There is a longtime friend who is going through difficulties at the moment, i don't want to go into every detail, but he has been out of work for some time, and he is always stressed about things when I talk to him. I've made some suggestions of things to try but it just seems none of it is working.
I'm trying to get him to see someone (professional consulor) but i'm sure he really doesn't have much money for the prices I was told.
I feel like I am on thin ice already and I was hoping maybe someone out there knows what this might be like and have any suggestions.

Thanks

At the risk of sounding morbid, try calling a suicide hotline. They're usually free (or cost the amount of a local call), and IIRC, they can handle people who are depressed. They can also help people who know someone who is seriously depressed (like you).

You could also recommend your friend to a doctor who can prescribe anti-depression medicine. I know, I'd be skeptical of taking medicine for an emotional state, but it's better than risking the alternative...

My advice....don't let him be alone too much time...

I would agree with the recommendation of calling a suicide hotline. Maybe it's overreacting, or maybe you're saving their life.

I am somewhat skeptical of anti-depressants. Clincial studies of their efficacy are inconsistent. I was diagnosed as bi-polar placed on anti-depressants (actually, mostly mood-levelers) at one point (I went through several attempting to find one that was effective). In my case, they either had no effect that was worth the side effects, or a negative effect. I attempted suicide at one point, which I blame on the particular drug I was on at the time (depakote).

In the mind of a clinically depressed person, they are alone, even when they're with other people (or even espescially then). They feel completely powerless about their situation, which often saps their motivation to improve things (which can create a vicious cycle). They can't see beyond their despair. It's so all-consuming that they can't even imagine a way out of the hole they're in. Importantly, their relationships with other people break down or become superficial. I personally think this is the point that allows suicidal thoughts to turn into suicide attempts. When the depressed person isn't at rock bottom, even if they have suicidal thoughts they're well aware that they would be hurting other people too. When they drop off, their ability to relate to other people is lost; the only thought is to end the pain, they aren't really even aware anymore of how they could hurt others.

It's important for you to communicate that they are important to you and that they matter. They may try to brush you off, but don't give up. Help them in whatever way you can. Real and visible, if incremental, improvement in their life situation is more useful than just something fun to cheer them up (e.g. a party that gives them temporary, but superficial relief).

From my own personal experience with depression I would recommend both medication and counselling. This is the usual prescription. It may take some time to get right medicine and dosage. A good counsellor is a great help. But, bottom line, depression is not to be fucked with. It can be fatal.

Use your influence to suggest that if your friend is tired of feeling the way s/he does, perhaps s/he might want to try something different. Treatment made a difference in my life as I have been away from counselling and off meds for five years. When told I might have to be on anti-depressents for the rest of my life I accepted that course as way better than being depressed.

If s/he is drinking and/or taking illicit drugs s/he is magnifying the problem through self-medication.

Good luck; do not treat this lightly.

Thanks for all the suggestions so far - I can see that others here have rather intemite contact with this as well.

AFAIK he is not showing signs of sucide - he has never been that way and more the opposite of usually enjoying life, he doesn't do drugs or alchol AFAIK. I can't say for certain what goes on in someone's thoughts but i would find it unlikely. It seems more a long string of rejections (jobs & girlfriend) and failures (several things he has done recently) which are causing him to cocoon himself, and I know he is on a really tight budget so there is (i think) some options that he doesn't have access to.

I didn't think of the suicide hotline because he doesn't appear to be sucidal at all but I think maybe it is a good idea.
I am not a big fan of medications (even if I can order everything now through my spam email!) but again it might be a good temperary mesurement.
I personally like the conselling and possible medication.

As I said I just feel like I am on thin ice a bit in terms of trying to help. He is in denial about his situation and doesn't seem to think he needs professional help, and I am at a loss of what to do more than to suggest stuff. His other friends don't seem to understand or want to deal with what is happening, as you pointed out the friendships take on a superficial quality and i don't think there has been any help from that side. I phoned up his mom being a long time close friend but she is in more denial then he is.

Any suggestions on what i could do to motivate him to take action himself or what I can do to help?

PS - thanks a lot guys - this has been bugging me for some time about what can be done and usually the people here are usually a really good bunch of people with good insight.

Having someone close to talk to definitely helps.

Let's say I have some education and experience in the area, but I don't want play Frasier in HA, not here .

