Print Story Ask Husi: How do you help a friend with derpession?
By Dr H0ffm4n (Tue Jan 13, 2009 at 01:01:31 AM EST) (all tags)
This morning I had 9 voice-mails on my phone left between 0030 and 0145.

I have a friend back home in the Midlands who I've known since we were at infant school together at the age of 6. He is morbidly obese to the extent that his hips are now knackered and he has to walk with crutches and that is with difficulty. He has suffered from depression for a number of years and has no other friends left, but me. He has a wife and two small children. If I don't call him for several weeks he has no outlet. The gist of last nights voice-mails was that it was my fault he was so depressed, he didn't know if he was going to make it through the night and if I was any kind of friend I would pick up the phone now and again. I shouldn't use WPKAW's death as an excuse not to phone him. He did make it through the night as I had another missed call this morning when I got back from a meeting at work.

He came and stayed in October, ostensibly to support me in my grieving for WPKAW, but spent the whole weekend talking about himself and how crap his life is. It left me drained and pretty down myself. Just what I needed to get me over my loss. Thanks mate.

The problem is that he can almost quote word for word everything I said that weekend. Any comment I made has been minutely picked apart and analysed for meaning. He claims that we are bonded in a way that I will never understand and I am his mentor and guide.

If I phone him back I fear that I am just perpetuating his reliance. He needs help. He needs to get out of the house and potentially in a hospital. I feel bad that I cannot help him as he needs help, but no one can make him better but himself. Maybe I'm just being selfish and I should just call him. How hard is that?

How do you help a friend without perpetuating their depressed state?

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Ask Husi: How do you help a friend with derpession? | 30 comments (30 topical, 0 hidden) | Trackback
Work with the wife by Phage (4.00 / 2) #1 Tue Jan 13, 2009 at 01:06:39 AM EST
To get professional help ?

Ob: You are not responsible for his state of mind.

He's been on tablets by Dr H0ffm4n (2.00 / 0) #4 Tue Jan 13, 2009 at 01:37:26 AM EST
And I thought they were working. Maybe he's come off them. And maybe just tablets aren't the answer. He has tried to get counselling, waited three months to see a counsellor who then just gave him a self-help leaflet about how to cheer yourself up.

Yes, he needs help, but he needs to take control and get himself heard by the professionals. His wife is probably at the end of her tether.

[ Parent ]
He may be lying to them by Merekat (3.50 / 6) #8 Tue Jan 13, 2009 at 01:46:56 AM EST
To the professionals I mean. And maybe a bit to you. To them to make it seem not as bad, to avoid the risk that the can fix him, and to you to make it seem worse and keep your attention. He doesn't sound like he has much - an illness can be almost something precious in such circumstances.

[ Parent ]
He needs supervision by Phage (4.00 / 3) #10 Tue Jan 13, 2009 at 01:57:49 AM EST
But not by you.
Talk to the wife, but not him directly as this will perpetuate the cycle. My thought is that you can support them best through her.

Get him back to the doctors, possible a new one. Get the wife to provide the doctor with a history, and to push them to give him a proper programme for recovery. I don't think a bored counsellor will cut it.

[ Parent ]
That's bad by nebbish (4.00 / 2) #11 Tue Jan 13, 2009 at 01:58:00 AM EST
Friends I've known with depression have got pretty good help on the NHS. I wonder if London's better for that sort of thing.

It's political correctness gone mad!

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Almost certainly. by Phage (4.00 / 1) #12 Tue Jan 13, 2009 at 01:59:57 AM EST
I think a new referral would be the way to go.

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Um by Merekat (4.00 / 2) #2 Tue Jan 13, 2009 at 01:20:49 AM EST
He's not just depressed. He's obsessed. This is not your obligation. Harsh, but true.

Not my obligation by Dr H0ffm4n (2.00 / 0) #5 Tue Jan 13, 2009 at 01:39:56 AM EST
but my conscience says I should do something. I don't want to become his crutch because I know I'm simply not up to the job and he's better off taking care of himself.

[ Parent ]
A friend by nebbish (4.00 / 6) #3 Tue Jan 13, 2009 at 01:35:46 AM EST
Kicked a depressed boyfriend out onto the street because he was lying in bed all day drinking and screaming at her, and refused to see a doctor and get help. He ended up getting sectioned and is now AA and rebuilding his life and, his words, the happiest he's ever been.

Apart from you having no responsibility whatsoever to someone who refuses to help themselves, you're probably not helping them either. I don't think many of us could manage the tough love my friend did, which included riding out the predictable suicide threats, but it was the best thing she could have done.

