DP needs me to be strong, but I'm not. And he keeps getting fobbed off. Where do I go now?

[TottWriter]

My DP has depression, and a lot of social anxiety issues. He finds it exceedingly hard to talk to people, particularly about his health, which has is obvious issues when it comes to getting help. I've started going along to his appointments with the consultant in order to make sure that the consultant is getting a proper picture - if DP manages to go to his appoinments (and often he can't make himself leave the house to go) he has a tendency to play things down.

He was on various anti-depressants, but he's stopped taking them, because he wasn't getting any benefit from them, and suffered badly with side effects. I can confirm that he was no better on them, by the way. He drinks a low but constant amount throughout an average week, which worries me.

The thing is, I'm currently 33wks pg, and we have a 2y/o DS. I also have epilepsy, so DP is actually my carer, as my fits are still somewhat uncontrolled. I've told this to his consultant. I've called up this morning and explained (again) to his consultant's secretary. He is currently not on a waiting list for counselling as he was unable to fill out the long forms for it, and managed to lose them before I could help him or do them for him. His consultant said at his last appointment (which I went to in DP's place as he couldn't leave the house that day) that he was referring him to the enhanced care team, who, if they took him on, would provide a community nurse (or something), but this was a month ago, and he still hasn't made the referral. I phoned today and complained again, but I'm running short on ideas as to what to do now. DP is barely functioning today - he was fine this morning pottering around in the garden, but a trivial matter has set him into a bad state and he's currently upstairs lying down.

I feel horrible, because a large part of me needs him to be better, and I hate putting that pressure on him because this isn't his fault. He has issues with counselling and appoinments anyway because of the cack-handed manner his parents went about trying to 'fix' him when he was a child, and I don't want to make things worse by doing the same. But I can't stand by and watch him growing worse, which is what's happening right now with the stress of me being pg. (Last time I was hospitalised a few times in the last stages due to fits.) I love him to bits, but I'm getting to the point where I'm going under at times from the strain of looking after him, and it's causing me to have seizures.

Do we have to wait for the consultant to refer him now, or is there anyone else I can call to get help? I don't want him to feel belittled, because his self-esteem is already rock bottom, but I do need to be realistic - at the moment he is getting no help from anything, and that can't continue.

Hi TottWriter you really are going through a tough time right now aren't you.

So sorry to hear your DP is so unwell. Also with your pregnancy and epilepsy that must be very very difficult.

Is there anyone who can have your 2yo should you need to go into hospital? What would happen if you went in, would your DP be able to care for him? Is there a family member or friend who could be on stand-by.

Seems to me, you need to take this pressure off yourself as it's not helping you right now. Just being 33 weeks pregnant is tough in itself, yet alone with the other stuff going on too.

Unfortunately I have found with mental health services you sometimes need to jump up and down a bit to be heard! If you are not very assertive it can be hard to get the treatment you need, unless the person becomes a danger to themselves or to others.

I'm afraid I think you need to keep pushing for this referral. And the louder you shout about it, the more likely it is to happen. Shouldn't happen that way, but it's often the case. Can you ring one more time, and then say you are going to follow it up with a letter? Say that this is really urgent now, for the reasons you've stated here.

If necessary you should be able to access the crisis team who would come out to your home to see DP. This would mean he wouldn't need to struggle to get out to appointments.

So sorry you are in this position. How many different ADs did he try? It's just there are absolutely LOADS of different ones, and they all work in different ways, so he may find that there is one that "works" for him, and has fewer side effects. Of the three I've tried, two were intolerable in terms of side effects, but the third one worked really well and didn't give me any side effects at all. Strikes me that he does really need to be on some kind of medication, because his depression and anxiety is pretty severe.

He tried quite a few, though I can't remember all the names now. I know the first one was Citalopram, but that was well over a year ago now.

It doesn't really help that he hated taking tablets as he didn't like the idea of relying on them, either. So it was a bit of a battle to get him to give them a go, but he did try them for quite some time before coming off them.

As for someone to watch our DS if I go into hospital, what's happened in the past is that my PIl have driven down from where they live (an hour and a half's drive if the traffic is good) and watched him. They're great with DS, but I do worry about calling on them, because my FIL is completely hopeless at understanding depression. It seems like every time we see them he and DP end up arguing. When DP had his initial breakdown, FIL's attitude was 'pull yourself together'. They are planning on moving nearby to downsize their mortage (houses are a lot cheaper here) and be closer to DS and DC2 when it arrives, and I know that's preying on DP's mind a little too. He's quite close to his family, (he calls them pretty much every day) but I think a lot of his issues come from them.

