Clinical Depression, why do some people not seek help? Options

[Rattgirl]

Well, this is just kindof a rant, but I guess it goes here since it deals with an Issue of the original sort.

I have a friend..my best friend, actually. She's like the older sister I never had, and she means just...TONS to me. She lives in Cedar Rapids, about a half hour from where I live. This is something of a bummer, since I don't have a car and neither does she. I get to see her more often than I did when she was living on the other side of the state, but I still don't see her anywhere near as much as I'd like. Anyway..

She lives with her boyfriend of about...ummm...I guess it's been about 5 months since they started going out. He's someone I know from back in 1996, when he still lived in Iowa City. He's a nice guy for the most part...one of the "sensitive, pseudo-hippy" types. He also has Clinical Depression. As far as I know, he's had it most of his life. Usually, he's able to keep it fairly well under control, but from time to time, he just kinda..gives up, I guess...and lets it overwhelm him and control him. She knew when they started going out that he had this problem, but he assured her he was going through psychiatric counselling for it, so it wouldn't be much of an issue.

Ok, I guess a little scene-setting is in order here. A (my friend) moved in with K (the boyfriend) back in October. K is going to Kirkwood Community College to get his chef's license..I think he's about halfway through. When A moved in with him, she started looking around for a job, so that she could pay her half of the bills, since K isn't working, and his only income is from his quarterly Tuition Checks from Kirkwood. Those are enough to pay his half of the bills, but not much more. Unfortunately, the job situation in Eastern Iowa isn't all that hot right now (still), and it took A a few months of searching before she found a job. K reassured her that it wasn't a big deal, since he knew she was trying hard to find a job. She finally got a job working at Wendy's (for any not in the know, Wendy's is a fast-food burger joint, much like McDonald's) part-time. She's making money, but not a lot, so things have been a little tight for them. She's been working for a little less than a month now.

A few weeks ago, K called me up to tell me he wanted to set up a little weekend Spring Break party with him, A, myself, my bf, and a few other friends from his town and mine. I got another call about a week later from A, to let me know that she and K had gotten a new cell phone and to give me the number, and also to let me know that things were still being planned for the Spring Break get-together (which would be this coming weekend). Since then, I haven't heard from either of them, so I tried calling them tonight to ask if things were still in motion. Well, their phone is deactivated (they have one of those plans where you buy a card that gives you a month of unlimited calls..so basically, their card ran out and they haven't gotten a new one), so I called A's friend L (who gives A rides to and from work every day) to find out if she knew anything about what would be going on this weekend. What I found out from her was this:

Apparently, K has not been going to his classes for about the last month. His depression has been acting up, but he doesn't want to admit it to anyone because he knows that they would urge him to 1) go see his counsellor and 2) take medication for it. He stopped going to his counsellor shortly after A moved in with him, because he decided he didn't need counselling anymore. He's never taken meds, because he believes they are a waste of his time and money. The thing is, his depression has been getting steadily worse as the years go by. His periods of depression last longer and longer, become stronger each time they hit, and he fights them less and less. He's gotten to the point now where he tries to pretend his fits of depression don't exist. Instead, he's not going to classes, spending all his time at home downloading and watching MST3K episodes, smoking a pack and a half of cigs and drinking a 12-pack of beer a day. He's not a violent drunk, but he gets cranky and snaps at A all the time now. He's also apparently unable to do anything for himself at this point. He can't even manage to make himself a sandwich...he just sits at the computer and waits until A gets home from work, then asks her to make him a sandwich and bring it to him. He just got his latest tuition check, and A had to badger him to pay bills with it. The rest of it, he told her he planned to spend on alcohol and cigarettes, because "it's his money, he can do what he wants with it."

A is going crazy to the point of pulling her hair out, because he won't go to counselling, he won't get meds, and he's drinking and smoking all their money away. He won't talk to her about what's bothering him, but he clings to her and expects her to do everything for him. She's afraid he's going to flunk out of classes or just decide to quit school, which means they won't have enough money to pay bills at all. L and her husband have been trying to talk some sense into K, but he's not listening to them, either.

