Depression Support Group
Depression is a real and debilitating condition that is often misunderstood by family and friends. Its meaning can range from a prolonged period of sadness to an actual mental illness with specific symptoms. Find and share experiences with others who are going through the same struggles.
Friends here know our story: happy, seemingly well-adjusted mother of 3, married 30 years, successful nurse with sterling reviews over 30 years, retired, problems with move near the beach, turned down homes in difficult market, went in hospital, went to 8 different hotels friend' and family homes, now in our own new house which everyone other than my wife says is beautiful and well-designed. Diagnosed with major anxiety and depression.
She has been through probably 6 different medication regimens. Before illness, compliant patient who did not take any medication dealing with life's challenges (including thyrooid cancer) on her own. Now physicians, family and friends strongly believe medication and therapy are needed (except for her sister). With the dramatic change in behavior, her sister maintained my wife had a stroke, and recently suggested Alzheimer's or other disease. Her sister constantly says about medication- "you need to understand these drugs are very serious, they change your brain. You need to start looking at physical causes which everyone seems to ignore." In fact, multiple doctors have basically rejected physical causes. Her sister is a strong Trump supporter, constantly talks about politics and like most strong-willed people on either side, believes her own views are extremely important, but has little interest in contrary positions.
While my wife and her sister are close, historically, my wife went her own way; her sister did not work for many years while my wife did, sis just kept with family while my wife had a large circle of friends, sister had family in her personal business and she in their's while we have been reasonably private until recently. One problem is that my wife seems to have adopted her sister's views for reasons that are unclear. My wife is constantly talking about physical problems which the doctors do not see; she (and her sister) blame a dimunition in vision to Lexipro though two opthomologists said there's just mild vision loss consistent with age.
It's hard, my sons who are bright and well-accomplished are constantly saying she needs to take her medication and they believe she has been non-compliant. She has periodically acknowledged that and I recently saw various unused pills under her bed. I try to monitor use but she apparently evaded that. Now, she remains severely depressed but rejects the solutions sensible people and her doctors outline. We hope to go out for dinner with her friend, but my wife says she looks terrible and has nothing to wear.
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I invited Bill to have dinner with me last Sunday. He wasn't willing to drive 7 hours to mid Michigan and teased me with his beautiful ribs!!! So, of course I ate alone and had cedar salmon
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Vision loss is a broad term. Does your wife have blurred vision or is she unable to see at all? Mild vision loss can be associated with age. Dry eyes caused by hypothyroidism can cause blurred and doubled vision, and the sufferers would need to apply drops for dry eyes to restore visual clarity.
If your wife is non-compliant with her oral antidepressant, perhaps you can discuss with her doctor/psychiatrist for an injectable form. Once the chemical imbalance in her brain is rectified, then perhaps normalcy (or close to baseline) may return. That is, if her depression is due to chemical imbalance in her brain, and not induced by the lack of thyroid hormone due to removal of the thyroid.
Find a primary care doctor who is willing to coordinate her treatment, and to refer her to appropriate physicians if needed. Best wishes, and good luck.
1. Antidepressant She's on Prozac now, 40mg.
2. Thyroid Takes Synthroid 137mg and is fully compliant with that. Her levels are now normal, and her endo does not see a serious problem.
3. Eyes Endocrinologist and 2 opthomologists say no connection with thyroid or other mediation, just normal age-related changes.
4. Injection Never thought of this and will check. One nurse psych diagnosed, reverse placebo effect, where the patient attributes various maladies to the medication.
5. Intern We have an outstanding internist. For 25 years, my wife liked and respected him. but when this started, my wife thought she was seriously ill, the internist diagnosed depression, and she is now somewhat skeptical of him. .
1. the Fluoxetine dose is still lowish. Perhaps you can ask your wife's psychiatrist to up-titrate the dose until your wife is asymptomatic for depression. Alternatively, the psychiatrist may need to introduce a second anti-depressant to prevent breakthrough episodes of depression instead of relying on one drug to control the depressive symptoms.
2. I am glad to hear that her hypothyroidism is well managed with Levothyroxine..
3. I am glad ophthalmologist has attributed her vision issues to age rlated changes.
4. I think that the best health professional to diagnose depression is the psychiatrist. The doctors have more extensive medical knowledge and clinical experience, so they would be the best professional(s) to prescribe anti-depressants.
