'm not sure if it's because his depression means he doesn't see a future for himself or if it's because he just doesn't want things to change + he refuses to think about it...

I absolutely don't expect him to job hunt, I just want him to take steps to get better and for the end goal to be him healthy and working. However he flat out refuses to get a job in the future. He says he's too anxious and he can't do it. He did 3 days of a job at the beginning of a year and had a awful panic attack on the bus on the 3rd day on the way there and now refuses.

Mental illness aside, he gets his rent and bills paid, food cooked for him, things bought for him, all mental load done by me i.e knowing when to pay bills, all money management and general life organisation, why would he want that to change?

I've tried to address this before, i.e saying right you can sort out the bills with me this month but it just doesn't go in, he gets really confused, doesn't know what to do even if I show him and just doesn't do it and so bills won't get paid.

I had to leave my last job because he was calling me everyday during work having panic attacks or he'd call ambulances thinking he was having a heart attack and I had to keep leaving work. I've just started a fantastic new job a few weeks ago and his mental health seems to have deteriorated more since then. I'm in 3K debt because I'm struggling to pay for everything on one salary.

He's definitely only under the care of his GP, he was referred for counselling and that organisation did an assessment and said his mental health issues were too severe for them so he got discharged and referred to a psychotherapy service but it's 2 years to be seen by anyone so we've not had any contact from them and that's that. He's just been left to it.

I'm going to contact the GP on Monday I think.

Sorry for rambling on

Oh god, that had paragraphs when I typed it

@Aquamarine1029

I'm very sorry, but you need to leave him before he completely destroys your life and your mental health. There is nothing you can do for him, and he clearly refuses to help himself. You can't fix him, op. You don't have a marriage, you are merely his caretaker.

I don't feel I can leave him when he is this unwell, he would have nowhere to live, no money, he has no friends. When he was well, our relationship was fantastic and he is the most caring, thoughtful and funny man. I feel a responsibility to get him better :(

This is severely affecting your life, your livelihood and your mental health.

Sometimes its hard to see the wood for the trees when you are in the middle of something like this. What is you support network like? For both of you and just you?

I've been there, and in the end I had to leave. I was young (in my 20s) and just didn't want to spend the rest of my life as his carer, whilst throwing away any chance I had of a happy life, marriage, children. Worry about what would happen to him made me stay longer than I would have. He moved back to his parents and of course recovered in time.

I have pulled myself out of a few of these holes over the years. In my 20’s and 30’s with the help of professionals and in my 40’s putting everything into practice I have learned.

The problem now with him is probably severe overwhelm and loss of hope. He won’t know where to even start unravelling the mess in his head and life. It’s a horrendous feeling, and extremely difficult to overcome when you have lost the will to fight. It’s all too easy to let the meds numb everything so you don’t have to face it.

My depression and anxiety was resistant to 20 plus years of CBT and medication, but the turning point for me was being introduced to The Decider www.thedecider.org.uk/ (Books can be bought on Amazon)
And in more recent times starting a “daily gratitude journal” you can buy them “for men” on amazon. (Might not be as useful at this stage but perhaps later down the line. It really helps me keep focused on the positive and it completely flipped my deep-ingrained negative thought-pattern habits in a very short space of time).
I also find that guided meditations off YouTube and getting out in nature to be very helpful in keeping my anxiety at bay.

I suffered panic attacks to the point I became housebound for years and have been suicidal twice. I needed intervention from crisis teams, it was no mean feat to overcome but I am now medication-free and able to go out whenever I like, so I know it can be done!

His depression won’t be fixed overnight as I’m sure you’re aware, but it can be reversed if DP wanted to but sadly it sounds as though he’s given up and got very comfortable in his “safe zone” having everything done for him and supported by you.

If he is unwilling to seek and accept any help then personally I think I’d be starting to get my ducks in a row. This is no life for any of you. Perhaps it would be the jolt he needed to address his problems?
Whilst someone is willing to enable his situation then he really has no motivation to get better. That is not meant to blame you in any way, most people would do what you are doing. Its just a no-win situation for you at the moment so if you could even just have a break and let him know you’re still there but you cannot continue to watch this unfold because it’s affecting you too much. Do you have kids? Are they watching this all unfold?

You mentioned he was diagnosed with alcoholism 10 years ago - does he still drink?

I really think you need to start looking at yourself and your needs.

Something is underlying his depression but only he can figure out what. Nothing will change until he does this and it looks like he is unwilling to start... Leaving him may be the catalyst for this process, as hard as it sounds :(

Thank you everyone. I have been off work this week looking after him + he seems better but desperately doesn't want me to go back to work.

feel a responsibility to get him better :(

You can't do this, only he can take on this responsibility.

I've experienced living with someone who had depression and did everything needed to manage it and it was still very difficult.

It isn't reasonable to expect you to become an out of work full time carer.

I would suggest you seek counseling for yourself where you can look at why you are staying in this relationship.