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When Depressed Husbands Refuse Help

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To the outside world, Emme lived a charmed life.  She was a successful model, creative director of her own clothing line, a television host, lecturer, and mother of a beautiful baby girl.  Only her family and closest friends knew she was actually dealing with a devastating situation that is all too familiar to wives across the country: a husband who has depression but won’t get help.

Phillip Aronson, the wonderful man she married, found himself in a downward spiral of depression, even attempting suicide at one point to escape his pain.  Phil was always an energetic partner, excited to go to work each morning either to the showroom to check on the latest graphic designs for the Emme line or to attend meetings about some new project.   He was a caring and loving father.  But as depression enveloped him, Phil “had no energy, no appetite, no drive…and this was in sharp contrast to how he usually was.  He was depriving himself of everything, and when you don’t nourish yourself —physically, intellectually, or emotionally—your body tends to shut down.”

In their book written in both their voices, Morning Has Broken, A Couple’s Journey Through Depression, Emme says, “No one knew what it was like, to be caught up in it like we were…it’s a lonely thing to be married to a man in the depths of a depression with an infant daughter at home…it was all about getting through each day.  I never felt more alone.”  Soon, Emme realized he could not even watch their daughter, Toby, and everything changed: the logistics of running the household and her ability to work.  Emme writes that every day they lost a little piece of Phil, and during the worst period, somebody needed to be with Phil at all times, “and that somebody needed to be me.”

Men and Depression

U.S. statistics state that women experience depression much more frequently than men: 1 out of every 4 to 5 women, compared to 1 out of every 8 to 10 men. However, many experts feel these statistics are simply wrong. “Men experience depression probably just as much as women, but they aren’t diagnosed,” explains Julie Totten, Founder of Families for Depression Awareness, a non-profit national organization. “Depressed men often get angry at others and abuse alcohol or drugs. Depressed women on the other hand may blame themselves, but then they ask their doctor for help.”

The consequences of untreated depression are serious and sometimes fatal. Depression is a leading cause of disability so many men can’t work. Depression also puts men at a high risk for suicide; they are four times more likely to take their lives than women.

Signs of Depression to look for in men:

* If someone is suicidal, treat it as a medical emergency. Call the person’s clinician, or call 911 or take him to your local hospital emergency room.

When husbands have depression, it can tear apart their marriage and family. Wives may take over and hope the problem will go away, or on the opposite end, withdraw, feeling betrayed and angry. More often, they alternate back and forth between these behaviors and emotions. Fifty percent of wives caring for a depressed husband will develop depression themselves.

The good news is that depression is highly treatable.  Once diagnosed, most people who get help report substantial relief.

The problem is that many men deny they are depressed and resist treatment (usually medication and/or talk therapy).  Their belief: depression is a woman’s disease.

Depression Affects Everyone

Dealing with a depressed husband who is in denial is not easy. But, by not addressing the issue, your husband continues to be ill or get worse, even suicidal, and you lose out as well. Depression makes men feel like they are worthless and hopeless. They can’t change how they feel without treatment. “Depression isn’t just your husband’s problem; it’s your problem and your children’s too.  Luckily, there are ways to address the issue,” Totten explains. “The top priority is to get your husband into treatment. You have to ask yourself, ‘What have I got to lose?’ You simply need to take action for everyone’s sake.”

Terrence Real, a psychotherapist and author of I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression, offers his perspective, “Women in a relationship with a depressed man feel faced with a painful dilemma.  They can either confront the man with his depression – which may further shame him – or else collude with him in minimizing it, a course that offers no hope for relief.”  He offers some strong advice to women, “You absolutely have the right, even the obligation, to put your foot down.  You have to insist on good health in your family.  It serves no one any good to back off; go to the mat on this issue.  It affects your husband and marriage, and absolutely your children.”  

He reminds women, “Remember, you are still married and at one time he listened to you.  Don’t be afraid to make this a fight…this is no time to stand on ceremony.  Make a doctor’s appointment, go out to dinner afterwards, be romantic, or bribe him; whatever it takes.” 

What Wives Can Do

Totten was able to help her father get diagnosed and treated for depression; but only after tragically losing her brother to suicide over fifteen years ago because he was never diagnosed.  She realized her dad was exhibiting signs of depression and started Families for Depression Awareness, after finding no help for families who wanted to get involved in a relative’s treatment.

