Since depression affects 20 percent of the population, this illness probably touches most of us. So what can we do when a loved one is depressed and refusing treatment? The “distraught mother” below will be joining me on tomorrow’s Web chat.
I enjoyed reading your column, but your last one on “the depths of depression” spoke to me directly. Over this last weekend, I discovered that my eldest daughter has fallen again into a deep depression. My husband and I struggled to communicate with her about her need to seek treatment. Then your article appeared. Very timely. She has four babies, with the youngest a year old, and after each one she had a postpartum depression. Her husband works long hours, which I am sure adds to the stress. We live in another state, which makes us feel more helpless and frustrated. Her situation is compounded by the depression that has developed since she stopped taking her medication about eight weeks ago. She has a history of eating disorders and feels the medication is making her put on weight. Lately she has been cutting herself off from everyone. But the most frightening part occurred last week when she called me hysterically crying and said she did not want to be a mother anymore. I know I cannot force her to take antidepressants. My question is, what can I do to convince her to get treatment before she hurts herself or her children?
Dear Distraught Mother,
Any good parent can understand the desperation you must feel. Our primary instinct is to protect our children. That only gets magnified with grandchildren.
By now you probably know my mantra about releasing our grasp on adult children, and not being reactive to our own anxiety and helplessness. All true – until it happens in your family.
Although you cannot control your daughter’s behavior or even her thinking, you also cannot be passive. That last phone call sounded desperate and dangerous. So I would suggest doing two things simultaneously.
I know she is seeing a therapist every other week, but that person should be notified right away about your daughter’s desperation. In some states that threat might be enough for outside agencies to get her into treatment.
Her husband also must know how desperate the situation is and some things he can do. He can contact their local county office of mental health or national groups like National Alliance on Mental Illness (NAMI) and the National Mental Health Association (MHA).
It would also help if friends and family could help with child care as four babies would tax anyone’s emotional resources.
You can do more. And here I don’t speak just as a family therapist, but as a father.
When my daughter experienced depression for the first time, she was an independent, young adult. Just like your daughter, her symptoms started in childhood when she would isolate herself. Like yours, the depression worsened as she grew, and began to engage in troubling behaviors. And like your daughter, whenever we spoke about her behavior, she became defensive.
She lived within driving distance so I asked her if I could come up and just hang out for a day. If this is possible, I urge you to consider it.
As I was driving, I thought back to when I specialized in substance abuse. I recalled how families thought the problem was drugs or alcohol, and the abuser thought the problem was the family! And then I realized that I had been thinking the problem was my daughter’s depression and her behavior while she was thinking that the problem was everyone else.
We spent the whole day together exploring her new neighborhood, visiting her worksite and hanging out with her animals. We didn’t talk about her depression or her risky behaviors. We just talked about her, and OK, about me too.
For the first time since the crisis began, I felt close to my child and I am sure she felt the same with me. It was then that I asked her about how she was feeling about her life and herself. And then I listened for a long time.
When she was done, I told her that her suffering broke my heart and that the reason she suffered was because of her genetic-based illness called depression. I almost cried when she looked at me wide-eyed and said, “I thought everyone felt this way.”
Although medication and psychotherapy combined are the treatment of choice for depression, there is also plenty of evidence that family therapy helps. If you or your spouse have had depression, an open discussion about your experiences, impulses and coping strategies would help diminish some of the shame your daughter feels. And very often starting family therapy helps the person with the symptoms feel less like “the sick one.”
Despite your terror, what she really needs from you is intimacy, safety, trust and love.