This is an email I received from a client who wanted to seek advice regarding their spouse. She gave me permission to share this on my website. Her inquiry and my response are as follows:
I am unsure of where to turn for help lately. My husband Gerry (name has been changed), comes home from work everyday and lays on the couch. If I have prepared a meal for him to eat he will get up and walk to the dinner table, eat something in silence and then go lay back down. This has been going on for almost two months now and I keep asking him if he is depressed. He always answers "no I'm just tired". When I ask him to do simple things like put food away or do the dishes in the sink, he just blatantly ignores me. It seems like the only time he actually is interested in me is when he becomes aroused. He will start rubbing me to see if he can turn me on and given his behaviour as I've described, I don't feel very close to him or want intimacy at this point. Is our marriage doomed and is my husband depressed?! What should I do?
Although the response that I generated to this client happened in person, I can summarize my response to her as follows. We will refer to this client as Alanna.
(Alanna is 32 and Gerry is 38. They have lived together for 4 years and have no children.)
Thank you for reaching out to seek input on your husband Gerry. It sounds like he is certainly tired beyond a reasonable amount, if you have presented those facts to me correctly. In terms of a diagnosis I am unable to generate one for you, however I can present you with the current diagnostic criteria from the DSM-V which is the Diagnostic and Statistical Manual, version 5, that most Psychologists use (see below). Aside from generating a diagnosis and potentially seeking medication, alternative therapies and holistic remedies are available for what you have described:
1. What is your husband eating? Food is so commonly overlooked as a source of malice within our bodies. Check that he is not binging on sugars during the day and then crashing at night when he gets home. Also try to reduce the use of plastic in your home and do some research together on the effects of BPA and Parabens on your food consumption and endocrine system.
2. Is your husband moving his lymphatic system on a regular basis? Stagnant lymph can lead to a variety of problems within our bodies such as headaches, cysts and overall feeling lethargic. Although we cannot see this system at work, it is very important to eliminate waste. Ways of increasing lymphatic flow physically are: running, jumping jacks, burpees or jumping on a trampoline. Alternate ways are to sit in a sauna or hot tub, take a hot bath with Epsom salts, steam rooms or anything that generates sweat. Hot spices cooked into food such as chili peppers, turmeric, habanero pepper, hot curry, garam masala etc... can also stimulate lymph flow.
3. Suggest that your husband take a Vitamin D on a regular basis (and do this yourself if you're not already doing it). Vitamin D intake dramatically declines in Canadians for a portion of the year. It is an important vitamin that we often don't get enough of.
4. Rooibus tea. If your husband is not a tea drinker, try to incorporate this into this daily pattern. This is a super tea which greatly boosts the function of your immune system. Rooibos contains polyphenols that generate anti-inflammatory, antiviral and anti-mutagenic qualities. Polyphenols are organic chemicals that are most often well known for their antioxidant capabilities.
5. Build on activities together that don't revolve around the television. If the two of you need to rekindle your sense of 'togetherness' discuss taking up extra-curricular activities one night a week that you both enjoy.
6. Discuss your future goals together. Goal setting as a couple can certainly increase your chances of making things last. This should be done individually and together once a year, and reviewed monthly or bi-monthly. For example "I want to save enough money to buy myself a new car by March of 2016" or "I want to work on the relationship I currently have with my father and hope it improves by the end of this year".
7. Review your husbands spiritual belief system. Generally I use what is called Logotherapy to review a client's understanding of their path in life. Sometimes this has been undervalued for a long period of time and the client begins to feel lost and unable to understand their purpose.
Depressive tendencies stemming from stagnation are quite common, but this is not the end of the line for your husband, or your marriage. I tell many of my clients that "humans thrive when they feel a sense of progress". It seems as though your husband is not feeling a strong sense of anything lately. First I always recommend you work on food and vitamin intake to ensure a physiological balance. From there, I focus on environmental influences each client may be dealing with and finally I review a general sense of purpose and self-worth.
The following is Diagnostic criteria for Major Depressive Disorder from the DSM-V
Specific symptoms, at least 5 of these 9, present nearly every day ( for at least two weeks):
1. Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
2. Decreased interest or pleasure in most activities, most of each day
3. Significant weight change (5%) or change in appetite
4. Change in sleep: Insomnia or hypersomnia
5. Change in activity: Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
8. Concentration: diminished ability to think or concentrate, or more indecisiveness
9. Suicidality: Thoughts of death or suicide, or has suicide plan
Due to the stigma around mental health and therapy, it is common that men are adverse to seeking help. They assume that therapy is admitting to failure or weakness and they feel ashamed if they are forced to seek help. In this particular case, her husband Gerry was unwilling to seek therapeutic intervention, so I worked with Alanna providing psycho-educational resources that she could give to Gerry.
Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes. (n.d.). Retrieved November 10, 2015, from http://www.psnpaloalto.com/wp/wp-content/uploads/2010/12/Depression-Diagnostic-Criteria-and-Severity-Rating.pdf
Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.