My husband suffers terrible bouts of depression. I am at my wits’ end as to what to say to him. It seems like everything I advise is the wrong thing and he doesn’t want to go to the GP because he says antidepressants don’t help him. He doesn’t want therapy. Do you have any advice?
This is a very difficult scenario – both for the person suffering and loved ones around them.
We cannot make anyone seek help if they don’t want to. But one option, as a carer, is to remind someone who is suffering what sort of support there is and offer to book a GP appointment whenever they are ready. If a face-to-face one is too big a hurdle, suggest a phone appointment instead.
You can also independently ask the GP what mental health services are available locally, so if and when they do want help you have all the information and how to get it.
If there is a concern that someone with depression may harm themselves or has suicidal thoughts, then speak to the GP urgently. In some areas, a crisis mental health team is available and can even visit the home of anyone at risk.
‘My husband suffers terrible bouts of depression. I am at my wits’ end as to what to say to him. It seems like everything I advise is the wrong thing’
When someone is in a difficult period of mental illness, they may not understand the impact it has on others around them. Depression comes with very negative thoughts towards oneself, so carers have to be careful not to add blame or pressure.
It can help to suggest activities such as walking, doing a hobby together or even seeing friends. These can act as a sort of therapy, but you needn’t mention that.
It’s also important that carers take time out. The impact of looking after someone with a mental health problem shouldn’t be underestimated, both physically and mentally.
Find a way to do things you enjoy: go to the cinema, the shops – whatever. Ask another family member or friend to be around while you’re out, if needs be.
My daughter was born with astigmatism in both eyes, but was diagnosed with something called dome-shaped maculopathy three years ago. Her sight is deteriorating – what can I do?
Astigmatism is a condition where the eyeball is in an elongated shape. It leads to problems with vision as well as headaches but, thankfully, it is usually corrected for most people with contact lenses or glasses.
Dome-shaped maculopathy is relatively common but poorly understood, unfortunately.
The macula is inside the eyeball, at the back on the retina. It is important for perceiving colour, fine detail and also what is known as central vision. It should be flat against the back of the eye, not dome-shaped.
It can have a massive impact on vision and quality of life.
Anyone with the condition should be under the care of an ophthalmologist but, sadly, it tends to worsen, causing progressive sight loss.
There are some treatments available but this would depend on the extent of the issue and complications – many treatments are still on a trial basis.
A retinal specialist would be the one to guide on this.
Your daughter needs to ask about the anti-VEGF injections, which are a class of drugs that could be an option. Reduced sight is very distressing. It takes time to adjust to. People who suffer may be eligible for certain benefits and it is worth speaking to a benefits advice service.
The Macular Society may be able to offer help and counselling (macularsociety.org). The RNIB has very good resources on sight loss (rnib.org.uk).
My husband had a heart rhythm problem a few years ago and had a procedure called ablation. He now takes a blood thinner and also has rheumatoid arthritis, so takes a low-dose steroid. He was prescribed a tablet for his prostate but doesn’t take it because the patient leaflet says it could cause a heart attack as a side effect. He gets up in the night to go to the loo between three and five times, which is disturbing for us both. Can we combat this naturally?
It is important to know the risks and side effects of any medication – but also to think about the risk of not taking any treatment at all. Someone getting up at night may be at risk of falling in the dark, for instance – it’s a lot more common, especially in older age, than you might think.
Also, repeated nights of broken sleep can cause daytime tiredness, anxiety and irritability.
The prostate is a small gland that sits around the exit of the bladder in men. It often enlarges with age and this growth can put pressure on the urethra, the tube that carries urine out of the bladder.
Symptoms such as a poor stream or dribbling when trying to pee, and also needing to pass water frequently during the night, are all common.
Tamsulosin is often used for benign prostate trouble. Heart attacks are not listed as an official side effect, so this would be worth discussing with a pharmacist or GP.
The same is true with another commonly used medication called finasteride.
Alternatively, desmopressin, which helps to control too much urination, is another option. It is also advisable to avoid caffeine and artificial sweeteners, which can increase the need to pee.
Sending patients to life coaches? I’m all for it
The Government’s latest health plan is for GPs to refer some patients to life coaches instead of signing them off as sick.
Ministers are said to be considering enlisting wellbeing professionals – who have no medical qualifications – to take on tasks that will get more people back into work (a record 2.5 million people are signed-off with long-term sickness) or help them overcome emotional difficulties.
A lot of doctors were unhappy about this, but I’m all for it. A great deal of patients don’t need medicine or a specialist. Many certainly don’t need a doctor. Some just need emotional or practical support, or a kind, listening ear – which is what a life coach has the time and experience to provide.
Much of the distress and even illness that GPs see has its roots in something non-medical: jobs, relationships or finances, for example. A discussion about big life decisions with a neutral party is often all a patient needs.
Plus, life coaches could also help free GP time and space for those patients who are in need of medical help.
As far as I’m concerned, it’s a win-win.
News to gladden hearts (and lungs)
Some great news – GPs will now be able to send patients straight for tests when they suspect heart or lung disease, sparing them lengthy delays in getting specialist appointments.
It has long been a frustration for GPs that a hospital specialist had to be the one to send patients for certain tests. It has meant that even if we knew exactly what test was needed, we didn’t have the authority to arrange it.
Some people I see in my clinic with heart disease have been waiting months and months just to get in front of a specialist, never mind undergo any of the tests they need.
But now, family doctors like me can refer you straight for vital checks that could diagnose heart disease, chronic obstructive pulmonary disease (COPD) and asthma.
It means faster diagnosis and, therefore, quicker access to life-changing treatments.
If you’re awaiting tests, ask your GP about this new option.