<p>My dear friend and neighbor has confided in me and I am looking for suggestions for her. Her DH is a very successful, hard-charging executive with a very demanding, high-pressure job which requires extensive travel. He has been on the go, barely home, for the past couple of years. He is not home very much ( and this was true even during his previous jobs) and, when he is home, is distant from his wife and children. His behavior has become erratic and he acknowledges that he is in trouble and needs help. I am trying to find some suggestions for my friend from my dear friends here.</p>
<p>My sense is that 45 minutes a week with a therapist is not going to be enough. I have no idea what exactly he needs, but peace and quiet seems at the top of the list. I’m imagining a facility somewhere out in the country.</p>
<p>I would be grateful for any suggestions, and information on success rates for different kinds of treatment would be very useful.</p>
<p>This is an extremely high-functioning person who is falling apart.</p>
<p>It sounds like the immediate needs are for an evaluation. Then have someone recommend what kind of resources are available for his needs. An evaluation can start with a primary care physician, who can recommend a mental health expert; in an emergency situation, they can make these referrals pretty quickly, as many good mental health experts are often booked up weeks in advance. </p>
<p>You’d really need to provide more information for anyone to make specific suggestions. Is he an immediate threat to himself? to others? etc.</p>
<p>Certain professional organizations (e.g., the state bar) have confidential help lines for persons in this situation. Is his field one where such an alternative might be available?</p>
<p>Your friend should contact her husband’s primary care physician (if he has one), and ask her husband to make an appointment. If she can go along, that would be best.</p>
<p>Also, the organization NAMI (National Alliance on Mental Illness) at [NAMI:</a> National Alliance on Mental Illness - Mental Health Support, Education and Advocacy](<a href=“http://www.nami.org%5DNAMI:”>http://www.nami.org) is a great resource for information and support with mental illness issues.</p>
<p>It is really good that he recognizes that there is an issue and that he needs help. It is nearly impossible to get mental health treatment for an adult in our society who does not want it, often with tragic consequences.</p>
<p>One way to help your friend think about this is that the brain is just like any other organ of the body, and it can have illnesses/damage just like your heart or lungs or any other part of the body. With this in mind, she hopefully can help her husband work with medical professionals to identify his issues and determine the best course of treatment.</p>
<p>I am not sure where you live, but most major cities have crisis teams that can respond in an emergency too. Often they are affiliated with a large teaching hospital. The local police can often give you the info if it exists in your area. If there is a psych hospital in the area, they may have a psych emergency room too. Find out these resources BEFORE he is in complete crisis. The time and stress you will save by have that info upfront can be life saving. As intparent mentioned, he needs to go to his PCP for eval and referral, that is the best place to start. If he does not have a PCP, or the PCP is not helpful, contact his insurance company directly, many of the major ones have mental health lines for referral and will help get the assessment that he needs. Hope that his helps!</p>
<p>To answer the questions, he is definitely not a danger to others. It has crossed my friend’s mind that he may be a danger to himself, so this is at least a possibility (probably not a strong one).</p>
<p>He is not in a profession (that might have helplines). He is a highly placed executive and visible (has been interviewed on business TV). </p>
<p>By “erratic and falling apart” I mean not showing up when expected, getting lost in very familiar places, having a sense of unreality, sobbing for hours. This is all completely uncharacteristic behavior. </p>
<p>Thank you for the advice to seek an evaluation with his physician. I agree that this is a good place to start. I’ll take a look at the NAMI site.</p>
<p>Thank you, limabeans - I had not thought about a medical cause, but clearly this has to be evaluated. Another good reason to start with the PCP.</p>
<p>^Based upon his symptoms, I would definitely start with the PCP. Unless he has a history of mental health issues, it really could be a medical condition that just looks like a psychiatric illness. Can be very easy to confuse the two. In addition to diabetes and Alzheimer, there’s a whole slew of neurological disorders that can cause those types of symptoms. It could even be a brain tumor, stroke or something like alcohol abuse (not that he has that but if he’s a heavy drinker, then it’s one more thing to consider). If it turns out to be a psychiatric condition, then the PCP could make a recommendation for an evaluation.</p>
<p>Agree with Limabeans about medical consult. Would also schedule appt with psychiatrist. Unfortunately, a clinical depression can hit middle aged men. Between these 2 physicians, referrals for neurologist or whomever can be made, and an evaluation of seriousness of condition made prior to treating inpatient or out-.</p>
<p>MomLive suggested some possibilities that I was thinking about, e.g. tumor or overuse of a substance. I was thinking that this family may already know a psychiatrist and not wait until first meeting wth PCP to then make an appointment.</p>
<p>unfortunately, I have a very bad feeling about this (and that feeling comes from very personal experience) and it’s not necessarily psychological…</p>
<p>Yeah, depression is the most likely culprit. Depression can be caused by all of the psychological pressures, as well as some minor medical conditions (think electrolyte/trace mineral imbalance, even anemia). The mention of cancer/tumor/and everything else, while they can have a side issue of depression, they are not the most common causes. So don’t let that freak you out. And don’t mention them to your friend, sounds like she has enough to worry about. Let the MD eval him and come up with the diagnosis. Good luck! '</p>
<p>Agree with others to pursue workup quickly. Many possible causes, including psychiatric, neuro, drug/alcohol abuse etc. Getting an appointment outside of PCP’s can take a bit of time. It is important to have spouse attend at least part of that appointment if possible. </p>
<p>Also, your friend is lucky to have your support. This is scary and lonely and people tend to think they are the only ones who are experiencing this. If he is as disoriented as described, part of what the friend can help do is damage control. Schedule some time off from work (it need not be protracted, especially initially), public appearances, etc. Don’t have him driving alone, etc. Behavioral extremes get noticed (and may be dangerous) and it can be hard to re-group afterwards, regardless of the cause.
Best to all.</p>
<p>Make sure they check his thyroid!!! Thyroid problems can cause depression - can even mimic schizophrenia. Often men are not tested as doc’s still think this is a woman’s disease. It is not. My husband had every symptom in the book and was depressed and going downhill at work - brain not working properly ('fuzzy brain") and doc only tested him because we asked for it. His numbers were off the chart. One pill per day and I have him back; he would have died of heart attack.</p>