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He is suffering from depression and has started seeing a psychiartist who has prescribed lithium.
We are feeling for his wife as she has bent over backwards to give him a lifestyle that is best suited to his needs.
They moved to the Med so they would see more sunshine, he's got his dog , kayak and fishing gear. All stuff that should make you a calm person.
She works her socks off supporting him and is at the end of her tether as she has no family support living so far away.
Once the lithium kicks in will it help? Will he get better help under the NHS? Currently she has to pay for his treatment and I'm sure the psychiatrist would rather drag the treatment out as long as possible rather than fix him.
She seeks advice from my wife , who seeks my advice so now it's over to you!
We would like to hear your positive outcomes of depression. Are you ever fully cured, do the best results come from drugs or is there a better way?
Currently she has to pay for his treatment and I'm sure the psychiatrist would rather drag the treatment out as long as possible rather than fix him.
I'm not sure that really works, apart from professional ethics you have the small problem of no income if the doctor fails to sort him.
Lifestyle supposedly helps a lot, drugs aren't the only answer and tbh I've heard a lot of mixed feelings on the matter, mainly centred around inappropriate prescriptions (wrong dosage, wrong drug).
I have a friend who was seriously bad, suffered a nervous breakdown and was in bad shape. She went to a pschiatric nurse and after getting put on the right drugs at the right dosage and getting dietary advice (which actually helped a lot) she is a completely different person, far less manic and prone to mood swings and healthier overall.
Conversely I found out yesterday that one of my friends hung himself on Sunday night, still not really processed that but the only thing I can say is to make sure he has all the support he needs.
I'm always hesitant with stuff like this but they keep saying blokes need to talk about it...
Experiences vary so there isn't a right or wrong answer. I'm on a pretty low dose of Sertraline and have been for a few years now. It [s]doesn't stop[/s] so far hasn't stopped the depression by itself, but it definitely makes a difference for me. If I stop taking it, after a week or two the low mood creeps in, and that's the start of a downward spiral that ends up in a very bad place. (Counselling has its place too but similarly that in itself hasn't cured depression for me, although it was helpful in understanding why). Anyway, in summary, with a low dose of medication I can keep myself off the slippery slope, and without it I gradually start sliding down it, so for me it's a definite help.
They moved to the Med so they would see more sunshine, he's got his dog , kayak and fishing gear. All stuff that should make you a calm person.
It doesn't really work like that. Depression is an illness and can strike rich and poor, overworked or bored, young or old, and it can come out of the blue. Under the NHS you will probably get an offer of anti-depressants (SSRIs) and maybe CBT treatment. The NHS pushes you towards CBT in a group environment because it's cheaper, and you have to wait for an appointment - it may be months. But it is "free at the point of delivery".
Support and tolerance is important but I can understand that it puts a strain on partners.
I'm with Nico. They would have been better staying put and making sure he had access to the great outdoors as it is some of the best therapy there is. They would also have had family support and a network of friends to help take the strain.
I went part time after a compulsory rest on the subs bench from the working world in 2009/10. It helped to get out and work up a sweat, also we had the local support for Mrs Sandwich. I'm working full time again now and off the SSRI drugs and coping with the stress of running someone else's business for them. I'm aware that I may need another session of SSRI at any time. They help get me out of bed and functioning when the blackness descends.
When dealing with a friend with depression we were advised to make plans with them.
Talk on Skype later?
Pub next Saturday?
Weekend away next month?
Holiday next summer?
That kind of thing, tips them away from "I'm letting everyone down, I shouldn't be here" to "I'd be letting everyone down if I wasn't there".
I've got no 'professional' advice other than keep talking to him, don't try and rationalise how he's feeling and there's no cure that won't come from inside him.
Talking is the main thing, imo. Just give him the space to talk without being judged.
Nothing major to add but I've suffered my whole adult life (now 42).
Had all sorts of counselling over the years, none of which has 'cured' me, but I think it's a good thing to seek out when you're very, very low as it can feel like you're not entirely alone.
I currently take 150mg Sertraline daily. It helps for sure. Don't think I'd be here without it.
As indicated above, lifestyle and possessions make no difference sadly.
