Severe depression, how can I help

I know someone who exhibits all the symptoms of severe depression. Finaly, this person is seeing a psychiatrist, but has only been on one session so far.

This is a 2 part question

First, is there anything as a friend I can do to help, or should I just wait it out and leave that up to the psychiatrist. For example, this weekend, I watched my friend literally sleep all day, up till about 6PM, then stay in the same spot watching TV, a few naps, and essentially repeated that throughout the weekend and up to now. Should I step in and force this person to get outside, get up, get in the shower etc, or is this counterproductive and better left up to a professional?

Second, the psychiatrist, seemingly is one that my friend really likes. For the first time I can sense a small amount of optimism in regards to getting help from the psychiatrist. Problem is, it is $200.00 per session, current insurance will only cover about 10% of that. With no family or friends to turn to financially, what can be done to not have to start all over with a cheaper psychiatrist?

I’ll answer part 1. Yes. Do it. Your friend will resist avery kind of help, even maybe get irritated for you. One of the nasty things about depression is that you tend to loose your sense of self worth and thereby you feel like a burden to everyone. Hence he/she will feel like your help is misguided and that he/she isn’t worthy of it, but persevere and try to make him/her do things. Getting up and out won’t cure, but it will alleviate the symptoms. Moreover, try to do things that will not require that your friend makes an effort to be happy, but that are engaging enough to not think about one self, like going to a museum, medium effort sports and so on. Avoid emotionally loaded stuff and things that would require your friend to be overly engaged.

Sparc

I second what Sparc said. I’m not sure a psychiatrist would agree with me, but MY advice would probably be to drive your friend nuts. Push until he goes out with you. Tell him/her you can’t do something without them and they MUST come along. Drag them to art museums, on little bike trips, shopping. Anything. Distraction isn’t likely to “cure” severe depression. But it CAN make a person realize the extent of their problem. It’s kind of like taking a break from depression while you do something else.

My favorite thing to do when I have trouble with depression (and my favorite thing to “inflict” on others with similar problems) is something creative that involves lots of use of the hands. Last week I “forced” a friend to get up off the sofa and paint clay pots with me. I mean, I really had to FORCE him. He kept saying, “But I’m TIRED, I don’t WANNA.” About halfway through finishing his coffee mug he looked up at me and said, “Oh! You can’t think about anything else while you do this!” There’s a reason they have ‘craft hour’ in institutions.

Good luck!

L

I’m not saying that the above advice is wrong.

However.

Be very very very very very careful about casting yourself in the role of their therapist (for example, listening to their recitation of problems for hours and hours, and/or attempting to solve same) or mother (making it your business if they get up in the morning).

It is good to include your friend and let him know that you care up to a point. However, don’t fall into the trap of believing that your actions might “cure” him. They wont. You did not not break your friend’s brain, and you cannot fix it.

As far as the cost issue, perhaps this therapist can recommend someone with cheaper rates.

I am not a doctor, but I have had episodes of depression. This advice consists of things you might not hear from a professional, which are anti-depressants, moderate exercise and talk therapy.

Be around people
Drink lots of water (works for me)
Get up early in the day. Set alarm on opposite side of room.
Have annoying friend call you in the morning.

As I have posted elsewhere on this board, I have suffered from chronic low-grade depression all my life. All the suggestions given so far are excellent. Doing crafts takes me out of myself and I find that I had energy that I didn’t know I was capable of. Walking is excellent therapy. Walk and talk with your friend, don’t let him or her push you away. I have a lot of trouble getting out of bed in the morning and it is only the fear of loosing my job that gets me going. I had a friend in graduate school that actually paid the departmental secretary to call her every morning and talk to her until she got out of bed. I thought that was a brilliant idea.

Warning: while engaging your depressed friend is an excellent idea, don’t get so wrapped up in “curing” his depression that you can’t stand him anymore. Compassion fatigue comes from doing too much, and letting your own self-image depend on someone else’s improvement

As life is often unbearable for the clinically depressed or acutely anxious individual, some unconsciously look for reasons to disengage, retreat, and drop out. Yet you cannot reasonably be expected to take responsibility for his/her recovery. You can help, yes. Solve his problems, no. Possibly the best you can do is to be supportive, encouraging, loving, and to gently prod him/her to get moving. Not that I am suggesting bootstrap therapy, but the lion’s share of the work is done between patient and therapist.

The possible paradox of overhelping, of course, is that should s/he have a personality disorder or dependent nature that you unknowingly play into, your actions might complicate, rather than ameliorate. Although I’ve never seen literature on this, my impression is that some people derive perverse satisfaction from their depression. Not from the illness, per se, but from the possibility it allows for emotionally manipulating those family members/professionals rushing to their “rescue.” In a way, the depressed person becomes the center of attention in people’s lives–in ways they possibly never were before. Of course, these rescuers themselves often derive their own unrecognized satisfaction, making for quite an artful dance.

I might also note that it is atypical these days for a psychiatrist to provide talk therapy. Managed care has relegated most of them to dispensing and monitoring meds. Most talk therapy is provided by less-costly mental health professionals. Working through your local mental health association, your friend should be able to find a competent professional who can help him/her for as little as $25-$40 a session.

BTW, IANAT, but rather a benefactor to a state mental health association. I also serve on a national board and I read a bit.

It is a lot easier to be despondantly unhappy than happy. Happiness takes a lot of effort for some people (like me, and your friend). I find it is very easy to slip into my old, bad patterns which can lead to the kind of state you described.

It is like keeping a huge ball rolling; almost impossible to shift at the beginning, but once you get it rolling its easy. I need to keep very active (physically and mentally) to keep this momentum up. If I ever cease I begin to slip back down the slope.

I suggest that you badger the hell out of your friend to go out with you as Sparc and SexyWriter suggested, but consider your timing. He/she may resent your involvement at first; depression can get very easy and comfortable. I think you have to try and gauge how he is doing with the ball: is he attempting to roll it? Is he not bothered at all? Only if he is trying to break out of his depression should you think about helping him. Otherwise you will be pushing two balls on your own.

If you can, take your friend swimming; I find it excellent therapy - it clears my head, gives me loads of energy, and is totally relaxing.

The things that helped me:

Zoloft
Excercise
Getting out of the house
Talking to friends, family, pastor
Sleeping in/not getting out of the house is the worst thing that your friend can do. Staying home sulking doesn’t help.

My therapist did more harm than good. I think that some therapists have their own problems. Maybe some are better than mine.

I got to the point in my depression where I just said “I’m tired of being depressed and feeling sorry for myself, the only way that things are gonna change are if I change them myself.” I started forcing myself to do things and kept so busy that I didn’t have time to think.