Spouse Won't Consider AP

This series focuses on coping with rheumatic disease and the challenges of the healing process, written especially for patients on antibiotic therapy. 

Dr. Susan E. Grober is a clinical psychologist.  She specializes in health and wellness as a researcher and psychotherapist, and often writes about issues important to patients.

Question: My husband was diagnosed with rheumatoid arthritis three years ago.  He went down hill quickly and is on prednisone, methotrexate and many other drugs that seem to be destroying his stomach.  He is very depressed and is going to have to think about getting on disability.  A friend of mine directed me to The Road Back web site and I bought the book about antibiotic treatment.  I am very excited that this could really help him but he won't read it or even look at the material because he said if it really worked his doctor would put him on it.  I am at my wits end and very afraid about his health and our future.  Please help me help him.

Answer:   This question encompasses many different issues that are frequently encountered in my work as a health psychologist and a couples therapist. I am going to touch on all of them briefly, not only to help you help him, but also to help you help yourself!  That said, I would like to first address the impact of mood and illness on motivation.  You describe your husband as very depressed, and also as having fairly aggressive RA. More often than not, depression enters the lives of people affected by rheumatic disease.  The loss of valued activities, the pain he experiences, and the exhaustion that is likely your husband's constant companion surely cause him to feel helpless and hopeless. This sense of despair naturally makes it difficult for him to either share your excitement about antibiotic treatment and or to read an entire book devoted to the subject.  It is important for you to understand that depression and enthusiasm are incompatible, and that depression also makes concentration and decision-making very difficult at best. There is also anecdotal evidence that men may be more passive about their healthcare than women (of course, there are exceptions), and that they have a less collaborative style when they visit doctors.(i.e. they tend to defer to the doctor's authority rather than asking a lot of questions).  Given these trends, and your husband's psychologically based and physiologically based lack of energy, it's not surprising that he has decided to defer to his physician!

Hopefully, this information enables you to more easily see this situation from his perspective.  And that's important now, not only to enable him to consider a new treatment, but also to decrease your stress, and perhaps to allow you to grow closer as partners during this crisis.  If you continue to expect your husband to share your excitement, you will surely be disappointed, and may even create unnecessary tension in your relationship.  At worst, your husband may become more fixed in his position that his doctor knows best. To avoid these problems, I'm going to suggest that you spend some time listening to his feelings of hopeless and helplessness, and allow him to talk about them without trying to make them better or go away. If this is too difficult for you, perhaps he can speak with a close friend or a licensed mental health professional.  If he understands that you can see his point of view, he may be more open to hearing what you are saying, although it is unrealistic to expect him to share your level of enthusiasm.  What is important, however, is for him to agree to consider the idea of antibiotic treatment, and by directing your well-meaning energies appropriately; he is more likely to do so.  Try meeting with his doctor and discussing antibiotic treatment with him/her.  Bring the Antibiotic Protocol with you, as well as a couple of scientific articles about it that you can download from our web site.  If this visit is successful, your doctor can suggest the treatment to your husband during their next appointment.  If this physician is unwilling to consider antibiotics for your husband's rheumatoid arthritis, get the name of a doctor who is amenable to this protocol, and make an appointment for you and your husband to get a second opinion. 

It may also be helpful to identify and then connect your husband with another man from the Road Back web site.  He may be more likely to discuss both his sadness and his treatment with another man who not only understands the male perspective, but has also lived with the same difficulties. These actions may not only help your husband consider a new treatment, but may also decrease your own feelings of helplessness and frustration.