I will try writing if I don't hear something soon - the trouble is, the consultant can only make referrals once a week when he has meetings with the teams, and the most recent one was yesterday. So now I have to wait a week and keep my fingers crossed he remembers DP's name. His secretary has promised to pass on my message when the consultant finishes his clinic today.

DP's come back downstairs now - he's sitting on the sofa reading. But he doesn't want to interact with DS at all. Normally, he's the most family-oriented man I know.

Hi it might be worth going to your gp and asking them to fight your corner for you. Hope something gets sorted soon x

i think you need to go to your GP and explain i from your point of view. then GP can speak to GP...

on practical level, if you had to go into hosp and left DS with your DP what would happen? would he totally not take care of him? put him in danger? or?

in a real emergency, social services could arrange emergency foster care for him. ie if you cannot leave your ds with your DP, take him wiht yu adn let hospital SS arrange emergency care. not ideal obviously but just to bear in mind...

thing is tho, longer term, your DP himself has to take responsibility for his own mental health. he is an adult. there is only so much you can do. unless really a danger to himself. is v difficult .

you need to take care of yourself and your DS and baby to be....

I know my DP would be able to look after our DS if I had to go into hospital - though when that's happened in the past he's called his parents to come and babysit so that he can visit me and make sure I'm okay. He's a good father though, and aside from allowing himself to get too stressed out once DS is asleep/I'm back, he's been fine looking after him before.

We're lucky, really. He has such a strong paternal instinct that (mostly) he's able to put on a smiley face and act as though everything's okay around DS. When it gets too much, that facade drops, but he's never been unable to look after DS before.

The worst that happens really is that he won't take DS out to toddler groups or to interact with other people. He can't cope with the socialisation himself, and can't hide behind DS to do it either. As, long-term, I'm the one who will be going back to work, that does worry me a bit, and it is a major reason I want him to get more help now. I just keep getting that nagging fear that I'll go to work and they'll both just sit here in the house, and if they go out at all it will be to the supermarket. How he'll manage that with two DCs I'm not sure. At the moment, if DS starts acting up when we're about to go out, DP's reaction is to not want to go at all.

I'm going to call the consultant in the morning and remind him to make that referral again. I don't know what our GP can do right now tbh though, because all he's been able to do in the past is refer DP for counselling, which I don't think he's ready for. I don't want to push him further away from that help by shoving it in his face. I might write a letter to the consultant about this referral to the enhanced care team as well. I'm really hoping that this will get us somewhere.

I think that is all you can do. persist with consultant and pester for the referrals - but -

does HE want the help?
what incentive is there for him to get better?
if he happy not going out to toddler groups then fine... espec as a man i think you need to be quite social!

if he doesn't want to get "better", face his issues etc - or is not ready, then is uphill battle....(i went thru that with exP)

sounds like he has had existing issues (you mention his childhood).

can you book DS into a nursery already? so he gets socialisation even part time? then it really does not matter if the rest of the time he is just chilling with dad at home...

thing is tho, as you realise, is v difficult to take care of two small children plus an adult - something has to give.

perhaps you can already look into projects like sure start to get volunteer help with the little ones when baby is born?
maybe a regular volunteer coming in once a week your DP could get to know would help him as well?

you can also ask SS for a carers assessment. for your needs and your DP's needs. that might bring in funds for extra regular support...

Hi TottWriter
Haven't got much to add to what other posters have already said, just wanted to pick up on your dp's drinking - alcohol is a depressant and could be completely negating any positive effects of his medication. You may want to mention it to his GP / consultant.

Sounds like you have a massive amount on your plate, and yet you have the strength to look at it all objectively and reason it out - and string a sentence together - much more than I have been able to manage at much less stressful times!

Keep us posted.

You worry that your Dp is not ready for counselling but to me he sounds like the perfect candidate for CBT - CBT is actually very man friendly because it is practical, about changing our thoughts and helping yourself, not digging in your past and feeling sorry for yourself. Has this possibility been considered or is this when the long forms got lost? Bit wrong that he had to fill in long forms. Neither DH nor me ever had to.

Really sympathise Tott. You have got a tough one there. DH has schizoaffective disorder and I recognise a lot of what you are saying.

Possible ideas -

both of you to get a carers' assessment, as you care for each other?

