Managing Severe Depression: Seeking Help for a Family Member

Q: Managing Severe Depression: Seeking Help for a Family Member

Hello, Ms. <br>Jan： I want to discuss major depressive disorder. <br>Despite multiple hospitalizations, the condition remains unstable. <br>It may be necessary to explore the underlying reasons, such as whether medication adherence is an issue, the presence of significant stress,

Bipolar depression

Dear Dr.
Chen, my brother is a patient with severe depression and has been receiving treatment at Chung Shan Hospital for some time.
He has also been hospitalized three times at the Taiyuan branch, but his condition fluctuates without any significant improvement.
I previously considered changing his doctor to see if there would be any progress, but that doctor advised against it, stating that their skills are already excellent.
However, my brother's condition has not improved and has recently worsened, with self-harming behaviors.
What should I do, Dr.
Chen? He is currently very resistant to hospitalization.
Please help me as soon as possible.

Miss Zhan, 30~39 year old female. Ask Date: 2004/07/28

Dr. Chen Wenke reply Psychiatry

Hello, Ms.
Jan: I want to discuss major depressive disorder.
Despite multiple hospitalizations, the condition remains unstable.
It may be necessary to explore the underlying reasons, such as whether medication adherence is an issue, the presence of significant stress, or the coexistence of other physiological or psychological problems.
These concerns can be discussed with your physician.
Hospitalization is just one mode of treatment; it is essential for cases with strong suicidal tendencies, as suicidal behavior is very dangerous.
I believe your physician is genuinely concerned about your brother.
However, if there is no significant improvement after a period of treatment, you might consider a few points to decide whether to switch doctors: 1.
Understanding of your brother's condition and treatment analysis; 2.
Whether there have been appropriate adjustments to his medication; 3.
Whether the physician shows patience, especially if your brother continues to exhibit self-harming behaviors, which must be addressed proactively.
It is crucial not to avoid hospitalization simply because he dislikes it, as this can lead to serious issues.
Seeking a second opinion from another physician is also quite normal.
Additionally, if self-harming behaviors remain uncontrollable, electroconvulsive therapy (ECT) should be considered.
Wishing you good health.

Reply Date: 2004/07/28

More Info

Managing severe depression in a family member can be an incredibly challenging and emotional journey. It is evident from your description that your brother is experiencing significant distress and has had a complicated history with treatment, including multiple hospitalizations. Here are some strategies and insights that may help you navigate this difficult situation and encourage your brother to seek the help he needs.

Understanding Severe Depression
Severe depression, or major depressive disorder, can manifest in various ways, including persistent sadness, loss of interest in activities, changes in appetite or sleep patterns, and even self-harming behaviors. It is crucial to recognize that depression is a medical condition that often requires professional intervention, including therapy and medication. The fact that your brother has been hospitalized multiple times indicates that his condition is serious and warrants ongoing attention.

Encouraging Treatment
1. Open Communication: Start by having an open and honest conversation with your brother. Express your concerns without judgment. Let him know that you care about his well-being and that it’s okay to seek help. Use "I" statements to communicate your feelings, such as "I feel worried when I see you struggling."
2. Normalize Seeking Help: Sometimes, individuals with depression may feel ashamed or believe they should be able to handle their problems alone. Normalize the idea of seeking help by sharing stories of others who have benefited from therapy or medication. You might say, "Many people find that talking to someone can really help them feel better."
3. Explore Treatment Options Together: If your brother is resistant to the idea of hospitalization, consider discussing alternative treatment options. This could include outpatient therapy, support groups, or even online counseling services. Emphasize that there are various ways to receive support that do not necessarily involve being hospitalized.

4. Involve Trusted Individuals: If your brother has a close friend or family member he trusts, consider involving them in the conversation. Sometimes, hearing encouragement from someone else can make a difference.

5. Addressing Self-Harm: Given that your brother is exhibiting self-harming behaviors, it is crucial to take this seriously. Encourage him to speak with a mental health professional about these feelings. If he is in immediate danger or has made plans to harm himself, do not hesitate to seek emergency help.

Managing Resistance to Hospitalization
If your brother is resistant to hospitalization, it may be helpful to understand his fears or concerns. Many individuals fear the stigma associated with mental health treatment or worry about losing control over their lives. Address these concerns by discussing what hospitalization entails and how it can be a safe space for recovery.

1. Highlight the Benefits: Discuss the potential benefits of hospitalization, such as a structured environment, access to medical professionals, and the opportunity to focus solely on recovery without external stressors.

2. Explore Partial Hospitalization Programs (PHP): If full hospitalization is not an option, consider looking into PHPs, which provide intensive treatment during the day while allowing patients to return home at night.

3. Emergency Intervention: If your brother’s condition worsens or if he poses a risk to himself, it may be necessary to seek emergency intervention. This could involve contacting a mental health crisis team or taking him to the emergency room.

Supporting Yourself
Caring for someone with severe depression can take a toll on your own mental health. It is essential to prioritize self-care and seek support for yourself as well. Consider joining a support group for families of individuals with mental health issues, where you can share experiences and gain insights from others in similar situations.

Conclusion
In summary, managing severe depression in a family member requires patience, understanding, and a proactive approach to encourage treatment. Open communication, normalizing the need for help, and exploring various treatment options can make a significant difference. Remember that you are not alone in this journey, and seeking support for yourself is equally important. Your brother’s recovery may take time, but with the right support and interventions, improvement is possible.

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