Should I Encourage My Girlfriend to Seek Mental Health Treatment Again?

Should I take my girlfriend for treatment?

Hello Doctor, at the end of June last year, my girlfriend was encouraged by her classmates to see a doctor, and she was diagnosed with depression.
In addition to medication, she also had weekly counseling sessions with a school counselor.
However, in mid-August, she suddenly did not want to continue treatment, refused to take medication, felt that the doctor did not like her, and often regretted sharing her feelings with the counselor, thinking that the counselor was just a stranger.
As a result, she unilaterally stopped attending appointments and counseling.

I stayed by her side during the two-month summer break after I learned about her condition, as I was really afraid she might harm herself.
I noticed that when I was with her, she seemed to be doing better, and not taking medication did not seem to cause significant issues.
She would feel uncomfortable the day after taking her medication, so I tried to minimize her medication intake.
After two months of summer, I felt she had improved and was doing well.

When school started in September, I had to return to Taoyuan (my girlfriend is in Taipei), so I could only see her on weekends.
Although she still occasionally thought about suicide, it was not as frequent.
At least when I was around, she seemed fine and showed no unusual signs.
However, recently she has started to struggle again, often waking up in the middle of the night or waking up an hour before her scheduled time.
She is easily distracted, unable to concentrate, and often zones out while riding her bike.
Sometimes she suddenly starts crying for no apparent reason.

It seems like her sleep duration has increased; she used to not take naps but now often says she wants to sleep, and when she does, she sleeps for a long time.
Her emotions have also become erratic; she can be happy one moment and then suddenly furious the next.
She isolates herself, not responding to messages or calls, saying she feels very low and does not want to interact with anyone.
Sometimes she even asks if I want to die with her.

Moreover, she has started to emotionally manipulate me; during this time, I have been busy preparing for graduate school and haven’t had time to be with her.
She would say things like she wants to die or that I would find out she’s gone once I’m done with my work.
Currently, she does not engage in self-harm, but she frequently fantasizes about death and questions why she is so weak that she cannot even go through with it.
When she gets hurt, she seems excited; recently, she accidentally burned herself and posted about how much she likes her scar.

Should I take her back to see a doctor? However, she feels that she has no problems and that her mood just fluctuates more easily than others.
I hope you can give me some advice.
Thank you, Doctor.

Wang, 20~29 year old female. Ask Date: 2017/01/23

Dr. Qiu Junda reply Psychiatry

Hello.
Your girlfriend's issues do indeed require continued treatment.
It would be beneficial to encourage her to seek medical attention.
Explain that this does not necessarily mean she has a mental illness; rather, consulting with a physician can help improve her overall mental and physical well-being.
I hope you can accompany her to the appointment to facilitate her improvement.

Reply Date: 2017/01/23

More Info

It sounds like your girlfriend is going through a very challenging time, and your concern for her well-being is commendable. Based on your description, it is crucial to approach this situation with care and empathy. Here are some thoughts and suggestions regarding whether you should encourage her to seek mental health treatment again.

Understanding the Situation
Your girlfriend has a history of depression and has previously sought treatment, which indicates that she is aware of her mental health struggles. However, her recent behaviors—such as expressing suicidal thoughts, emotional instability, and self-harm fantasies—are concerning and suggest that her mental health may be deteriorating. The fact that she feels uncomfortable with therapy and medication is not uncommon among individuals with depression, as they may feel vulnerable or distrustful of the therapeutic process.

The Importance of Professional Help
1. Recognizing Symptoms: The symptoms you describe—such as difficulty concentrating, mood swings, increased sleep, and suicidal ideation—are serious and warrant professional attention. While you provide her with support, it is essential to recognize that you are not a substitute for professional help. Mental health professionals have the training and tools necessary to address these issues effectively.

2. Encouraging Treatment: It may be beneficial to gently encourage her to revisit the idea of therapy. You could frame it as a way to help her manage her feelings better, rather than implying that she is "sick." Emphasize that seeking help is a sign of strength and that it can provide her with coping strategies for her emotional turmoil.

3. Addressing Medication Concerns: If she has had negative experiences with medication, it might be worth discussing these concerns with a healthcare provider. Sometimes, finding the right medication can take time, and side effects can vary. A doctor can help her navigate these issues and find a treatment plan that works for her.

Strategies for Encouragement
1. Open Communication: Have an open and honest conversation with her about how she feels regarding her mental health. Listen to her concerns without judgment and validate her feelings. This can help her feel understood and may make her more open to the idea of seeking help.

2. Offer to Accompany Her: If she is open to the idea, offer to accompany her to her appointments. This can provide her with a sense of support and reduce any anxiety she may feel about going alone.

3. Highlight Positive Changes: Remind her of the times when she felt better while receiving treatment. Sometimes, reflecting on past positive experiences can motivate individuals to seek help again.

4. Emergency Plan: Given her suicidal thoughts, it is crucial to have a plan in place for emergencies. If she expresses a desire to harm herself or has a specific plan, do not hesitate to seek immediate help from professionals or crisis hotlines.

Conclusion
Encouraging your girlfriend to seek mental health treatment again is a responsible and caring approach. While your support is invaluable, professional help is essential for her recovery. Be patient and understanding as she navigates her feelings, and continue to express your concern for her well-being. Ultimately, the goal is to help her find the right resources to manage her mental health effectively. If she resists, continue to be there for her, and remind her that seeking help is a positive step towards feeling better.

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