Depression - How do you tell someone that you think they need help?

Purples, yellows, greens and peaches (bet you can't guess that one).

Do you have a primary physician? I admit that I don't know the ins-and-outs of the Canadian health care system, but if you have a regular doctor he/she might be a good place to get a referral.

Quintin_Stone wrote:

Do you have a primary physician? I admit that I don't know the ins-and-outs of the Canadian health care system, but if you have a regular doctor he/she might be a good place to get a referral.

I do have a family doctor yes. He once told me he could refer me to someone but after asking me a bunch of questions of how I was feeling, said he didn't feel it was necessary and that I should think about it first. Since he's not the psychiatrist, I don't see how he was qualified to make that decision personally. I can always ask him again but I really didn't like the approach he took with it. He's also the one who heavily pushed the weight gain aspects of anti-depressants on me which I wonder if he wasn't doing to try and scare me off somehow. I think I'll try to talk to him again next week.

I don't want to derail this insightful discussion of another's situation with my own but this seems a good place to solicit this advice. Can anyone here offer a good method for finding a psychiatrist? I've been having some mental and emotional struggles for several years and while I've largely thought them to just be the result of some turbulent circumstances I've had in that period, I am curious if I do suffer from some form of clinical depression. This has impacted other aspects of my life and probably caused some negative things to happen that didn't need to. Many of the moods I've had and recent symptoms I've observed could be classified as depression and I'd like to talk to a professional to see what's really going on. The problem is that I don't want to just pick up the phone book and point to a shrink. None of my friends have seen one recently and while a family member has, it is a person who only deals with individuals over 50. I'm really not sure how to best locate someone. Any ways to approach this?

It's a start. At least you don't have to worry about cross-matching his referrals to a list of doctors approved by your plan.

It takes work to find a good psychologist or psychiatrist. I've seen about 8 in my life. Only two of them I saw more than 4 times. One woman wanted me to get well by mentally visualizing serene places. I didn't dump her until I realized she wasn't helping AND she started eating lunch while working with me. Ridiculous.

One guy wanted me to quit all medications I'd started with a previous doctor in favor of intense exposure therapy. Like, if something makes you anxious then let's expose you to a lot of it. Dumped him.

I think in the end you have to be willing to learn about mental illness. Ask questions, hang around the WebMD boards or other communities. Visit a local group if you have one. That way you can easily tell the good docs from the bad ones.

For me, the doctor that wanted me off the pills recommended a different psych just for the purpose of getting me off the pills. He knew her. She evaluated me and said "that won't work, you need medicine while going through talk therapy at least." I stayed with het and she was my psych for 6 years. I made huge strides with her.

So, sometimes it's random luck. Sometimes it's having an excellent primary care doc that can make excellent referrals. But I would start with educating yourself so that as you look for the right person you don't stick with a bad doc.

Parallax Abstraction wrote:

I don't want to derail this insightful discussion of another's situation with my own but this seems a good place to solicit this advice. Can anyone here offer a good method for finding a psychiatrist?

Trial and error. Be sure to call first and ask questions. Make sure they specialize in what you're looking for (child psych, couples therapy, etc). If it doesn't work out with the first doc, go see another. When I moved to San Diego, I wanted to see someone on a regular basis to help me get over my past and cope with military life. I was given a list and just picked one based on the location. It's one of the best decisions I've ever made.

From my experience, psychologists and psychiatrists operate very differently. I'd recommend finding a psychologist first. A good psychologist will recommend a psychiatrist if they feel medication may be necessary.

My best Uni friend's brother committed suicide due to undiagnosed depression. The linked article has a lot of (UK) help groups. There will be some kind of local version of these support groups, and even if there isn't, those groups are hopefully not so parochial that they wouldn't give you advice. Someone else will have been in a similar position, and they'll have practical advice about what you could try to do.