She needs help to tackle it though. Must be very hard for her to deal with alone.
She obviously loves him but we can detect that she has almost stopped caring for him.
If you talk to him the swagger comes out and you wouldn't know there was anything wrong.
I have had a friend kill himself and no matter what we tried to do for him he wouldn't respond. It was always a given that he would do it and when he finally did , we breathed a sigh of relief for him.I know that sounds harsh but that was the horrible truth.
His brother was also suicidal. The husband mentioned above also has a sister with "issues". Can it be genetic?
We've all been to dark places but fussing a dog or a walk on the coast always sorts me out.
It must be terrible to be down and not know why you are.
We've all been to dark places but fussing a dog or a walk on the coast always sorts me out.
I, along with many others on here, envy you in that regard.
It must be terrible to be down and not know why you are.
It is. It's probably worse for his wife though. Just be there for both of them and try not to judge.
Depression is never a one size fits all approach, either in symptoms or treatment. Everyone's causes are different, plus we aren't born 'perfect' and as such even those with the most careful upbringing can find themselves plunged into mental illness.
Certainly, it's not something that can be "fixed" quickly. Fixes are slow, take effort and commitment from all involved. Lithium will help with ironing out the moods, but the dosage may take some time to get right, but talking therapies and CBT will also be useful in unison.
I appreciate it's hard going for all involved, there may be misplaced anger on his part or he may be emotionally unable to express affection right now. Op, you hit the nail on the head with "It must be terrible to be down and not know why you are".
She obviously loves him but we can detect that she has almost stopped caring for him.
That's probably not helping matters
The only times that I've ever really gotten truly on top of my depression and sustained it for any length of time has been after a complete change of lifestyle..
For me that means ditching any relationship, giving up my tenancy, putting a rucksack on and buggering off to try to find a new life
Could be the relationship that's holding him down (and her)
I'm currently in a bit of a dip at the moment. It's at these points that I find it particularly difficult to talk. Why do I think I'm depressed? I'm not comfortable with myself, I don't like myself. This most likely came from when I was younger through various (but normal) situations that affected my in a different way to the next person. I have to rebuild what I think of myself. It's so true that having all the material stuff really doesn't matter. I could have everything I've ever wanted and in the very short term I'd feel good. But that would soon change. A lifestyle change is the next step. How I do things. Maybe stopping doing some things and doing new things.
Sorry, bit of a ramble.
This guy needs to talk, in anyway. It might just come out in the end.
When dealing with a friend with depression we were advised to make plans with them.
Talk on Skype later?
Pub next Saturday?
Weekend away next month?
Holiday next summer?
That kind of thing, tips them away from "I'm letting everyone down, I shouldn't be here" to "I'd be letting everyone down if I wasn't there".
This^^^^^^^^
I am not a Dr, but my understanding is Lithium can take some time to get to a therapeutic level. It has been used for a long time so side effects and monitoring is understood with regular blood checks and talking. Is it definitely depression he has and not BiPolar disorder?
When down, doing anything can help, even something simple like washing a teacup, having a wash or as mentioned walking. These things can be mountainous tasks but he could reap the benefits. As for his wife, information and trying to understand the illness can help. Information equals power. There may be a support group nearby or she could have a chat with the Samaritans too.
I hope they can get the support they deserve.
Very good points Roper. I have fond that when I'm coming out of a bad spell I find the basic tasks strangely rewarding. I'm allowing myself to do something and feel good about it.
Do you think that once our brains weren't used 100% for surviving the rot set in?
In the last few years I've developed an aversion to flying. Last year I was driving to the airport and feeling all the usual panic symptoms coming on. It was dark, raining and visibility was poor.
All of a sudden the road lighting stopped , we were plunged into darkness and a car was coming at us on the wrong side of the road. I had to take action to avoid a crash.
After this was all over in a matter of seconds all my previous panic was gone. The rest of the journey and subsequent flight was taken in a totally relaxed state.
If he's suicidal and has been put on lithium then clearly he has a very severe illness. Lithium is as I understand it only generally used outside of bipolar disorder when other antidepressants haven't worked, and when symptoms are very bad.
We are feeling for his wife as she has bent over backwards to give him a lifestyle that is best suited to his needs.
