How to deal with depression

My previous placement was musculoskeletal outpatients. I prepared by going through pst lecture notes and refreshing my mind on how to do subjective and objective assessment etc. What I was not prepared for was an encounter I had with a patient who had come to the clinic due to chronic LBP. This patient was a 65 yo male, who had a history of chronic LBP for 10 years. As I observed this man I noticed tha he sat with very poor posture and he was quite over weight. But my main concern was not what I saw...it was what I found out subjectively.

Initially the patient was reluctant to "chat" with me and only gave me short, quite abrupt answers to my questions. My initial reaction was to be abrupt back and I began to think why am I even bothering with this man! (It is a reaction that thankfully I am beginning to change) As this reaction got me no where, I changed my attitude and opted for the really nice and caring approach. The patient finally opened up and began to tell me about his life. He used to be a doctor, never married, no kids. He sleeps 15 hours a night with a 5 hour nap during the day (that right he was awake for 4 hours a day) however he then said to me he suffers from insomnia??. He stated that he becomes extremely depressed if a letter (from anybody) arrived in the mail and he hs 2 dogs which never get walked.
I have never ever come across someone so depressed, I cannot explain by writting words how sad this man was. Prior to this encounter I honestly thought depression was something every second middle aged office worker had. This man made me realise how depression is such a serious illness.

I saw this man 3 times on my placement. Initially I focused on his LBP through massage, PAIVMS and PPIVMS and propriceptive taping. I soon realised this was not enough to help this man. So I drew up a day to day life plan for this man. I told him he ws allowed to sleep for 10 hours only, he then had to get out of bed and take the dogs for a 30 min walk and I provided him with very basic exercises to do after his walk eg 1/4 squats, marching etc. I told him he was allowed to have a 2 hour nap in the arvo but no more and then he had to get up and go for a walk or take the dogs to the beach again. This may sound strange that I told this man how to life his life but I honestly did not know another way to break this depression cycle.

This patient had huge effect on me. I can not imagine living a life like he was, but he has made me understand how serious depression can be. Unfortunately my 5 week prac finished and Im not sure how he is doing or if any of my ideas to help him had any impact. Id like to hope that I made some difference to this mans life but realistically I really doubt that my small attempt to change this viscious depression cycle would have worked.

I am still unsure what I will do if a similar event like this occurs (I am sure it will!). I will have to read more psychology texts I think. It is a really sad sad issue and I will need a lot more experience and knowledge to deal with situation again.