18th January, 2009
Question
My husband was diagnosed with depression three years ago. He is on sick leave ever since, takes medication, and attends a therapist once a month. Last year he attempted suicide and almost didn't make it.
He spends most of his life at the moment sleeping, or sitting in front of the television. He is very easy to live with as all the moody behaviour has ceased and our house runs very smoothly and is stress-free. He doesn't want to engage with outsiders other than members of his family - and here is my question. When any one of his family visit, he is bright, cheerful and talkative. But as soon as they leave, he disappears to the bedroom again.
How can you be depressed one minute and not the next? I heard a doctor on the TV say that depression should get the same care and sympathy as a physical condition. But a person who is physically ill can't turn off the symptoms at will, which is what my husband can do with his depression. He is 55 years old now. Is this the way he's going to remain? I'm afraid to challenge him on anything in case he attempts to take his own life again. I'm also on tender-hooks if I have to leave the house for any length of time.
We got no advice from the hospital, or the psychologist, after my husband's suicide attempt. In fact, not one member of the medical staff spoke to me or my family about the episode. I'm so confused I don't know how to cope anymore.
Answer
You're on permanent suicide watch. That's not sustainable. You're going to have to systematically think through possible solutions. Of course your husband has to be cared for. But so do you. I can't, of course, give you the answer. I can lay it on the line, which will hopefully help you clarify your thoughts.
Yes, to answer your question, depression can seem capricious. Your husband probably makes a huge effort when his family come to visit. And yes, that is very frustrating. Why can't he do it for you, and why can't he do it all the time, and what's this depression really about - all reasonable questions. The problem is that such questions actually get you nowhere. Your husband probably doesn't even know, not at any conscious level anyway. All I can tell you is that serious depression is accompanied by terrible exhaustion. The effort to be cheerful can't be sustained. His family visit occasionally. You're there all the time. It may well be as simple as that, at some level.
This occasional lifting of mood is also part of the reason why a suicide watch is so wearing. Such good moments don't let you off the hook. You know only too well that some people go smiling to their own death. In short, not only are your husband's bright moments frustrating, because it seems he can pick and choose, they don't even bring relief from worry, because they don't promise any real improvement.
The hard fact of life is that looking for answers to your husband's depression gets you nowhere. You have to focus instead on your own well-being. To do that, you need to get several things straight. You can't keep your husband completely safe. Trying to do so is an empty exercise. Someone who wants to commit suicide will find a way, no matter how watchful you are. Short of a lock-down cell in a secure unit, there's no stopping the determined seeker of eternal oblivion.
That's why you do need to have a serious discussion with your husband's therapist. You need help in finding a balance between reasonable care of your husband and reasonable care of yourself. You need your sleep, time off, relaxation, fun, friends, a regular break from home - the lot. That means getting professional guidance on what constitutes an appropriate input of care from you. Indeed, you need to know how your husband's doctor rates the suicide risk. In short, you need serious back-up.
You can't send your husband to suicide either. None of us can make someone else kill themselves. If he does, it will be his decision. Certainly you should be kind, thoughtful and loving. You cannot be a doormat. You have to be able to challenge your husband on ordinary things. I understand. You don't know the true parameters of his depression. For example, if he doesn't shave, is that part of his illness? Maybe it is, in the sense that he has opted out of all self-care. But can't you, then, politely ask him to do so?
Nobody can live eternally walking on eggshells. There is an onus on us to be kind to those who are sick. There is, however, a huge difference between being kind and being totally silenced. I can't pick your path for you. I do repeat, however, that you urgently need professional guidance about finding a realistic role in this sad situation.
