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Please help.. My boyfriend is, I believe, clinically

depressed. He thinks he is...
Please help.. My boyfriend is, I believe, clinically depressed. He thinks he is, too. He is currently enrolled as a first-year medical student and absolutely hates it. He is stressed out to the maximum every day, hates his work, dislikes his peers, doesn't really know anyone in his new city, lives alone, doesn't see a future in his schooling/career, etc. Lately he has been easily angered and gets out of control when he gets upset. He snaps at me a lot, usually when I don't deserve it, and we have been fighting more and more often. He doesn't like to talk about his feelings or problems, and refuses any time I try to help him work things out.
He's come to the point where he realizes he is starting to make me unhappy and told me he's just not the guy I'm looking for, because he can't be "magical" (as he put it) and make me happy after he's had a crappy day. I told him I don't need him to attempt to make me happy, just for him to stop snapping at me randomly. He says he can't help it. Okay. He is making me unhappy lately. But, I do love him very deeply and don't want to leave him, knowing that, without his depression, he is a wonderful, caring man. I also think leaving him will throw him into an even steeper spiral of depression, and I don't want to cause him that pain.
The problem is, I suggested he get professional help, or at least try out some depression workbooks. He refused, saying he doesn't have any time for them and that they don't work anyway. He refuses anything else I try to suggest and just doesn't seem to want to help himself in any way, either for the sake of himself, his career, or the sake of our relationship. He says he wants to be better, but doesn't want to try anything to help (which makes no sense to me). How can I help him, both on a day-to-day basis and long-term?
Thank you.
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Answered in 6 hours by:
12/3/2011
psychlady
psychlady, Therapist
Category: Mental Health
Satisfied Customers: 6,893
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There is a major problem with mental health care when a person doesn't want help. Because therapy is based on total honesty it needs a cooperative patient. No one can address their mind if they are unwilling. It takes total disclosure. You can't help him if he isn't willing. Someone has to sort of bear their soul to be able to resolve anything in the mind. It seems that he is not in a place that is receptive and our profession does not work that way. However you don't know that he will always be resistant. Many times when people are at their worst then that is when they are most receptive. You have to hold out for that time. You also have to bring attention to the fact that he is harming the relationship right when it happens. You aren't doing either of you any favors by waiting. Instead stop the interaction and direct his attention to the fact that he is being irritable. When the relationship is at risk then he may want attention. The Depression Workbook is excellent. I would ask him how long you should stay with someone who is not taking care of himself.

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psychlady
psychlady, Therapist
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Customer reply replied 6 years ago
Relist: Other.
Just want to know if anyone else has any other opinions
TherapistMarryAnn
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The other expert made excellent points. It is hard to help someone if they will not help themselves. It is a frequent occurrence and can be frustrating and difficult to cope with.

When someone will not help themselves, that leaves loved ones to find a way to cope with their behavior and try to help them in an indirect way. If you feel your boyfriend is clinically depressed, you can start with learning more about depression. This will provide you with answers when he acts the way he does and help you help him. Here are some resources to help you get started:

http://helpguide.org/mental/depression_signs_types_diagnosis_treatment.htm

http://helpguide.org/topics/depression.htm

http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml

You can get ideas and support on how to help him from NAMI, which is the National Alliance for Mental Health. They offer numerous resources to assist those with a mental illness and those trying to help.

Support groups are another option. You can join one for family members and loved ones. Through the group, you may learn more about how family and friends have tried to help their loved ones get help. Here is a link to help:

http://psychcentral.com/resources/Depression/Support_Groups/

It may be that when your boyfriend sees you getting support and working towards a solution, he may be willing to try as well. You can always ask him to join in or ask his opinion. It may be enough to get him engaged.

I know it's hard to deal with your boyfriend's behavior. Trying to find ways to respond, keeping the relationship going and helping him can take a toll and you can get wrapped up in all the tension and stress. Be sure to care for yourself and take breaks as needed. Take time each day if you can or at least each week and get out of the situation. Go out with friends, talk to people who are supportive and if you feel you want to, try therapy for yourself. It can give you much needed stress relief.

I hope this has helped,
Kate

TherapistMarryAnn
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Customer reply replied 6 years ago
Hi, could I ask another clarification question? I plan to accept both of your answers. When he snaps at me or is irritable towards me, should I just ignore him and let it go, giving him leeway because he's depressed and/or having a stressful day? Or should I hold him accountable and point it out to him, for the purpose of getting him to apologize? His irritability is hurtful and so far I've been pointing it out every time, to try to get him to watch himself and prevent it from happening again. But, every time I do that, it turns into a fight because he is stubborn and irritable. I'm just not sure how to handle this situation and it happens almost every other night...

