After 20 years of marriage, my husband, who has always been a great father and husband and all around good guy, has become distant, moody, critical, unhelpful, unable to sleep and eat, and in general just has lost any pleasure in life. He goes to work (he has a white-collar position that demands long hours and is highly stressful) and comes home to sit in a chair and watch TV. Our family doctor told him he might be in a mild depression. My husband doesn't believe he is, and he doesn't believe in therapy. Our life at home for myself and my two teenage children is so different, confusing and stressful. This has been going on for 14 months now. It gets better, then goes back to him being by himself and not wanting to be with any of our friends.

C.N.

It can be difficult for family members (or friends) to be around someone who seems to be miserable and yet refuses to change or seek help. There may not be much you can do for your husband unless he acknowledges his misery and wants that to change. But I'll mention some options you might explore -- asking that you keep in mind, of course, that none of my musings are definitive because I haven't talked to you or your husband personally.

If a client of mine reported that her husband was displaying such behavior, one of the first things I'd wonder about is what's going on in his job. Have there been any changes in management or job demands? Is he becoming frustrated and exhausted by what seems like the rat race or treadmill of his career? Is he no longer enjoying his work or finding meaning in it? All these things (as well as just plain overwork) can contribute to burnout, depression, etc. Sometimes these and other issues -- concerns about aging and mortality, for instance -- can manifest themselves in what's commonly called a midlife crisis.

If the relationship between husband and wife has traditionally been good, I might encourage the wife to sit down with her husband in a private place -- or maybe over a good meal in a restaurant without the kids -- and ask about some of these things. She would need to be prepared, however, to handle some possibly scary news. For instance, her husband might reveal that he would like to quit or change his job, which could have financial ramifications for the family. However, she might be willing to exchange some financial security for a happier husband and home life.

If her husband refused to acknowledge any problems, much less to consider getting any help, it might be necessary for her to set some limits with him about his behavior with her and the kids. He might choose to be or stay miserable, but it's unacceptable to take that out on the rest of the family. She could demand that he change behavior affecting the household. (I recommend never giving an ultimatum, however, unless one is willing to follow through on the threatened consequences.)

That said, if you are unable to connect with your husband and improve things for you and the kids, please consider consulting with a therapist for some specific support and guidance in this matter. If your husband won't accompany you, go alone.