Totten says she had to call her father’s doctor and tell him her father had depression. But she didn’t know how to get him to see the doctor. “Finally, my dad said he thought he had the flu, but he didn’t. I agreed with him and was able to get him to the doctor under this pretense.”

With a resistant spouse, Totten believes women need to take a similar tack.  “Call the doctor and explain that your husband has depression. Explain what the symptoms are. Then, make the appointment for him.  Go with him.  If he resists, ask him to do it just for you, to make you feel better.”

Anne Sheffield, author of Depression Fallout,  agrees with Totten.  “Denial is very common, particularly in men.  They think depression is a sign of weakness, or someone with it is mentally defective.”  She reinforces that wives should not be accusatory and instead need to address different behaviors, like sleep problems, “It’s better not to say: I think you have depression.  He is most likely to come back with `If anyone’s depressed it’s you!’”

She points out even though men may willingly go to talk therapy, sometimes they are unwilling to take any sort of medication because of a possible loss of libido.  “He doesn’t want to be stuck with no sex drive.”  Sheffield stresses to try different or a mix of medications and “tell your husband to give it at least six weeks to work.”

How to Help Your Husband

What Not to Do

Men with depression are suffering from a medical condition, not a weakness of character. It is important to recognize their limitations.

Laura Rosen, PhD, co-author of When Someone You Love Is Depressed, says wives need to educate their husbands.  “Leave brochures out; highlight a section so he has some understanding.”  She suggests, “I’ve noticed you don’t seem yourself…it would help me if you talk about it; I’m up at night and really anxious.”   Collaborate together and then go so far as to get a consultation, get a name, and make an appointment.”

Another way to get husbands educated is to have them take an anonymous depression questionnaire, a quick screen for depression as well as for bipolar disorder and/or suicidal tendencies.

Steve Lappen, a writer and support group leader, who has himself been treated for bipolar disorder (manic depression), recommends that husbands watch the Real Stories of Depression online video from the National Institute of Mental Health (NIMH). The film includes ‘tough guys’ such as a firefighter, a retired Air Force sergeant, and a police officer. The video shows men that depression is a treatable medical condition, not a sign of weakness and gives permission to men to ask for help.  According to Lappen,  “Men won’t even ask for driving directions, so we must let them know asking for help for depression is OK.  Reaching out is a sign of strength, not of weakness.”

With Treatment, Relationships Return

Because depression ran in Phil’s family, Emme says, “Depression was the last thing Phil wanted to admit to.” His father’s mother had been in and out of depression for most of her life and relatives described her as ‘quirky’.  Phil’s grandmother also had a sister who was institutionalized and lived out her days in the psych unit.  Back in those days they didn’t diagnose depression by name; the ‘quirkiness’ ran in the family to include a couple of cousins as well.

Finally, Emme asked Phil’s brother, Seth, who had depression on how to help get Phil into treatment.  Ultimately, their family doctor reached out to them.  He had helped Seth get through his depression in 1986 and had been helping the family deal with Phil’s other brother, Jonathan, living with brain cancer.

It was at the end of a family session with the doctor that Seth stepped in and asked to spend time on what was going on with Phil.  It was almost like an intervention.  Emme says, “We all turned to Phil and said, ‘We love you, you’re here.  You are clearly depressed.”  They left Phil in the room with the doctor to discuss it. This was the beginning of Phil facing his depression through a combination of talk therapy and medication.

But this was not yet the happy ending.  Emme threw herself into being Phil’s caregiver, even at times explaining to his doctor the status of treatment, symptoms and behavior.  She offers concrete suggestions to other wives: learn everything you can about the illness; get a clear, medicine container to keep track of daily dosages when it is too overwhelming for your husband, make a chart listing his moods.  Her biggest suggestion is to carry around one notebook at all times dedicated to your spouse’s treatment.  She also suggests telling well-meaning friends and family to keep their private feelings about therapy and medication to themselves.  Phil eventually had to turn to ECT (Electro-Convulsive Therapy), and is now recovered.  Emme says, “It was our last resort and it was a lifesaver.”

Most importantly, Emme’s message is one of hope and survival.  “My story is just one of many that are happening every day around the world.”  Although their heavenly life turned into a living hell, Emme and Phil, along with untold other couples, conquer depression together and look forward to a new beginning in their relationship.

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