How Should Depression Causing Marital Problems Be Treated?

Hello thanks for asking from HCM She is suffering from chronic depression and in chronic severe depression a number of somatic symptoms are seen. Decreased sexual interest, apathy, inability to find pleasure in sexual activities etc are common symptoms. Drugs used in depression (especially SSRIs and SNRIs) are also causative in reducing sexual interest. All these factors collectively are the probable reason for her weird behaviour about you. She might have developed depression with psychotic features which can be a reason for such behaviour. As per my opinion she needs treatment. She is refusing to take medicines so in such case either she can be given medicines without her knowledge or non-medicinal methods of treatment should be tried. If you are her primary caregiver and her psychiatrist agrees then some medicines are available which can be given by mixing with food. Antipsychotic drugs like Olanzapine can act as mood stabiliser and can help her to come out of acute symptoms and then conventional antidepressants can be given. Though detailed evaluation by a psychiatrist to confirm her diagnosis is required. Other option for her severe depression is Electro Convulsive Therapy (ECT). ECT is safe method reserved for severe depression. Consult her doctor for details. Thanks, hope this helps you.