Partner is having a serious mental breakdown and I don’t know what to do

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My partner is an incredible man. I am the main provider and he is carer to our 4 year old autistic son. Over the years we have both lost many of our friends because we do not have childcare or family near us (I’m NC with my parents) and he is only in nursery 6 hours a week because he cannot cope with much more. Our DS is the most amazing little boy but I won’t lie, it is hard work. I had severe PND after pregnancy and my partner was my biggest support, he has always stood by me and supported us and he is just the most amazing dad and I know I am very lucky.

Over the last few months I have scaled back my business so that I can also do more childcare but it’s proving hard because we desperately need the money and we’re in quite a bad financial position since so I really need to scale it up again. We’re in receipt of child benefit and have applied for DLA.

My partner has always struggled with depression, and I knew this before we met, but he was in a much better place.

Recently he’s been struggling to the point I am so worried about him. He has been so off and just away in his own head. At first I thought it was me but he has told me he is so down and anxious. I have told him that he can always talk to me and we are very close like that, we always have interesting conversations and personal conversations, but he struggles to tell me because he says he cannot pin point one thing, that he just feels so sad.

The other day he drove to the shops and there were 5 car accidents, he was stuck with in traffic for 3 hours and then the car started over heating. He started just crying and almost having a panic attack. I ordered an Uber for him to get home because I didn’t want him driving in that state.

He was previously on sertraline but stopped taking it, but he’s started taking it the last week and he said he’s feeling even worse.

We’ve had what I thought was a wonderful day today - took DS to his favourite soft play (luckily wasn’t busy) and then spent an hour at the beach.

When we were driving home he was very quiet, and I asked him if he was okay and he sort of shakily said yes - I reached out and squeezed his hand and told him it’s ok and he just started breaking down. I told him to pull over and he sat for a while and I drove us home.

I know he’s trying to deal with it and I’m worried he feels a burden which he is absolutely not. I want to support him as much as possible but I just don’t know how. I try encourage him to talk but I can’t force him to of course, I have said he needs to call the GP first thing and ask for a face to face appointment, not just a phone call.

However I am worried he needs more than this and is in crisis, but he would never go to A&E to see the crisis team (I have been under them previously so am aware of their process).

I’ve suggested therapy and I’m thinking maybe suggesting calling Samaritans because they don’t advise, they just listen and maybe he’d feel better opening up to someone who is there to listen and not judge.

All I get from him is ‘I don’t know, I’m just sad and anxious all the time’. I will of course give him the biggest hug and then he’ll break down again.

He has the most incredible relationship with our DS and I’m worried I’m going to lose him.

I want him to get the right support but I am not enough and he needs professional help.

What can I do?

If he's just restarting sertaline it's going to take a couple of weeks potentially worse before things get better.

I'm sorry he's struggling so much. Could you look at a mortgage break and take a few weeks off/minimum? It must be incredibly difficult to recover while caring for ASD DC.

Sorry that your partner is feeling like this it must be very worrying and stressful for you. You should get him an appointment at the gp also contact 111 for advice. I have had severe depression and was under the mental health team for a while they are really good and have access to stronger meds.

Hello, when you start antidepressants you can feel worse before you feel better as you get used to it. Just knowing that might make it easier for him to manage?

do you think your DH could also be autistic? If he is talking therapies may not be the best thing. Reducing the demands on him with lots of time to wind down and relax and avoiding stress might work better.

Apparently Sertraline can sometimes make you feel worse before you feel better.

The obvious answer is that he needs to see GP face to face. Can you make the call for him and book the appointment?

But the important thing is for you to remember that none of this is your fault, this is a "him" problem. It's very hard when you see loved one's struggling, but if you can try to have a practical approach rather than emotional one, then this might help you.

Also, if you can find the time and the money, then a few counselling sessions for you, so that you can talk through your worries with someone other than your husband.

He needs to see his GP. And he needs to take his medication.

If he's just restarted his sertraline, has he seen the GP recently? Or did he just start and stop by himself? I Think you have done exactly the right thing in encouraging him to see the GP, as a starting point.

It doesn't sound like he needs the crisis team at this stage. 'Crisis' in A&E mental health terms, means likely to harm himself or others and absolutely nothing you have said suggests he is at that point. Make sure you take time to look after yourself as well. Being the partner of someone mentally unwell can be exhausting and lonely.

Sertraline could take some time to work. And when I tried to cut it GP always made sure I take plenty of VD, especially in winter. Sending best wishes, and look after yourself as well op

I’m currently going through the same and it’s so heartbreaking and I don’t know what to do. Bloody therapy discharged him after 4 weeks and since then it’s been a constant spiral. He just wants to be by himself and is staying away with work. I briefly saw him today and he broke down on me. I feel for you I really do, i just don’t know what to suggest except be there as much as you can, but very much not taking my advice but it’s ok for you to be upset and show it too

Do you have a local mental health hub? Have a Google for mental health hub and your area name, we used them for my partner when his mental health hit the rocks and they were brilliant, a year later and he is still under their care and doing well with regular appointments.

Just to say that I think you are doing a great job, being there for him and supportive and allowing him to let his feelings out, this is all so protective. I think if I were you, I would say to my DH that I was worried about him and that I felt really strongly that he needed to see the GP for an urgent appointment. I might make this more about me, like “I’m feeling worried and i would really like for you to see the GP”. It’s really important for the GP to review and check that the current medication is right for him; at the correct dosage. The GP could also (if needed) make a referral to an appropriate service.
I would also ask my DH if he was having thoughts to hurt himself or complete suicide, if I was worried about this and especially if he doesn’t see the GP (as they would ask about this). I know this can be a difficult question to ask, but there is evidence that, rather than increase the likelihood of it happening, asking the question is in fact protective (see Samaritans website). Then you’ll have more of a sense whether he needs urgent support from a crisis team or whether he is really down and upset and needs support from you and can wait to see a GP for a few days.
Honestly you sound really supportive, approachable and non-shaming. I hope your family will all be okay

He needs to see a GP and have a risk assessment. GP can then refer to the crisis team if the risks are high. He doesn't need to go to A&E for that unless your area has an unusual referral pathway.
He may need to go to an assessment suite but this is usually separate to A&E.

