Concerned for H’s mental health. What to do?

[Anonymous]

Anonymous wrote:You sound incredibly supportive and levelheaded. Standard care for depression is talk therapy/cbt and possible treatment with SSRIs (antidepressants) especially if this is a relapse and drugs were helpful before. He needs to see a counselor and a psychiatrist. You can help him make appointments if he’s struggling that profoundly. He seems to be leaning on you a lot and looking to you for guidance. So you might as well counter his request for your permission to do weed with support instead for proper care.

I say this as a person with recurrent depression myself who is currently leaning hard on my partner. But also doing the work with weekly therapy and med management with a psychiatric nurse practitioner.

All this. He needs meds and therapy. However I didn’t find CBT helpful and he might not either. Maybe he needs a therapist with a different approach. Maybe he needs just some emotional processing, somebody to hear him, and many therapists take that approach. What I needed was dialectical behavioral therapy which is a branch of CBT but was far more helpful than generic CBT for me.

[Anonymous]

Anonymous wrote:Medications and especially weed are a crutch. He needs to get his ass to the gym and lift. Best thing you can do is go with him to the gym to encourage him to do it.

We have three kids, I can’t go to the gym with him.

Also, as someone who has lifted most of her adult life, I think this is very dangerous advice. Medication does have very real benefits, and a barbell doesn’t replace them. Some of the biggest meat heads I’ve known also suffer from mental illness. One of my good friends is a leading expert in the strength and conditioning field and he struggles with depression.

[Anonymous]

OP, you sound incredibly supportive and he's fortunate. Please don't forget that YOU are a person in this family too, with your needs. At the risk of sounding cold (but it's easy for me to do since I'm a stranger) but I think you might want to start telling him he needs to commit to getting a handle on his issues rather than burdening you with them and seeking permission to do things he knows aren't in his or his family's best interest, because your support tank is running dry and your resentment tank is starting to fill. And you mention that you have kids?! Kids pick up on more than we think. Have you checked in with them about their joyless, do nothing father? Separation might be best for everyone involved.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:


Don’t fall into the weed trap- small amounts may mimic an anti-depressant but large amounts may worsen depression. Why did he originally stop taking anti-depressants? I would insist on a psychiatrist and anti-depressants, once he is stabilized let him discuss marijuana use with his doctor.

OP. I completely forgot to mention that. He is still on his anti depressants, but has been talking about how he misses the “highs” of his more manic periods. He recognizes that the medication levels him out overall so his lows aren’t as bad but he wants the highs again. This is very concerning to me, and I’m worried he’ll go off his meds without the guidance of a doctor.

He sure sounds bipolar to me. There's bipolar 1, with severe manic periods, and bipolar 2, with less severe manic periods. And to confuse matters more, my ex-H was diagnosed with bipolar 2 even though he never had "up" periods, and it was explained to is that he experienced dysphoria instead of euphoria, so instead of feeling happy, his manic periods were marked by agitation, anxiety, and irritability. So he sang between that and depression, which all just looked like depression really. Anyway, my point is, he probably needs a cocktail of meds including a mood stabilizer.

OP. This is interesting. The weird thing is I’ve never really noticed any swings. He’s never irritated or anxious. I’ve never even seen him angry. All I noticed is that once in awhile he’ll get really into a hobby, and once in awhile he’ll spend more time sleeping and will give up things like working out. I didn’t even know he was feeling swings until he told me.

I wonder if part of the problem is he has only seen a GP for anti depressants. He should probably see an actual psychiatrist instead.

I have bipolar 2 disorder. I see Dr. Mehra who has offices in Alexandria and Fairfax (I think?). She is brusque and runs a skeleton practice but has been wonderful for me. The great thing about this illness is that there is one medication for it—Lamictal—that is almost always very effective. And it has a generic so it’s cheap.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Medications and especially weed are a crutch. He needs to get his ass to the gym and lift. Best thing you can do is go with him to the gym to encourage him to do it.

We have three kids, I can’t go to the gym with him.

Also, as someone who has lifted most of her adult life, I think this is very dangerous advice. Medication does have very real benefits, and a barbell doesn’t replace them. Some of the biggest meat heads I’ve known also suffer from mental illness. One of my good friends is a leading expert in the strength and conditioning field and he struggles with depression.

OK....but is he exercising? At all? he needs to be running, walking, doing yoga, something...ANYTHING. So maybe don't nitpick the well-intended advice by chastising strangers.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:


Don’t fall into the weed trap- small amounts may mimic an anti-depressant but large amounts may worsen depression. Why did he originally stop taking anti-depressants? I would insist on a psychiatrist and anti-depressants, once he is stabilized let him discuss marijuana use with his doctor.

OP. I completely forgot to mention that. He is still on his anti depressants, but has been talking about how he misses the “highs” of his more manic periods. He recognizes that the medication levels him out overall so his lows aren’t as bad but he wants the highs again. This is very concerning to me, and I’m worried he’ll go off his meds without the guidance of a doctor.

He sure sounds bipolar to me. There's bipolar 1, with severe manic periods, and bipolar 2, with less severe manic periods. And to confuse matters more, my ex-H was diagnosed with bipolar 2 even though he never had "up" periods, and it was explained to is that he experienced dysphoria instead of euphoria, so instead of feeling happy, his manic periods were marked by agitation, anxiety, and irritability. So he sang between that and depression, which all just looked like depression really. Anyway, my point is, he probably needs a cocktail of meds including a mood stabilizer.

OP. This is interesting. The weird thing is I’ve never really noticed any swings. He’s never irritated or anxious. I’ve never even seen him angry. All I noticed is that once in awhile he’ll get really into a hobby, and once in awhile he’ll spend more time sleeping and will give up things like working out. I didn’t even know he was feeling swings until he told me.

I wonder if part of the problem is he has only seen a GP for anti depressants. He should probably see an actual psychiatrist instead.

I have bipolar 2 disorder. I see Dr. Mehra who has offices in Alexandria and Fairfax (I think?). She is brusque and runs a skeleton practice but has been wonderful for me. The great thing about this illness is that there is one medication for it—Lamictal—that is almost always very effective. And it has a generic so it’s cheap.

There you go OP. Pick up the phone, make him an appointment. Get moving on this. Now.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Medications and especially weed are a crutch. He needs to get his ass to the gym and lift. Best thing you can do is go with him to the gym to encourage him to do it.

We have three kids, I can’t go to the gym with him.

Also, as someone who has lifted most of her adult life, I think this is very dangerous advice. Medication does have very real benefits, and a barbell doesn’t replace them. Some of the biggest meat heads I’ve known also suffer from mental illness. One of my good friends is a leading expert in the strength and conditioning field and he struggles with depression.

OK....but is he exercising? At all? he needs to be running, walking, doing yoga, something...ANYTHING. So maybe don't nitpick the well-intended advice by chastising strangers.

Yes, he does.

There’s nothing wrong with advice to exercise, my issue is the statement that medications are a crutch and lifting will fix everything. It won’t.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:


Don’t fall into the weed trap- small amounts may mimic an anti-depressant but large amounts may worsen depression. Why did he originally stop taking anti-depressants? I would insist on a psychiatrist and anti-depressants, once he is stabilized let him discuss marijuana use with his doctor.

OP. I completely forgot to mention that. He is still on his anti depressants, but has been talking about how he misses the “highs” of his more manic periods. He recognizes that the medication levels him out overall so his lows aren’t as bad but he wants the highs again. This is very concerning to me, and I’m worried he’ll go off his meds without the guidance of a doctor.

He sure sounds bipolar to me. There's bipolar 1, with severe manic periods, and bipolar 2, with less severe manic periods. And to confuse matters more, my ex-H was diagnosed with bipolar 2 even though he never had "up" periods, and it was explained to is that he experienced dysphoria instead of euphoria, so instead of feeling happy, his manic periods were marked by agitation, anxiety, and irritability. So he sang between that and depression, which all just looked like depression really. Anyway, my point is, he probably needs a cocktail of meds including a mood stabilizer.

OP. This is interesting. The weird thing is I’ve never really noticed any swings. He’s never irritated or anxious. I’ve never even seen him angry. All I noticed is that once in awhile he’ll get really into a hobby, and once in awhile he’ll spend more time sleeping and will give up things like working out. I didn’t even know he was feeling swings until he told me.

I wonder if part of the problem is he has only seen a GP for anti depressants. He should probably see an actual psychiatrist instead.

I have bipolar 2 disorder. I see Dr. Mehra who has offices in Alexandria and Fairfax (I think?). She is brusque and runs a skeleton practice but has been wonderful for me. The great thing about this illness is that there is one medication for it—Lamictal—that is almost always very effective. And it has a generic so it’s cheap.

Thanks for the recommendation. We don’t live in DC anymore, but I’ll pass along the medication recommendation.

[Anonymous]

Anonymous wrote:


Don’t fall into the weed trap- small amounts may mimic an anti-depressant but large amounts may worsen depression. Why did he originally stop taking anti-depressants? I would insist on a psychiatrist and anti-depressants, once he is stabilized let him discuss marijuana use with his doctor.

Weed is ruining my eldest’s kid’s life. All his decisions are made under the cloud of weed. It’s not as benign as people think it is.

[Anonymous]

Anonymous wrote:OP, you sound incredibly supportive and he's fortunate. Please don't forget that YOU are a person in this family too, with your needs. At the risk of sounding cold (but it's easy for me to do since I'm a stranger) but I think you might want to start telling him he needs to commit to getting a handle on his issues rather than burdening you with them and seeking permission to do things he knows aren't in his or his family's best interest, because your support tank is running dry and your resentment tank is starting to fill. And you mention that you have kids?! Kids pick up on more than we think. Have you checked in with them about their joyless, do nothing father? Separation might be best for everyone involved.

Thanks I wouldn’t say he’s joyless around the kids. It’s more like, I’m trying to be supportive by letting him sleep in, which means I care for the kids all morning. Which is fine once in awhile, but every weekend is wearing on me.

[Anonymous]

I'd be depressed too if my spouse was micromanaging me the way you're micromanaging him. Geez.