Parallax Abstraction wrote:

I don't want to derail this insightful discussion of another's situation with my own but this seems a good place to solicit this advice. Can anyone here offer a good method for finding a psychiatrist? I've been having some mental and emotional struggles for several years and while I've largely thought them to just be the result of some turbulent circumstances I've had in that period, I am curious if I do suffer from some form of clinical depression. This has impacted other aspects of my life and probably caused some negative things to happen that didn't need to. Many of the moods I've had and recent symptoms I've observed could be classified as depression and I'd like to talk to a professional to see what's really going on. The problem is that I don't want to just pick up the phone book and point to a shrink. None of my friends have seen one recently and while a family member has, it is a person who only deals with individuals over 50. I'm really not sure how to best locate someone. Any ways to approach this?

You live in Ottawa, so you might simply try calling the Royal Ottawa, and asking how to go about speaking to someone to find out *if* you need to talk to someone more.

If you are not comfortable with that, then go see your GP and tell him, in no uncertain terms, that you want to have a referral to see a psychiatrist.

It's intimidating and scary to walk into a stranger's office and start unloading your guts onto the floor, but it could also be the best thing you've ever done. And I have to second, if you don't click with your care provider, keep looking. Any therapist worthy of the name will understand if you tell them that you don't think it's working. They should be willing to refer you to someone else who has different techniques, or is older, or younger, or whatever you need to feel comfortable.

Everything that I could have said has been mentioned already, so I will only add my personal advice: I went through two years of crippling depression when I started college. I told no one, hiding it as well as I possibly could. No one knew about it definitely, but I'm sure a couple of my close friends suspected.

All I wanted during those times was for someone to reach out and help me, but I didn't want to seem weak and advice for support. Help this person.

Parallax Abstraction wrote:

I don't want to derail this insightful discussion of another's situation with my own but this seems a good place to solicit this advice. Can anyone here offer a good method for finding a psychiatrist?

Ask your primary doctor to come up with a few suggestions. The psychiatrist is going to deal mostly with medication management and how you are physically doing. You'll need to trust this person, but this relationship can be pretty professional.

Finding a psychologist is more a matter of matching your needs to their strengths. If you want to work on something specific, look for one is also interested in that area. You may need to talk with several before you find one who you can feel comfortable. Depending on how personal the reasons you have for seeking out a psychologist, you'll want to find someone with whom you feel comfortable. The more personal your motives, the more I would encourage you to talk to multiple psychologists before settling on one for any serious work.

One thing you may consider doing is finding one you can communicate with on an intellectual level in order to become comfortable with just meeting with a psychologist and being able to ask all the "stupid" questions about what happens in a session. Once you're comfortable with the idea, you may start identifying things you want to work toward. When I decided that I wanted to work on some very old anxiety issues, I knew that I wouldn't be comfortable being that emotionally open with the psychologist who I checked in with to make sure I wasn't on a slow slide to depression. He was however, the perfect person to give me a short list of local people that he thought would be able to work well with me. He wished me well, then said I was always welcome to come back and talk with him.

Good Luck and always remember that you are paying them to help you, so you can always say goodbye. While I don't recommend treating them as disposable, you are not obligated to keep seeing a specific therapist or remember their birthday.

Thanks again everyone for all the advice and support. There's so much good advice here.

DSGamer wrote:

- On that note, you can start off by being that person for her. You say she isn't speaking to you, but what are you saying to her? My wife absolutely had the best approach with me. She talked to me in a way that reassured me she wasn't going anywhere. That she wasn't panicking. She would just ask me how I was doing, how I was feeling. "Are you okay with this?" if it was something I had anxiety about. She was very gentle and loving and amazing.

If possible, I think you need to try to become her biggest advocate. Not to "fix" her, but just to make RIGHT NOW better. If you can help make RIGHT NOW better, then all those right nows will eventually stack up and she'll see things more clearly and start to feel better. The worst thing you can do is to push her into therapy or medical treatment. You guys need to hunker down together as a team and take care of each other. It means you may have to live in her dark mood for a while. This is the price for loving someone who has depression, unfortunately. But if you do this, I promise you that eventually she'll open up. Eventually she'll start talking to her friends and family.

