Living with a spouse with anxiety and depression

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DoveGrey
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Re: Living with a spouse with anxiety and depression

Post by DoveGrey »

TW: ideation

I'll tackle this one issue at a time, from the perspective of the ill spouse. My disease is well managed, but it took work to get here. And as I always say, anyone who is hurting can feel free to reach out to me. A list of international hotlines can be found here. https://blog.opencounseling.com/suicide-hotlines/

Antidepressants and Libido

With the exception of breastfeeding, I have had a pretty high libido. That drastically changed as my mental health slipped. I knew I would not survive a pregnancy - I had a pregnancy early on in which I became suicidal because my anxiety jumped through the roof.

I've said this on these boards before, but I became so terrified of a pregnancy that I tried to avoid sex as much as possible. The only time in those months I was ever relaxed was when I was on my period. Every abdominal twinge frightened me. Fool that I am, I never told my husband my fears. You can imagine what my avoidance did to him.

When I finally saw a psychiatrist and asked for an antidepressant, I was floored by his response. "I'm concerned what your husband might think if your libido drops," was the first thing he said. I was thinking, Buddy, if you only knew! How can this get any worse?

My point here is this: My libido did take a hit - I now don't think much about sex for the week before my period, where that hadn't been the case before. It was far better than it was in the days of fear.

I know that my husband would prefer to have a lower libido wife than the train wreck I was before. It was a relief for him. As for me, I know enough through reading and this board that I don't need to "want it" to initiate sex during that off week. I aim for 3x per week, and I typically initiate on a Wednesday or Thursday if it hasn't happened on a weekday. I can do that even if my libido isn't feeling it. Our marriage needs it, and that's enough for me.

But it did take a lot of work to get there. Beside my own work, my husband was put through family support therapy when I was hospitalized for depression. It mitigated his feelings of helplessness. I'd recommend that for any spouse of a patient. It can be a tough road.
Myers-Briggs INFJ - The Advocate

"She will do him good and not evil
All the days of her life.
"

~24 years and counting~
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DoveGrey
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Re: Living with a spouse with anxiety and depression

Post by DoveGrey »

Pregnancy

As for pregnancy, we were already done having kids. He made a vasectomy appointment right after he heard I was scared of pregnancy. I do remember having a conversation about how we would have been done anyway once I started on meds. I don't know what the current risk factors are with meds; 14 years ago they were enough that neither of us wanted to have a high-risk pregnancy.

I have taken 2 pregnancies to term. However, during those pregnancies my depression / anxiety were more latent. I was sufficiently self medicating through exercise. Even with that, I had mild prenatal depression in the last half of my second. Never underestimate the toll a pregnancy can have on a woman's body - especially a woman with complicating factors.

I could not in good conscience advise another woman to go through pregnancy with unmanaged mental illness. Not when I struggled so much myself. I know it can be done, but you've got to have good mental health care and an obstetrician who truly understands pregnancy and mental illness.

Know your local medical situation before you get pregnant if you want to lessen your wife's anxiety. We've got parts of the country that don't have OB/GYNs at all, including the closest major hospital to my chosen town of retirement. If I lived there now, pregnancy and anything causing pregnancy would be off the table. I need more care than that region can provide. We'd be on multiple kinds of birth control, plus probably no vaginal sex until well after ovulation. Just to save my sanity and possibly my life. My husband would need to understand that.

If I lived there and my husband insisted on having kids, well, that would throw me into a tailspin that would make either our marriage or my life unsustainable. Fortunately, my husband is exceptionally understanding and it would never have come to that. But that's difficult for some men.

Know what you're getting into if you're hoping for pregnancy. You're the one who has to know the signs of trouble and watch your wife. If you aren't seeking outside help yourself, there are plenty of books that help spouses of mentally ill folks know how to cope. We aren't born knowing this stuff, and most of us need some kind of support. It's normal and healthy to seek that support, because hope is out there. I'm grateful to Crow for starting this thread for that reason. The stakes here are high - it's a life threatening condition.
Myers-Briggs INFJ - The Advocate

"She will do him good and not evil
All the days of her life.
"

~24 years and counting~
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Jpops
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Re: Living with a spouse with anxiety and depression

Post by Jpops »

Wifey has bipolar 2 depression and generalized anxiety disorder, both are treatment resistant. When we were dating in high school, her anxiety presented more as being sheltered and nervous which I took as needing to be given opportunities to lighten up and try new things. Her depression wasn’t as evident at the time, and both it and her anxiety got significantly worse after I left for college and we were long distance for around two years. I didn’t understand or recognize the signs at the time and naively thought her mood issues were only caused by the distance that was straining our relationship.

