Persistent Depressive Disorder/Dysthemia?

[Caddycat]

I've recently came across this condition and I think this may be what my DH is suffering from. I'm wondering if anyone else is suffering from this or has a relative who has and could share some info/reassurance/direction.

For background, DH has had low self estime his entire life, struggled to feel happy, make friends, have hobbies. He is pretty successful in his career, but he feels he's a failure, that everybody else does better than him, earns more etc. He says he has no friends but refuses to use social media, effectively cutting off a lot of old friends. He struggles to sleep, has nightmares about not being a good enough person, can't deal with stressful situations.

He had a few big depression episodes over the years and was put on sertraline for those but the gp eventually takes him off them.

He is currently feeling really bad after a recent bereavement. He's refusing to go to the gp but doesn’t sleep, keeps saying how pointless his life is, how useless he is, how he ruins everybody else's life. I'm starting to feel really anxious and can't see how to help. Does it never get better?

I could have written much of your OP.
My DH HAS Dysthymia and spent many years in despair very much as you describe your DH. Insomnia, extreme tiredness, depression and anxiety which was off the charts. He eventually developed a physical tic as a result (I've read that this indicates the extreme end of anxiety).

He did eventually get help from a psychologist who showed him how to relieve the tic and asked his GP to prescribe Citalopram. He spent a few years on it an life moved on.
We had our children.

He had been seeing a private therapist for some years and worked very hard at changing things. I commend him for this, it took a lot of work.

It seems that at that time, GPs were trying to hit targets for various things and getting patients off long term ADs was one of them. DH had to virtually beg for repeat prescriptions.

He decided to wean off ADs and everything went to shit.

Life for a few years was fucking unbearable.

I put up with many years of tiptoeing around him but it was unbearable and I decided to plan an exit for me and the DC.

He seemed to sense that I was pulling away and decided to go back to the GP to see if he could try again with Citalopram.
The GP listened and issued a prescription.

Before DH took it, he went to talk it through with his therapist who thought it was a backward step and only masked the problems. DH threw away the prescription.

The next few years were fucking awful. I'd lost the momentum to leave and we limped on in utter misery.

DH stumbled across an article about Dysthymia which described to a tee everything about his lifelong mental health and interior pain.

He decided to return to the GP (who hadn't heard of it) but agreed to issue a new prescription.

He told his therapist (who had also never heard of it).

DH has taken Citalopram ever since and I can't see a point in the future where he won't be taking it.
Life has improved immeasurably.

He still has to work very hard at it but has learned how to use the tools and recognise when he is overwhelmed and how to work through/around it.

I think of ADs (for him) as an essential drug to keep him on an even keel much as other drugs are essential for other conditions eg thyroxine for those with an under active thyroid, insulin for type one diabetics etc.

OP, I don't know if any of this helps you except for the fact that I really do understand what you are going through.

If your DH refuses to access any help from the medical profession then there is nothing you can do sort this out for him.

If he continues to refuse to seek treatment then all I can recommend is to get out and save yourself and your children (if you have them).
I don't say this lightly.

None of this will improve on its own.
Living in this situation is bloody awful.
I really know about it and I feel for you.