Things have settles at the moment, so this is the route I'm taking for now. If there is another blow up that gets out of my control, then I will suggest that WE as a couple get some help.

I'm willing to admit the possibility that there may be issues from my side, so someone with objective advice could help both of us.

And Parallax, this is the perfect place to ask for advice.

Not much to add other than to echo that finding that right shrink/therapist is hard work of the kind a depressed person really doesn't want to face, but it's worth persevering. I eventually found out it was cheaper to find a therapist on my own than to go via my health plan who made it as infuriating, obstructive and expensive as possible. I treated my first session with each therapist as a interview - I was looking for someone who wasn't too chummy, as I felt I was going there to do renovation work on my head and didn't want to just chat. I also, crucially, needed someone I felt was smarter than me and knew it.

Took 2 psychiatrists and 4 therapists over 2 years, but I found the person who was right for me in the end.

Parallax, GPs are trained in a bit of everything. My own has a poster on his wall with the differences and similarities between anxiety and depression. So you may want to ask your GP *why* he doesn't think you need to talk to a psychiatrist. He may recommend a psychologist instead, or he may have some other reason. But he can certainly do a preliminary psych screen, and it sounds like he did.

Also, doctors have lots of professional contacts and friends, so they can usually recommend someone *they* trust with their patients. Which is why his advice will be good for you - if you are comfortable with him, you'll be comfortable with the people he respects, most likely.

So talk frankly with your GP and see what he thinks about your current situation. You might be surprised.

(Also, let me note here - if you *wonder* whether you have depression, check this out. But frankly, if you have it you'll have gotten a lot of feedback from friends and family over the years. "Oh, you've got that black cloud over you again, are you all right?" That kind of stuff. And Pink Floyd's The Wall will describe feelings you've lived through. Anyway, in my opinion, the more reason you have to question it, the less likely you are to have it. It's not something you question, it's something you push aside until it overwhelms you.)

Parallax Abstraction wrote:

I don't want to derail this insightful discussion of another's situation with my own but this seems a good place to solicit this advice. Can anyone here offer a good method for finding a psychiatrist? I've been having some mental and emotional struggles for several years and while I've largely thought them to just be the result of some turbulent circumstances I've had in that period, I am curious if I do suffer from some form of clinical depression. This has impacted other aspects of my life and probably caused some negative things to happen that didn't need to. Many of the moods I've had and recent symptoms I've observed could be classified as depression and I'd like to talk to a professional to see what's really going on. The problem is that I don't want to just pick up the phone book and point to a shrink. None of my friends have seen one recently and while a family member has, it is a person who only deals with individuals over 50. I'm really not sure how to best locate someone. Any ways to approach this?

If you are religious, you can also go to them to see who they recommend. Our church's deacons keep a list of therapists and psychologists and the like for all sorts of needs.

The great Doc I found was suggseted to me by my girlfriend's OB/GYN @ our prenatal visits. He was the fourth Doc I had seen. I hated the other three. I lost a lot of faith in doctors during that time. Be skeptical PA- this is your LIFE.

Ego Man wrote:

Along with the advice above, I would like to add that you should encourage her to do something physical like take a walk. The endorphins can help to make her feel a little less.... bleah. Also, try to encourage her to reconnect to something, i always felt that was too afraid or apathetic to do anything, which led me to keep my self "safe" in my own apartment. Does she like sports or some other activity? Something that she can do while feeling safe? If there is something she always wanted to do but didn't feel like she had the time, try that....

Also, keep away from the "Im so sad I wanna blow my own head off music"... nothing like mood music to reinforce a bad mood. I did this waaaaay too much

Great advice here, especially the 'take a walk' part. I've found that spending a couple hours in the park does wonders for my sense of perspective.