Supporting DH with depression on citalopram

[frazzledwife]

My DH has been on citalopram for nearly 3 months having suffered from depression for longer than I care to remember.(Took him a very long time to admit the problem and came to near breaking point before he would go to see the dr about it.)

He started on 10mg but this wasn't enough so he went up quite quickly to 20mg. He seemed really good on this for a month but for the last month he has really taken a nose dive and I have spent a terrible weekend with him not really knowing what to do or how to support him.

He saw the dr this morning and he had the choice of trying something different or upping his dose to 40mg the latter of which he decided to do. I know he doesn't really want to up his dose as he is suffereing stomach probolems and sexual difficulties but hasn't really any other choice. Anyone else out there on such a big dose?

I am so worried about him as he works away during the week and he is very uncommunicative when he is seriously depressed. He calls every evening to talk to the dds and I can always tell how he is from the tone of his voice.

There is no doubt that the ADs help him as he has behaved very differently to me since he has been on them even in the bad times .

I am torn between wanting to support him and feeling guilty that I feel angry about being totally neglected myself. I would never look elsewhere but just want things to change. Will this ever get any better?
Just see a long road of misery ahead.

Sorry a bit long and rambly but needed to vent.

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I know nothing about the drugs your DH is taking or whether he will be better but you sound pretty down yourself so I just wanted to say your posts haven't gone unnoticed.

Do you have anybody who can support you? Family or good friends who will take your DC off your hands to give you some time to yourself or to spend having some fun with your DH, when he feels like it?

It is very hard being everybody else's support network - you need to take care of yourself too or you will get resentful.

Not alot of support really as he does not want anyone to know. My sister is the only one I've told.

Can't really burden my mum and dad as my mum is seriously ill and they have enough to worry about.

I haven't got that many friends in RL. My best friend is one of these types who takes support when she needs it but not great with other people's problems and she has rather a big mouth so couldn't trust her not to tell anyone.

We are going away for the weekend in few weeks with out the dcs (which he has organised) which is a start but its just the endless worry during the week when he is away that gets me down.

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Could your husband maybe go back to his GP and talk about switching tablets to another type of AD?

I appreciate how upsetting it must be for you, in fact, me and my DH are currently going through the ringer a little bit as he tries to understand what he can do best to help me through the depression that I am experiencing at the moment.

Working away must be even harder as he will have no-one he can talk to if he doesn't want anybody else to know. It becomes very easy to just internalise it all which simply makes things worse in the long run. Is there anyway your husband can take some leave from work, at least until the AD's settle and make things more manageable for him?

He was offered a different AD this morning or the option to up his dose of citalopram. He decided to stick with the one he is on.

Taking time off work is just not an option. He has a crazy job in a F**cking awful huge American bank (who boast about their wonderful work life balance policy which is supposed to include regular breaks and lunch hours which in real life means their staff have to work 15 hour days with barely enough time to go to the loo!)

His job, like many others in the City at the moment, is hanging by a thread as it is and taking time off work for depression would be frowned upon followed by a swift exit. People are also far less likely to employ someone who has known mental health issues.

He is looking for a new job but very little around at the moment.
He is really stuck between a rock and a hard place.

Oh dear. I myself used to work for such a huge American Bank - wonder if it is the same one?!! Sounds similar!

Okay, I can see how the leave may be impossible but I'm not sure how taking sick leave would necessarily result in a swift exit unless they are currently making redundnacies and he thinks they may use his illness as a reason for him to be selected, albeit secretly. Do you think this is what may happen if he even thought about going sick?

Many organisations such as this who boast about family friendly/work life balance policies often have employee assistance programmes. This means they can have access to counselling sessions, free of charge and most importantly, they are confidential. His manager will not know that he is receiving help for depression as they are often ran by external agencies and initial contact is made via a telephone helpline. Maybe he has one of these he could use and at least try and supplement the AD's with further help?

I really feel for you and your DH. Its very hard to deal with depression when out in the open let alone when you are under huge pressure at work and are unable to get some respite.

My DP (also on citalopram) was offered an 'unfit to work for 2 weeks' note while it took effect. He wouldn't have 'known mental health problems' if the HR dept behave like professionals. This is not a subject for gossip and they could get sacked for talking about it.
The way that the drug works means that it can take up to 6 weeks to get to full strength, so don't expect immediately obvious changes, but hopefully you will see the effect of the 40 mg tablets sooner than that.
Does he have anyone to talk to? Friends, family, etc? Has he ever been like this (even a little bit) before, or is it just a result of his job and the whole situation in the city at the moment?

I know what you mean TrillianAstra and agree that an individuals health problems shouldn't be open for discussion. The thing is though that when HR communicate to management that somebody is off sick and are unable to divulge why, this can sometimes make the gossip run even wilder iykwim?

It's difficult, because sometimes the policy is that it is best to let line management know so that they can keep an eye on the employee to make sure that they are not struggling when they return and subsequently notify HR. If the line manager is a supportive type then thats great but if it is an awful atmosphere (which it sounds like) then the chances of receiving support or even feeling like you want anybody to know is slim. Definitely agree that having somebody else to talk to about it would be a big help and take some pressure off frazzledwife.