No problem! I am happy to help.

If he is depressed and angry, then the best way to respond is to put the feelings back on him. If you take responsibility for them that will take a toll on you with increased stress and resentment about the relationship.

When he is irritable with you, you can respond by saying, "I am sorry you feel that way. If I can help let me know." Then walk away. This lets him know you realize he has a problem, you are not taking blame for it, and the next response you will accept is him asking for your help. It does not leave the communication open for further arguing or for blaming you.

Getting him to apologize only makes him angry because he probably does not feel it is his fault. It also causes resentment and anger for both of you.

Giving him time alone is a good idea. That also tells him that although you care for him, treating you badly is not an option. He needs to find ways to deal with his stress in more healthy ways. Taking out on you is not healthy.

Kate

TherapistMarryAnn
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Customer reply replied 6 years ago
Should I let him know his action or words hurt me when I walk away?

You could add something like, "I feel hurt by your words" then leave it at that. The more emotion and blaming that is put into your response, the more fuel there is for him to blame you for being mean or unfair. You want to keep it neutral as you can so he can look to himself as the cause.

Kate

TherapistMarryAnn
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Customer reply replied 6 years ago
Hi Kate, sorry, I thought of one more follow-up question. Hopefully you can answer it for me. My bf and I are long-distance, so when his irritability happens, it's usually right before the end of the night, on a Skype video call. Just to check, I should say this, right?: "Hey, I'm kind of hurt that you ______. I'm sorry you're feeling irritable right now. If you need anything, I'm here for you." And then hang up the call, right? The thing is, though, I think if I do that he'll just go to sleep, forget all about it, and talk to me again the next day like nothing's wrong. But I'll still be hurt by what he said/did from the night before. Any advice on how to handle this?

Yes, that is a good way to put your response when he hurts you. It keeps the blame out of it and offers to help.

I would hope that he would not forget about you feeling hurt by your next contact, but it is possible. In that case, you can start the next conversation off by saying "I still feel hurt by the night before. How can we work to change this?" And see what he says. Hopefully, he will be open to working on what he is doing and change it. I don't think he will be able to try to continue a conversation with you after you have said that.

The idea is to show him consequences to his irritability and treating you poorly. If you do not blame him or become emotional, he cannot blame his problems on you and see it as you causing his irritability. And if you phrase your responses so they are neutral and supportive but to the point ("I am hurt" for example), there is no way he can dismiss you.

Let me know if you have more questions. I am happy to help.

Kate

TherapistMarryAnn
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Customer reply replied 6 years ago
Thank you for your response.
"If you do not blame him" -- The problem is, if I just say "I am hurt", he does blame it on me. He says back to me "Well, then don't be hurt. Stop looking at it in a negative way." or something like that.

In that case, I'd say that there is an underlying issue he has that does not allow him to see his own faults as part of a problem. It either has something to do with his background, maybe possible abuse or something similar. Adults who were abused as children sometimes feel so neglected and humiliated emotionally by what happened to them that they can never afford to let others blame them. It reminds them too much of how they felt as children.

He could also have a personality disorder such as narcissism. Narcissism can cause a person to blame others for everything, including things they are clearly to blame for themselves. Here are links to describe narcissism and personality disorders:

http://psychcentral.com/disorders/sx36.htm

http://www.nmha.org/go/information/get-info/personality-disorders

From what you described about your boyfriend, I doubt he has a personality disorder. But he could have traits only and not a full blown diagnosis. In that case, he would need therapy to deal with his issues. Personality disorders/traits cannot be dealt with without professional help.

Kate

TherapistMarryAnn
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Customer reply replied 6 years ago
I appreciate the insight. The thing is, he tends to say things like that initially, and then later on will (usually) apologize, but I'm not always sure he gets it. He has never had a good relationship with his parents but I doubt there was ever any abuse. He also usually puts me first, except when I get emotional and upset over what he deems as "silly things". When that happens, like I said, he fails to look at the issue as important, because he feels I am overreacting.

That says to me that he probably doesn't have a personality disorder. But just in case, I thought you could use the information to look over and see if he has any symptoms.

He needs to work on valuing you as a person. It is common for men to sometimes dismiss a woman's feelings because they do not understand them well. They may feel overwhelmed by them or learned as a child that women's feelings are to be dismissed. It may go back to his childhood and the relationship his parents had. And if he is young now, he may not have had enough time to develop his own experience and change his viewpoints.

If he is putting you first, apologizing, and generally treats you well, I'd say your relationship is solid. Every couple has issues. It is just getting him to see he needs to participate in resolving them that is the trick.

Kate

TherapistMarryAnn
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