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I need some guidance on how to help my best friend. He is

Hi. I need some guidance...
Hi. I need some guidance on how to help my best friend. He is normally a very closed off person who doesn't bother people with his worries and problems. He does however open up to me somewhat about things that I feel have been very damaging to him. He has spoken with me about a past depression phase a while back and is currently going through another. I think the last time he finally did get on medication, but is currently not taking anything. He has what I feel is borderline distorted thinking. In past conversations he has told me that he feels he is here on Earth to help others out with their problems but to live himself a miserable existence, (he helped me through my divorce) also that he was being punished for something, which he says he doesn't know what. He is in a "roommate" type of marriage with one child age 10, that is the center of his existence. They tried counseling to no avail. This marriage I feel is what thrust him into the first depression a while back. He told me when the child was born a few years later he started trying to distance himself from him and prepare himself to leave but never could. This I know stems from his own childhood consisting of divorced parents. He holds onto resentment mostly for the dad. He has told me on several occasions that the way he fathers is basically being the opposite of his own dad. He has issues with the mom at times, especially focusing on how much they moved over the years, but continually has more resentment toward the dad. He has told me that he has had counseling himself for anger issues and something else which he asked me not to question him about, which of course I did not. He obviously trusts me and feels a security within me to tell me about the things he confides in me about. I always talk to him nearly everyday. He has been struggling since October and he deals with things on his own until eventually he will without warning cut off all contact, not responding to texts or calls, not just from me but from others as well (he knows he does this and has told me several times not to take it personal he does it to everyone) I have learned to just let him have his space, but still worry...I have never known it to interfere with his job too much but around the first of the year after an extended Christmas break, he went back one day and the next two days called in texting me that he could not make himself get out of bed (this was !:00-2:00 in the afternoon each day) I told him that he needed to see someone that he was depressed (he has always told me how much depression hurts and that he never wanted to go there again) he responded saying that he would be fine, he would fix himself he always did and thanked me for being such a sweet friend. I feel like I know him better than he knows himself. This past weekend he once again closed off and retreated into non-responsiveness. I let it be giving him space. After 3 days of not hearing from him he texted and said he was sorry and he was just sad and was going to the doctor for depression. I said good and asked if I could do anything for him. He later called and we talked (he always says I make him feel better) as we got on the subject of his marriage he told me he wanted to go but worries about the effects his leaving would have on others. He worries about how his mother would treat his ex because they are still friends, he said I don't think I would be the same person if I left. He thinks the child would be fine but that he wouldn't. He says he doesn't even know what person he used to be and don't know how to get back...the reason I am writing to you is not only due to the reasons above but mainly this one thing he said during our conversation...he said what if I leave and I change the path of things and something happens to my son. I asked what do you mean and he said what if my ex and her new boyfriend or whatever goes somewhere and takes the son and something happens to him. I changed the outcome because I left, I could have protected him or something and I wasn't there. I told him that I understood what he is saying but that no one could control that. He was worrying about something out of his control and I used the situation of what if you don't divorce and her and his son go out together without him, like they often do and something happened then? He said it was different. I am always positive with him and tell him I understand his concerns, but I just thought this was an extreme way of thinking. He has so much turmoil going on inside him. It kills me for him not to be happy. He knows he needs help, but he has this "self help" way of thinking that sometimes gets in his way. He has always said I would make a counselor have to go to counseling. He kids about it, but I know he really feels this way. Just wanted some advice on maybe what to say if he didn't go to the doctor to help him gradually alter his thought process. Thank you!
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Answered in 15 minutes by:
2/13/2013
TherapistMarryAnn
Category: Mental Health
Satisfied Customers: 5,862
Experience: Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Hello, I'd like to help you with your question.
Depression is characterized by feelings of hopelessness and worthlessness, lack of energy or motivation, thoughts of death and/or suicide and trouble concentrating. It is common to feel there is no hope and no way out. Guilt can be a large part of depression, which may be why your friend is experiencing the thoughts he has around leaving his partner. He feels that he could not cope with the guilt if his leaving somehow affected his son to the point that his son was hurt. It is not logical, but it makes sense if you experience a high level of guilt.
Remind him that he does not have to do this alone. And if he feels better, he can overcome his guilt and live a better life. Keep letting him talk to you, and offer suggests such as help and how he can improve each thought, just as you have been. You can also add things like asking him about the source of his thoughts. If it was past trauma, you can relate his current thoughts to patterns or responses he learned as a child. A person can change their thought patterns, but only if they are motivated and willing to work through the pain. Hopefully, your friend will consider professional help so he can change his circumstances.
If your friend is willing to see the doctor, then that is a good first step. The doctor may be able to convince him to try a medication so he feels better, enough to try therapy. Therapy is often one of the best ways to feel better. Medications are helpful to deal with the symptoms of depression but they do not get rid of them permanently. Therapy can do that though. To have a better chance at finding a good therapist, try searching on line at http://therapists.psychologytoday.com/rms/.
Medications can also be helpful to ease the symptoms but they do vary in their effectiveness so your friend may need to try a few different ones to see what works for him. Each person has their own body chemistry and what works for one may not work for another. Also, once someone takes medication for a while, the body becomes accustomed to it and the person either needs an increase in dosage or they need to try a new medication. But the medications can help you deal with the symptoms until the therapy begins to help.
Motivation is a very difficult symptom of depression. It often keeps people from helping themselves and reaching out to others. But support and self help are vital in helping your friend overcome depression. Ask him if he will consider support groups, either on line or in person. People who are experiencing the same symptoms as he is can offer invaluable support, ideas and companionship to help him feel better. Also, working on his depression at home can supplement his therapy or other treatment. Here are resources to help him get started:
http://psychcentral.com/resources/Depression/Support_Groups/
http://depression.supportgroups.com/
http://www.nami.org/
http://helpguide.org/mental/depression_signs_types_diagnosis_treatment.htm
I hope this has helped you,
Kate
TherapistMarryAnn
Category: Mental Health
Satisfied Customers: 5,862
Experience: Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Thank you very much for the positive rating and bonus! I appreciate it.
My best to you and your friend,
Kate
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