Helping my husband recover from depression

[Cristiane]

DH started on Prozac 1.5 years ago. After being made redundant and death of friends, he has been much worse, and was at the stage when he could not get out of bed or communicate for several weeks. Seemed to go through a very up and down phase, shrink was concerned that he may be bipolar, but appears not. Though he does have rushes of energy and optimism followed by awful lows. I thought he was improving but he appears to have dipped again and retreating into quite a bad place. He hates himself and gives himself such a hard time.

He has started seeing a cbt counsellor on NHS but i don't think it 's enough. Or that they get in particularly well.

What can i do to help him? I can't bare seeing him suffer so much and it appears to be getting worse again. He takes 60mg of Prozac every day, has been on this dose for a year.

I guess no-one can really help. I just feel I want to do something to help him. He can talk to me but no-one else and it's hard.

Please tell me anything that's helped you or your DPs

God, this must be so hard 4 u to live with -he is really lucky that you are so understanding and want to do everything you can to help him. My other half has also suffered from depression in the past, tho tbh not to the same degree as yours- so anything im abt to suggest may not even be appropriate but may become more practical in the future.I would imagine tho that the way things r just now you would try pretty much a/thing?
First of all he needs to try and get to the root of what is actually causing him to b depr-does he talk to u in detail abt specifically what is making him so low?Sounds like he had a pretty tough year and if he is still stuggling with grief then it might b time 2 contact a service such as cruse to help him with this. You said he had bn made reduntnt?This iprob makes him feel inadequate and really dented hia confidence/self esteem....u cd turn this round and say "ur health more important and maybe just aswell not working at the moment as gives u time to recover" make sure he knows that u love and value him and his long term wellbeing more than a wage. If ur struggling financially this is easier said than done mind you. Is retraining an option?
Its also maybe time he went back 2docs and ask for a different anti-dep-a year at that dosage is pretty strong and dosent seem 2 be helping much so mayb its time to try s/thin new. Also try and think back to anytime he was depr b4(dnt no if i wd rule out bipolar)what worked then?CBT will help with gen dep but it will take time.
Finally,(hope u dnt take this the wrong way) but b careful ur not making it too comfortable for him to stay depressed....u sound just lovely and s/times when we r being well looked after and given sympathy and dnt have to deal with problems (such as trying to find work in the current climate)it bcomes all to easy to jst stay that way and wallow in our comfort zone.
Try set him tiny small goals such as "get up for an hour" or "get dressed" and grad increase these-it may not feel like it but it will help in the long run. Also make sure you look after yourself! Take care hun x

Thank you for your detailed response. Very good points that you make, thank you.

You are right that we need to get to the bottom of it. Think he has long term confidence issues and he has had a traumatic life, lots of pretty awful things have happened to him. We have just been fire fighting without getting to the bottom if it. His parents divorced when he was young and he was sent away to school at 13, his family lived abroad and he came to the uk. He also had a "guardian", a woman who slept with him when he was 13 until he was 18, she was 25 when he was 13, she was entrusted to look after him on weekends out away from boarding school. Can"t have been good for him. His best friend died in horrific circumstances when he was about 21 too. Am not sure whether cbt will ever get to the bottom of all this. But i don't think we can afford to have an extensive psychiatry... But of course if it's the Only thng that will get him better then we will find a way.

Financially - we are ok because i am working full time and he looks after our children, one is a school and the other is going to start nursery two mornings a week. But me working full time might make him feel emasculated, but someone has to, and we could easily increase the childcare if he did get work.

I do get your point about not making it too comfortable. And sometimes i really want to just pull his socks up a bit, but it is hard. Even the times when he is better, the slightest bit of pressure just sets him off, so even a small deadline is enough to set it off. He had taken on a bit of free lance work but it's not really working out, even though it's quite manageable he just sits there not able to concentrate and takes hours and hours to do a little thing and gets himself stressed for taking so long and then gets worse... It gets so frustrating.

We have just bought a house that needs a lot if work done to it. A that is my DH"s line of work he should be into it, and he sometimes is, but sometimes not, and then he spirals into despair again and is unable to function.

I am going to investigate immediately changing drugs. It is a large dose. I think setting small targets is a good idea. I do send him little to do lists when things are bad and i am at work.i am a bit worried that he is getting wrse and not able to look after dd2. I had to leave work early last week to pick up the pieces as he couldn't cope with the children.

If he is getting worse again he needs to see the doctor to either change his medication or up the doseage on what he already takes.

It is not unusual for someone to get initially worse when they start CBT as you are having to talk about things that hurt and go into great detail about things that make you sad.

That in itself will bring back bad memories for your partner.

All you can do is be there to talk to him, to tell him that he is doing well.

Hello Cristiane. My DP has major depressive episodes, where the only thing he can do is go to bed for the day, so I know something of what you might be going through, both of you. Three things come to mind:

1. Has he been referred to a psychiatrist, rather than simply the doctor prescribing medication? If not, I would definitely consider a referral, which can make a significant difference.

2. When/If he sees a psychiatrist, then it is possible that Prozac (fluoxetine) is simply not the correct AD. A year is a long time to be on something when it isn't working, and I'm surprised that alternatives haven't been at least suggested.

3. Given your husband's very traumatic past, my first reaction is that CBT simply is not going to be touching sides. CBT works very well for certain things, especially phobias and OCD; but when depression can be linked back to formative - especially childhood - experiences and trauma, then it is often not enough. I would consider another form of therapy - not counselling, which is too short-term and also lacks the depth that I think he would benefit from. Consider finding a therapist through BACP or UKCP - one that works with someone at least weekly - no less. I am a counsellor, and currently training to be a therapist, so I have some basis for this suggestion.

Yes, and look after yourself.

All the best.

I've just spoken to my DH, and he says that a psychiatrist is essential, and that sometimes you have to push to get one, but if you're insistent, you'll be referred. Going to a doctor for long-term depression is tantamount to trusting him to operate on your knee. In both cases, you need a specialist trained in that area.

Also - and sorry to get personal here, so I'll understand if you choose not to respond - but is there any sign of addiction, i.e. to alcohol or drugs? Often they go hand in hand because the substance becomes part of a spiral of self-medication. And how far was the bipolar investigated? My DH is also bipolar, and he asked about bipolar without knowing about that from your OP.

Thank you for all your responses.

I have been finding out today about therapists and dh has spoken the doctor today who is referring him back to the psychiatrist.

They think he's not bipolar because the highs don't last long, maybe half a day. He likes to drink but i don't think he is addicted, he can easily say no.

I think that he definitely needs to change drugs and i agree cbt won't help.

I wish dh would do exercise but he doesn't want to.

You have my sympathies. My husband has had long term depression (I mean about 20 years) and has been on ADs for ages. He swings from being lethargic and morose to being angry, irritable and very critical. He functions at works and can pull himself together in front of other people but has terrible self esteem and hates himself with a vengence (and then takes it out on me).

The problem I have is that he really wants to have another child but also says he feels suicidal. Any advice on how to get some real medical help for him? I had thought that our problems could be addressed by couples counselling but his issues are more deepseated than I thought.

pimmers if he can hold it in front of other people he can for you too
if he takes it out on you - well you need to set your boundaries
if he feels suicidal - call 999 or get him to A&E or GP immediately.

my exP was/is like this. for eyars i put up with it, said oh pooor him he is depressed etc...

I had a read of Why does he do that by lundy bancroft;
buy it and read
www.amazon.co.uk/Why-Does-He-That-Controlling/dp/0425191656 it wont all apply and maybe you will conclude that it is all about depression - but by reading you will be clearer in your mind

• and i saw a counsellor after he had a particularly severe depresive episode - and these helped me separate in my mind what he could and could not control -what was personality, what may be depression, what wsa something else entirely...

depression etc is NO excuse for bad behaviour and taking it out on you.

set some boundaries and start making it clear what behaviours you wont put up with any more.

he feels suicidal - he must go to A&E or GP for help
he feels angry - he can go for a walk; go for a run; take it out on a pillow etc - he is an adult not a child he can control it in front of others. so why not for you?

some of it is medical help - some goes way beyond that and veers towards someone who has gotten away with behaving just how he likes towwards you for some long times.

look at changing how you respond to and enable his behaviour -to instigate changes in his

christiane - "I wish dh would do exercise but he doesn't want to." - well he is making a choice. he "doesnt want to" .

you have a choice too - you can let this lie or you can issue ultimatums - you get help, you TRY exercise or we have to seriously consider our relationship and whether we can continue to live together . you can say - " will suport you but you need to try exercise and [other things ] too"

CestlaVie - many thanks for your advice.

Yes, I'll take a look at the book and start setting boundaries.

It's getting a bit easier to think about standing up to him now my child is older and I'm not quite so tired but I definitely don't want another child in these circumstances.

I'm a fan of the saying "be the change you want to see in the world". I can't necessarily change his behaviour but I can change mine.