Crucially she realised that someone who won't even attempt to help themselves deserves no sympathy.

It's political correctness gone mad!

He went to a self-help group once by Dr H0ffm4n (4.00 / 4) #6 Tue Jan 13, 2009 at 01:41:50 AM EST
But didn't go back as all the people there were miserable and wallowing in self-pity.

[ Parent ]
If he's in Walsall & Dudley, by ambrosen (4.00 / 1) #16 Tue Jan 13, 2009 at 07:15:53 AM EST
I can confirm that the adult mental health services there are shite.

It looks as if it's something where CBT would help, and I'm sure he could self-refer to private care, or he could press for it from the NHS, and possibly get it. It'd probably be several thousand quid for a course from a private company. I'm guessing that'll be difficult for him.

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I can't kick him out by Dr H0ffm4n (4.00 / 1) #7 Tue Jan 13, 2009 at 01:42:47 AM EST
But do I just ignore him? Or tell him to go get help and not bother me again until he has?

[ Parent ]
The second one by nebbish (4.00 / 7) #9 Tue Jan 13, 2009 at 01:55:54 AM EST
Set out an ultimatum basically - don't call me until you've sought professional help. You'll be making it clear that you care.

It's political correctness gone mad!

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IAWTP by Phil the Canuck (4.00 / 7) #13 Tue Jan 13, 2009 at 02:10:14 AM EST
Anything else would just be feeding his obsession with you.

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helping friends who have mental issues by garlic (4.00 / 1) #21 Tue Jan 13, 2009 at 02:05:35 PM EST
like depression can be very, very tough. That's all I got, because I'm shit at it too.

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What about his wife? by jump the ladder (4.00 / 4) #14 Tue Jan 13, 2009 at 03:22:54 AM EST
Why isn't she kicking his arse in gear or is she equally fucked up? Surely his wife who lives with him has to take some responsibilty at least for the sake of the kids?

I'm really not sure by Dr H0ffm4n (4.00 / 1) #15 Tue Jan 13, 2009 at 03:26:57 AM EST
She may be in denial and just work around him. Since she's been around during his decline she may simply see things as the status quo. I don't have her number or else I would ring her.

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He needs professional help by debacle (4.00 / 2) #17 Tue Jan 13, 2009 at 07:20:47 AM EST
A psych and a liposuctionist.

It is not your fault anything. He is the way he is, and that's just the way it is.

"we are bonded in a way that I will never understand and I am his mentor and guide." --> Crazy.

Depression is hard. It's really, really hard. But it's not your fault.


Offer him by wiredog (4.00 / 1) #18 Tue Jan 13, 2009 at 11:11:56 AM EST
A .45 and some privacy

Earth First!
(We can strip mine the rest later.)

Can you even get malt liguor in England? by georgeha (2.00 / 0) #27 Wed Jan 14, 2009 at 05:08:12 AM EST

[ Parent ]
That'd help, too. by wiredog (2.00 / 0) #28 Wed Jan 14, 2009 at 06:04:32 AM EST
And probably less messy.

Earth First!
(We can strip mine the rest later.)

[ Parent ]
Yes by ambrosen (2.00 / 0) #29 Wed Jan 14, 2009 at 01:59:17 PM EST
But we tend to go for cider rather than lager. I guess this person is the exception that proves the rule.

[ Parent ]
This is probably a deeply offensive comment by Dr Thrustgood (4.00 / 4) #19 Tue Jan 13, 2009 at 12:19:24 PM EST
I don't know why, but your diary reminds me of BDSM quotes, boiling down to that in any sub/dom relationship, it's the sub that's in control and has the power. Sure, there's nothing sexual here - I hope - but your description leaves me feeling that there's power exchange at play, for him at least.

Depressed people by Herring (4.00 / 2) #20 Tue Jan 13, 2009 at 01:25:12 PM EST
are arseholes. It's kind of a definition of the condition.

I don't believe that the pills work for longer than a few months anyway - unless the dose is continually increased. And when they do work, I think that the placebo effect is at least as important as any "conventional" effect.

That said, it sounds like the health service is being very unhelpful - which is not surprising. Generally mental health services are rubbish and GPs can't tell someone with a bad job/marriage/haircut from someone with "genuine" depression. There are private counsellors, many of whom are quacks and the whole field is largely unregulated.

The other thing is that in the brave new world where patients are "customers" and it's about "customer driven services" the customer who can't drive is a bit fucked. It's the NHS for people who aren't ill.

Insofar as there is a cure (which I'm not sure there is) then it comes from within - or rather from ceasing to look inwards and starting to look outwards. You can't pull him out of it. Saying that, there are some pointers - the depressive is only interested in their life so try to find some positive in there (might be hard). Encouragement to look for the things that aren't shit and nurture them.