Please take this very seriously, starting sertraline can often make things worse before it gets better and that is a dangerous time if there is any suicidal ideation

He needs to see the doctor but you need to be with him and fully involved, they can prescribe benzodiazepine for a few days that takes the edge of the run in of sertraline but when I had this situation with DH I had to keep them secure to prevent overdose

you say your young DC has autism, is it possible that your DH is autistic too? It’s so common for parents to be recognised and diagnosed after the children in the high functioning community, it may help you understand and plan forward

if it helps you, my now adult DD was diagnosed first, DH was diagnosed later and all 3, DS DD and DH are now diagnosed as neuro divergent with anxiety/depression and ADHD.

It’s been a long road to balance all their mental health needs but they are all in good places now, but DH. Will never come of sertraline again, he’s tried and failed twice and we’re lucky he’s still here

If your DS is autistic is it possible that your husband may also be autistic?

This is very worrying, I don't know if anyone that suffers with depression but I suffer with anxiety .. for me this screams red flags. Sounds like he needs urgent assessment. Hope you are ok you sound so caring and supportive x

Hi, my exh had horrendous MH issues and had times like you are describing.

Most GP practices save some appointments each day, so you have to start ringing them the moment they open on tomorrow. Alternatively, you could ring 111 now and they'll set up an appointment for you tomorrow and communicate with the GP practice or a walk-in. I do think it's very important that he sees a doctor tomorrow morning.

In the meantime, he should basically go to bed. That's what my husband used to do when he had a crisis. Sleep can sometimes head off the very worst of it.

I am very sorry you're going through this. My husband was so ill at some point that he was writing gobbledegook on FB.

For tonight, it's best if he's in a calm, quiet, stress-free environment - basically, lying in bed.

Again, strongly reiterate that he should see a doctor in the morning, even if he feels better.

Big hugs to you. This isn't easy. And it sounds like your poor husband is really suffering and is at the mercy of his brain chemistry right now.

Hi, mental health nurse here. Firstly, you sound like a wonderful supportive wife and it seems that you make a great team.

From what you’re describing it seems very likely that restarting sertraline is exacerbating his symptoms. This is very common in the short term and can significantly worsen feelings of depression and anxiety.

As a first port of call I would suggest contacting the GP tomorrow morning, explaining that his symptoms are intolerable and request something to be prescribed alongside the sertraline in the short term to get him through the process of retitration.

A talking therapy referral sounds as though it could be useful. Although he’s probably too acutely unwell to engage in this meaningfully at the moment, by the time he’s offered an appointment he will hopefully have stabilised somewhat on medication.

If you’ve got any concerns for his safety ask your GP for details about how to access the Crisis Team in your area.

Good luck and look after yourself x

Definitely a GP appt is needed, but also, maybe a job would help. I felt similar when I was a stay at home parent

As others have said, GP as soon as possible and then they may refer to crisis team for assessment. It sounds as if he needs it. Therapy won’t work while he is so low. He needs to get a bit better and that may need better drugs.

Is he autistic? Summer is a horrendous time for those of us with sensory issues. Do you live somewhere quiet or do you have neighbours? General "life noise" in Summer makes me suicidal so anything you can do to create a quiet environment for him may help.

I've been on Sertraline for over 10 yrs, only 25mg but I used to be on 75mg. It takes some weeks to see results - I am 100% fine - but would never come off them as the alternative is so much worse. He needs to keep taking them and combine with therapy. And he needs to see someone sooner than later xox

Does he have any respite from childcare? Can you ask about Short Breaks from your local authority (you nerve to be awarded middle or high rate DLA first)

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I just saw in your message that he stopped taking sertraline. Does that mean he tapered off under the supervision of his doctor? Or do you mean he just abruptly stopped talking them on his own, and then restarted on his own? If it's the latter, no wonder he's feeling very unwell. You aren't supposed to mess about with those meds. My husband did, and it would bring on a crisis.

I agree - starting Sertraline is horrendous. When I’ve done it I’ve just tried to hunker down somewhere quiet - bed mostly - for a while until I start lifting - hard to do I know with family but the benefits will outweigh this initial hell. What worked well for me for the two times I have restarted was to keep a diary of how I was feeling - just for those 2 weeks or so. So I could see the slow improvements happening.

I have used sentraline in the past, and the first few weeks (can take up to 6), you can feel nauseous, tired, generally ill before it kicks in and then you begin to feel on a much better levelled playing field.

I also coupled this with therapy and was lucky enough to get this on the NHS. It's not a quick fix (took two years for me) but I felt so much better to cope with panic after. You might need to get this privately if you can as wait lists are ridiculous. But don't just rely on pills they take the edge off but they are by no means a cure x

I too have an autistic child with a global delay. And it's so incredibly challenging day to day. I can't remember the last time my husband and me had a date or time to ourselves. Thinking about it now even the strongest relationships need feeding! Rather than date night being out of the house, can't you make date night (even if it's once a fortnight) be a time where you go all out with food, cocktails, movie or what we did recently which worked was an escape room but in a box (the works does them). My therapist was suggesting that it's making time in the present focusing on the present rather than what's happened or what will happen is the key.

I know these things can't be the entire shift but small steps can lead to feeling brighter x also you mentioned he felt like this in the past... what did he do to help himself then?