My Father Has Depression . . What to Do?
Depression is a disease in its own right but it may also be a symptom of various medical conditions. In our ‘Ask a Question' section simi_k says, ‘my father is suffering from severe depression for the past year . .what to do?'
Many of the signs and symptoms then listed sound exactly like depression. The low self confidence, weakness, hesitation in meeting people, constipation, insomnia and inability to make decisions are all classic symptoms. But there are other things on the list such as numbness in the hands and feet and fevers that could suggest something more organic.
Despite having seen many doctors and psychiatrists there is a sense that nothing is getting better. Simi_k wants to know where to turn next?
It is a standard approach that when signs of depression are seen the very first step should be to rule out organic diseases. For this reason, and despite a history of seeing various doctors, a good clinical diagnostician is required. At this point there are various possibilities. One, for example, is that the depression is a symptom of some existing medical condition. Another is that the depression is co-existing with a physical condition. These aside it is clear that a fever is not normal and this, along with the numbness, needs to be checked out as a matter of some urgency.
Depression can be triggered by a major life change, such as divorce, separation, long-term illness, bereavement or job loss. Sometimes there is no obvious reason. As a middle-aged man there is always the danger that depression can be brushed over as either the male midlife crisis or male menopause. The so-called midlife-crisis does appear to be a very real issue that can last up to a decade and affects maybe 20 percent of people, most of whom will be male. It remains a rather poorly researched area however and much of what we read is fairly subjective. With this in mind there are some indications that men from about the age of 35 upwards can experience profound levels of disquiet about the meaning of their life, their purpose and their future.
Some lines of enquiry point to hormonal changes in men - perhaps accounting for the male menopause label. Within the medical profession there are mixed views about the effects of androgen hormone deficiency. Some doctors are firm believers and others are not. Supporters of the deficiency model will point out that around 40 percent of males between the ages of 40 - 70 experience signs of hormone deficiency. These include some lethargy, depression, irritability, sleep disturbances and decreased libido. Some suggest that the symptoms are actually rather vague. The argument being that if we put depression to the top of the list, all the other symptoms would fall beneath this. However, male hormone deficiency remains a legitimate line of diagnostic enquiry so perhaps should not be dismissed too lightly.
In terms of work and lifestyle we know, for example, that physically active men appear far more protected from depression than those whose lives are more sedentary. We also know that for many men their sense of self and their friendships are embedded in their paid employment. If this is removed, either by redundancy or retirement, mood changes can quickly follow. Also relating to work we know that financial strain is a strong predictor of depression in older men.
Males clearly do experience depression but because of their upbringing they will express it in different ways. Typically, men will emphasize physical complaints and focus on work difficulties rather than looking inwards at the effects on themselves in terms of emotional turmoil and upset.
Simi_k is clearly a strong advocate for the welfare of her father. To her I say don't give up. Sometimes the path to correct diagnosis and treatment can be difficult but what was not so clear to the medical profession a year ago might be far more obvious now. Try to find a clinician who can look at your father from a clean-sheet perspective and not be influenced by his previous records. Your father also needs to know that depression is treatable but that the answer may not lie just in one approach (e.g. drugs). Some doctors say that a number of patients are treatment resistant. To me this smacks of blaming a patient for not responding to drugs when clearly it's the drugs that aren't up to the task. Where you can find a good therapeutic team, the best approach, based on all the evidence to date, is a combination of drug and psychological therapies.