They moved to the Med so they would see more sunshine, he's got his dog , kayak and fishing gear. All stuff that should make you a calm person.
She works her socks off supporting him and is at the end of her tether as she has no family support living so far away.
This isn't how depression works. It's not like a bucket that you can pour hard-work and care into to make it go away. It's a bottomless pit that will swallow up everything you throw at it if you treat it like that. Indeed, this sort of approach can make it worse because the depressed person knows for sure that everyone has upended their lives to accommodate them and that just pushes them further down.
Don't confuse the illness with the sufferer - it's very easy to start judging the depressed person and thinking of them as selfish and demanding when they really have no choice about how they are acting. Of course living in a lovely sunny place with lots of nice stuff to do and nothing much to worry about should cheer you up. The fact that it hasn't worked tells you that it's a very real, very unpleasant illness.
Quite often the partners of those suffering from depression will end up depressed themselves, making it harder for them to support the first ill person. It might be a good idea for his wife to speak to a medical professional about this herself, she may well benefit from some treatment and support too. If appropriate, that would help her husband too.
As for positive outcomes, it is possible to recover, yes, and if not completely then it is usually possible to live with it and manage it. But it isn't easily fixed in many cases, particularly severe ones, and quite often it comes and goes and then comes back again. There's no one cure or treatment that will always work, there's no easy fix, and unfortunately some people simply don't get better.
Was Lithium prescribed abroad or by a UK Psychiatrist?
Was prescribed abroad.
Are you sure its just depression? No substance abuse involved or other mental health problems etc?
If it is depression I would honestly question that especially if that is the first anti-depressant he has been placed on. I was on Lithium for 10 years but it was to control my mania (Im bipolar) and I was on a separate anti depressant to control the depressive side of the spectrum.
Al I would say is that they should have 100% confidence in the Dr as from my own experience Lithium is seriously powerful drug that needs continual blood monitoring and can alter your personality in a fundamental way.
http://www.bbc.co.uk/programmes/b06zr3zn#play
"A report from the Office of National Statistics suggests that, on average, we are at our most miserable during our middle aged years. Where younger people and the over 65s tend to be more satisfied with life, people aged 45 to 54 report a lower level of personal well-being than any other age group. Anxiety levels are also higher among middle aged people. "
It's probably worse for his wife though.
Looking after her is probably the best you can do for both of them.
Yes macavity exercise can help but in my experience it can also hinder as it gives you another thing to beat yourself up about. 'I'm not fit enough", "my skills are rubbish", "Ill never be as quick as I was last year" - all great ammunition for the depressed mind.
As above, there's no single answer and the best you can do is to support her and be there for him. For me it was a whole host of therapies over several years that got me out of that way of thinking, and aware enough to know when I'm doing it again and how that's making me feel.
[quote=thepurist ]Yes macavity exercise can help but in my experience it can also hinder as it gives you another thing to beat yourself up about. 'I'm not fit enough", "my skills are rubbish", "Ill never be as quick as I was last year" - all great ammunition for the depressed mind.
You pretty much stole my words. I know that in general terms doing exercise makes me feel better - or at least if I don't do any then my mood will gradually get worse. However apart from my usual difficulty in getting out of the door I'm currently really struggling to balance that with how much less fit I am than I used to be, and the realisation that not only will I never be that fit again, but that it will be a lot of work to get from where I am now to anywhere close to that. Having been very competitive and competed at a very high level I find this all very difficult to cope with. I have at least found a strategy of doing things where I'm not competing and have plenty of room for improvement such as rock climbing and unicycling, but even with those being unfit and "fat" and unable to do what I think I should be capable of (or could do a couple of years ago) is getting me down. It's all a bit of a vicious cycle at the moment.
Aracer - slight thread hijack but it sounds like you're aware of your thoughts, have you had any luck with cbt? That helped me, plus the realisation that nobody quicker than me has lived my life so it's not a fair comparison. I bet they're all crap at some stuff I can do 😉
I have a bi polar pal who has attempted suicide. (That was the first anyone knew of her illness including herself she reckons). She is on lithium I think and advocates mindfulness and admits it takes a little effort to not be negative about herself. Something we should all take on board.
