Doctor's Response
Date:Jan / 2012
Thank you for your question.
Sorry you are having a tough time with this.
I'll answer the second question about thyroid problems first. There is a lot of material out there on the internet about thyroid disease that simply isn't true, and lots of spurious material, that I have not read any evidence for, about dietary supplements and their effects. In non -westernised countries lack of dietary iodine is a common cause but this is very rare in the UK. However, Hypothyroidism, or an underactive thryoid, can mimic lots of other conditions, including depression. I'm not sure about low mood or stress causing hypothyroidism, but the reverse is definitely true, having an underactive thyroid can make someone very depressed. Lots of the other symptoms you described (cold all the time, tired all the time, hair loss, constipation, poor concentration ) would fit with hypothyroidism, but this condition is known as the great mimicker! That is why doctors have a very low threshold for checking thyroid function, to exclude it from the list of differential diagnoses. See below, www.patient.co.uk/health/Hypothyroidism-Underactive-Thyroid.htm. I would strongly suggest that you persuade him to see his GP to have his thyroid function checked, as you won't know for sure until he has the blood test done, and it will only deteriorate without treatment if it is that. Treatment couldn't be more simple, and usually people feel better very quickly.
So assuming you've mananged to drag him there for a blood test, and say either he's on treatment or the test was normal, ( which is entirely possible - his symptoms would also fit with a moderate depressive episode) that brings us to the first question. How to support someone in this situation. It's very difficult when he can't see that he needs some help. You are being extremely supportive already taking on household chores etc, and listening which can be very hard over a long period of time. I would consider whether concealing the impact this is having on you is the right thing to do. I would agree with you that he ought to see his doctor to discuss using medication, and / or arranging some CBT for him. If he can't see this yet, perhaps letting him know or see that you are struggling to hold things together for both of you, he may get the message that he can't ignore things any longer. Although this will be hard, it can be done in a supportive way, and ideally you could accompany him to the appointment for moral support, or to talk on his behalf if he finds it hard. Some patients have taken their emails with us to their doctor to read if it's easier than telling the story. Normalising depression and trying to de-stigmatise it may help. 1 in 10 people have an episode at some point, including yourself! It's not a sign of failure seeking help - quite the opposite, ignoring it is the path of least resistance, but gets you nowhere.
If he absolutely refuses to see anyone, there are some online resources for CBT. Having used them myself they are written for the average layperson and will be pretty simplistic for a man like your husband! However, it may be a road in to discussing it more with him. A drip drip drip approach until he sees that he may need some help, and that it's not normal or ok to go on feeling like this.
www.patient.co.uk/health/Depression.htm
moodgym.anu.edu.au/welcome
This website has some good material on low mood depression and stress, and also a self help toolkit.
www.breathingspacescotland.co.uk/bspace/controller
Good luck, I hope you can persuade him to seek help.
Thank you for using ThanksDr. I do hope this information is of use to you.
Yours faithfully,
The ThanksDr Team