First things first, like they say: The treatment of a depressed person starts by "normalizing" his life. That's what they do in mental institutions, too. Like sleeping, eating, going out of the house once per day,stuff like that. That's a part where friends can help too, by calling by phone, going for a cup of coffee in a cafe, cooking dinner at his place and doing the laundry and so on. But do not make a big number of it, just "silently" keep him connected to "the real world". Many depressed people wake up at 4a.m and can't sleep anymore, or they sleep 14-16 hours per day. Ask about that. And they only eat couple of sandwiches per day, that's all. Ask about that, too. So if you can manage to keep a living contact to him, he doesn't hopefully fall to the next, darker level of depression.

Most important thing: Don't say "Cheer up", "Sun is going to shine tomorrow, too" or stuff like that.... Depressed people don't enjoy being depressed, they hate their life at that point, _if they could cheer up by themselves, they would have done it already_.

And try to show him, that you care for him not only when he is successful and happy and telling good jokes, but also in the dark times of our lives.

All of us (especially the best ) can find ourselves in the same situation, in some part of our life. Maybe sooner, maybe later. He is doing his hardest work now.

Where I live (Finland) we have also free counselling and toll free phone numbers, maybe you have too? Check the yellow pages, some services could be run foundations... If he is part of a church, maybe they have counselling, too. Not all counselling there is connected to religion. One mission of different churches and religions is to help a person in need.

If his condition gets worse, get professional help. Couple of months off from his worry life in a hospital could then save his life and make rest of his long life much better.

I am sorry for my bad English, Finnish is my mother tongue.

edit:typos

Talk to the people that are close to him, his mother is probably not a good choice for start, but at the same time behave in such a manner that he wont feel like your doing something behind his back, with more than one mind you will be able to choose what is 'best' for him and at the same time you wont have to deal with all the responsibility - which is overwhelming in situations like that. In any case he will feel that people DO care, and thats one and the most important thing imho - for starters (and also: dont wait - do it now.)

but remember:
- everyone is responsible for themself and noone else
- let the pros decide what would be the best for him

yea - i've found that out - it took awhile for me to realize that there is quite a difference between "being in a rut" and having depression, I don't think I would have made a good therapist.

from what I know (been spending more time the last 2 weeks with him) it seems like the depression has been going on for several months and just gradually getting worse.
I did check the yellow pages and all the places I contacted were expensive, but I did not think of the church services.

Do you think I should print this out and show him? I have the feeling that if I do something "wrong" that he will just cut me off but at the same time I'm trying to show that I'm trying to help.

I personally think he should see a professional about it right away but the few times I have hinted at it there has been a fairly negative reaction to it, so I am a bit of a loss about how to get him to go?

Don't worry about the negative feedback, it's part of the thing... Everyone starts with that. "I don't need that, Do you thínk I am crazy, Me to shrink, never... and stuff like that.

Well, does he realize that he is depressed? Has he told you so? It's no use to force him unvoluntarily into counselling, the counselling has little chance of succeeding then.

What councellors usually see as no1 role to family members and friends of depressed people is to try get the depressed person accept and notice that he would benefit from help from pros. The hard part is that people really don't want to think that they are "crazy". But they aren't, that has to be told to them. They don't have rolling eyes and sound like a monkey, no. This convincing doesn't have to happen in one day.... It almost never does.

"If you get your leg broken, you go to doctor, right? You _are_ feeling miserably, you hate your life and yourself, you have very dark thoughts, going to councelling is useful, if you feel at least little bit better after that, right?"

But like smok3 very wisely put it, you are not responsible for his illness or treating it. But as a friend, IMHO one should try to support him and speak about difficult things, too. IMHO it's a better way of handling the situation than taking more distance from the person, who has started to behave odd, and just keep one's fingers crossed. Those people seem not to be so good friends, after all. Always there, when you win a trophy, but the other way around... nope.

Most depression sites on the net are run by medication companies, it's good that one knows that when reading them.

Medication can make one feel better, and stop or slow down the pace depression is getting deeper, but it doesn't remove the things that caused depression. With councelling you may get longer term results. But if councelling is a total no-no to him, ask him to give a visit to a doctor.

other opinions:
http://www.depression.com/interview1.html?content=treating&

edit:typos

I think so, he says he knows but that might be a little lip service. I spent some time with him the last 2 days and talked about doing something. So I think he is willing but needs someone to hold his hand at this point. I kind of wish there was someone else to help since I find myself with not enough time at this point.

