How do I help my girlfriend?

[concerned]

Hello all,

First-time poster here. I do not suffer from depression but my girlfriend does. We have been dating for about 6 months now and I care about her a lot, but I have come to the realization that I am not helping with her depression and I am worried that I will become a crutch she can use to avoid seriously addressing the problem.

My girlfriend frequently gets into a depressed state, and has a severe lack of self-esteem despite the fact that she is very charming and intelligent. She can get very depressed seemingly about nothing; even a minor problem can randomly cause her to get into a very upset state. We have recently graduated from college and the difficult job search has compounded her self-esteem problem. A few months ago she became extremely upset and was screaming/breaking stuff/etc; I was worried she would hurt herself so I called an ambulance and had her taken to the hospital. The doctor diagnosed her with depression and prescribed Prozac. I later learned that she has seen doctors/therapists before but has never made a serious commitment to keep up treatment or regularly take the prescribed medication.

It is becoming an increasing strain on me to take care of her. She is from China so she has difficulty making friends here due to language/culture barriers and has parents with impossibly high expectations. In other words, her support network at the moment is almost exclusively me. As a consequence, I often become the target for her frustration and we get into fights quite often. I don't mind being there for her but I am worried because 1. I don't think her mental condition is improving and 2. she distrusts doctors/medication and is not making an effort to acknowledge or address her depression. She does not see a therapist and does not take the Prozac unless I nag her about it. She has become very dependent on me, and the need for me to constantly pay attention to her in order to help with her condition has taken a toll on my academic life and my ability to maintain relationships with friends/family. I care about her a lot and I don't want to abandon her in this time of need, but I am starting a new career of my own and I don't want my life to be dragged down by being the sole caretaker of someone who won't seek to deal with her own problem.

So I suppose my question is, how do I motivate her to confront her depression? Everything I have read suggests that a combination of loved ones, medication, and regular therapy is essential, but she has no interest in these latter two and vehemently resists when I bring them up. I have tried to emphasize that she has a medical problem and that seeing a doctor for it is no more shameful than seeing one for a physical injury, but to no avail. For those of you who suffer from depression or have loved ones who do, how can such a person be convinced to seek help for themselves? I know that no matter what I do she will only get better by wanting to address the problem, but she seems to be in denial that it exists. I am feeling emotionally exhausted by this and I would appreciate any advice you can offer.

Thanks

[DrSusanHickman]

Dear Concerned,

I am so sorry that you are going through this. It is clear that you care very much for this person and have been making strong attempts to get her to seek the treatment that she needs. As I am sure you are figuring out, there is no easy answer to your dilemma, but gaining some perspective should at least help to make your choices and a good plan of action more clear. First, no matter how much love and effort you pour into another person, seeking treatment and moving toward healing does ultimately become their responsibility. In fact, the more you do for her, in some ways, the more you are enabling her to stay in the same behavioral and emotional trap. No matter how much you want to, you cannot MAKE her get better. She can only choose this for herself. Second, I suspect what you will find yourself needing to do (probably sooner rather than later) is to put good boundaries in place. For example, in order to continue in the relationship, she has to seek help. And you absolutely have to have time to yourself, time with your own friends and time with your family. You cannot let another person's disorder and seemingly unwillingness to seek help hold you hostage. Only you know what boundaries you can put in place and you can start with small ones, such as walking away when she becomes too aggressive in targeting you (or leaving the situation). But to do any of this, you will have to fortify yourself with the knowledge that her choices of seeking treatment or not, making friends or not, fighting with you or not...all have consequences and one very big one may be the ultimate loss of her relationship with you. Just know that once you place a boundary out there (if you do this, then I will...), you absolutely HAVE to stick to it, so make sure the consequence is something you are willing to follow through on. Hope this helps.

[concerned]

Thanks for the kind words and the advice. I think you are right that I need to set up certain boundaries. While she does have more difficulty controlling her emotions than I do because of her depression, I think I need to keep in mind that at the end of the day she does have control over what she does and I can't keep saying it's not her fault if she takes out her problems on me. I have let her know about certain rules I'd like to have from now on: she needs to take her medication and seek therapy, she can't get upset with me when I spend time with other friends/family, etc. Hopefully having some structure will improve our relationship (and perhaps her own mental state), but if not I need to keep in mind that she is an adult woman and not a child that I am responsible for taking care of 100% of the time.