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For issues specific to caring for someone with mental ill health.
Hi all,
I am caring for my husband of 21 years. He is suffering from severe depression, anxiety and agrophobia.
We have found the provision of mental health appalling. We waited 6 months for his first counselling session, it took a lot to actually get him up and there, and then he was extremely worked up once he finally got there, after 3 very shortened sessions the councillor said he wasn't talking about his feelings only what was going on in his life and discharged him!. We then had to wait for another assessment at the GP, we were told he needs counselling, but could only be offered the service who discharged him early !!!!. Or self refer to Mind, which he has done, another 3 plus months wait.
All the while I watch my husband get worse, he has considered ending it all on more than one occasion.
I am coping on my own and feel awful when I am angry with my husband, I know he can't help it, but I am struggling with dealing with everything, trying to stay positive and trying to persuade my husband to get out of bed and washed, day to day living and then all the financial worries, along with supporting our son at university.
Sorry for the long post, I felt background was necessary.
Ann, hi, and welcome to the forum.

I'm going to say straight off that I have 'views' on depression that are not, shall we say, 'universal' - let alone accurate!!! However, here goes - but PLEASE take what I say now in the context of above, and simply chuck it out of the window if it makes you feel I'm totally missing the point here!

(My own background which formed these views is that I was raised by a mother with MH 'all her life' and now have a niece of 35 who has had MH 'all her life', ie, since adolescence. To my mind they both are 'ruining their own lives' and also making the lives of other members of their family a misery as well.....)

I do think that the key to dealing with someone you love who has depression is 'firm love'. 'Tough love' is too tough, and can be both counterproductive as well as cruel, but 'firm love' tries to steer a middle line (tricky!) between 'sympathy and tolerance' and well, perhaps 'bracing and realistic'.

With firm love, say, instead of trying to 'persuade' your husband to get up, you simply leave him to make his own mind up. If he wants breakfast. he gets up, or goes without. (etc). I just don't think there is any point 'pandering' or 'indulging' him. Sympathy can be soaked up and goes nowhere. Not saying be 'unsympathetic' just 'firm'. He has to take the consequences of his behaviour

Of course, I do appreciate that the 'terror' of the situation is that he may, indeed, seek to end his life, but, in a way, that, too, is HIS choice - ghastly though it is to think of it that way. It's also, of course, a form of 'blackmail' and pressure on you

Those with depression can be ruthlessly 'self-focussed' which comes across as total lack of understanding or sympathy for what they are putting anyone else through. It's one of the most 'self-centred' wagys of existing. I'm not surprised you feel angry sometimes - you have plenty to feel angry about.

I know you say the NHS MH services are appalling and yes, they are. I don't think it's worth beating your head against a wall. Just keep the pressure on and 'keep nagging' .Be warned, as you probably know, they may easily 'lose' correspondence etc etc which is all about delaying actually handing out treatmen
It's interesting you say his counsellor said he wouldn't talk about his feelings but only 'phatic' stuff - ie, 'everyday ordinary things' because surely that is what a lot of people with MH do - they 'present' with things that are 'irrelevant' and it is up to the damn counsellor to 'drill down' and get the patient to start exploring WHY they are so unhappy etc. Do YOU have any idea why your husband wouldn't talk to them?

Do you, in fact, have any idea WHY he has depression etc? Does he talk to YOU??? And if not, why not?

Do you have ideas of your own as to what is behind his MH? Do you think this is about long-surpressed childhood trauma, for example? How long has he had it and if not throughout your 21 years of marriage, do you know what has 'set it off' now?

I ask all this not for you to necessarily tell us but to indicate that quite a lot of 'psychoanalysis' can be done without official counsellors. That said, of course, there are things that a patient might not want to say to family (for example, a trauma of childhood abuse that is now 'surfacing' etc etc).

Finally, irrespective my, as I admit, 'atypical' views of depression, do bear in mind something that is said very often on these forums, and that is to distinguish between 'supporting' someone and 'enabling' them.

With support, the direction is always FORWARD. Your behaviour in caring is to move them ON, to a better place.

