friend is suffering depression but is not getting help... what should i do?

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mochajave

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#1
My friend was hospitalized for a few days and diagnosed with depression. He had been suffering from insomnia for about half a year before that.

After going home from the hospital he stopped working, he had seen a few psychologist & psychiatrist but he felt like they don’t understand him, and also every time he visit a new psychologist/psychiatrist he needs to tell them his story all over again and the process was exhausting. After the hospitalization episode I noticed he is not as articulate as he used to be, and just seems to be in a very confused / anxious state all the time. Now he is just not getting any professional help at all, and head spinning negative thoughts all day long. He worried that he will never be normal again and wouldn’t be able to support his family (he is married, and support his mom, who has bipolar).

I told him he needs to get profession help, take med etc. But he said he had seen the side effect of med has on his mom and doesn’t go that route. When he was hospitalized they gave him med, but he said those med made him couldn’t talk, can’t think straight, so he doesn’t want to take the med. And I said maybe just start with psychologist, but he would say he doesn’t think just talking can help him. So he just ended up doing nothing, sitting at home and letting the negative thoughts downward spiral.

I’m no depression expert, never know anyone personally that suffer from it. This is the first time for me. I feel like he really need to be seeing a psychiatrist, be on the some medical to get out of the downward spiral… But he is not willing to do that. I have been doing a little reading and seems like inability to seek help is not uncommon in ppl suffering depression… I’m really worrying about him, as a friend what can I do? Do I have to physically cajole / escort him to see some psychiatrists? When his wife ask him to get help he wouldn’t listen. I feel like sometimes maybe someone would listen better to a friend than a spouse...

Anyways I’m a noob, just joined this website to start to get some ideas who has experience in this… I’m open to any idea / suggestion. Thanks in advance...
 
wolram

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#2
Hi mochajav

I suffer from depression and anxiety, and I can tell you that meds do work, get him to a phyc as soon as you can, if one med does not work for him then he has to be patient and try another,
If he refuses to go phone the Samaritans first and they will advise you how to get him to seek help.
All the best Woolie.
 
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mochajave

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#3
Hi mochajav

I suffer from depression and anxiety, and I can tell you that meds do work, get him to a phyc as soon as you can, if one med does not work for him then he has to be patient and try another,
If he refuses to go phone the Samaritans first and they will advise you how to get him to seek help.
All the best Woolie.
thansk @wolram . i know he needs help, professional help, just don't know how to get him to get help... he is an adult we can't just drag him to the psychiatrists' office... i will look into samaritans see what advice do they got... thx.
 
blacksmoke

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#4
all you can do is just to be there for him. i know of someone at the mo in my life who struggles with what i would say is severe but functioning depression and when i have seen them the last couple of times its like they are saturated with gloom dark gloom and i just keep things light and try to not add any more stress to the already taught trip wire.

like you say folk who are struggling with depression find it next to impossible to reach out for help. part of that is with depression there is a heavy thick fog that feels very heavy so as for clear and rational thinking...and also that can trigger anxiety so miserable really

i notice that you are from the USA Samaritans dont operate there ...but there maybe something similar. have a look in your phone book lol they probably might not exist in the USA all on the net now. anyway usually in the first few pages you might find a helpline in those pages . just a thought
 
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OCDguy

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#5
You mentioned that you saw a change in him after his hospitalisation. Could it be that was a very traumatic time for him. Seems to me he is being honest with you when he is asked questions. What may be more of a help right now is giving him a chance to get things off his chest and work with him a plan for progress. Hope this helps :)
 
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mochajave

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#6
Just want to give everyone an update.

I went do see my friend last night, the plan was to see if I can talk him into going to a hospital's mental emergency care, with his wife and myself together, see one of the on call psychologist and determine the next steps.

He is not in good shape, most of the time he can't even speak in complete sentences, he would utter 2 or 3 words and then pause for several minutes before next word comes up. Very hard to have a real conversation with him and get a read on what his thought process is now, other than he is feeling very confused and is very anxious with what's going on.

