I think my boyfriend's depressed — what do I do?
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. When it comes to seeking treatment for mental health, there are a number of avenues he can take. If he feels more comfortable, your boyfriend may want to see his primary health care provider, especially if he would be more at ease discussing mental health matters with a familiar face. However, most internists and family practitioners aren't specifically trained to diagnose and manage mental health conditions. Mental health professionals, on the other hand, such as psychiatrists and clinical psychologists, are trained to diagnose and treat depression. Psychiatrists are experts in the physical causes of mental illnesses and the medications used to treat them. Clinical psychologists can't prescribe medications but specialize in various types of therapy, a powerful, proven method of treating depression. These practitioners can also all refer to each other so that if he starts with any of these providers, they can make referrals to ensure that he is receiving the care that is more appropriate for him. If your boyfriend wants to try looking for a provider off-campus, he may find the SAMHSA Behavioral Health Treatment Service Locator helpful in identifying resources in the area.
To diagnose a patient with depression, a provider might do a few things. First, they may conduct a physical exam or ask for blood work to determine if other health conditions, such as thyroid problems, may be causing the depressive symptoms. A provider may also conduct a psychiatric evaluation by asking about how the patient is feeling and how it is impacting their behavior and lifestyle. They will likely evaluate a patient's responses using the Diagnostic and Statistical Manual of Mental Disorders (also called the DSM), which includes specific criteria for diagnosing depression, such as feeling "empty" or hopeless. To be diagnosed with depression, symptoms must be present for at least two weeks. As for what your boyfriend needs to say at the beginning of an appointment, health care providers, especially mental health professionals, are trained for these potentially-awkward encounters. An honest, open discussion is likely the approach that will best serve your boyfriend's health needs. Also, he may feel better knowing that each session is confidential.
If your boyfriend is diagnosed with depression, he may be offered several options for treatment, including:
- Psychotherapy: Also called talk therapy, psychotherapy involves talking with a professional about your depression. There are several different types of therapy, such as cognitive behavioral therapy or interpersonal therapy.
- Lifestyle changes: Getting enough sleep and physical activity may reduce symptoms of depression, along with abstaining from use of drugs and alcohol. This might be recommended along with other forms of treatment.
- Medications: Antidepressants are often commonly prescribed to people with depression. There are many different types, and some may take several weeks to start working. People also respond differently to different medications and may need to try different kinds or doses to find one that works.
- Electroconvulsive therapy: Electroconvulsive therapy, or other nerve therapies, are sometimes recommended if medications aren't working. Nerve therapies use electric shocks or coils to stimulate nerves.
Unfortunately, like you mentioned, none of these treatments are guaranteed to be a "quick fix." It may take time to find medications that work or a therapist that he feels comfortable with. Finding the appropriate treatment option for him may take a bit of patience and support.
Support from friends and family can be invaluable to a person experiencing depression. This can range from doing daily activities together to keeping them on track with their treatments or medications. It sounds like you're already a great source of support for your boyfriend. He also may benefit from talking with other friends or family members or by finding local support groups for those experiencing depression.
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 he may move at a different pace than you may when it comes to addressing mental health. 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're concerned about supporting your boyfriend as he seeks help, seeking out support for yourself if you feel overwhelmed can also be helpful; caring for your mental health is crucial as well.
Originally published Sep 24, 2004
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