5. There is also a perception in the medical community that if the doctors / physicians cannot find the cause of ailments in women, they would attribute the ailment to depression regardless of the patients' medical histories.
If your wife feels that her ailments need further exploration, and that you can afford the medical expenditures, perhaps you can allow your wife to obtain 2nd and 3rd opinions of diagnosis. You will find that a diagnosis is only the personal opinion of a doctor, unless the diagnosis is verified by medical evidence.. Best wishes, and take care.
1. Prozac That the dose is low makes sense. The problem is both my wife and her sister attribute problems to the medication, and say the medicine will not do any good. How could we convince her to take a higher dose, if we already have a problem getting her to do this one reliably.
2. Second medicine Her psychiatrist previously recommended a second medication suggesting Ambilify and Wellbutrin, but my wife refused to take them. So we're in the situation as he puts in, where we can only use one medication because of her preference. (unlike teachers or policemen, psychiatrists try to work with the patient's preferences even if they seem unreasonable).
Do note for a period she had schizophrenic type issues (that too developed in the last 2 years) delusions, so we were using a second medication to address that more serious issue which has fortunately subsided.
3. Discussions with her sister. What you've said is basically what my three sons, and her two friends (one a psychiatrist) have said. However, my wife speaks most frequently to her sister, and seems to get comfort there. I work 50-60 hours per work spend 20-30 hours coordinating things for her and taking care of the house.
Her sister believes she (the sister) was the victim of an attempted sexual assault by her psychiatrist and over-medicated, and she has a negative view. When he husband briefly took medication, she recites a pattern of horrors that supposedly happened. So my wife is already negative on medication has her primary contact continually pushing the idea of a physical cause.
We had a vigorous argument over the holiday- sister, we've tried things your way over a year and a half and your wife is still ill, these drugs are obviously not doing any good and probably doing harm, me- nice try but we have never been in a position of being compliant with prescribed medication and assessing her, drugs recommended are not taken, she wouldn't take Ambilify or Wellbutrin.
4. We did see a neurologist yesterday at a prominent hospital in NY and he is recommending a particular brain PET Scan. A neuro-psyc evaluation to determine whether the problems lie has been recommended.
She took a group of tests and generally performed them well. Her memory is better than mine though she is a couple of years older. However asked to recite a 4 or 5 digit number, 37954, and then backwards, she had problems doing that. Perhaps its stubborness, but I was able to do it while listening.
5. Erratic behavior Most depressed people look and stay depressed. If they have say social anxiety that is readily apparent. In contrast, my wife readily switches back and forth. She stayed in bed more of the day but I suggested we get together with her good friend who was in our area. My wife was reluctant and then said she looked terrible and had nothing to wear. She did agree to go.
At the restaurant, she smiled and was socially engaging and skilled. She looked good, listens well, smiles, compliments, and is an engaging person (her dad was a diplomat and my son quite popular with similar skills). But then when done, she's like Cinderella, starts mumbling, complains her feet hurts, is almost crying talking with her sister, and disintegrates.
6. Therapy She is resistant to therapy. I periodically attend simply to give the doctor or therapist an idea of the seriousness of the problem because otherwise it gets soft-pedalled. She is doing mostly telephone therapy and had fallen asleep a couple of times. To the extent she discussed problems, it's relentless focusing on what has been done, saying she ruined things for her family, but resists discussing the present and future.
I asked her therapist for a detailed plan, but the therapist noted but my wife has difficulty taking simple direction- take a walk each day, so how can we talk about more. Note she has had probably 5 therapists in the last 2 years, after being seemingly happy and functional for 30 years.
This seems to be quite a puzzle. Did this all start after her retirement?
It is concerning that she has had schizophrenic like issues. Is there a missing diagnosis, i.e., Lewy-body dementia (there can be some significant psychiatric, behavioral and emotional issues)? I find that sometimes there is not one single issue but many and it can take time putting the pieces together.
Is this hard on YOU? Caregivers are often placed under enormous stress and
often benefit from support. I think that there may be a support group for caregivers on DS. If not there are many both online or in person in most communities. It seems like she has had a rapid decline in many areas over the past couple of years and, as you say, it's not a matter of coming up with a plan, it's getting her to follow one. Just one more question: Is she competent to make medical decisions on her own? It sounds like she probably is? Having worked as a hospital social worker it's hard to get anything done if the person chooses to make decisions that are not in their best interest. So sorry that this has had such a profound affect on your entire family
1. perhaps you can tell the sister in law not to interfere with your wife's medical treatment because she would adversely affect your wife's long-term prognosis.
