Boyfriend Depressed over Failed Transplant

Discussions for Patients, Family, and Friends PD For Patients
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Hello -

Does anyone have any suggestions on raising the topic of couples therapy to a depressed HD patient?

My 34 y.o. boyfriend has been on dialysis for 4 years. Combination of HD and PD. He received a transplant in Aug '05 but due to a loss in blood supply to the kidney, the organ was removed and he is back on HD. He has beeen on disability from work since the transplant and is extremely depressed. He is reluctant to talk about things with me or a therapist because he feels talking will not resolve anything…a transplant will. He has begun to isolate himself from friends and family - which is clearly making the depression worse. I love him and want to be as supportive as possible. However, our relationship is suffering and I don’t know what else to do. I spend as much time as possible with him on the weekends but his lack of energy leaves little activities for us to enjoy besides sitting home and watching television. I know he tries to keep his spirits up and wants to be actively engaged when we are together but often times it just does not translate. Our sex life is non-exisistent which is becoming a source of frustration and anger for me. I have tried to rationalize that it will get better but I’m feeling less and less positive as time progresses.

I want to start couples therapy so we can at least acknowldege our issues and begin discussing ways to reconnect. But I’m concerned my request will fall on deaf ears or he will interpret this as adding to his burden. If anyone has dealt with this, I would apppreciate any suggestions or thoughts on how to approach the discussion.

Thanks!

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My husband and I are very lucky that we can communicate our feelings. I definately would let his Nephrologist know about his depression. There are some meds that can help that feeling he’s got. I have severe depression and am so glad they discovered it. I’ve been on meds for 9 years and it really makes my life better. Good luck :smiley:

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Every dialysis clinic should have a social worker who is trained to do clinical social work. Sometimes it appears that they are just pushing papers, but most social workers really prefer to help people cope with kidney disease, including setting goals for the future and working toward them. If the social worker doesn’t feel that he or she can help, ask for a referral to someone in the community who has worked with people with chronic illness.

When people get depressed, they often do the worst thing possible – they isolate themselves from those people who could help pull them through it. One thing that I have suggested in the past is to put the need for counseling on you. Tell your boyfriend you’d like him to go to counseling with you so you can learn how to cope with his kidney rejection and be the best help to him. A counselor can talk with you and him about things to do to help overcome the sense of hopelessness that I suspect he is feeling right now.

I wouldn’t be surprised to hear that your boyfriend is afraid you’ll leave because he has kidney failure, is a burden, has no future, and on and on with negative self-talk. He may be preparing himself for you leaving by isolating himself and pushing you away. It is important to start working on changing his negative self-talk into positive self-talk right away.

If he was on dialysis before he had his transplant, he probably went through a similar emotional reaction. If you weren’t in the picture then, ask what did he find that helped or hurt then? When I counseled with patients, I always encouraged them to be active (exercise helps to improve physical and emotional well-being), to set small goals (achievable), to visit with friends and family (socialization helps), to look at the things they could do. If he’s doing in-center dialysis, he probably doesn’t like feeling out of control. Encourage him to consider home dialysis – either PD or HD.

Ask the social worker if he/she knows another patient who went through a rejection and is coping well now, on the transplant list again, or who has gotten another transplant. I know someone who has had 3 transplants reject over his 30+ years of having kidney failure. He was a teenager when he was first on dialysis, has married, adopted a child, has a full-time job, bought a home, takes care of his home and his family, travels, etc. He’s on his 4th transplant now and is doing well with it. I know that he had his share of depression, but he chose not to let kidney failure win.

I’m sure that others will post suggestions too.

1 Like
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  1. HD, but is it daily home HD? This can go a long way in cheering a person up while waiting for another transplant. Not being able to eat or drink normally is very depressing just by itself. Daily home hemo gives that back to most people. In fact, he would probably have to make an effort to eat and drink more than usual.

  2. I haven’t even been through the transplant route yet. Still waiting on the list (3 and a half years now). However, I can imagine how utterly devastating it must be to lose a transplant after a relatively short time like that, and to have to go back on dialysis. It may take a while to get over that. It’s pretty hard to be happy after something like that happens, but eventually, perhaps with professional help, you get your perspective back.

  3. I’m really going out on a limb here, but when you say he says only a transplant will help him, could it be that some of that is his way of showing his rejection at nobody he knows being willing to donate a kidney to help him? I know from personal experience that it’s extremely hard to know you’re on dialysis (we make the best of it, but it’s not an easy situation by a long shot) and that seemingly nobody cares enough to offer a kidney - among friends, relatives. I’m not saying this is rational or acceptable, just stating it as a possibility. He might need the help of a good renal social worker to help him work this out.

Good luck.

Pierre

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Anti-depressant medications can be helpful when someone is depressed, but so can a variety of other things – counseling including learning how to talk to yourself differently, keeping active, exercising, visiting with family and friends, and in general doing things that bring you happiness.

When you’re depressed, you’re likely to do those things that are totally contrary to the things that would help you. Many people withdraw from friends and family, sit in a dark room and think about how miserable life is compared with how it was in the past, worry about things that may or may not happen in the future, sleep a lot, drink too much or take recreational drugs, and stop doing things that bring them joy. You might want to read Module 5 on Coping with Kidney Disease in Kidney School at http://www.kidneyschool.org and if you and your boyfriend work through it interactively, it will suggest an action plan at the end based on how you answer questions throughout (no data is saved, by the way).