Why the hell can't he just admit that he's got a problem and deal with it like a man? He's making life miserable for the person he supposedly loves more than anyone else in the world, and I don't see how he can miss that fact. It seems like he's bound and determined to ruin his life, and take her down with him. I can't just sit by and let something like that happen, but what the hell can I do? I've asked L if she could bring A down here for the weekend...maybe if K has to spend some time fending for himself, he'll realize that he needs to do something about his depression. I just don't understand how he could delude himself into thinking that he can control what is obviously a chemically-induced problem (well, neurotransmitter-induced, I guess) by sheer force of will...and then think that by drinking himself into stupidity is supposed to help. I just don't understand clinical depression....can anyone here shed some light for me?

[Thus Spoke Zarat...]

A lot of people don't seek help for clinical depression, because to them, that is losing. There is an unneccesary social stigma attached to any kind of illness of the brain, and so people feel that to seek help, is to accept that they are 'mad' or some kind of 'psycho'.

Also, when in a depression bout, he is likely to not be in any mood to seek help from shher lack of motivation to do anything. And when he is feeling better he probally does'nt feel the need to seek help - a vicious cycle.

From my experience the first step is making sure someone does'nt think seeking medication is giving up, or admitting madness. Then the challenge is making sure they take it....

[Pixelgoth]

Why the hell can't he just admit that he's got a problem and deal with it like a man?

It's the hardest part. Admitting you have a problem. Not everyone can do it. Not everyone wants to do it. You really can't force someone to realise they are to blame or have issues.

The only thing you can do is be there them. Be someone who listens, offers a shoulder to cry on. Don't try and force the issue to be resolved or go away. It isn't your issue it's theirs. Harsh as it may seem I would have been very offended if someone had come up to me and told me I had problems and needed to sort them out. It's something he needs to realise and work out by himself.

Hope that makes sense?

[Untitled.]

I am quite convinced that I have clinical depression but my situation is so complex that people either say " oh no, Alex is a really funny upbeat person whos really comedic " or " stop being so depressed! c`mon, lets have some fun " and just look at me expecting another joke... and this is exactly how my extreme mood swings just dominate my life. Im so sick of trying to explain... Im so afriad of living my life, but I want to live doing what I can stand doing. Im just stuck in a hole and i guess society has got to deal with it. oh look im a happy man

[CommieBastard]

He needs treatment, pure and simple. It's not a psychological thing, he can't be talked out of it. His brain loses serotonin faster than it can produce it, and he needs antidepressants to slow the loss and build up serotonin levels again.
The problem with antidepressants is that the effect isn't noticeable for several months. After that, apparently, the patient experiences a very noticeable change in their mood and happiness...but it can be hard to convince a depressive to stick with it that long.

[antagony]

I'd been depressed for years (from bipolar disorder, as I later found out) before I got help. I probably should have done it sooner, but even when I was getting help I regretted it sometimes. The process of admitting that you have a problem is humilitating. Talking to therapists is humiliating. People constantly treating you like a mental case is, you guessed it, humiliating. Sometimes I've got to wonder if therapy really helped me at all. Most of the time it just made me feel stupid and inadequate. This may not be the case for most people, but for me that was the main reason it took so long for me to get help.

In the end, the reason I stopped taking my meds was because I hated the psychiatrist's appointments. When I was depressed, I thought the "recovery process" would be bad, but it was worse than I imagined. If K has gone through therapy already (and if his experience was in any way similar to mine) that's probably why he doesn't want to do it anymore.

I'm sorry I can't really help... like I said, I don't know if other people's experiences were anything like mine, but if his were then that could be the reason. Other than that, well, what Pixiegoth said. Having a friend who listens is 1000 times more helpful than a therapist who's being paid to listen. Sometimes that's the only thing that can help.

[Rattgirl]

It's the hardest part. Admitting you have a problem. Not everyone can do it. Not everyone wants to do it. You really can't force someone to realise they are to blame or have issues.

The thing is, he's already admitted that he has clinical depression, and usually he'll notice that it's happening..that's when he was doing counselling sessions. For some reason, this time he's refusing to admit that he has it at all.

I suppose it might be like antagony suggested: he hated his therapy sessions and doesn't want to go back to them at all...I don't know. I've been doing a lot of reading about the brain (in general) and psychological disorders (specifically)...haven't taken any classes for it; just done a lot of reading. So I know that clinical depression is marked by greatly reduced levels of brain activity just about everywhere but the amygdala and (can't remember the name) the portion of the brain that concentrates on living and reliving events in your mind. So yeah, life loses meaning and you can't break yourself out of your own head.