2. If the fear of sexual assault by a psychiatrist was induced by the sister, perhaps you can find a female psychiatrist to treat your wife. Sometimes, treatment by a female doctor may be better, and this may encourage your wife to disclose her troubles/delusions/depression to the doctor. There is a possibility that your presence during your wife's consultation with the psychiatrist may discourage disclosure = perhaps allowing your wife to have the confidence to disclose her troubles to the doctor would achieve better outcomes.
3. If your wife has a diagnosed schizophrenia, perhaps an anti-psychotic is a better choice than an anti-depressant. This is a conversation the patient's carer can discuss with the psychiatrist. The use of an anti-psychotic may bring forth side-effects, but you would have to weigh the risks against the benefits gained.
4. The psych-neuro tests are aimed to find which part of the brain has been impaired. If your wife is unable to cite numbers backwards, then it may indicate short term memory loss. The Digit Span Test backwards is often used to detect mild cognitive impairment for the early detection of certain conditions such as dementia.
5. Perhaps psychotherapy (face-to-face) is a good option. Tele-counseling, though convenient, allows patients to conceal emotions that otherwise can be detected by the therapist if the session is conducted face-to-face. If COVID is the reason for non-physical contact, there is the option to have counseling done face-to-face through the web.
6. Your observation of your wife's cognitive difficulties to recall particulars or to take directions, seem to suggest the onset of dementia, providing that her cognitive impairment is not induced by drug(s). The psychological changes caused by dementia also include depression, confusion, paranoia, agitation, hallucinations, anxiety..... You have mentioned that your wife's age is not young, so perhaps consultation with a geriatrician to assess for dementia may be helpful. People in their 30s and 40s can also suffer from dementia.
Perhaps you can explore the above options to see if you can find the appropriate treatment for your wife's current medical condition (s).
What things can I do to help my wife?
1. She really needs some structure. Would creating a list each day help. I tell her to do things like put away the dishes, take a walk, get dressed but she 'll say in a few minutes and not do it.
2 . Dimentia. It seems this requires memory loss. She did fine on the memory test, name 10 fruits, 15 minutes later, she recites what she had said, memory is fine. And its strange, my wife can shift into normal when she wants, for example, seeing her psychiatrist, she asked pleasant questions about how his summer was. Its strange to have someone say no, no, I don't want to see the doctor, and then appear, and be pleasant and cooperative.
She did not do well on the digit test, and that seemed to me an issue of cooperation and flexibility as well as memory.
The test requires you to do something differently, go backwards, and she has become somewhat inflexible. When I suggested she prepare a list of things she could do to get better, she wrote 100 times, I can defeat this illness.
2. Sister My son is concerned she is overly reliant on her sister who again is anti-therapy, anti-medication. It's confusing but no my wife is not concerned about sexual assault or the like, but does tend to hide or minimize problems which frustrates therapy. I've seen it and multiple doctors have related it. Her sister did not unduly influence her for 30 years but around Thanksgiving was minimizing the need for medication or therapy and saying there was a physical cause. She's the only family member who says that and all my wife's friends see the need for medication and following instructions.
Since sis believes she is smarter than everyone else, there's little chance she would take a subsidiary role, since she believes the overriding problem is no one is listening to her. She had her own serious anxiety and for years blamed Obama and the Democrats for any problems in their lives.
3. Me. Sure it is stressful, but I'm old school, for better for poorer ... She was a wonderful wife for 30 years, easygoing, likeable. I'll do my best and I'm here to try to understand what will help. I do exercise regularly but can't escape the stress and unpredictability. Right now, my wife is quite possessive and does not want me to leave the house without her, and I am a little afraid to leave her alone.
From your descriptions of your wife's symptoms above, I suspect of an organic cause coming from the brain. I think that your plan to have for a neurology assessment by a neurologist is a good idea.
I tend to suspect the onset of dementia, which often begins with behavioural changes with mild memory loss, but the patient can still converse and react appropriately as though their cognitive function is intact. However overtime, the dementia progresses and may manifests in terms of delusional thoughts, impulsive illogical actions and considerable short-term memory loss until it comes to a final (and terminal) stage where the sufferer can no longer remember anything/anyone, including the requirement to eat.