But with 'enabling' all you do is allow them to stay where they are.

Which brings me back to the concept of 'firm love', which is what 'support' so often requires.

My apologies if I sound unsympathetic to him, but what is actually WRONG with his life right now, or in the past?
I am more used to helping people than being helped. I've also had jobs where I had to keep my own feelings hidden, whilst I did my work.
When I started counselling, it took weeks of talking about mundane things until I felt able to open up more about what I was struggling with. I find it difficult to believe that any counsellor would turn someone away because they didn't immediately open up.
A skilled counsellor would use whatever a patient was talking about to lead a conversation in the right direction.
Do you think your husband would be happier writing things down for a counsellor, rather than having to say them? I found this easier at times. When I wrote one page, and took it in, the counsellor asked me how I could be so cheerful on the outside and miserable on the inside. It was just my way of trying to get through each day. Everyone is different, counsellors should know that!!!
I'm glad BB indicated that yes, a good counsellor should EXPECT it to take a while to get past the 'phatic' phase, and know how to guide the patient into 'opening up'. I also think it's an excellent idea if your husband can start to write down, however incoherently and 'off the top of his head' about what is going on inside him and how he feels, and how and why he is so distressed.

And if HE can't bring himself to do so, the other option (and you could do this as well anyway) is for YOU to write down everything YOU think is 'wrong' for your husband, and give as much, much, much background as you can, plus your own 'analysis' (don't worry if you fear the counsellor will 'only' take that as truth, he.she will know it's 'your' interpretation and factor that in), as that will give the counsellor 'something to work on' - it's a good idea, to my mind, to do that anyway - think how many counselloing sessions it could take before, say, a patient says something like 'I was abused by my uncle' rather than having that set out in a written communication (either by the patient or a relative) right from the off!

Speaking of 'many counselling sessions' I wonder whether, given the intense shortage of counsellors on the NHS (ie, the NHS won't fund any more) and the intense pressure on appointments, whether this particular counsellor just thought they were 'wasting precious appointment time' on someone who was 'stubbornly unresponsive' and thought their time would be better spent on someone 'more willing to talk'???

If so, that isn't, of course, a justification, but it might be an explanation!

The trouble is, if there is one 'class' of patient that is likely to be the MOST difficult to get to open up about their feelings and problems, surely it has to be the middle aged male!!!!!! They are simply not used to talking about 'themselves'.....(sad but often true....)

To be honest, I do think that even if the only counselling on offer with the NHS is with the same (unsatisfactory) counsellor, that your husband should take it - otherwise he may have to wait even longer, and he may also be labelled as 'uncooperative' by the NHS who may well feel they then don't have to 'bother' with him as he can't be 'bothered' to take the counsellor they offer? But, if as above, either/and he/you writes to the counsellor to 'plot them in' as much as he/you can, then that, surely, should catalyse a bit more useful discourse and disclosure.

Finally, not sure if this is possible, but would it help if YOU went with your husband into the sessions, at least for the first one or two, to help, again, 'facilitate' some more trust/disclosure etc etc?
How is your son coping with his dad's MH? Is he 'away' at uni, or living at home?

Do you think he needs some counselling on how to deal with it? Unis these days are usually pretty good at supporting their students psychologically, so hopefully something would be available for him.

Remmber he will probably be protective of you, and he may be saying 'I'm fine, Mum, don't worry about me!' as he can see YOU are under such stress. That is OK, and, indeed, could help HIM cope with it, giving him a sense that he is 'doing something to help' (which he is), but just be aware that he may be 'putting himself out' to an extent and hiding his deeper level of concern??

It is hard to have an MH parent (I had one!), as children naturally worry, and also may blame themselves (I did!), and yet at the same time resent that they HAVE to 'worry' (I did!) and chafe about all the attention going to the MH parent......

If you feel at all that his uni work is suffering, then please do alert his tutor etc that his father has MH at the moment, and a particularly stressful homelife. As I say, unis these days can be far more sympathethic about the pressures on their students, and it should go on his record that this is currently influencing him, and may be adversely affecting his academic output etc etc.

