Today I'm sharing a story. It's a real clinical case, a success story about overcoming depression while receiving treatment in my practice, but all personal details are changed beyond recognition, so privacy is protected 100%. This story is a story of hope, and this is a story of love. And this story starts a few years ago, at the time when this elderly man walks into my office.
He is in his mid-70s. His wife just died. They had been happily married for 50 years, and she was the love of his life. He was referred by his primary care physician because he was complaining of a depressed mood. He endorsed the idea that he doesn't see the point of continuing to live without her, and he lost a tremendous amount of weight.
He was kind. His eyes were very, very, very sad. He was well-spoken and eager to talk. The amount of suffering and sorrow in his voice was tremendous. Obviously, we explored suicidality, and it was very clear that he had passive thoughts of death, induced by his loss and emotional pain, but he's really not going to do anything.
He was meeting all the criteria for depression. Initially, it was understood as complicated grief, but it became really severe. It started to be a moderate to severe depressive episode. He would have a hard time falling asleep, and if he did fall asleep, he would wake up very early in the morning with a sense of despair, emptiness, and loneliness.
His mood was depressed for most of the day. He lost a tremendous amount of weight. He really did not enjoy anything anymore. He was just existing. And he wanted to get some help or to get out.
We started psychotherapy together with antidepressant medications, and initially, it did not go well. The first medication choice, he did not tolerate well. He ended up vomiting, and we had to switch the medication. The second medication was tolerated well, but it was not clinically effective. We were increasing the dose, increasing the dose, increasing the dose... nothing happened!
Unfortunately, depression was not lifting. His only activity that would get him out of the house was his weekly appointments with me when he would come for therapy to share his grief and his depression!
He was very discouraged; he believed that nothing was ever going to work, that nothing was going to help him, and that only death and rejoining his wife in heaven would relieve this pain. He was willing to try "just one more" medication. We changed the class of antidepressants, and obviously, he stayed in therapy. Very, very slowly over the next couple of months, his depression started to lift. It was very insidious. He started sleeping better, eating better, gaining back some weight, not feeling exhausted and unmotivated all the time, and actually started watching the football game that he previously would not miss but during his depression couldn't care less about.
I started talking to him about other things. His therapy sessions were not revolving only around pain and loss. He started sharing other details of his life. He began speaking about the reasons how and why he and his wife did not have kids, about her infertility, and his tremendous love for her that was augmented by the fact that they literally spent all of their lives together.
He spoke about fidelity. He spoke about certain temptations throughout his life, but he said absolutely nothing was a temptation strong enough to take him away from his beloved wife in any way. Slowly, he started remembering her not with tears, but with smiles. Instead of remembering death and loss, he started remembering beautiful moments that they had throughout 50 years.
He would tell me anecdotes, or moments when one of them was embarrassed, or moments when one of them helped out the other one, moments of laughter, moments of passion... his perspective changed. His medication was optimized. He kept coming to therapy religiously, but to my delight, he started being open to other activities as well.
He was getting out of the house, getting his own groceries. He started cooking. He was not ordering food anymore. Throughout this process, he started helping a neighbor. This neighbor was also an elderly woman. She herself had a hard time getting groceries. Actually, she had a problem that was impairing her capability to walk, making it quite challenging for her to go up and down the stairs. He became somebody who is helping her out and getting her groceries. Obviously, this additionally helped him because he finally regained the sense of purpose. He felt like somebody needs him. And very, very slowly, we stopped talking about his wife's death and started talking about his daily activities, his neighbor, and his thoughts about his "new" life that was gradually developing.
His neighbor was grateful for his effort to get her groceries so she could start cooking, and to return the favor, she started cooking for him and inviting him to have a meal with her together. For example, she would make soup and insist that he come for a plate of hot soup with her. She baked a dessert and insisted that he come over.... Slowly but surely, they developed a little bit of a romance. One day, he decided to help her down the stairs and have a lovely walk in the park because it was the first lovely day of spring. With increased activity, he actually reported that his neighbor's gait and capability to walk started improving. Then one day, he came to my office. He was stuttering, blushing, and asked if he could be prescribed....... Viagra. After evaluating cardiovascular risk, it was possible for this to be done, and it was clear how and why he needed this medication. Therapy sessions shifted completely. He started talking about falling in love! Passionately falling in love with this woman... And then we encountered a whole new problem!
He loved his wife so much. He spent 50 years with her. He never engaged in any type of romance with anybody else. Here he is now, after his wife's death, having a relationship with another woman. Feelings of grief surfaced again, this time intertwined with feelings of guilt and shame. Our entire treatment shifted from dealing with grief, depression, and loss to dealing with guilt and shame and the fact that he honestly, genuinely, passionately loved his wife and that he now honestly, genuinely, passionately loves this woman who happens to be his neighbor.
One sentence that resonated with him was my feedback that his love for his wife was genuine, that his wife must have loved him back, and he agreed with that. With that love in mind, his wife would most definitely want him to be happy. And one of his responsibilities, his legacy to her, is to take care of himself and to allow himself to be happy because his happiness would make her happy. This really helped with his feelings of shame and guilt.
Suddenly, he started missing his therapy sessions. He would apologize, cancel, and say that he really wanted to go to a museum with his girlfriend. Gradually, we terminated the case. He developed a whole new life, a whole new love.
He overcame severe depression with passive suicidal ideation. He regained his health, was passionately in love, and was sexually active. Interestingly enough, quite passionately sexually active, and, you know, sometimes eager to even brag a little bit about it. It was clear that we can stop the treatment, that he's good enough, and that my door is open if he ever needs help again. (He did continue maintenance antidepressant treatment daily... continued by his primary care doctor)
I never saw him again, and I'm very happy that this case ended the way it did. It warms my heart because it tells me, and it tells you, that it is never too late for anything in life.
I love this story and I hope you love it too. It is squeezed into a few minutes but this treatment lasted about two years. The first year was really focused on depression, and the second year was focused on handling this romance and the conflicting feelings that I mentioned. It is a short story, but it reflects almost two and a half years of treatment with therapy and medication, and it resulted in triumph and a happy ending.
I'm very glad that I never saw this guy again.
Have a wonderful, wonderful day !
Dr S.
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