Listening would be great, you're right. And i'd be the first to offer an ear...but he doesn't want to talk about it. A asks him if anything's bothering him and he snaps "nothing!" L and her husband ask him how things are going and he pretty much ignores them. It's like he WANTS to be depressed. I don't get it.

[Pixelgoth]

It's like he WANTS to be depressed. I don't get it.

Unfortunately unless you've ever been depressed you probably won't

[Smee]

Hey,

I've suffered from a bout of depression a while back, cuz i was getting bullied @ school, and if it wasn't for my friends i'd probably be 6 feet under right now.

I didn't want to admit to my depression cuz i was ashamed that i had let it take control over me. I felt like a freak and i would just stop eating for periods of time.

Where is his family in all of this? Surely he's got more than just A?? I think that his family should try and sort him. It certianly worked for me.

Or tell him that if he doesnt i'll come over there and bug him, and i ll bring a crappy comedian and if that doesnt work, well i happen to know of clown army which i can easily send his way! tee hee!

Most of all, don't worry. he'l pull through

luv Smee

[Rattgirl]

He has his mother, who seems to be a very caring individual, but I don't think she knows about it.

I've been depressed before...my family supposedly has a history of Bipolarism; my brother was diagnosed with it a few years ago. But if I do have it, it's really mild because I'm usually able to get through it with a minimum of fuss. Having someone around who cares and is willing to listen and give me the kick in the pants that's sometimes necessary helps a lot...

but how do you do that to someone who doesn't want to admit it even when you tell them you want to listen?

[gothictheysay]

I can understand him not wanting to get help. You really can't make him; however it would help to discourage the smoking, drinking, etc.

Why doesn't he want help? Fear of psychologists/psychiatrists and medicine is a prime factor. Going to a counselor or professional and taking medicine doesn't help as much as you think it will I'm afraid I was diagnosed with it three years ago, and to tell a person how you're feeling is a scary thing to do. However, you could advise him to seek help on some matters and not others. For example, I didn't tell my psychiatrist everything, but I've gotten over a few things on my own. And if he does end up taking medicine? Be very careful. I can only advise against that seem good...but...I hope I help you *some* way. Even if you think he needs it, don't dose him up on too much - he'll end up needing it all the time, can't get off it, have withdrawal, etc. (If I went off my meds right now, I don't want to imagine what would happen.)

I wish you the best of luck, these things are quite hard to deal with...

[Aria]

I'd been depressed for years (from bipolar disorder, as I later found out) before I got help. I probably should have done it sooner, but even when I was getting help I regretted it sometimes. The process of admitting that you have a problem is humilitating. Talking to therapists is humiliating. People constantly treating you like a mental case is, you guessed it, humiliating. Sometimes I've got to wonder if therapy really helped me at all. Most of the time it just made me feel stupid and inadequate. This may not be the case for most people, but for me that was the main reason it took so long for me to get help.

I know exactly what you mean. I went to a psychiatrist, not for depression, but I ended up being put on medication. I felt like I was worthless and defective, and honestly, I still do. I stopped taking my medication because a) they didn't seem to work, and it was a reminder that I was defective and worthless. Now that I've stopped taking the meds, I still have the problem, but at least I feel somewhat better about myself as a person. I can admit I have problems. I know that. I just can't deal with it. I can't.

Maybe that's the same thing with him? :\

[Tigersong]

I know exactly what you mean. I went to a psychiatrist, not for depression, but I ended up being put on medication. I felt like I was worthless and defective, and honestly, I still do. I stopped taking my medication because a) they didn't seem to work, and it was a reminder that I was defective and worthless. Now that I've stopped taking the meds, I still have the problem, but at least I feel somewhat better about myself as a person. I can admit I have problems. I know that. I just can't deal with it. I can't.

Maybe that's the same thing with him? :\

Sorry but I must play the doctor here:

1) Does your MD know you went off the meds?
2) How long were you on them?

They won't work for everyone, but they do have a 80% success rate at treating depression. It takes a long time for the effects to be seen, however, and most people who stop taking them didn't take them long enough in the first place.

Believe me, I went off meds a while back (after a very high dosage), and there was basically no side-effects because I came down with a doctor's help. While they were ineffective for my form of depression, for many many patients, they are extremely effective.

I *hate* the social stigma that is attached to medication. People don't seem to want to admit that this has to do with brain chemistry, in many cases, and the only effective treatment can sometimes be slowing the uptake of seratonin...

[Silver Star Ange...]

