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Suggest Treatment For Atypical Depression, Diabetes And Myasthenia Gravis

Posted on Sat, 14 Nov 2015

Question: I'm concerned about my husband. He sleeps all day, from 5-6 am until 4-6 pm, someimes later. He weighs 412 pounds, and refuses to do anything about it. He's being treated for diabetes, myasthenia gravis, and depression/insomnia (he refuses to call it depression). Within the last few months I've noticed a developing pattern. For one thing, he wasn't sleeping like this at the beginning of the summer. And, prior to going to retiring in the morning, he becomes irritable and verbally abusive. This is not his normal behavior. Normally, he's very nice and quite low key. I feel like I'm married to Dr Jekyll and Mr Hyde. Is this something I need to be concerned about? What could be causing this sudden change, and should we get help from either his psychiatrist, neurologist, or primary care physician? As you can imagine, this would be difficult. I can't force him to get help. He refuses to admit any disabilities or challenges he might have. These appear to be signs of weakness to him.

Answered by Dr. Chintan Solanki (1 hour later)

Brief Answer:
you need help from psychiatrist for evaluation

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern.

Your husband is suffering from many physical as well as psychological problems. He is very much obese. Obesity is a big risk factor for many physical illnesses like cardiac problems and joint related problems. He needs counseling for reducing weight.
Excessive sleep and mood changes suggest 3 possible diagnoses.

1. Atypical depression in which person sleeps and eats more.
2. Irritability and abusiveness favor possibility of bipolar disorder.
3. Depression secondary to general medical conditions/medicines.He has lots of physical problems and he is taking multiple medicines secondary to that he has lost interest in living and remains depressed.

If similar complaints in past at specific season of the year for 2 years there is possibility of seasonal pattern affective disorder.

For confirmation of diagnosis detail history and mental status examination are needed and done by a psychiatrist. He needs motivation counseling and supportive psychotherapy to fight with his physical problem and stressful life.

You need to motivate him to visit psychiatrist for better living of life.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (27 minutes later)

I will try to join him for his next psychiatry appointment. He was referred for counseling over two months ago but has failed to call for an appointment. He really doesn't want me involved in his care. To make matters worse, I have recently gone into remission for my own psychiatric issues. He acts like he is jeolous of my progress; and, although others have told me I've changed, he tells me that i haven't. This is extremely hurtful and insulting. He equates my spiritual pursuits with his video game addiction... when he is awake, he uses three tablets at one time to play an unwinnable game called, "Boom Beach". This game not only keeps him occupied, it also upsets him most of the time while he plays. Yet, he continues to play.

Thank you for your response. I will do what I can.

Answered by Dr. Chintan Solanki (10 minutes later)

Brief Answer:
take help of family member or a friend

Detailed Answer:
Hi,

Thanks for more information.

At present the first step is to make him ready for psychiatrist consultation at least. If he is no cooperating you try to take help of family member or friend on whom he can rely.
I appreciate your love to him that even after his negative behavior towards you, you are empathetic and caring for him.
He needs a therapist who can change his psycho dynamic and poor defence mechanisms.

I wish you will succeed in your efforts for your husband's well being
Take care.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar