Depression: When to Seek Help for Your Partner

Q: Depression: When to Seek Help for Your Partner

Hello, cat lover： Based on your description, it appears that your boyfriend has significant emotional issues, particularly characterized by emotional instability and impulsive self-harm (or even suicidal tendencies). <br>From the symptoms you provided, I do not fully agree that h

Do people with depression always need to seek medical treatment?

My boyfriend is the same age as me; we are both high school freshmen.
We started dating last April, but we don't talk much at school, possibly because I'm shy and don't dare to speak to him, even though I can talk naturally with other friends and classmates.
Over the past two to three months, he has seen me talking to other boys, and he wonders why I don't talk to him.
As time has passed, he seems to have developed depression.
During arguments, he harms himself, cries, and even has thoughts of suicide.
Sometimes when we go out shopping, in public places, he expresses a desire to jump off a building or repeatedly hurts himself by scratching.
During winter break, I accompanied him to see a doctor, who prescribed him "Paxil." I heard that mental illnesses can now be treated with medication, and the effects are quite good with manageable side effects.
However, when I suggested he see a psychiatrist, he refused, saying that as long as we don't argue, he will be fine.
But I feel that medication is necessary because his condition is quite serious.
He becomes very jealous and doesn't want me to talk to other boys.
What worries me the most is that he might self-harm or attempt suicide; sometimes he even bangs his head against the wall.
Doctor, is it possible that my boyfriend has depression or bipolar disorder? Does he need to see a doctor to get better? If he takes Paxil, will it be harmful to his body? How can I encourage him to accept treatment? Thank you, doctor.
^^

Mao Mao, 10~19 year old female. Ask Date: 2004/05/16

Dr. Chen Guangpeng reply Psychiatry

Hello, cat lover: Based on your description, it appears that your boyfriend has significant emotional issues, particularly characterized by emotional instability and impulsive self-harm (or even suicidal tendencies).
From the symptoms you provided, I do not fully agree that he is a typical patient with major depressive disorder; rather, I encourage you to consider other aspects.
How are his interpersonal relationships (are they usually unstable and intense)? What is his "clinginess" like (is he very afraid of abandonment)? How stable is his emotional state (does he experience rapid fluctuations in response to external stimuli, and is he prone to inappropriate anger)? What about his impulsivity (aside from self-harm and suicidal behavior, does he often engage in harmful activities such as excessive spending, gambling, reckless driving, alcohol abuse, or substance misuse)? How is his self-identity (is his self-image unstable)?
I believe that in addition to being caught in the whirlpool of emotions, your boyfriend may possess certain personality traits that contribute to his current behavior.
If my assumption is correct, the issues may be more complex than simple major depressive disorder or bipolar disorder, and the effectiveness of pharmacological treatment may not be ideal.
Long-term and in-depth psychotherapy is essential.
As the saying goes, "A leopard cannot change its spots." Individuals with personality disorders often perceive themselves as having no problems, while those close to them may suffer greatly.
You should reflect deeply or seek a more professional mental health team to ascertain your boyfriend's issues, and then determine both his treatment plan and your own path forward.
I wish you a wise decision.

Reply Date: 2004/05/16

More Info

It sounds like you are in a very challenging situation with your boyfriend, who is exhibiting signs of severe emotional distress and possibly depression. It's commendable that you are concerned about his well-being and are seeking advice on how to help him.
From what you've described, your boyfriend's behavior—self-harm, suicidal thoughts, and extreme jealousy—are serious indicators that he may be struggling with depression or even a more severe mood disorder, such as bipolar disorder. These symptoms can be very alarming and should not be taken lightly. It’s crucial to approach this situation with care and understanding.

Understanding Depression and Its Symptoms
Depression is a mental health condition that can manifest in various ways, including persistent sadness, loss of interest in activities, changes in appetite or sleep patterns, feelings of worthlessness, and thoughts of self-harm or suicide. When someone expresses a desire to harm themselves or talks about suicide, it is essential to take these statements seriously.

When to Seek Help
1. Immediate Danger: If your boyfriend is expressing suicidal thoughts or engaging in self-harm, it is vital to seek immediate help. This could mean contacting a mental health professional, a crisis hotline, or even emergency services if you believe he is in immediate danger.

2. Professional Help: You mentioned that he has seen a doctor and was prescribed medication (likely an antidepressant like Prozac, known as "百憂解" in Chinese). Medication can be an effective treatment for depression, especially when combined with therapy. If he is resistant to seeing a psychiatrist, you might encourage him to consider therapy as a first step. Sometimes, talking to a therapist can help individuals feel more comfortable about the idea of medication.

3. Supportive Environment: It’s essential to create a supportive environment for him. Let him know that you care about him and that you are there to support him. Avoid placing blame or making him feel guilty about his feelings. Instead, focus on expressing your concern for his well-being.

How to Encourage Treatment
1. Open Communication: Have an open and honest conversation with him about your concerns. Use "I" statements to express how you feel, such as "I feel worried when I see you hurting yourself" rather than "You need to stop hurting yourself." This approach can help him feel less defensive.

2. Normalize Seeking Help: You can normalize the idea of seeking help by discussing how common mental health issues are and how many people benefit from therapy and medication. You might mention that even people who seem fine on the outside can struggle internally.

3. Offer to Accompany Him: Sometimes, the idea of going to a doctor can be overwhelming. Offer to accompany him to his appointments or help him find a therapist he feels comfortable with.
4. Educate Together: If he is open to it, you could research together about depression and its treatments. Understanding that he is not alone in this struggle and that help is available can be encouraging.

Addressing Medication Concerns
Regarding your concerns about the medication he is taking, it’s important to understand that while all medications can have side effects, many people find that the benefits outweigh the risks. It’s essential for him to discuss any side effects or concerns with his doctor, who can provide guidance and adjust the treatment plan if necessary.

Conclusion
In summary, your boyfriend's situation is serious, and it’s crucial to approach it with compassion and urgency. Encourage him to seek professional help, whether through therapy, medication, or both. Your support can make a significant difference in his journey toward recovery. Remember, you are not alone in this; there are professionals who can help guide both of you through this difficult time.

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