Q. My husband has been depressed for a long time. To make things worse, he now has impotency. He won't go to counseling and won't talk about what's wrong, saying it will only make him feel worse. How can I help him, if he really feels like talking about why he's depressed makes him feel worse?

A. I can imagine that this is a frustrating and painful situation for you. Depression is still a source of shame and stigma for many people, and perhaps more so for men. Many of us grow up with the idea that real men don't get depressed, or that only crazy or weak people get depressed. Of course, these myths make it very hard for some to seek professional treatment, which is clearly what your husband needs.

Impotence may, indeed, be a part of the depression syndrome--but it may also be due to organic causes, such as poor blood supply to the penile vessels. Depression, too, may be due to undiagnosed medical disorders, such as low thyroid function. You may be able to use this physical cause scenario to get your husband to see your family doctor. If you don't have a family doctor or GP, you may still be able to persuade your husband to see one just to make sure you don't have any medical causes for the way you feel.

Perhaps this would be less threatening to your husband than starting with the psychiatric route. If the family doctor is perceptive and asks the right questions--perhaps with your input--he or she should be able to make the diagnosis of depression and pave the way for appropriate treatment. This could involve prescribing medication, referral to a psychotherapist or psychiatrist, and/or consultation with a psychiatrist. It need not mean that your husband has to embark on long-term psychotherapy.

Failing all this, you might try getting your husband the book, "Living Longer Depression Free", by Drs. Mark Miller and Charles Reynolds; or, "Depression: How it Happens, How It's Healed", by Dr. John Medina. Both of these fine books may give your husband some information that will help to de-stigmatize his illness--but, of course, they are not substitutes for professional therapy.

You may also want to consider discussing this matter with your local chapter of the Depression and Bipolar Support Alliance (<http://www.dbsalliance.org> or call 800-826-3632); they can often provide helpful suggestions for dealing with reluctant family members who need help. I hope things work out for you and your husband.

Other Resources:

• More Questions on Depression

December 2003

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