Do you and your son talk about dad? Again, your son may both feel it helps YOU to talk about his dad, but it may, very well, help HIM if you talk about it! You don't have to say 'everything' you feel, and it's perfectly OK, please do believe me, to say that you find it difficult to cope and that you get angry with his dad as well. It's only natural, and to an extent is IS justified as well. But what is REALLY important is that your son feels he CAN talk to you if he needs to, and if he finds comfort in knowing he can help his mum cope with his dad, that he's 'pulling his weight' so to speak in the family

He may also feel under pressure to 'grow up faster' in a way because his dad is 'ill' - ie, he may feel he has to become 'head of the household' given his father's incapacity???

No idea if any of this applies, but just to point out that some of it might, and maybe to keep an eye out for it???

Finally, can you and your son have any enjoyable 'time out' at all, where the two of you just go off and do something you both enjoy, however 'trivial', even if it's just going for a pizza lunch or whatever, to show your son that life is NOT all 'doom and gloomy' and that there are 'workarounds' his dad, and that his dad's mental state does NOT have to cast a dreadful pall over your life and his own.
Thank you all for taking the time and effort to reply, it's great to have people who understand what is happening.
My husband started his depression when made cc redundant in 2011 after a long career with the civil service MOD, a job he loved cc and was good at. Sadly he was out of work for a while, getting only temp poorly paid jobs, he became depressed but not too badly. Then got a longer term contract a job he hated but he did it with no complaint.
I then became unwell and lost my job, it took a year to get a diagnosis, with everything from cancer to IBS being diagnosed, turns out I am Coeliac. So I am sorted, then the contract ended and no work again, so it just all came to a head, and to top it all our private landlord wants our house back so now in the dreadful situation of going to have to go down eviction route, as we can't now afford the private landlord route.
I am tougher on him now and have started to let him get on with it a bit and I have a very good family and a very close friend who support me. His family don't understand and its taken months for them to really understand and I still feel not fully.
I agree he should take the councillor on again and he has agreed, I will definitely write things down and encourage him to do Softbank you agree as in for your support cans great suggestions.
Thanks Jenny I am very lucky as my son is doing extremely well at uni in fact psychology is one of his subjects, so he has a unique insight into all this, luckily he has stayed positive and I do always keep positive with him whilst he is away. So no worries on that score so far, but I v do monitor it as I want him to b have the best university experience. He also has a great girlfriend, so lucky.
It might be a long shot but if you look back through the paperwork when hubby was made redundant there might have been details how to access to an employee welfare scheme, or even something through civil service union or staff clubs that may still kick in. Or even a ex civil service charity that may help with costs of counselling.

You could also consider telephone or online counselling both for yourself as well as hubby. You can self refer for these, and I think they have recourse to longer sessions for more severe cases.

We too found our first try difficult to access, the most obstreperous and officious receptionist defending a supposed caring service who scared my boy into vowing never to set foot there again.
Keep persevering, there are different providers and the next may be better. Ours was.
Ann, I'm glad you weren't too upset etc by my very 'strong' post! This might come out the wrong way, but I'm 'glad' that your husband has actually got something to be depressed and down about.

I think, personally, it's something that 'we women' can find hard to fully appreciate, but how dreadfully hard men take redundancy. To us, I sort of feel that having a 'glittering career' is always a sort of 'bonus' - yes, we've worked hard to get it (if we've got one that is!), and we know we deserve it through our skills etc, and we enjoy it as an achievement and for its own sake, but I always feel a career doesn't actually 'define' us in the way that, I fear, it does for a man.

I think for a man it really is something that is rooted in their 'manhood', and so if you take a job away from a man, it's like 'emasculating' them. They feel 'useless' and 'rejected' and 'having no value'. Combine that with the difficulty of finding another job (especially in middle age!!!!!), and then financial pressures (loss of the ability to 'provide' for one's family - again, a key defining characteristic of 'the male pscyhe') and you do have something of a perfect storm in regards to crashing like a stone.

