My husband is a 57yo and has been diagnosed with Major Depressive Disorder and Anxiety. His problem started in April, 2010. He is unable to read and write. He became obsessed with this due to changes at work with them implementing classes and computer usage for the supervisors and working foreman, which was his job title. He put himself under so much stress from this and the fact that his 90 year old mother was suffering from ovarian cancer and dying that he became suicidal and religiously preoccupied. He was hospitalized for a week and discharged to outpatient care with a psychiatrist. He has had several medication changes with no improvement in his condition. He has been tried on Effexor, Ambien, Abilify, Ativan, Xanax with increased titrations. He is now on Celexa 60mg., Trazadone 50mg and Ambien 5mg., and Klonopin 1mg qid. He showed no improvement on the Effexor after increases up to 300mg. The Celexa started at 20mg. with Abilify as an additive. He took this for about 1 month and complained constantly of memory loss and not being able to think. The doctor stopped the Abilify and increased the Celexa to 40mg. He still complains of not being able to remember what to do or think. His last increase in med was on October 15. Celexa went to 60mg. Trazadone down to 50mg and Ambien 5mg added to help him sleep. He’s crying, complaining of daytime sedation, memory problems, saying “I just can’t make it”, and that he feels he’s being punished for his sins. He just can’t seem to get on an even keel. He’s been back at work since August and having a very hard time with it but the doctor says he can work. I forgot to say his job is constructing power lines. He is getting ready to leave in the morning to go to another state because of the storm damage and is so agitated and wringing his hands that he’s got me in tears. The doctor told him a while back to just quit his job if it bothered him that much. We need his income and the insurance so this is not an option. Wonder how the doctor would feel about not being paid. We are currently waiting to see a neurologist as a CT scan and an MRI done in the hospital denoted some “white matter” changes. What that means, I have no idea. I guess I’m asking what would be our best course of action and what can we do to facilitate some improvement in his condition? He isn’t willing to go to therapy as he is really stressed over financial matters too.
A: Sometimes life really is unfair. Your husband has had a number of stressors piled up on each other at an age and time when life is supposed to be getting a little easier, not harder. It must be both terrifying and sad to watch this good man crumble like this. I’m sure the psychiatrist is doing the best he can with the medications but it may well be that his psychiatric condition is only part of the picture.
By all means, please, please follow through with the neurologist. There are a number of medical conditions that can provoke agitation, depression, and thought disturbances (like the religiosity). It may well be that the psychotropic drugs aren’t working because the problem isn’t entirely psychiatric.
If he is medically okay, then it really is time to see a psychologist. Pills alone aren’t going to help him feel better about himself or learn how to manage the multiple stresses he is under. His ego has taken a major wallop. For years, he got along fine without being literate and now technology is making him feel inadequate and scared. His role as a provider is being threatened. If, like most men, his self-esteem is deeply tied to his work, that too is under siege. His mother is dying. He doesn’t feel in control of his own mind. He worries about worrying you and letting you and the family down. It’s no wonder to me that he is so upset.
A psychologist or other licensed mental health counselor can help him set priorities and learn new ways to manage stress. He will get emotional support and a positive sounding board for his anger and fears. Because he knows you love him and care for him, your husband probably protects you from some of his thoughts and feelings. He doesn’t need to do that with a therapist.
I understand that money is tight and your husband is therefore reluctant to pay a therapist. Many companies offer free counseling through an Employee Assistance Program as part of their benefit package. You might see if your husband’s workplace has such a program. If not, ask your doctor if there is a clinic or a private practice that offers a sliding fee scale. Consider that paying for some sessions now may help prevent your husband from further deteriorization and pain.
I wish you both well.
Last reviewed: By John M. Grohol, Psy.D. on 20 Nov 2010
Hartwell-Walker, D. (2010). Husband suffering with anxiety and depression. Psych Central. Retrieved on April 24, 2014, from http://psychcentral.com/ask-the-therapist/2010/11/20/husband-suffering-with-anxiety-and-depression/