I spent hours trying to talk him into going with me, most of the time was just me talking, giving positive spiels on how treatment will help, we ought to give it a try etc etc... Given most of the time he doesn't respond in complete sentences, it's hard to get exactly what he is thinking, but I think deep down he just believe getting treatment is useless, because last time he went to hospital didn't help. At various point I tried to push him just to get out of the house to go with me, but he just wouldn't budge... From his wife, currently he is just spend the whole day (and night, since he is not sleeping) worrying and despairing, thinking that this is the end of everything, because he won't be able to work again, and they will run out of money etc...

His wife managed to get the hospital's on call psychologist to talk to him on phone for some evaluation, mostly just asking him yes / no questions. Somehow when he is on the phone, he agreed to make an appointment to go to the hospital. When the call was finished, we asked him again that when time comes for the appointment, will he go with us. He didn't want to answer... And then he said he was being forced to do this. Obviously we explained that his thought process is not straight right now, that's why he felt forced, just trust us we're trying to help him to get better etc... I don't know how much is really getting through.

I worry that when the appointment time comes, probably in the next couple of days, it would be just like last night again - that he just wouldn't go. His wife told me at this point hospitalization must be voluntary, because he is not showing sign of harming others / self harm, and is not having problem in caring for himself yet (on the caring for himself part, I think it is arguable, because he is not eating well and sleeping, not being able to talk / articulate himself at all... If his wife doesn't bring food in front of him, he doesn't have the capability to get food himself). I think he really needs help and medication etc, I just don't know how to do it if he's not cooperating. I suppose we can push on the point that he is not able to care for himself, call an ambulance and drag him to the hospital, but then I worry about the ordeal is going to put a big toll on his mental state, makes him not trust us anymore, and even when he is in hospital, I don't think they can force medication on him? If that's the case it won't really help? But at the same time if the situation continues it is only going to getting worse...

Really need some help / suggestions here, especially if someone had similar experience himself / with his loved ones. Please chime in...
 
blacksmoke

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#7
Gosh don’t quite know what to say here. Other than only tell him stuff at the point of needing to know as he sounds very fragile and just cant take much on board at the moment.
 
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OCDguy

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#8
His verbal communication isn't what it should be. What about his written communication? Does he ever use this forum? When I have tried one method several times and got nowhere I think to myself it's time to try a different approach. Has anyone asked him how he is feeling and what he would need to make him feel better etc?
 
Muddleduck

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#9
You are a kind friend but remember that it is his life and he can make his own decisions. No matter what you do or say, people use make their own mind up about everything. He sounds intelligent and capable of making his own decisions so as long as you have said you are there for him to talk to (you need to just listen sometimes) that is all you can do.

I personally believe he should be on medication giving the family history. It does take time to feel better and even then, some people never get back to as well as they were before the first episode of illness. It is up to him though.

If you are ever worried about suicide, then you should interfere, but otherwise, just be there when you are needed, listen, and offer advice when asked for it, i would suggest.

Don't forget about yourself and your life.
 
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mochajave

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#10
@OCDguy I don't think writing would be any different, i sent him texts and i don't see him reply often. he is basically having problem to articulate himself, expressing his thoughts, and his thoughts are probably very clouded / confused. I don't think at this point he can get on the forum here. He doesn't have the capacity to get himself to try a different approach, he just thinks everything is doomed and there is no way he can get better. At least that's how I think he feels from his limited communication to me. I asked him how he were feeling, he would say he is confused and anxious, don't understand what's going on with him. If I ask him what he thinks he need to get better, he probably would just not answer or answer something that imply nothing can make him feel better...

@Muddleduck I think he is getting to a point of not being able to make rational decisions about himself. And we can't have much meaningful communication with him anymore because most of the time he would just utter 2 words and then pause for minutes... Trust me I gave him all the patience there is last night, to try to understand his thoughts, but there was very limited details he can convey. Most of the time he just pause / frozen there... I absolutely agree that he needs to be on medication. I was talking to a friend who is a psychiatrist she explained to me the process of involuntary committing and treating a patient. Unless he comes around and start to get some treatment he is only getting downhill and I think we'll need to go that route... Not pretty, but seems like that would be the only way to help him...
 
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OCDguy

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#11
Could he be heading for a nervous breakdown? I'm no doctor etc. might be running it past someone who is...
 