If dementia can be diagnosed early, there are drugs that retard the progression of dementia, that slows down the cognitive decline until well into old age. There is a new drug released on the market Lecanemab that reputedly improves the symptoms of dementia by slowing down the progression of disease. There are also drugs such as Donepezil, rivastigmine and galantamine that are used to treat the symptoms of mild to moderate Alzheimer's disease.
Whatever your wife's conditions are, the neurologist and other physicians can arrive at the diagnosis.
It is very stressful for a carer of a family member with psychiatric problems and cognitive decline, to cope with the daily fluctuating moods and behavioural abnormalities of their loved ones. Patients with depression and delusional thoughts can say hurtful things and do dangerous things, e.g playing with fire or water, climbing to great heights and falling over. The sick patient may express the wish to die, or for self-harm, so you may have to arrange for around the clock care.
Additionally, you have to think of your long-term health and make a long-term plan for your wife's future. Perhaps a professional carer may be required - the hospital may provide professional carers or community nurses to assist you with the care of your wife, if you cannot afford to fund these services privately. Overtime, when the need for medical management increases, you may need external assistance with daycare, or 24 hours professional care, or with the basic transport to take your wife to and fro from the hospital for medical checkup.
For now, perhaps the first thing to do is to encourage your wife to submit to the neurological tests in order for the doctors to arrive at a differential diagnosis. Once a diagnosis is obtained, perhaps you can research more into the disease and start planning for the future for both you and your wife. A hospital social worker may be able to assist with the planning, and liaise/connect you to the right allied health agencies that could provide your wife with additional support.
I hope the above would help, and please write us a post whenever you can to update of your wife's progress. Best wishes, and take care.
https://www.mayoclinic.org/drugs-supplements/dextromethorphan-and-quinidine-oral-route/side-effects/drg-20074618
Appreciate all the help and kind words and I find the group really helpful in trying to address situations, Some questions,
1. To 30+ years, my wife kept the house clean. Now, I ask her to put the dishes away and can't seem to get that done.
2. She has a meeting with a woman's group tonight. Hopefully she will make some new friends, any suggestions if she gets nervous.
3. At night, she now says she's in pain. She complains about her feet, but resists going to a foot message place and her doctor found nothing. How do you respond.
4. Still trying to figure out things. Our son said he was going to NY and he and his fiance are seeing one of her girlfriends, my wife mentions a name and is right, who remember stuff like this.
Men may retain physical strength till old age, but women may not retain the same strength as they were young. That is, what your wife could achieve during youth cannot be compared to her current incapacitation due to chronic illnesses. If your wife is well enough, mentally and physically, I am certain she would do the simplest task, but look at her current ailments now, as you have described. It's time that her family should step up to help her with the simplest chore, as it is time for your wife to relax and enjoy the break during ill health and old age. If you are overwhelmed with housework, perhaps you can contact community help to come and assist with household chores, or pay for these domestic services yourself if you can afford it.
From your description, it seems that your wife is an amicable person. I am certain that her eagerness for new friendships will dispel any anxiety.
An important aspect about dementia is that the sufferers lose short-term memory, but they can recall long-term memories to minute details, especially memories that are of significant value. I would not be surprised if your wife could recall details of your son's fiance.
Take care Bobby and don't worry too much. Let the doctors work things out, and take each day at a time.
My youngest wanted to meet with her yesterday. He is a corporate executive and she will call him sometimes repeatedly during the day. He was very upset when he talked to her that she did not acknowledge her depression and anxiety, calling it "the least of my problems", but talked about her feet and not feeling well. People wear compression stockings, do exercise, walk moderate amounts, try reflexology, see podiatrists, get comfortable shoes, none of which she has done or has seeming interest in doing.
Today, Sat I wanted to go out. She didn't want to go, wasn't get dressed and lounging around. Older son called. He said he is not available for repeated calls during the day to talk about meaningless pleasantries; and he says that stresses him. He said let's talk about what's going on, telling his mother, you have serious depression and anxiety and nothing is being done about it, adding it's a family characteristic. He mentioned her sister who also has serious anxiety, is skeptical about psychiatrists, but says my wife has physical problems.
He wants my wife to commit to some action and says from now on he will calling her on that, to the extent she wanted a crutch to avoid her problems, that's not his function. Again both kids are busy, solve problems at their work and as men are prone, to do, like to solve problems rather than her people ventilate. Kids are upset at the lack of progress, and inability to acknowledge problems.