My husband is the light of my life and we’ve had more than 30 years together. During much of this time, he’s had clinical depression. When he takes his medication, all is well…he works, enjoys family, social activities and hobbies, and is fun to be around. But every four or five years, he decides to try getting through life without medicine. Of course, this always turns out badly. I cannot seem to help him understand that stopping his medication “this time” will be no different than previous attempts. My husband is a smart man. Why doesn’t he see this decision is not in his best interest?
 

Congratulations on maintaining a stable, enriching marriage despite depression. Your husband’s attempts to manage without medication are not unusual. For modern American men, it can be difficult to acknowledge the need for ongoing medical support. Yet it is clear that he is better off on an antidepressant. Explore with your husband his reluctance to continue taking medication. Does he simply want to “go it alone,” or is he bothered by side effects? A visit with his physician will inform him that many newer antidepressants have fewer side effects. You can talk with him about his reluctance to stay on the medication and let him know you understand his hesitation. Tell him how much you enjoy life with him. Remind him of successes at work, pleasant time with family, and good times between the two of you. Let him know how much you appreciate him and want to keep life flowing smoothly. If he insists on another attempt to go off his medication, you could approach this as a time-limited experiment with a specific beginning and end. Working with him to set goals about a certain level of functioning at work, with family, and in social situations will let the decision to resume taking medication rest with objective criteria. In this situation, as in most relationships, a positive approach will be much more fruitful than a critical or nagging one. 

Betsy Douglass, M.Ed., MSW
Licensed Clinical Social Worker
Westport Plaza
314-432-1462

Wanting to stop medication periodically is quite common for people with chronic mood disorders. Many people do not like taking medication and especially do not like feeling that they need it in order to function optimally—there is a natural desire to feel more self-determination. However, because depression that is treated leads to a higher quality and enjoyment of life, it is difficult for bystanders to watch someone repeat a pattern that seems destructive for them. The risks of stopping medications include a return of depression and a renewed sense of failure (and resulting depression) at managing one’s moods. When someone wants to try going off of medication, especially for chronic depression, I recommend consulting with both a physician and a therapist. The physician can address the physiological effects of discontinuing a medication. The therapist can help thoroughly evaluate the pros and cons of the decision and help prepare them for all possible outcomes. The perspective of a professional not directly involved in the situation is often very beneficial in helping the person fully evaluate the decision. Also, if the depression returns, there is a safety net in place to help soften the fall and quicken the recovery, as well as sort out what was learned from stopping the medication.   

Michael G.S. Gottfried, Ph.D.
Licensed Psychologist
777 S. Ballas Road, Suite 129W
St. Louis, MO  63141
314-304-3707

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