What do I do about suspected depression?
My boyfriend is a Columbia student; I am not. For quite some time, I have suspected he is depressed. Just last week, it got so bad that he's finally come round to admitting maybe it would be a good idea to go see someone about it. He made an appointment at Columbia's CPS office on the Morningside campus — they couldn't fit him in for another 2 weeks, and his schedule means he can't get to the walk-in hours.
But I'm wondering if that's who he should be seeing at this stage. Actually, he's not even sure whether his appointment is to see a counselor or a psychiatrist or what. If the suspicion is that he's depressed, should his first stop be at his internist? Who can diagnose him? Who can determine whether he needs anti-depressants, and give him a prescription if necessary? I always read that depression is an actual illness, and given this, I don't want him to waste time just talking with a therapist, if what he really needs is to see a doctor. I've never dealt with any of this before, and I'm just not familiar with how it works. And when he goes to his appointment, should he basically just walk in and say, "Hi, I think I might be depressed?"
He's in such a terrible state, and I'm so worried about him, and this has been so long in coming — I know there won't be a quick fix, but I really want him to get started as soon as possible.
Clueless and Concerned
Dear Clueless and Concerned,
Your questions about getting help for your boyfriend's possible depression show awareness and caring — he's lucky to have someone so vigilant and concerned in his life.
Mental health specialists, such as psychiatrists and clinical psychologists, are trained to diagnose and treat depression. Your boyfriend may want to see his regular health care provider if he would be more comfortable discussing mental health matters with a familiar face as opposed to a new one. However, internists and family practitioners are not specifically trained to diagnose and manage mental health conditions. Psychiatrists are, in fact, medical doctors and are experts in the physical causes of mental illnesses and the medications used to treat them. Clinical psychologists cannot prescribe medications, but specialize in talk-therapy, a powerful, proven method of treating depression.
It is common for more than one health professional to help an individual manage and overcome their depression. Because getting help for depression is important, whichever health professional your boyfriend would be willing to see first is the best option. Then that person can refer him to someone else with additional or complementary skills, if it is necessary. In any case, you're right in thinking that the earlier he is diagnosed and begins treatment, the sooner he (and you) can start to feel better.
Here at Columbia, psychiatrists and clinical psychologists at Counseling and Psychological Services (CPS) jointly serve students' mental health needs. Many members of the Columbia community use CPS and, as you've found, sometimes appointments are scheduled a week or two from when the call is made. However, all students who call CPS to make an appointment will receive a phone call from a therapist within 24 hours of calling to assess their needs and concerns. CPS also has drop-in counseling offices around the Morningside campus, which could work for your boyfriend. Students who urgently need to see a counselor because of a psychiatric emergency can be seen at CPS without an appointment during office hours. Just tell your boyfriend to go to the 8th floor of Lerner and he will be helped. If your boyfriend needs urgent attention after business hours, he could call (or you could call for him) the CPS clinician-on-call at (212) 854-9797. Another option is to call 911. The psychiatric emergency room nearest the Morningside Heights campus is at St. Luke’s-Roosevelt Hospital Center Psychiatric Emergency Room. Also an option if your boyfriend is in crisis.
Regarding what your boyfriend needs to say: health care providers, especially mental health professionals, are trained for just such potentially-awkward encounters. They will probably ask your boyfriend some questions about why he thinks he might be depressed and general questions about what is going on in his life. An honest, open discussion is likely the approach that will best serve your boyfriend's health needs in this matter. (Also, he may feel better knowing that each session is confidential.)
Keep in mind that everybody has a different comfort level in dealing with emotional and mental health issues; you can encourage your boyfriend to seek treatment and express your support, but recognize he may move a little slower than you might like. For more information about how to help someone close to you who may be depressed, you can read through the Related Q&As listed below. You may also want to make an appointment with your own school's or even his counseling service to learn ways to be there for your loved one in need. Although you are concerned about supporting your boyfriend as he seeks help, don't be afraid to reach out to others if you feel overwhelmed, your mental health is important as well.Alice!