When depression never seems to end

[Aiming4Optimistic]

Hi all,
My dh had a breakdown about 18 months ago - it was sparked by him making a bad decision, that knocked all the confidence out of him. Since then, he's been on medication (with seemingly no effect, despite trying lots of different ones) and is seeing a therapist (for EMDR - again with seemingly zero positive effect). There's no sign of any improvement - it's like he's lost his ability to think, to plan effectively. He's a different person - a shell of his former self.
My question is how does a person ever find out the true root cause - is it always a guess at best? And what do you do when nothing seems to work?
Im trying to be supportive, but I'm at a loss - I don't recognise this person who needs constant propping up and it's wrecking my family. The whole household is struggling because of it and I feel like I'm failing my kids because my attention is so divided and I'm under pressure to parent, keep working (job is insecure).
All advice would be much appreciated .

I really feel for you OP. My husband has periods of depression and I definitely go through phases of resenting for it but it’s different to your scenario as he has always had up and down periods and I married him being fully aware of it (albeit perhaps not understanding fully how it might affect our ability to parent together well, but anyway….)

The first thing I want to ask is that, as well as therapy and medication, is your DH doing the absolute basic things that can make such a difference to mental health: routine, sleep hygiene, good food, hydration and proper exercise three times a week. I would start to really push him on this, if not.

You say you don’t recognise this person, which I understand. Can you say any more about the mistake? Was it something that cost Him a lot financially, or in terms of career success? I’m wondering if he needs forcing into taking on responsibility again in some area of your life?

You sound as if you’re feeling less sympathy as you feel undersupported yourself. Does he have any understanding how much you’re doing for him? What would happen if you pulled back a little ? Maybe that would be positive as he’s be forced to act (and make a plan etc)

Hi, thanks for the reply. I'm trying to get him to do things which are out of his comfort zone because I think he needs to remember that he's an intelligent, capable person.

He is doing exercise etc.
I guess where I'm struggling is that I thought I knew him but I don't have any real explanation of where this has all come from. I mean, it doesn't just happen out of nowhere, so obviously the potential for it was bubbling in the background and then he tipped over the edge.
But where do people go when there's no sign of getting happier?

How long have you been together? I agree these things tend not to be a total personality transplant… Does he have any history of low mood, eg back as a teenager or before you met?

18 months isn't that long in depression treatment or management. You mentioned he's tried lots of different medication which sounds counter productive. Was that hyperbole? If not, if he's hopping from one med to another without allowing for a period of adjustment and increasing the dose to a therapeutic level that works for him, then it wouldn't be surprising that he hasn't found something that works yet. In 18 months I'd expect someone to try two or three medications, maximum. The side effects are often disruptive on an introductory dose but the patient needs to dig in and see how they are once they're on a proper dose.

You say he's seeing a therapist for EMDR, is this for PTSD? Has he had any talking therapy, any CBT?

I understand your position and how hard it is. I hope you have a support network you can lean on. In the meantime, your other half may need to stick to one medication for a while and access alternative therapies unless the root cause of his depression is PTSD.

You have my sympathy as i have been through similar with dh.
I have an idea where his depression originates but he will never tell me. particularly when unwell. I don't think he can admit it to himself.
I guess what I'm saying is you may never know and finding ways to support him may have to be done without understanding.
Is your dh doing much to help himself?

He's doing some CBT I think - the therapist is trying to find things to help, but so far nothing seems to be happening. He's had 4 types of anti depressant - tried them all for a decent period of time but none have helped. He hasn't had negative side effects to taking them either, as far as I can tell. It's like he's been taking smarties. I would have expected some mood uplift within a couple of months of taking a medication, but there's nothing.

The psychiatrist said it's situational depression but even if that's the case, what do people go to get out of it?

Sleep is a problem - he tries (and has medication to help) but sleep quality is low and he doesn't sleep for long, so he's always tired, which isn't helping.

Tbh, I'm losing faith in the doctors - it feels like they are just guessing and have no more clue what to do than I do!

OP, what’s the situation? You mentioned a mistake. With some detail we might be able to give more targeted advice eg what kind of therapy might work best

We've been together for 30 years. No real history of depression apart from one incident when he was much younger - he had a boss who was a bit of a bully, but Dh changed jobs and was fine again. He's always been a bit moody I suppose - had a temper which could flare (no dv or anything like that, just the odd explosive row).

I miss the person who was competent, reliable and independent. I sound like a selfish cow here, but I'm struggling - my house lacks all joy right now because we are all so stressed out.

He made a bad career choice, which has had far reaching financial implications. But I'm thinking it must go deeper because there's no resilience or bounce.