DEAR DR. GOTT:
I am a trim and healthy 65-year-old man. I have been married to my wife for 25 years. She is overweight and has no energy. I am writing because I am concerned about her lack of a sex drive.

She has been on antidepressants for about 10 or 12 years. She blames her lack of energy on her weight and her lack of sex drive on her antidepressants. She has not been to a doctor in years and doesn’t even have one. She doesn’t get her “happy pills” from a physician, but rather from a friend who works for a doctor.

She refuses to see a physician about anything because she says she is afraid of what a doctor may find wrong with her. She has a good job and I own my own business. We have insurance and can afford to go to the doctor, so it is not a matter of not being able to.

Her lack of libido is hurting our relationship and our marriage. I love her more than anything or anyone else on earth and I want us to have a mutually satisfying sex life. I do not want to seek sex outside of the marriage, I simply want her and her libido back.

We have three children who are all grown and on their own now. She had a hysterectomy and gallbladder removal in her 40’s and since then she has not been the same. She has had stomach problems every since. Her constant companions are Tums, Rolaids and Pepto Bismol. Neither of us smokes or drinks alcohol.

We are a typical upper/middle class white suburban couple who attend church regularly, keep our home and yard neat and get along with each other, our children and neighbors. We do not fight about this touchy subject. When I attempt to discuss it and urge her to see a doctor, she refuses so I do not push her.

DEAR READER:
There are several issues at play here. I will first discuss the most serious and potentially harmful one first; the antidepressants.

You say your wife hasn’t been to a doctor in years but is on an antidepressant she receives from a “friend”. Was she first prescribed antidepressants by a doctor but then stopped going or did she and her so-called friend come up with the diagnosis and treatment on their own? These are important questions in that not only is your wife’s friend breaking the law by giving your wife prescription medication without a prescription or medical license, he or she is potentially harming your wife. Without proper testing and diagnosis by a trained, licensed medical doctor, there is not way to know if your wife truly has depression or some other condition that is causing depression-like symptoms.
Another issue here is that your wife appears to be suffering, perhaps from depression, that is not responding to medication (assuming she truly is receiving an antidepressant). This could mean many things, such as she doesn’t have typical depression, doesn’t have depression at all or is suffering from an underlying medical condition such as thyroid disease or other hormone imbalance.

Your wife’s comments about why she will not see a doctor suggest to me that she may have a degree of paranoia. She appears to be coming up with excuses to justify her actions and behavior.

I commend you for sticking in there. You have clearly reached a limit and are now writing to me for help. However, I believe you have your priorities slightly askew. Your wife needs help immediately, not for her lack of libido but rather for her assumed depression, stomach issues, weight and other symptoms. She needs to be seen by a physician and psychologist or psychiatrist for thorough physical and mental examinations. She cannot get any better until she is properly diagnosed.

As an aside, antidepressants can cause weight gain, loss of libido and gastrointestinal upset (heartburn, nausea and others). Perhaps everything that is currently wrong with her is due to the illegal medication that may improve after discontinuation.

Now on to advice for you. If your wife is not interested in changing, perhaps you need to alter your approach. For example, counseling may be beneficial in helping you to cope with your feelings, coming to terms with your wife’s behavior and allowing you to move on to a more healthful place. With this approach, your wife may want to have the same successes you are achieving. You cannot make her get the help she clearly needs; she must do it on her own terms and in her own time. It may not be what you want to hear, but there is only so much you can do before it’s time to throw in the towel and I fear that time may be approaching for both of you.