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I believe I can help you with your concern
I am so sorry that your friend is going through this difficult period of her life, I can understand how you want to help her
You mentioned the possible use of an anti-depressant, but is she in therapy at all?
No she is not. We live in a very rural community and she is not employed ft- so we are very limited on support groups or therapy- not sure if she would go or not.
Well therapy should be a must for her because the medications, while effective, only lessen the symptoms of her depression (this has graduated to depression from grief because of the length of time) and do not cure it, only therapy can cure her symptoms.
But I can recommend some good techniques that can help her right now and possibly I can recommend some online therapists that would be willing to help too.
She has to have the motivation to do this for herself because only then will she be cured and can process these feelings effectively
yes I know
So the best and most evidence based therapy for these symptoms is called Cognitive Behavioral Therapy (CBT). CBT has a premise that your symptoms are caused by negative thoughts, so if we change your thought process to be more positive and objective as well, then your symptoms will lessen.
So this link may help her, it contains a technique I use with patients called a thought record. It will help her keep track of any negative thoughts she has. She puts the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want her to come up with an alternative thought for the situation (more objective and plausible). This will help her change herr way of thinking to be able to think more positive and not automatically go to a negative type of thinking.
In addition, these two worksheets are very good at helping to lessen her depressive symptoms. It can help her focus on the big picture and the objective/positive thoughts and outcomes.
Also individuals with severe depression have a poor coping mechanism, so this worksheet will help you develop a better coping strategy to manage your symptoms better.
Also these books can be very helpful too.
And this is a good website for online therapy as well
ok. If we sit down and have this talk and she looks at me like I am crazy or just blows me off- that means she isn't ready yet, correct?? I have not had any kind of talk with her about getting help yet- I just try and listen to her with 100% attention.
Well right now she is going through the nontechnical term called complicated grief, so while she may not be ready for therapy it is important for her. I think pushing her to get help will be important for her and you can give her this information worksheet describing what complicated grief is
ok- any other suggestions that might help
I think right now the therapy will help her process these feelings that she is having, because she is reliving the past and reliving the loss on a constant basis, so she is not moving forward with her life, which is unfortunate. Therapy can point her in the right direction as can these books and techniques too
Was there anything else I can assist you with?
yes you are right, this is being re-lived on a constant basis b/c she took care of her while she was sick and she lived over an hour away so it really took a toll on her
is there anything else that I can do to help her other than try to be there for her and sit down and talk to her about all of this
I can imagine it would and anyone would go through this level of grief, but she can overcome this and I think therapy will do the trick for her
Try to help her move forward with her life and re-focus the conversation to the present and not the past
Try to ask her what would her sister want her to do with her life now
ok- thanks for your help Dr Z. I feel better now that I have something concrete
I do have that conversation with her and tell her that her sister is happy and wants her to be happy but I don't want it to sound like I am being cold or trying to push her where she doesn't want to go
and her sister LOVED life
I know you do not want to be mean, it does take a delicate and firm touch to do this, that is why I recommended a therapist who is more trained in this delicate process and to not put the burden on you
should I offer to go with her or is this something she should go alone
You can definitely offer to go with her, but you do not have to push that to her
ok- well I have a lot of info to gather so I can talk to her this week. thank you for your help. I really appreciate it.
Anytime, I am always happy to help. I wish your friend all the best and I truly hope that she gets the treatment that she needs and that her symptoms lessen very soon.
My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime. Before you sign off though, I would very much appreciate if you could rate my performance in helping you so that I can get credit for this question. Thank you very much
I will - thank you.
You are most welcome :)