how to support someone with a major depressive episode

[donnashamshar]

I am 55 years old.  I have been "dating" an old high school flame for 6 months.  he suffers from severe major depressive disorder and generalized anxiety disorder and takes to SSRI medications.  the medications are not working.  he has been in therapy for 10 years.  he also has a fear of intimacy (relationship, sexual).  When his medications are not working, he becomes angry, often with cruel words and at times cannot remember what it is he says (as if he dissociates).  his behavior, tone and inflexion in his voice, facial expression, change and his words "hurt me to my heart."  I want to support him during this time, but am finding it increasing difficult as I am taking on his problems to "fix" .  How do I continue to support him, keep myself emotionally healthy, not try to "fix" him, not feel as if i need to "walk on eggshells"...develop a tough skin.  i keep asking myself if this is worth it.  for a friend...is it worth it.  my OCD interferes and my own difficulties from "letting go" and fear abandonmnet.  If I call him, he gets angry; if i don't call, he gets angry.  What do i do to support myself, him, without going down the abyss with him?  and is it worth it?

[Wanda Ropa, MPEC]

Thank you for writing.  There are 2 parts to your question and I will try to answer them accordingly.  
1. Relationship with the Self
2. Relationship with your significant other

Whenever I coach my clients regarding relationship issues, I always start with the most important relationship of all – your relationship with your self.  I know it might not be where you would immediately place your focus, but it is vital to develop a great relationship with yourself before you can fully care for someone else.

Consider flying in an airplane, it is always recommended that you put on your Oxygen mask first before you help someone else.  You need to be strong before you can support another.

What I have discovered is that it’s not about the answers; it’s always about asking the right questions.

1. What are you currently doing to support yourself?  (see below for checklist)
2. Do you have a counselor or therapist to support you emotionally?

Actions to Support Yourself:
1. List all the activities you enjoy doing.
2. Give yourself permission to have fun.
3. Schedule at least 1 daily activity that brings you pleasure.  Minimum of 15 minutes.
4. Schedule at least 1 activity on the weekend that you truly enjoy.
5. Increase the time you spend enjoying yourself by 5 minutes each week till you reach a comfortable level.

The second part of your question relates to your relationship with your significant other.  The first thing would be to open the door to communication in this relationship.  If that is not possible without additional support, then I would recommend that you engage his therapist to help you explore ways to communicate more openly, as well as alternatives to his current therapeutic regimen, including current meds.

In any relationship, it is about the active power of choice.  You choose, either actively or passively.  For instance, if you choose to take action, that is activating your power of choice, and stepping into the driver’s seat.  When you remain in a situation, without actively choosing to be there, the choice is made for you.  It’s important to review what you enjoy about your significant other.  

1. Make a list of all the things you like and/or love about him.
2. Make a list of all the reasons you would like to continue in the relationship.
3. Write down what needs to change so that you will be happy in this relationship.
4. Seek a professional counselor or a therapist to help you to begin to communicate how you would like to improve the relationship.  You can’t do this by yourself.

Remember, it is not about you figuring this out.  It is about you seeking support to help you, even asking for support from your significant other, to get his buy-in to make the relationship happier for both of you.  His therapist is an immediate resource because it will important for him to be aware of how the dynamics of your relationship will affect his patient’s overall condition.  

This is definitely a complex issue, which cannot be fully addressed in the context of this forum, so I strongly urge you to seek a professional counselor to support you and work with his counselor to help you communicate with him and explore different therapeutic treatments, including his medications.

[neetsiepk]

What an important response Wanda left for you.  She is absolutley right.   You have to love yourselft before you can love anyone else and you have to be healthy before you can help someone like your boyfriend - IF he wants to be helped.  You are taking on a huge commitment with someone like this.  So many people are just lonely and want someone in their lives, but you may be taking on more than you can handle, and you don't have to feel guilty if you decide that this old high school friend is not the right person for you.  You don't need to be treated with disrespect, even if it is the sickness.  When people take their medications, they can live normal lives.  Are you already in love with this man, or is he still just a man you are dating?  Don't be a victim.  We allow ourselves to be used.  We teach people how to treat us.  It is better to be alone with those 2 cats who love you unconditionally, than a man who abuses you verbally and can't give you what you need emotionally or intimately.  You DO NOT have to feel guilty about that either.  You can be his friend and help him.  He needs to get help with his therapist and find the right medicine and therapy.  He has to find a way to communicate with you when he is in a deep depression that is not so hurtful.  Stand up for yourself Donna.  You are an educated woman.  If you do love him, he has to work with you and his therapist to find a way so ya'll will both be happy.  It will be hard work, but it can happen.  I took trazadone years ago.  I know it made me sleep at night.  I tried lexapro, but I didn't find it helped me.  Anita

[donnashamshar]

anita....thank you so much for the wonderful statement.  actually, my boyfriend got very angry at me last night when i mentioned how i was feeling and accused me of some inappropriate, untrue situations.  i feel fairly good about myself, and recognize many of his symptoms, as i worked in mental health.  i know that since his medications were changed in June, he has been spiraling downhill.  and his med adjustments aren't helping.  i can not support him, emotionally and accept the emotional coldness and abuse...i do not believe that is part of his diagnosis.  wish me luck.