Another 'view' is that, if he has tried so hard to get another 'good job' and almost got there, ie, via contract work, and then that vanished as well, is extra much so that, perhaps, being 'ill' as he is now, gives him an 'explanation' for why he is 'unemployed''s a 'get out of jail free' card in that sense.

I'm usually very critical of get out of jail free cards when it comes to a lot of MH (my poor 'unemployable' niece, for example - she can work, no doubt about it, as in, she will do hard manual labour to help her parents with their holiday lets, but she's never actually been 'waged' in her life) (ie ,'I CAN'T work, I've got MH!'), but I think that in your husband's situation, that 'get out of jail free' card is more a card of 'desperation' than 'excuse'. It may give him the 'breathing' space he feels he needs now, to 'explain' why he is a 'failure' (as redundancy and unemployment can make him feel).

Add to that his probably 'supressed' worries over YOUR illness, and the time it took to diagnose, and his fears (terrors?) that it was something deadly like cancer, and yet he felt he had to cope all the same, and he might, in a way, now simply being 'in collapse'. He just has run out of 'psychic energy' so to speak. He's crashed and burned and just can't scrape himself up to re-start the engine....

Looking at it at a larger scale, though, do you think there is any impact from, say, his childhood/youth? For example, if he had a father who 'expected a great deal' of him, eg, a glittering career, being the breadwinner, looking after his family, then the experiences he's had as unemployed and a 'failure' could be exacerbated by feeling he's 'failed' his own father?

I know someone whose husband had a glittering career, but it wasn't 'glittering enough' for his parents, especially his mother, who liked to 'boast to her friends' about her brilliant son (and it WAS 'boasting' not 'pride' if you see what I mean - she just liked the 'glory' and the 'money' etc, she was a selfish woman says my friend her DIL). Anyway, the guy crashed and burned when he failed to get a promotion he thought was 'his'....and had a complete breakdown.....the pressure was just 'too much' for him.

Does your husband talk to YOU about his fears, pressures, anxieties etc etc? If he does, that has to be a good step. Had he only 'crashed and burned' quite recently, one might say 'let him be, he needs to have 'time out' before he can dust himself down and restart the engine'.....but it does seem to have been going on for some time. As if he's got 'trapped' in a low level, and can't remember how to be anything else?

Speaking of 'anything else' - IS there a chance he could still find work in his established line, or has that become impossible (eg, if it was IT, say, then it's a young persons game, no doubt about that). Could he find satisfaction in doing volunteer work, something that restablishess his sense of sefl-worth, even if it doesn't bring in a wage as yet?

One of the men I know whom I admire most, is the father of one of my son's friends, who had three sons, and out of the blue was made redundant in IT. He could NOT get another job - and retrained as a plumber. He 'dropped' from being a middle class professional to being a 'tradesmen' but he did it because hey, he had to get food on the table etc etc.

So, is there anything your husband could retrain as, even if it is not as prestigious as whatever he was doing before? Or is that financially impossible, as indeed it might well be.

Speaking of money, does he discuss it with you, and are you a 'team' when it comes to the family finances, and going through this nightmare of eviction (what are your plans for rehousing???, and when are you likely to have to find alternative accommodation finally?)

It's clear there are huge pressures on your BOTH, but if you can get him 'onside' it will both help lift him (and empower him) and take some of the pressure off you.

I'm glad your son is thriving, and as you say, that he is studying psychology can only help him deal with the situation at home.

Wishing you as well as can be - KR, Jenny
Thanks for the suggestion re civil service charity I will look into that.
Jenny thanks again , I would never be offend by what you say you have lived with this so are in a position of personal experience and I do value any advice given thank you.
My husband will talk a little to me but I do believe that his father has some part in all of this historically,that's me surmising from my observations over the years. We talk 're finances but then it bbc gets to a point where he just has mind blank and can't talk anymore, I know you are right when you say he feel useless as he has always been the main bread winner, and earned the most. Trouble is unless he can get better in dealing day to day he won't even get through an interview, so in a vicious circle at the moment. I have suggested he try volunteering as I already do this and I love it.
Thank you again everyone I really appropriate your time.