She also loves to be involved in stuff and be invited to things. She knows she can be hard work to be around sometimes and has been forgotten about. The support network of pals is often full of people with similar traits, I think she is loving being accepted by someone not on the spectrum.
Her ex couldn't cope and had his own issues probably as a result.
This is an interesting listen. Ignore the Clickbait title, it's really quite an insight into the mind of someone with Bipolar disorder.
http://www.wnyc.org/story/your-sanity-or-your-kidneys/
This probably won't help the OP.
Helps the OP as it makes you wonder why Lithium was prescribed unless there are underlying issues.
[quote=thepurist ]Aracer - slight thread hijack but it sounds like you're aware of your thoughts, have you had any luck with cbt?
On the waiting list with the NHS having eventually gone back to my GP 3 months ago - no idea how long the waiting list is, I've just got a letter telling me they'll contact me "as soon as possible". I first went to my GP almost 4 years ago and saw a gateway worker (and some drugs which did nothing for me), but never anything further having been told the waiting list was long - one of the issues I have with my mental health is that I'm not good at pushing these things or indeed getting round to doing anything (TBH it's an anxiety related issue I've had as long as I can remember, whilst I don't think I've actually been depressed my whole adult life, though I've come to the realisation it might have been in the background for a long, long time). It took me over a year and the excuse of a different medical issue to summon the courage to go back to the GP 🙄 To some extent the trigger for needing to go back was my issues with exercise, having had my second hernia op in September, having never got back the fitness I lost after the previous one the year before - I knew it was going to be a problem not having my drugs of choice for the 6 weeks I was off exercise, but whilst I coped with that by doing even more avoidance than usual I hadn't appreciated the longer term issues.
(apologies for the hijack - I often try and stay away from these threads, but sometimes get drawn in)
Sounds to me like he's making excuses to an extent - need to move to the med,need a dog, need my toys... My first thought was;
Could be the relationship that's holding him down (and her)
I get in the same state when I'm stressing over bigger things - relationships, jobs, "life decisions". If what he thinks he wants doesn't fix it, there's probably something bigger, and I'm not rubbishing their relationship, just could be something like that. Does he work? Do they have / want kids? Does he (do they) really want to live in the med? The best thing might be to give him some space rather than bend over backwards, be prepared to let him go ("set him free") but also he might just need to realise what he's got and could lose.
He is just setting up his own business which in reality is him getting a van and pottering. She has supported him most of the time we've known them. From what we know he is good at his job but doesn't seem to hold it down too long.
She didn't have kids as she didn't think she would be able to look after them and her husband.Whether that was an excuse as she didn't want kids I don't know.
When they got married most of his speech was devoted to his dad who died about 20 years previous.
The more I think about it the more we remember the WTF moments.The last time we flew out he met us at the airport showed us where the cab rank was then drove off saying he would see us later. We still have no idea why he didn't give us a lift. Then we had all arranged to go out for my wife's birthday. His wife appeared at our hotel , we sat there waiting for him to park the car but he decided to go home instead.
We never felt anger towards him whenever this happened (as it has on many occasions) just sorry for his wife.
It's all such a real shame.
OP...
Could it be worth your friend's husband (or your friend) experimenting with coke and hookers?
I've found it to be a great restorative during times of deep depression in the past
When dealing with a friend with depression we were advised to make plans with them.Talk on Skype later?
Pub next Saturday?
Weekend away next month?
Holiday next summer?That kind of thing, tips them away from "I'm letting everyone down, I shouldn't be here" to "I'd be letting everyone down if I wasn't there".
Not sure I agree with this, and I know other people who've had depression who feel the same. Trying to stick to plans can feel pressured, and if you wake up and decide you can't face it you feel like you are letting people down. Half the time when I've been really down I barely know what day it is and any attempt to keep on top of a diary is going to be a total failure.
Better to offer company or stuff to do that day or in the immediate future, IMO.
The tricky part is that sometimes you really do want to be left alone, but no-one wants to feel abandoned either. There is also (apparently) a really difficult balance to be kept in supporting someone with depression - you have to be careful not to enable/encourage negative behaviour by trying to be helpful.