Who would make a decision on whether he is clinically depressed - a doctor? or do they have to refer you to a phycologist? It just doesn't seem like something you go to the hospital for? I was thinking for medication who would be able to order that and are there standard products for this?

IMHO, doctors and psychiatrists and stuff like that can't help him. In that situation, only close and deep friendship can help. So, you just try to show him that you care, that he isn't alone and listen to what he says. Let him tell you what he feels, what are his fears and all; he probably needs just someone who will listen to him and accept him the way he is. It's not easy to deal with depression, but it's possible to cure it.

Also, I'm personally against medicaments; they can screw up things too much, and it's not very certain that they work.

"Also, I'm personally against medicaments; they can screw up things too much, and it's not very certain that they work."

One of the scariest things I have run across in having years of experience with depression is non-medical folks with no experience saying that prescribed medicines do not work and/or should not be taken. Consider that you may be countering a trained professional's advice and experience on the basis of your own pedestrian knowledge. Do not lose sight of the fact that by telling someone to not take or stop taking their meds you could be leading them to suicide.

In other words, without professional knowledge and exerience you might want to consider very caefully what you recommend.

I know few folks who offer up engineering, accounting, archtectural, legal, or electronic advice as freely as those who offer up medical advice. Why is that??

Been there; done that; got the T-shirt; got the scarf.

As a depressed person who sounds like he's in the same situation as your friend I think i can sympathise with him some. I am at a really low point of my life financially and all the friends I used to have want nothing to do with me, so if i do something I am forced to do it by myself be it going to a movie or eating dinner. It just doesn't make you feel good about yourself. I never was really good with social things since my mother, who is now dead which didn't help my depression, was really overprotective of me. I didn't get out much (at all really) as a teenager and as a result I'm now 20 and have no friends, no social life, and have never had a girlfriend. If I didn't have a job I wouldn't see other people. It's just hard to feel like it'll get better because it seems I'm always getting kicked down again.

Sorry for the rant but it was nice to vent.

Be the best friend you can be to your friend. I wish I had someone who really cared and didn't judge me. I'd like to go to counseling myself but can't afford it.

In this case, I share RIV@NVX's distrust of behavioral medication, but I support its use when it can save lives (hence the reason I suggested it). The last time medication was prescribed to improve depression, we got cocaine and heroin. And a drug that alleviates behavioral problems either treats the symptoms or cures the problem (or is a placebo, which I suspect may be the case with some drugs on the market). If it cures the problem, then great! If it helps in the cure of a problem, like a bandage helping to heal a cut, then great (that was the case with my brother).

But if it merely treats the symptoms, then it's theoretically habit forming (even if only on a psychological level). And that can lead to prescription abuse/malpractice. Anyon who has seen or dealt with doctors/psychologists being overzealous in prescribing ritalin to children can appreciate the wariness people have with other behavioral drugs.

However, as I stated earlier, if I had to choose between the drugs and a suicide, I choose drugs. But I prefer not needing to make that decision.

@ TwoJ, in my non-trained opinion, depression that doesn't stem from a particular source is very difficult to help. A doctor or a psychologist is probably the most capable of diagnosing chronic depression. Obviously, that's expensive, even if he has medical insurance, which would tend to cover that.

I would hazard a guess that he's either depressed about his life in it's current state, or where his life is heading (or NOT heading). The cheap, oversimplified way of pulling him out is to help him identify what he doesn't like about his life or future and give him specific goal or tasks to rectify that problem. Obviously, it's not that easy, but that's typically worked for me and my friends.

Edit: Posted more of my thoughts that may or may not be helpful...

Perhaps some of the things people suggested here might help? Helping yourself is sometimes the hardest things to do. I think most people like helping other people with their problems instead of addressing their own.

I think the sucide helpline might be good - even if you consider it extreme they probably have a fair number of people who are depressed and can offer suggestions i'm guessing.

I'll keep you updated on the developments

"The last time medication was prescribed to improve depression, we got cocaine and heroin."

Surely you know something more recent about pharmacopia than what happened 100 years ago. Current anti-depressents are effective and useful. I have not heard any competent professional advising the use of anti-depressents without simoultaneous counselling. Together they do work.

I have now idea where you live but would suggest that if cocaine and heroin are being prescribed for depression there you are hoplessly out of the loop. Go to WebMD and read up on what is currently being used to treat this terrible condition.