Maybe he's really deep into it and not focused on getting help.... I can't really say. I've never been clinically depressed. Hope I at least helped a little!

[Aria]

Sorry but I must play the doctor here:

1) Does your MD know you went off the meds?
2) How long were you on them?

They won't work for everyone, but they do have a 80% success rate at treating depression. It takes a long time for the effects to be seen, however, and most people who stop taking them didn't take them long enough in the first place.

Believe me, I went off meds a while back (after a very high dosage), and there was basically no side-effects because I came down with a doctor's help. While they were ineffective for my form of depression, for many many patients, they are extremely effective.

I *hate* the social stigma that is attached to medication. People don't seem to want to admit that this has to do with brain chemistry, in many cases, and the only effective treatment can sometimes be slowing the uptake of seratonin...

I wasn't being treated for depression, although depression was/is apparently one of the symptoms. Yes, my MD know I went off the meds, since I haven't seen in her in months, and the last time I did, I said they weren't working, and I wanted off. I was on them for about... 5 months. I *lost* 5 months of my life.

[Tigersong]

I wasn't being treated for depression, although depression was/is apparently one of the symptoms. Yes, my MD know I went off the meds, since I haven't seen in her in months, and the last time I did, I said they weren't working, and I wanted off. I was on them for about... 5 months. I *lost* 5 months of my life.

I'm really sorry to hear that. Since I don't know the specifics of your situation, I really can't comment or anything like that, but I'm really sorry about the 5 months. I really hope you find a treatment that is effective for you!

[Aria]

I'm really sorry to hear that. Since I don't know the specifics of your situation, I really can't comment or anything like that, but I'm really sorry about the 5 months. I really hope you find a treatment that is effective for you!

Well, I'm managing without, so far.

[gothictheysay]

I *lost* 5 months of my life.

Yeah, sometimes I feel that way too. Like the drugs are altering my experience of life. Oh but I'll expand on this later... no use depressing myself when I'm in a semi-happy mood.

[Tigersong]

Well, I'm managing without, so far.

I'm glad.

And yeah, to the original topic. It sounds like it's really not a healthy relationship, one way or another. She needs to tell him to shape up, because she doesn't deserve that. She also needs to consider her situation: is he really the guy for her? If so, she needs to stick by him and help him get help. If not, then I guess she could always leave...

The sticky part of the situation, however, is that if he's not willing to get help, she needs to get out before she gets dragged into the spiralling pit of despair that is depression...

I know I'm being harsh, but this sounds like he really needs some serious help now. And regardless of what some people say, psychiatrists/therapists *can* be very helpful. Once you get over the initial problems, they're not like a friend in that they're biased in the situation. You can't tell them *anything* and they won't bat an eye. It's not for everyone, but again, there's about an equal treatment effectiveness for cognitive behaviour therapy -- aroudn 80% success.

One way or another, his outlets right now are obviously not sufficient to deal with the depression, and he needs help. Friends aren't just going to cut it in this situation, probably.

[Rattgirl]

And yeah, to the original topic. It sounds like it's really not a healthy relationship, one way or another. She needs to tell him to shape up, because she doesn't deserve that. She also needs to consider her situation: is he really the guy for her? If so, she needs to stick by him and help him get help. If not, then I guess she could always leave...

The sticky part of the situation, however, is that if he's not willing to get help, she needs to get out before she gets dragged into the spiralling pit of despair that is depression...

Yeah, that's pretty much the stage I"m at right now: worrying about her getting stuck in that relationship. To be honest, I'm a lot more worried about her than about him. I'm sure this makes me sound like some kind of supreme jerkoff, but oh well. She's been my best friend for 5 years, and he's been someone I knew. On top of that, he's taking the current course of action knowing FULL WELL how his actions are going to make her life worse...how could he not? He's still fully conscious of his situation; it's not like he's had a lobotomy. I just found out tonight that he succeeded in flunking out of school. Again. So now, A's part-time Wendy's job is supposed to pay all their bills? While he soaks up cigarettes and beer?

