The warmest of welcomes to you at one of the most challenging times in your life. I feel for you so much and my heart truly goes out to you.
Based on personal experience, sometimes the most important thing with a depression comes down to establishing whether we've reached an emergency situation in the depression (aka 'rock bottom'). If so, it's important to treat it as an emergency. The priority is to stay in this life, so as to find a way out of the depression. Btw, while the inner dialogue we can be experiencing at rock bottom sounds so convincing, it's vital to not pay attention to it. It might shock your wife, which is not a bad thing, but it may be time to admit to her something along the lines of 'I haven't told you this 'til now but I've been seriously struggling with depression and it's now bad, really bad. I just can't do this anymore'. It may be the wake up call she needs, as opposed to her perhaps simply thinking 'He doesn't care about anything'. While the dialogue of depression may insist 'Don't tell her, she won't care anyway', don't listen. Based on my own experience, the dialogue of depression is full of sh**, to put it bluntly.
In an emergency situation, it can be time to do what you wouldn't normally do. If you never take time off from work, it may be time to call in sick. If you never cry in front of your wife, it may be time to do that. If you never have others advocate for you, it may be time to get someone to say to one of the local doctors 'While you're not taking on any new patients, you need to take this guy on. He needs someone more local, just for a period of time'. Of course, in an extreme emergency, it can involve going to an emergency department.
I've found, the thing with depression is you can convince yourself 'I can cope with this, I can manage it' and then all of a sudden it's like BAMM, you feel like you've suddenly dropped to rock bottom. You don't necessarily see it coming. Personally, I've come to see a depression as a well. From teetering on the brink all the way down to rock bottom, there are all the in between levels that we can be trying so hard to manage. When it comes to that 'light at the end of the tunnel' people speak of, at rock bottom in that deep dark well or depression the light at the top of the tunnel has pretty much disappeared. It's dark, seriously dark, and the despair can be pure and brutal. While despair can be horrible, pure despair is a whole other story.
Not sure if it will help but over the decades, as a 56yo gal, I reached the conclusion/revelation at some stage 'I'm not going to settle'. What I mean is I never settle for 'You have depression'. I don't have it, I'm in it and I want to know why and how I got into that well. Without knowing why and how, how are we expected to get out of it? Whether life has become naturally depressing for reasons we can be yet to understand or whether there's a chemical issue (such with issues relating to dopamine uptake in the brain or ADHD factors for example), there's always a reason for why we're in that well. 'You have depression' doesn't give us the reason. Your mission, if you accept it, is to find the reason. You have to be here in order to do that. Btw, I can imagine how exhausted you are after all these years. Depression will do that to a person. While these days I'm more inclined to experience short term periods in a depression for good reason, I'll never forget the impact of a long term stay in that well, of 15 years or so. Long term depression can lead us to believe we'll never get out. Remember, don't listen.