TrillianAstra he has suffered from this for a very long time even before he worked at this particular place, but worked for another American bank. I have no doubt that it is largely work related but depression does run in his family. My MIL, BIL and his nan have all been on ADs at some time or another which is why I am surprised he refuses to tell them. Perhaps this will come in time. As i said- it has taken him a very very long time to admit that he has depression.

He says it's easier for him to be away from us during the week as he doesn't have to worry so much about the impact his condition is having on me and the dds. He has to try too hard to be nice and try to hide it.

He refuses to have counselling and just would not take time off for this.

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Bumping for the evening crowd. I still want to know if anyone else is on such a high dose? Most seem to be on 20mg.

Sorry can't help with med advice, but my DH suffering from depression, hopefully comind out of it now, but yes, its bloody hard being the support. I actually feel like i was not a good enough support as by the end of the day i was too knackered having worked/done DCs/all housework and extras, to give a comforting ear. However my DH did end up going sick, had true 'nervous breakdown' as dr described it.
Any way your DH can take timeoff at all? Just time away from the main source of stress may give him relief. And time out to try to come to terms with it all? HAs he any annual leave left? But obv a sick note would be better.
BTW it was months before the meds worked, the prob is, the whole thing takes time. I had noone to offload to either, its really hard. I really feel for you.

30 mg at the moment.
The doses go up to 60 mg according the BNF (doctor's book of drugs). They make 40 mg tablets, so your DH's dose can't be that uncommon.

I'm afraid you might not get very many responses on here, except from those of us who are going through the same thing, just becasue people don't know what to say. I saw a poster on a bus shelter the other day with a lady saying 'my friends found it easier to deal with my cancer than my depression' and it's true.

frazzled - up here in Scotland the area psychiatric hospitals have special teams who come out to give help and support to the families of people suffering from mental illness.
Is there anything near you?

We found lots of helpful notices and leaflets when visiting the psychiatrist (outpatient)

I really hope you can find some help as it is a huge strain coping with a partner with depression.

The new prescription is for 40mg tablets. I am quite surprised that the dose has been doubled.I thougt it would go up in 10s.

Yes he has got some annual leave left but will not use it. He is entitled to 6 weeks a year but no-one ever takes all their leave as it seems to be frowned upon to take it all.

Even when we are away they won't leave him alone as they have him dangling on a string with his bloody blackberry.

I wish I could persuade him to take some time off. When we went away for 2 weeks earlier in the year he was a different person (this was before he was on ADs.)

Thanks for your support every one.

Have just spotted another support thread for partners of LOs with mental health problems. Actually our problems pale into insignificance compared to some of the ladies on there.

40 mg citalopram is not uncommon. It can often be combined with different ADs at the same time. I am on 40mg citalopram and 20mg mirtazapine. I have had 2 severe depressive bouts and it is so hard to have and also to understand if you are the partner. Have you thought about reading "Shoot the Damn Dog" by Sally Brampton. It might shed some light on what your husband is going through. I also know of a psychiatrist who is starting a practice in the Lloyds building which is specifically targetting city professionals under stress/depression in these difficult times. THere is help out there if you tap into it and also if your husband is prepared to go for it. If you would like any extra info send me a PM.

I am on 20mg. One thing I will say though is that docs are supposed to offer counselling along with medication. Even if the waiting list is long and your dh feels better by the time he gets it, it will do him good to reflect on how he became depressed. It's all very well medicating but how do we prevent future relapse if we don't know within ourselves what causes the depression and how to deal with it?
I should get counselling in about 3 months.

Thanks Jigger I have contacted you via CAT. WIll look into the book. The Lloyds building is just over the road from where he lives- the practise sounds interesting.

Dalrymps he has been offered counselling by several doctors but will not take this up. As I said before perhaps he will go for this at a later date.

DP has had one appointment with a psychiatrist, the next is in December. Long waiting lists apparently.

Our GP has been very good though, and it's not as if he's the old-fashioned family doctor who knew everyone in the village (possibly cos we're not in a village), we hardly saw him before this. He's been giving DH only a week's worth of sleeping pills at a time to make sure that he comes back and talks to him every week. So next time your GP is running late he might have been taking extra time to talk to someone with depression because he knows that they'll be waiting for months to get any official counselling.

Trillian-Our doctor is like that, we are very lucky.

I am actually wondering about going to see him myself- not that I expect him to talk about DH- but just for some practical advice.

There's a netdoctor page on caring for someone with depression Nothing that we couldn't work out for ourselves really, but still worth reading.

Your GP won't techniclly be able to speak about your DH if he's not there, but I don't see why you shouldn't go for some advice on how to deal with it. He will be able to subtly tailor the advice he gives to the particular situation, and I think it will help for you to have someone to talk to about it. Luckily for me we are very talky so I hear what the doctor has said when DP gets back (although he never seems to say enought to fill the time they spent talking, but that's just normal man behaviour).

Thanks Trillian- have looked at the link-you've been a big help.

I spent a lot of time looking stuff up on the internet when we first got the diagnosis (and before, when we suspected but weren't sure if it really qualified).

It's good to know that talking on here is helping you, especially if you don't have anyone to talk to in RL. Keep us updated, let us know how it's going.