It's ironic. I got ahold of her today and invited her to come down this weekend for some away time. We talked a little bit about how stressed she was, and it was so painfully apparent how tense things are in their house. She had to say everything in a deliberately offhand way so he wouldn't overhear and get insulted. She's been having to take sleeping pillls (the Tylenol kind), ibuprofen and Pepto Bismol to get her body to relax enough to get to sleep. She's pulling out her hair (literally)...and when I offer to have her and L come down for the weekend, she says "well, I can't, because Sunday is K and my 6-month anniversary and I want us to try to do something fun." *sigh*

She's had a long string of bad luck in relationships, and it pains me to say it but I really don't think being in a relationship with K is going to be any better for her. And I think she knows that too, which is why she's spending less time talking to L and me (being as how we're both trying to hint that she and he need some time apart). I don't know. I'm trying not to be overly manipulative in her life and at the same time I so desperately want her to realize the facts of the situation and stop trying to do the very romantic (but highly impractical) "Love Conquers All" thing.

When it comes down to cases, she and he are doing the same sort of thing: attempting to ignore the current situation and pretend that everything is normal.

[Tigersong]

To be honest, I'm a lot more worried about her than about him. I'm sure this makes me sound like some kind of supreme jerkoff, but oh well. She's been my best friend for 5 years, and he's been someone I knew.

I think that's perfectly fair. Just... try to avoid blaming him, at least if you're talking to him. It really won't help. But yeah, I don't even know either of them, and I'm on her side! I just hate to see any woman being treated in such a way -- women! You can do better! -- but I also understand why he's sunk into a new low, having dealt with depression for an extended period of time. It's hard to explain, but even though he knows he's depressed... he doesn't want to admit it. Again. Because it's almost as hard as the first time. You want to pretend you're fine, you're not suffering, you're not depressed, you're just a low in your life and you'll pull out of it. The sad fact is, clinical depression isn't something you can just "pull out of."

Also understand that even though he rationally understands he's depressed, and whatnot, it's his BRAIN that's malfunctioning, and therefore it's hard for him to make rational, good decisions about his treatment. The reason he needs treatment? He's depressed. The reason he doesn't want treatment? He's depressed.

[Atari]

Oh dear, I feel for this fellow and everyone in his life. I'm no stranger to the denial of mental illness while it shreds your life. Not depression, but something that warps one's perspective equally if not moreso.

He's going to try and ride this out as long as possible. Treatment is hard, its painful. It makes you face all those little demons that you've hidden so well. He can stay home, get his check in the mail, and have his sandwhichs made for him. Its the path of least resistance, it hurts less (for the time being). For me at least, I didn't seek treatment until I couldn't maintain that life for myself.

What I'm trying to say is, that, he may need to hit rock bottom before he fully acknowleges where he is. Depression is a powerful thing, and rock bottom is a dangerous place. Those that care for him should be vigilant just in case, but at the same time give him the space to feel the reality of his situation.

Love, David

ps: About the meds, its "if I don't take medicine, I'm not sick".

[Rattgirl]

*sigh* you make a lot of sense. It's just so hard to sit by and watch him ride the depression to his absolute lowest, because it affects her too...so damn much it hurts to watch . I know she loves him and she wants to be there to help him through it, but she gets to lose all her happiness to boot.

I got a call from him yesterday...apparently A struck a deal with him whereby they come down to Iowa City for their 6 month anniversary and go to a few bars with their IC friends (namely me and the bf and our friend charles). Now, it'll be nice to have a chance to perhaps work a little of the Ratty Anti-Depression magic on K, but I REALLY don't think he should be drinking more. I mean...hello? Alcohol = Depressant? But what do I know?

[Smee]

Sometimes it best just to let them know that your hear for them and will support them whatever they do. And that your willing to help if they want

[artist.unknown]

I have a mate who was (is) severely depressed and yes, it can be a trial to keep up with them. He ended up in a mental hospital for some time and went through several different kinds of medication--they all altered his personality so that yes, he wasn't depressed, but he wasn't himself either. I wanted to strangle him every time he chucked his meds out, but when someone is depressed, you can't tell them what to do. It does make you feel rather helpless, but the best thing you can do in the end is stand by them and if it gets too bad, get help. Remember, they're still human; they do notice when you're there to lend a hand, even if they don't seem to.

When a person becomes downright destructive, however, do get help for them. It feels like ratting them out, which is an awful feeling, but it's better than letting them hurt themselves and those around them.

Also, a note: Asperger's syndrome and bipolar disorder run in the family, and if there was one thing the doctor warned us about, it was alcohol. People with oddly connected brain synapses and chemical imbalances are born alcoholics. If they touch alcohol, they will become addicted to some degree or another. Another warning: the effects of alcohol on this type of person are much more devastating. Alcohol can permanantly wreck the normal brain functions.