My Son: Is it depression or bipolar disorder? I need help

@bosmac

I must be very frustration to be watching this happen, but not be able to do anything about it. As a nurse, he knows this is not normal, but not willing to get help to change. Sometimes medical professionals are the worse patients. Either they have seen to many examples where treatment did not help or they think they can take care of themself.

Does your son and family live with you?

In this situation, have you expressed your concerns to his wife privately? What are her concern about what is happening and affect it is having on her and their children?

I certainly hope you can find some answers soon. This would worry any concerned parent.

You mention that he goes in and out of these "seasons". Have you noticed any particular events that cause him to start and stop feeling this way?

Interesting that he's a nurse yet refuses to see a doctor. Is it possible he had some traumatic event that causes him to question the profession? PTSD can take strange forms sometimes.

He mentions being exhausted -- is it possible he has a sleep disorder?

Does he ever express irrational anger? Or is he detached and indifferent?

Does he have a spiritual life? Belong to a church or other group? Have interests in any particular spirituality?

So many questions, yet only a qualified professional can help with answers. Hopefully, you'll find some soon. Best of luck to him, to you, and your families.

Thanks Laurie for your response. Indeed, it is very frustrating watching my son wasting away and being unable to do anything to help the situation. Not sure why as a medical person he does not want to be treated. He says the drugs are addictive and that he will not come out of them easily due to withdrawal symptoms that he has seen at the hospital where he works. As you put it correctly, he behaves as though any medical intervention is not helpful that he will be okay with time.
Yes, he lives with me. His wife and son are in another country, waiting for their visa to join him. Wedding was in 2021 and we are still awaiting for response from immigration dept. While this may be the reason that is depressing him, but he has been in this same situation in 2019 when he split up with his previous girlfriend of 3 years.
I have not expressed anything to his wife but he tells me she is aware that he is not been working for the last 4 months and that he is depressed. I will now talk to her privately as per your questions and hear what she actually knows and what she is concerned about.
Thanks again very much for your response that has made me think I need to approach his wife and get her thoughts. They last saw each other in February this year

Thanks Scott for your response and thought-provoking questions that are making me see the bigger picture of this problem. The first time i saw him depressed was in 2019 when he split from his GF of 3 years and later he stopped working as a nurse from a reputable hospital. He was depressed for about 6 months and one morning he woke up, applied for jobs and started working again. Again since the start of this year, 2024 has been depressed so badly that he sleeps most of the time. This time round I have particular reason why he is upset, apart from the fact that immigration have taken 2 years since his wedding to grant her a visa to join him. Prior to start of the year, he has no sleeping issues. I doubt if he has any sleep disorders. No anger issues. Used to be very pleasant and warm but currently he is very aloof and detached. Prefers to keep off in his bedroom and not join us in the leaving room.
Used to be very active in the local SDA church. Very church oriented but now has lost all interest and does not attend since he started being depressed.
This is a very though time for and rest of the family as am personally dealing with other medical issues (diabetes, high blood pressure, CKD and lately have a blood disorder that is being investigated)

I am hearing in your comments that it is kind of taboo to open up to each other enough to understand each other in your family. I wonder what would happen if you, and maybe your husband and/or other family members, would just go to your son and maybe his spouse together and open it all up with him. It seems he might believe he is on his own to improve when he does not know how and just gets confused, as most depressed folks do. Then shut down seems the thing to do.

Thanks msmerri for your response. It may appear that we are not close to each other but on the contrary we are very close together as a family. The problem is when it comes to this mood disorder when my son just goes mute and prefers to be left alone. Because he is a nurse, he flatly refuses any medication. I think he is the type who wants to appear that all is ok mentally to avoid stigma associated with being diagnosed as depressed. Yesterday we had a big family meeting where we discussed his condition openly and just called it what it is. He promised to see a GP by end of this week.

Generally, if a family member needs counseling and refuses to take counseling, it never hurts to get into counseling yourself. Then you can brainstorm with the therapist about the best way to approach the issue.

There maybe ways to coax the person into counseling and a few techniques or suggestions might help.

@bosmac I live with a physician (retired) who sometimes is much the same as your son. He is often mistrustful of other medical professionals but there is a big however coming here. When he knows that something is not "right" such as a recent infection he saw on himself after a tick bite he went straight to his primary care provider and put on antibiotics. When he is prescribed medication he is compliant and takes the full course.

Whatever is happening with your son is as real as the infection I described above. This isn't a few days of feeling sad but a very real health problem that has terrible consequences for himself and his family. I know you know that and so it's good that your family got this out in the open together yesterday.

My husband has seen the worst of the worst during his career as a pathologist and medical examiner. Your son could say the same but that doesn't mean his response to antidepressants or whatever course his GP recommends will be the same. I do want to encourage you and your family with this. Antidepressant medication is not "addictive". (See below) The medication does not check the boxes for addiction. field).

Antidepressant medication can be physically difficult during the withdrawal period but when a person works with their doctor and titrates slowly, slowly down from the medication when it is time to go "off" the medication those withdrawal symptoms are minimized.

Cleveland Clinic: Addiction

-- https://my.clevelandclinic.org/health/diseases/6407-addiction

I hope your son will see his GP as promised and will see a mental health therapist who can help him through this period of depression - this will also help him in the future know the signs of relapse for depression.

I am sharing the above advice because I've had several episodes of depression during my life time. The first and most severe episode occurred in my mid-20's (I'm not 72 years old). Each episode has been less severe from the previous ones because I know the signs and what to do for myself when I start to detect symptoms. A psychiatrist once explained to me that I need to treat this as a "chronic" condition much like a physical health disease. I wish the depression would go away forever and when it returns I remember the words of my psychiatrist.

Will you let me know what happens with your son?

Thanks @naturegirl5 for your detailed response. Much appreciated. I have checked the Cleveland website you sent, it is very helpful.
I will update you on my son. Am just hoping that he will live to his words and see a GP soon as he promised and get help. All this is coming at a time when am dealing with my own truckload of medical issues.
Kind regards

@bosmac Thank you for letting me know that my response was helped to you.

All my best wishes to you, your son, and your family as you all move forward.

If we, at Mayo Clinic Connect, can be helpful in supporting you through your own medical issues I hope you will start another discussion concerning you.