I know that many well-meaning folks counsel against medication for emotionial/psychological conditions without having the proper medical credentials to do so. They would never think of telling a diabetic to stop taking insulin but for some reason feel qualified to counsel and advise about mental aberrations. Unless you are a qualified doctor and familiar with the person in question's case I would caution against saying that medication does not work. Just as with a diabetic you are playing with someone's life. Depression kills.

I was going to respond in my typical style, but this thread is too important to be wasted on a flame war.

I can't say 100% sure (because, as everybody here already pointed, I'm not a doctor and can't be considered professional in this area), but from experiences I have been having close contact to, I'm pretty certain that a depressed person just wants something desperately. It usually starts with a desire of something that is impossible to get or doesn't exist, and as the time passes the person wants it more and more. The moment it faces that it won't happen anytime (but not just beeing told, but actually understanding that, just not wanting to accept it), depression starts. So, you might try talking to your friend about his desires, and if he tells you anything it could a lot easier to decide what next...

If anyone disagrees on any of this, please post. I have probably made mistakes, because, as I said, I have no professional knowledge.

Wow, that makes a lot of sense to me. That certainly applies to myself. I know exactly which things that I want and that I can't have and yes it just gets worse over time. I actually think the thing I want is pretty stupid but I still want it anyway.

Some people said that depression comes from a too high level of idealism in life and belieef in unrealistic desires. For centuries, depression wasn't considered anything special, it was just a type of personality; many great artist suffered from it, but they weren't considered sick by that time.

I'm sorry, but in my mind's logic, medicaments can't help something like that. I won't try to convince anyone, it's just my opinion.

I think that this is a very gross oversimplification of matters. Casting depression as "idealism" or "wanting something unattainable" is a bit irresponsible in my opinion.

I think even a passing glance at depression research, by people who actually deal with it on a daily basis (I'll grant that I'm not the biggest fan of psychology in all respects, but I know enough not to condemn everything) shows that this is a way more complex issue than you have given justice for.

And simply saying that "in my mind, medication won't help this", is just as irresponsible. Medication won't help what exactly? And which medication? Or are we just being vague and uncritical? Do you have any experience with depression? With psychological treatment? With medication? Or are you simply making a bunch of wild guesses based on something you "heard somewhere.?" Or are these just your own wild conclusions?

Sorry, but I don't think you have a clue about what you are talking about here. It also bothers me to see these kinds of unsupported, and obviously unjustified statements on this board. Although this is the offtopic section, what you've done here would be a repeated volation of TOS #8 if it had anything to do with audio...

As for the original poster, I would recommend a couple of things for his friend. First, it would seriously be worth thinking about trying to get professional help for him in some manner or another. If that's out of the question, the next thing I would do is try to get him involved in something in a community. Since I know nothing about this person, I don't really have good examples to give, but I've found that for people suffering from depression, being involved in something and feeling like they are a part of something, often will help things. If not for the fact that it gives some people purpose, it gives them things to do to keep their mind off of the depression.

This kind of goes hand in hand with the goal setting thing that was mentioned earlier. Also, the bit about "normalizing" one's lifestyle is a very good suggestion. Part of the problem with depression is that once a person gets in a cycle of doing things a certain way, and they are constantly deperessed, a lot of times this kind of behavior will continue to renforce the depression. If you can get someone to change their lifestyle and their environment, if only a little at a time, it will almost certainly help to bring about a change in their mood and outlook as well.

Anyway, I have to go to class now so that's about all I can think of. Good luck with your friend -- you certainly will have your work cut out for you.

I read about a research on antidepresives here (it's croatian, but in short it says "antidepressive medicaments increase probability of suicide"). Speaking of expiriences, yes, I have some cases I have been close to and they always showed the symptoms I mentioned. I'm in somekind of a way happy that I can't support my claims more than this.


This is a great idea indeed.

Well - i wish i had 1 hour to write down everything - I think I will need some conselling too!
He has been up & down - I've been taking the advice and tring to normalize him but I seriously think that this is depression at a very serious level. I've found a church organization that does consuling and I've contacted them - I think it is a good place to start. I have to convince him to go, so I have to convince him to go. I really think he may be at the point of needing medication, i've seen the same symptoms in alcoholics - the denial of symptoms.
Anyhow - I should have more news soon and a big thanks to everyone here for the help so far.