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mochajave

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#12
Could he be heading for a nervous breakdown? I'm no doctor etc. might be running it past someone who is...
i'm no expert neither, to me "depression", "anxiety", "nervous breakdown" all sounds correlated and to some degree describe him... i just hope next week when appointment come up he will cooperate and go, and the psychiatrist will be able to point us to a sensible next step...
 
Bizzarebitrary

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#13
This is a very difficult position to be in, I understand why your suffering and I'm sorry for how this has impacted your mental health. I hope you're taking care of yourself, keeping your needs in mind.

I live with Major Depressive Disorder. My prospects for a better life, my capability for resisting negative thoughts and anxiety did not improve until I was ready to receive help and to do what was necessary to help myself.

At the moment, your friend seems unable to recognize how the disease is worse than the cure. He has no control over how his thoughts affect his feelings. I have no idea what it will take or how long it will take for him to seek help.

With regard to mental illness, I'm certain that until a person suffering with mental illness wants help, there is no trick, manipulation, tactic, reasoned argument or powerful stories that can effectively convince them to want help. This is not a simple matter of taking a pill every day your friend needs to participate in his own treatment and recovery. The illness affects the very part of us we need to make reasonable decisions.

From what you wrote you've been a great friend to him and on behalf of myself, thank you for caring for a mentally ill person in distress. You are a good person.

Now, let go of making it your responsibility for him to get better, for all your trying you cannot make this happen.

What you can do:

Listen. Catch yourself trying to offer advice and stop offering solutions - just listen and empathize.
"That sounds awful. I'm so sorry you're feeling that way."
"I can understand why you feel so anxious. I would feel the same way if I believed I was unable to do anything about it."
"Can you tell me about why you feel so alone?"

Reduce the frequency in which you tell him how he must get help for this can lead to his avoiding you and being even more isolated.

Be present, be in his life without trying to fix him: tell him you'd like to come over and sit with him, that you or he doesn't need to say anything at all.

“I respect that you want to be alone, but I don’t want us to make the mistake of having you be alone too long.”
“I know that this is driving you crazy and I’m here for you. But this [fear/worry] isn’t very helpful to go over and over.”


If my advice seems counterintuitive it's because naturally, we want to rescue the people we care most about. But this is not one of those times we can put them over a shoulder and carry them to safety.

I really hope this helps you, please let me know if you'd like more clarity and take good care of yourself.

- Bizzarebitrary
 
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OCDguy

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#14
My concern is that he is getting to the point where he is not functioning and may need some responsibilities removed from his shoulders until he is well enough to take them back on, if that makes sense... Seeking the advice of a professional in my opinion is key....
 
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mochajave

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#15
My concern is that he is getting to the point where he is not functioning and may need some responsibilities removed from his shoulders until he is well enough to take them back on, if that makes sense... Seeking the advice of a professional in my opinion is key....
I agree @OCDguy , my current thinking is if we still fail to persuade him to seek help, we will have to get help for him, even involuntarily.
Although at the same time I do worry pushing him to get help involuntarily will alienate him further from us, erode his trust in us. He already thought the first time going to hospital was a turmoil to him, push him to treatment again involuntarily might do further harm to his already fragile mental state... It’s just so hard to weigh the potential benefits v.s. drawback in the involuntary treatment route, if we come to that...
 
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OCDguy

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#16
Sorry I was thinking more in terms of seeking professional advice (let them take that side of the pressure) and unburdening him of some responsibilities to take some of the strain/pressure of his shoulders. Hopefully he may in turn/time string a sentence or two together and shake your hand etc. when he has recovered.
 
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mochajave

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#18
Perhaps they could do a home assessment...
Yes, that would be the next step, if we can’t bring him to the doctor. One of my psychiatrist friend referred me to a “mobile crisis team” that can do in home assessment and facilitate admission or other kind of follow ups... I just have a feeling that will likely be the path that lead down to involuntary admission / treatment.
 
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OCDguy

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#19
Thing is if he won't help himself and his condition is deteriorating the options are limited... at the end of the day that is a decision made by people who know what they are doing. You are just looking out for your friend's welfare, and if he won't go to the mountain, the mountain must go to him ;) As a loyal friend concerned only for his welfare I'm sure you will agree that you can only be there to offer support and encouragement in his time of need :)
 

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