We got married and she broke down in tears on our honeymoon from the overwhelming change of it. We moved several states away the following week and she was incredibly homesick. As I had always done, I did what I could to mitigate and alleviate her anxiety, not really understanding what was really going on in her head for the next several years.

A seemingly constant chain of life struggles over the years including kids and postpartum depression that ensued ramped up her depression significantly while also revving her anxiety. I became increasingly overwhelmed from trying to manage it all and hit burnout 6 years ago.

I laid bare my struggles and feelings about our relationship being lopsided. Her response was to finally let loose and tell me everything that was happening inside her head. She was majorly depressed and crippled by anxiety. We started down the path of getting her help, with the intention to work on both her and my struggles at the same time.

In practice, that effort has been mostly one-sided with me supporting her and having to pick up all the things she can’t carry. In the last 6 years I’ve gone from burnout to running on fumes that gave out last year. Reflecting on both the span of our relationship and my adolescent years before we met I’ve realized that I’ve not had anyone I could rely on for emotional support or comfort. I’ve gone through the stages of grief and am somewhere between depression and acceptance. I’ve just started with my third therapist. The first two were meh, with the second acknowledging the difficulty of the situation but not giving any practical advice. Wifey says she wants to be there for me and I believe she really does. She recognizes the strain it puts on me and our relationship which is just another thing for her to be anxious about. She engages me more frantically like “I did a thing, please don’t be upset”. So I end up constantly having to reassure her to the point that whatever benefit she was trying to give me saps me all the more. In our sexual relationship it manifests as me having to do nearly all the heavy lifting and try to get her out of her head enough that she can be in the moment. Like everything else, I put forth tons of effort, little comes back in return.

It’s not willful or malicious, she wants to be there for me, she just can’t. And pushing or demanding would just reinforce her negative internal monologue that already runs constantly, tearing her down. No matter how much I tell her the opposite or try to giver her praise or affirmation it’s never enough. I can’t compete for space in her head.

I’ve lost count of the medications she’s tried, all with varying levels of marginal success coupled with destabilizing side effects like vivid anxious dreams, dizziness, excessive sweating, tanking libido preventing already difficult arousal and orgasm, and sedating effects that result in her falling asleep within minutes of sitting on the couch in the middle of the day. She’s had five different therapists and three prescribing doctors for anxiety and depression. She recently changed to a new office because the faith-based counseling center she had been using doesn’t prescribe classes of drugs that can be addictive; she ran through their list of medications that they would prescribe. We’ve worked both sides, psychopharmacology and hormones. Like Crow’s experience it seemed like the hormone doc was more interested in pushing expensive supplements and playing whack-a-mole with levels, prescribing one thing to counteract the side effects of another. We’ve pared down to just progesterone which has always been low including pre-pregnancies. Her OB (an absolute saint) had put her on progesterone as a precaution to prevent miscarriage which would have likely happened given her levels. She also takes thyroid medication to boost her sluggish thyroid levels. They had always been borderline low, but not low enough for doctors to do anything about it. After several years of paying out of pocket at a compounding pharmacy we’ve finally found an endocrinologist that will treat and bill insurance.

I’ve been reflecting more recently on my life as a whole and where I want it to be in the future. I’ve pretty much given up hope of ever really having someone I can rely on. I don’t complain when I ask her for something and it doesn’t happen. If I want it done I do it myself and give myself grace when I just don’t have anything left. I’m concerned for our kids who are definitely getting old enough to recognize it all. I’m trying to figure out how to best support them and hopefully prevent passing the generational torch of mental health struggles, or at least make it less in the next generation.
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