Ring your/dh's GP secretary and blub on her shoulder, if she is at all nice. If not, the GP. If not, then the consultant's secretary. Find someone who will chase the consultant for you. You need that referral. Much of dh's best support, and most acceptable to him, has come from community psychiatric nurses. Also, can they give you a number for a local crisis team?

Ring Homestart. I have heard varying experiences of them but if you got a good volunteer, it could really help.

Do you have a specialist epilepsy nurse? She may know more about support locally. Or just your health visitor. We have a similar problem in that dh's parents are lovely but he tends to be actively worse when he has seen them (depends on the circumstances). We have to be a bit careful when and how we ask for their support. What would happen if he reduced the number of times he called them a bit, maybe to 2 x a week or something? Is there another family member he could call instead? Could he email or write letters to them - phone calls can be very weird?

IMO I would investigate proper childcare for when you return to work. The fact is, neither of you has perfect health; few people do. You need layers of backup, and his parents drive him nuts (i'm trying to present it in a way you could present it to him). We had a wonderful nannyshare but we still needed my mother, my inlaws and various local friends to get us through the early years, and in fact we still do. If cost is a consideration (of course it is!) then consider applying for DLA - talk to the disability advisor at the Job Centre? It's a miserable process but if his illness makes him so ill that he can't function, well, that's what DLA is for.

DH's best help now is a low level of meds, a LOT of exercise (I'm talking a couple of hours a day minimum), and a mindfulness meditation course. He was referred onto the latter by his consultant and it's been brilliant. But this is after 20 years of consultant care, therapy etc. Group therapy was helpful in the past but quite extreme.

Do you have to take meds for your epilepsy? Would reminding him of that help him to feel that it's not a personal defeat if he takes meds for a while?

yes ask for number of local crisis team.

in my case they werent much help as i tended to call when exP was in severe mode (they said - call the police) but for the kind of scenario you describe when he is ahving a bad moment - could well be good. ie they could talk to him/come round/discuss medicatioon etc.

Okay, update.

I called the clinic again yesterday, and spoke to the consultant's secretary. I guess my timely reminded (the consultant was having his weekly meeting later that day) payed off, because I got a call today from a community support worker.

He's going to come round and make an assessment of my DP next Tuesday. Only I buggered up slightly by trying to get DP to organise the appointment over the phone, when he's having a bad day today. He can't really do phone calls at the best of times, let alone when we're about to go out to the dentist's (DS had an appointment too, hence me going along). So he was a bit fraught while we were out, and he said some dumb things and I said some dumb things. I hate arguing with him, when I know that the problem is something else entirely. I know he's now scared about this assessment, and this morning he confessed a really worrying level of anxiety about Ds and DC2 - he's been having nightmares recently that the baby will die, and he worries about DS and myself a similar amount. So I just feel like I need to be extra perfect to not give him something else to worry about, but I had a fit yesterday, and I snapped at him today, and I can't help feeling like I'm making things worse .

Sorry, self-pitying moment over. I guess I just feel quite alone myself, you know? I don't have depression, so I can't be there to relate to how he's feeling, but equally, he doesn't seem to realise how hard he can be to live with, and I don't want to lay it on him because he's unwell enough as it is. Anyway. enough circular ranting. This sort of thing can go on all day.

Thank you for all the advice and support, everyone. Oh, willsurvivethis - DP had CBT before, but around here you only get six sessions and then you have to wait three months for another set. He found that it helped him a little all the while he was going (though I think he may have ducked one or two appointments), but the benefits didn't last. If I get a chance, I'll bring this up with the man coming on Tuesday, though I expect he'll only really be talking to DP.

make sure you really wind your DH up on monday and on tuesday morning before the appt - so he is at his WORST on tuesday...you dont want your DH to be in good mode when the guy comes round.

you want him to be at his WORST.

the other day i found an email i had written to friends in sept 2006 - saying that P (as he was then) was in "autumn blues" again and it was hard for me to get out the house each day to work as he was crying, pleading with me for help, etc... one wise friend wrote back that he was thriving on the attention...

i dont know if you H demands attention from you? or just gets on with it?

from here - years on and now separated... i know that NOTHING i did or didnt do in teh biogger picture had an impact on exP's depression - he was depressed when i was with him; he gets depresed now when i not with him... it is not what you do or dont do... you just have to focus on you and dcs...

of course there were little things that set him off more... so - to reiterate - if you can trigger him into being the worst possible for the assessment then it can only help both you and him to get the right input...

what you absolutely dont want is an assessment in which your H says "oh i am fine".

otoh - if that is what happens -then you will need to seriously consider some other strategy....