"I had no idea how seriously depressed John was," says Sue, 30. "If I'd known, I never would have left him alone." Sue's parents had invited her and son Kelly to drive with them to Houston to visit relatives -- and that's when John called the suicide hot line. "Thank God he had the good sense to do that," Sue sighs.
By a cruel twist of fate, Sue was laid off from her secretarial job one week after John quit his post as a middle manager in the city government. "I'd actually encouraged him to leave his job," Sue admits. "I knew he was bored and disillusioned, and his moodiness was affecting our love life. I've always had a higher sex drive than John, and his frustration with his work was only making things worse."
All John talks about is relocating back East to his hometown. "He's obsessed," Sue says. "He has convinced himself that the only way to be happy is to go back home." However, the thought of moving -- and leaving her parents, with whom she is still extremely close -- fills her with dread. "It would break my parents' hearts for us to be so far away," she says.
Still, she's shocked and guilt-ridden by John's admission that he'd been tempted to kill himself. "I love my husband dearly, but I don't understand him at all."
John doesn't understand himself either. "I'm overwhelmed," sighs the athletic-looking 36-year-old, his voice flat with despair. "I thought I wanted to be by myself to think things over, but once I was alone, a blanket of gloom settled over me. Life didn't seem worth living."
John has a long history of feeling bad about himself. Raised in a town where his parents operated a furniture store, he disappointed his father early on, he insists, when he quit the high school baseball team. "Dad dreamed I'd play pro ball," John says. "I really let him down."
John's problems at work began when the city cut back on funding. "Some new guys were hired, and they had a different set of priorities than I did," John explains. He'd come home so upset he could hardly eat dinner, much less make love. "When I'm under stress, I can't focus on sex," John says.
John believes that moving back home will give him a second chance. "I'm a failure as a husband and a father," he says. "This might be the opportunity I've been waiting for."
"John was referred to our agency after doctors at the suicide center diagnosed him as suffering from situationally induced depression and placed him on antidepressant medication as an emergency measure," explains Gail Donoff, a psychotherapist in Dallas, Texas. At this point, John and Sue began counseling.
In some cases there remains some stigma about seeking professional help or taking medication for an emotional problem. Yet mental health experts agree that, in many cases, medication -- carefully prescribed and monitored -- is an important adjunct to counseling and can often make a difference in the quality of a person's life.
It's important to educate yourself about these new drugs. Keep the following in mind:
* Adults as well as children can suffer from abnormalities in the way the brain metabolizes certain essential chemicals, most notably serotonin. Low levels of these chemicals -- called neurotransmitters -- may trigger emotional and behavioral problems. Antidepressants work by altering the level of these chemicals.
* Antidepressants may be prescribed only by a medical doctor, and they are most helpful for those suffering from depression with a persistent pattern of physical symptoms: general sadness or apathy; lack of energy or ability to concentrate; sleep or eating disturbances. A complete physical examination is necessary first rule out any other organic causes for these symptoms -- diabetes or a thyroid condition, for instance, can trigger symptoms that mimic depression.
* The most commonly prescribed antidepressants are the older generation of drugs, the tricyclics such as Elavil, Tofranil and Nardil. The newer medications, known as SSRIs (serotonin reuptake inhibitors), include Prozac, Paxil and Zoloft. Patients may notice their depressed symptoms ebbing in three to four weeks, though the drugs can cause side effects in some people (insomnia, anxiety, nausea, interference with sexual pleasure). However, the newer medications have fewer side effects.
Medication helped John feel better about himself, and with renewed spirits he focused on his problems. A trip back East convinced him that his hometown was no utopia, and upon his return he zeroed in on several job opportunities before accepting one. In counseling, he and Susan grappled with ways to share their feelings openly and no longer feel personally rejected.
John stopped medication after four months and, though this couple's problems have not suddenly disappeared, they both feel better about themselves and their ability to work through issues that divide them.