Am I Causing My Husband's Depression?

Q: My husband suffers from depression and has been pulling away from me little by little. Now we are more like roommates than like husband and wife. He travels a lot for a living, so the growing apart has been very gradual. He's concluded that I am the root of his unhappiness and he refuses to get help because he truly believes that I am the problem. What can I do? 

— Karen, Colorado

A: 

I'm sorry to hear that you and your husband are growing apart. Relationship problems are seldom one-sided, but for the moment, you may need to seek help by yourself, at least to help clarify the issues and develop a plan of action. For starters, you might seek out a therapist or counselor who sees both couples and individuals. That may help you figure out some better ways to approach your husband about the issues you are facing as a couple.

http://www.everydayhealth.com/depression-specialist/am-i-causing-my-husbands-depression.aspx

Serotonin Syndrome

Symptoms of Serotonin Overload

Serotonin syndrome can cause a wide spectrum of symptoms due to overstimulation. Gastrointestinal symptoms include diarrhea and vomiting. Nervous system symptoms include overactive reflexes and muscle spasms, said Su. Other signs and symptoms include high body temperature, sweating, shivering, clumsiness, tremors, and confusion and other mental changes.

Symptoms of serotonin syndrome can range from mild to life threatening. In extreme cases, body temperature can become very high, muscles may break down, and a person may go into shock.

Treating Serotonin Syndrome

Serotonin syndrome usually requires treatment in a hospital. The first step is to stop any drugs that raise serotonin. You may need medication to control anxiety and relieve muscles spasms and possibly a drug that blocks serotonin production, called cyproheptadine.

"Cyproheptadine is only available in oral form. Sometimes we need to crush it and give it through a nasogastric tube. Cooling baths may be used to bring down body temperature. Fluids, blood pressure, and breathing support may be needed for severe cases. Most patients are better within 48 hours," said Su.

Drugs That Cause Serotonin Overload

"A single antidepressant can cause serotonin syndrome if a patient overdoses on the drug. Another cause is starting a new antidepressant before an old antidepressant has been completely washed out of the body," said Dr. Su.

"But the most common cause is adding on another type of drug. This can happen if a patient doesn't let a doctor know they are on an antidepressant or if a doctor is not aware of the danger." Some common add-on drugs that could lead to serotonin overload are the pain medication meperidine (better known by the brand name Demerol), the cough medication dextromethorphan, drugs called triptans used for migraine, and the recreational drug ecstasy.

Serotonin syndrome is a dangerous depression drug reaction.

Serotonin is a brain chemical that helps regulate mood and behavior, andincreasing serotonin is one way of treating depression. But if you're taking depression medication that increases serotonin too much, you could be at risk for a dangerous drug reaction called serotonin syndrome.

"Serotonin syndrome usually happens when a doctor prescribes a drug that increases serotonin to a patient already on an antidepressant," said Mark Su, MD, assistant professor of emergency medicine at Hofstra University and director of the Toxicology Fellowship at North Shore University Hospital in Manhasset, N.Y.

An Action Plan for Handling Stress

Stress can take a physical and emotional toll, so be prepared to address it head-on.

Stress is on the rise. 

 Among the leading causes of stress are money, work, family and health issues. Even children aren’t exempt —  looks specifically at stress in kids caused by marital conflicts at home.

But it does need to be addressed. Stress can have a very real impact on a variety of body systems, from the cardiovascular system to muscles. “There’s often also a physiological reaction in addition to the mental experience of feeling stressed,” said Bufka. “And that may manifest itself in terms of headaches, or stomachaches, or muscle tension.”

Any kind of exercise, from high-energy activities to yoga, can help. “When you exercise, your body releases endorphins, which are hormones that fight stress.

Eat well-balanced meals, limit alcohol and caffeine intake, and make sure you’re getting enough sleep.

People should also consider what the source of their stress is, and whether or not they feel it’s at a manageable level. “It’s when our ability to cope with stressful events exceeds what we have to offer…or when it starts interfering with our functioning and our ability to work or be a student or be a parent,” said Bufka. “That’s when we really need to think…maybe I might need some additional support from a mental health expert.”

Often patient does raise stress as an issue, some physicians may simply not feel that they can adequately address it. Doctors also may not recognize that a patient is overly stressed and needs help.

If you can’t identify what’s causing your stress or if it persists and starts interfering with your daily life, then speak to psychologist or counselors or psychiatriists.