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Question
Posted by: Bradley | 2010-09-27

Major depression and midlife crisis

Hi, I am 38 years old and have been suffering from depression for most of my adult life. I was recently in a clinic for a Major depressive episode. During hospitalisation I actually felt worse and am now feeling the same as when I went in. Depressed with passive agression symptoms and a general feeling of " emptiness" . The psyciatrist changed my meds from a fluoxitine base to a newer AD called Remeron and I am still waiting for the effect to kick in. I feel trapped and through a series of recent events all of my life dreams have been blown up.
I got married very young (at 20) out of wedlock and we have had a wonderful marriage up to recently. I feel that I missed out on a lot things that my peers did and that I never had the opportunity to discover myself and discover my true vocation. I am stuck in a dead-end job which I have to do because I am supporting a family. I cannot follow my true vocation because that will mean it will let my family down financially. I am also feeling some (irrational?) ressentment toward my wife. She has had a few previous lovers prior to our relationship but I was her first. I will always wonder what it feels like to be with another woman, even if it is to know that she is indeed the best for me.
Bottom-line: I have always been the strong one and put my family first before everything else and it feels so unfair that I am now suffering from major depression because of the sacrifices I made.

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Our expert says:
Expert ImageCyberShrink

In any complex situation of Depression, it is wise to engage in CBT style Counselling / psychotherapy rather than relying solely on antidepressant meds. Yes, in the earliest stages of a severe depression, one may not be capable cognitively and emotionally of dealing ideally with the therapy ( also depending on the method used ) but its still worth aiming towards.
Don't keep looking backwards at whatver you think you didn't get round to doing in the past - look ahead to what you can still do in the present and the future.
I don't know what it is you do, and what you consider your "true vocation", but isn't there a way for you to move towards that vocation in your spare time, and in voluntary work ? As Maria says, first work strongly to get clear of the depression, than make realistic but more satisfying plans for the future.

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Our users say:
Posted by: Maria | 2010-09-28

You''re right, one has to be on a certail level of functioning before therapy is useful. Two weeks is not very long, for some ad''s it can take 4 - 6 weeks before you feel the benefits. Hang in there.

Reply to Maria
Posted by: Bradley | 2010-09-28

Thanx Maria your advise really makes sense.

I have been on Remeron for about 2 weeks. The drug should start working soon. I also follow a very rigorous physical excercise routine and a healthy diet.
The problem wih psychotherapy is that imo it does not really help when you are at the lowest point of a clinical depression. I went for psychotherapy but my state of mind made it difficult to really benifit from it. As you probably know depression makes you forgetfull, foggy, unable to concentrate and screws with your cognitive thinking. I''ll take it one day at a time for now.

Reply to Bradley
Posted by: Maria | 2010-09-28

Hi Bradley. Changing meds and then it also doesn''t work is the pits. How long have you been on the Remeron?

Remember that being depressed really messes with your ability to think clearly and evaluate your life objectively. Please don''t make any major decisions while you feel this way. Are you seeing a therapist? I think that is very important right now so that you can get support from someone who is objective and professional. I''ve made bad decisions udner the influence of depression.

I hear that you feel your wife experienced a bit more of life than you did with more sexual partners. Being with only one partner is not necessarily such a bad thing... people are hurt and scarred emotionally when relationships go wrong.

You got married very young and now feel trapped by your responsibilities. The trap is partly real and partly an illusion created by depression. It is always possible to change your life even if it isn''t easy. I''m a computer programmer who lost all interest in the field. I stay in my job because of finances but I''m also studying part time to fullfill my dream of becoming a psychologist. When you are feeling better you can look for ways to change things without a major impact on your family. I don''t know what your passion is but perhaps it is possible to study, volunteer etc. to get you close to that dream.

I would also suggest some marriage therapy for your wife and yourself once you are less depressed. I assume she is around the same age as you are and having been together for a long time the relationship has gone a bit stale? You may want to try and " start over"  by discovering yourselves and each other as you are now. You''re no longer 20, you can relate to your wife on a whole different level.

Take care.

Reply to Maria
Posted by: cybershrink | 2010-09-28

In any complex situation of Depression, it is wise to engage in CBT style Counselling / psychotherapy rather than relying solely on antidepressant meds. Yes, in the earliest stages of a severe depression, one may not be capable cognitively and emotionally of dealing ideally with the therapy ( also depending on the method used ) but its still worth aiming towards.
Don't keep looking backwards at whatver you think you didn't get round to doing in the past - look ahead to what you can still do in the present and the future.
I don't know what it is you do, and what you consider your "true vocation", but isn't there a way for you to move towards that vocation in your spare time, and in voluntary work ? As Maria says, first work strongly to get clear of the depression, than make realistic but more satisfying plans for the future.

Reply to cybershrink

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