Saying that, it does sound like this guy is in a bad way and could do with professional help (something more than a Community Mental Health Nurse). I feel sorry for his wife. But then I feel sorry for my wife.

Did any of that make sense?

christ, we're all old now - StackyMcRacky

depends who you are by LilFlightTest (4.00 / 3) #23 Tue Jan 13, 2009 at 02:44:13 PM EST
some people can't find any med that works more than a couple months. some people do well on the same med for years. some people do great on one med but not another.  it's frustrating, but if you're willing to try a couple kinds without giving up, you can usually find the right one eventually.  on the other hand, try telling a depressed person to be motivated enough to keep searching.

Overall (this is where this stops being a reply to you and starts being a general comment): I'd agree with others that he does need professional help.  what might work (though I don't know the guy) is to tell the friend that you're behind him all the way, but HE needs to take the first step. You can't fix him and sometimes just letting him know that YOU know that is enough of a kick to make him realize it, if he doesn't already. If he's playing for attention, if he knows you're on to him he just might stop.  definitely tell him to go back to the therapist. there are some great ones out there, and there are some crap ones. you just need to find a good one.

if de-virgination results in me being able to birth hammerhead sharks, SIGN ME UP!!! --misslake
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I've tried by Herring (4.00 / 2) #26 Wed Jan 14, 2009 at 02:27:44 AM EST
5 different antidepressant meds. Effexor worked the best, but that was in continually increasing doses and I eventually got out of that episode with (private) counselling. It's only my opinion, but if in the first 3 months it doesn't lift you high enough to grab the edge of the hole so you can beginning climbing out on your own (convoluted metaphor), then it isn't going to work.

christ, we're all old now - StackyMcRacky
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i've tried 6 by LilFlightTest (2.00 / 0) #30 Wed Jan 14, 2009 at 03:07:41 PM EST
if they worked, they worked for over a year. one made me puke so I gave up on that one before I could find out if it worked. one made me so easily distracted I couldn't function at work, even though it worked really well for the depression. the last one i was on was Effexor, which worked very well, but the withdrawal was hell. I'd have to be pretty desperate to go back on that just because of how bad the withdrawal was.

if de-virgination results in me being able to birth hammerhead sharks, SIGN ME UP!!! --misslake
[ Parent ]
Depression is shite. by ambrosen (4.00 / 3) #22 Tue Jan 13, 2009 at 02:10:33 PM EST
But then so is Crohn's disease. But I still try my best to ventilate and clean toilets after I've used them. And to make sure my dietary needs don't impinge too heavily on anyone.

I'm not a mental health professional (although I intend to become one), but I'd be pretty sure that he was not at risk of suicide last night. He wanted your attention, and he wanted it bad.

But only because you're the only source of comfort he could think of, and the fact that you weren't available meant that he wouldn't have to confront the possibility (certainty) that you wouldn't be the magic bullet that would fix things.

My advice to you would be to tell him the times that you're available for crisis calls, tell him to work out strategies for de-escalating crisis periods (e.g. go and make some camomile tea; watch an episode of Scrubs or Friends - not have a drink, a wank or a ciggy) and find out how to access the local Crisis Team. I think they may need prior notification from a community psychiatric nurse, but if things are liable to become genuinely unbearable for him, then the CPN should be able to give the contact. I should look these up for you.

But he has to ride out crises without your involvement, and the promise of an ear to listen to him at a time that works for you is a bribe that may work. Also, you'll need to be very explicit about the fact that you are human, that the fact you can't do everything for him doesn't mean that you aren't happy to do something for him, and to state bluntly that there'll be no discussion of things you've previously said.

I'm not sure how helpful this is, and I have to say it's crap that you're having to deal with this when you should have some decent sources of sympathy, but hopefully I've got you some stuff to chew on.

Seven. by Phage (2.00 / 0) #24 Tue Jan 13, 2009 at 10:29:43 PM EST

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This by sugar spun (4.00 / 5) #25 Tue Jan 13, 2009 at 11:28:35 PM EST
with the note that simple depression sounds slightly off as a diagnosis to me, considering his analysis of meaning and extreme reliance on you. I'm not presuming to actually make a diagnosis because I don't know anything about him, but that level of hyperengagement with another person's words may be something a little more flag-raising.

You're not responsible for him. Don't take responsibility for him or allow him to foist it upon you.

[ Parent ]
Ask Husi: How do you help a friend with derpession? | 30 comments (30 topical, 0 hidden) | Trackback