Signed,

A woman

[Anonymous]

Anonymous wrote:OP, you sound incredibly supportive and he's fortunate. Please don't forget that YOU are a person in this family too, with your needs. At the risk of sounding cold (but it's easy for me to do since I'm a stranger) but I think you might want to start telling him he needs to commit to getting a handle on his issues rather than burdening you with them and seeking permission to do things he knows aren't in his or his family's best interest, because your support tank is running dry and your resentment tank is starting to fill. And you mention that you have kids?! Kids pick up on more than we think. Have you checked in with them about their joyless, do nothing father? Separation might be best for everyone involved.

I fully agree with this. I am 60 and have lived with an ADHD spouse for 26 years. He smoked weed for years to ‘fix’ the problem. It didn’t. He’s been using extreme exercise which he thinks works, but it doesn’t. Covid forced him to work at home and it’s been a bit of a nightmare - every time I have to say something to him, I run the risk of being told to ‘shut up because I’m ruining his concentration’, etc. Well, then give me the unilateral power to make household decisions and don’t expect to be consulted. The kids are grown and right now I’m planning two months way with family up north with the dog for some R&R. What he doesn’t know is I might not decide to come home.

[Anonymous]

Anonymous wrote:Medications and especially weed are a crutch. He needs to get his ass to the gym and lift. Best thing you can do is go with him to the gym to encourage him to do it.

Do NOT listen to this person. This is not how mental illness works. Medication is very important. and my husband who has depression and anxiety op, also uses weed. I agree it's not the best and we have gone through very very similar discussions. He stopped using weed for one year and at the end of the year he felt like he really wasn't feeling better off the weed, and the weed did help him relax so we came up with a plan with very strict boundaries (only after kids are in bed and I am home, no driving after etc for example) to keep it open between us.

OP our situation sounds very similar though my husband doesn't have any us, sounds like maybe your husband feels like he's having hypomania. If he has that - I really really think he needs to see a psychiatrist. It can actually be risky to take some antidepressants if you have a history of mania so that needs to be assessed and not be a PCP. Normally fine to have pcp prescribe if it's just depression but it sounds like more of an assessment is necessary.

I will say that most people here are not going to understand. they will say I am a horrible person for being ok with my husband smoking weed on a regular basis. but my husband is an incredible father, husband, and he happens to struggle with this and after many years of back and forth I decided it was NOT worth our marriage to fight over weed. I'd rather us have open conversations about it. He is also on an antidepressant and sees a therapist about monthly.

The first step is the psychiatrist and therapy. THen you all can work on a plan together that maybe includes weed.

[Anonymous]

NP.

OP, you mention how he at times gets really "into" a hobby (hyper focused, would you say?) then can go the other direction and just lie in bed. I am not going to diagnose him here and I'm no doctor but this sounds like my friend who was misdiagnosed for YEARS as depressed when she actually had bipolar disorder. Some doctors are poor at diagnosing BPD unless it exhibits very, very "textbook" symptoms. Misdiagnosis leads to giving a patient the wrong medication that does not address the real condition. I would get him seen by fresh eyes and suggest the idea of bipolar at the very least to rule it out if it's truly not the case.

The fact he wants his "high" feelings back again is extremely worrying. Has he articulated that to a doctor in exactly that way? He feels too "evened out" and misses the peaks? A doctor really needs to hear that AND needs to hear that DH is trying hard to justify weed use.

I think you are right to say that weed use should come only with a doctor's say-so and a prescription for medical weed. Your DH is clearly seeking, very hard, for the green light to self-medicate with weed. Don't give it to him. Despite the belief by many that weed is innocuous, it interacts with hundreds of medications, and if he starts smoking on his own while taking meds (or worse, quits meds in favor of weed) -- your problems will worsen. I"m not saying weed is evil, I'm saying it's still a drug that will affect his mental state and his treatment with other meds (and could even affect any talk therapy, if he feels he doesn't need to talk to anyone because weed alone is enough for him to feel fine).

Word of warning, too: If he just goes out and buys weed, he could end up with weed that is much more potent than he realizes. A friend got very sick from smoking weed that "wasn't like the stuff I smoked a few years ago" -- it was knock-you-on-your-ass potent stuff. There's a huge variety out there now, and your DH could end up with something that makes him feel sick-- or makes him feel higher than before and becomes way too attractive to him.

You are right to intervene here, because he is not thinking straight. You need him to sign off on whatever is necessary for you to talk to his doctor(s). At a minimum you can talk TO doctors and give them informaiton and your observations, even if they claim they can't talk to you about DH. But I'd find out how to get much more involved in his treatment, especially as he wants to treat himself. Not a good thing.
Come back and update us someday. I truly hope it will be a positive update and he will get the help he needs.

[Anonymous]

Anonymous wrote:I'd be depressed too if my spouse was micromanaging me the way you're micromanaging him. Geez.

Signed,

A woman

You should be ashamed of your ignorance about mental illness and your inability to tell the difference between "micromanagement" and caring involvement.

OP is smart enough to know that you should be ignored.