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January 23, 2010 6:57 PM   Subscribe

Please help me treat a depressed boyfriend the best that I can.

I really, really need some help with this one. I have been seeing a young gentleman for about 3 months now. So far, he is about the most wonderful boyfriend anyone could ask for....almost too good. How much should I take a diagnosis of depression into account?

My situation: I am a 31-year-old woman who has been frankly working my ass off for the past five years just to live and pay rent and whatnot. By "working my ass off," I mean 3 jobs at once. And still not much left over for extras, meaning if I want a sweater, it goes on the Mastercard. Stay with me....it gets relevant.
So I meet this guy. He's pretty wonderful. In fact, he is almost too good to be true. He's kind, considerate, caring, can be witty at times, etc etc. The problem is, MeFites, he's been diagnosed with, apparently, severe depression to the point where he's on Seroquel. I know that's for bipolar, but that's not how he's describing his issues to me. I know in advance that I am going to sound like an unsympathetic, cold-hearted bitch, but please stay with me! I'm not really one! I just want to know what is reasonable to expect here and if there's anything that we mefites can do to make a life better....

1) I've read so many threads on AskMeFi where the asker has a SO who turns out to have significant depression/emotional problems, and then the SO turns abusive. My question here would be, how much does one hold an SO responsible for their own abusive behavior hen they've been diagnosed with depression? Is that a free pass?

2) I've always been led to think that one of the key causes of depression is lack of a purpose in life, or put another way, lack of goals that one should work toward. So it seems counterintuitive to me that the "therapy" that this guy goes to would tell him that he "can't" work. At all. If I didn't work, I'd be depressed too. I think he's bored and would do a LOT better with something to work for.

I really see a great deal of potential in this guy. He is kind, considerate, and quite frankly the best boyfriend I've had, ever. And by "potential," I mean SMART! Could be a prodigy. I really, really want to help him, but I find that the help I give him doesn't coincide with what these group sessions tell him. They say that it's OK to be dependent on the government when you are a 36-year-old male, no physical problems, has a great many marketable skills. I say, get a part-time no-commitment job doing something that he loves to do (for instance, he knows how to fix wind instruments such as trumpets when someone drops it or spits in it too much. He also knows how to run cranes. And tie flies. And plays a mean guitar). They say, and he seems to agree, that if he even so much as tries to do anything job-related he will wig out and possibly never recover. Is this true? Really? YANHD, but really? Am I just missing something here?

Again, you think I'm cold and unsympathetic, but I'M NOT!! I have been dealing with depression my whole life, and I never ever chose to go the route of shutting off and not bothering anymore. All of my jobs allow me to help people in profound and lasting ways, and I admit I couldn't live without knowing I was doing something good for the future of the world. But that's just my point! If I didn't work, I'd be miserable too! And should I, in that case, allow some gov't worker to tell me that I COULDN'T work? Couldn't help people? I'm not jubilant all the time by any means, but I would NEVER allow some therapist to drug me and disallow me from my job.. Are they doing right by him? Is he doing right by allowing them to keep him from a meaningful life? Should I break up with him before something weird happens? Like me bringing up the fact that I work 70-hour weeks to provide him with his SSI? Which I will never, ever see when I'm old? Am I completely insane? Please help!

PLEASE don't think I'm judging anyone for having depression,. I have it too! I am, however, judging those who take someone's already fragile emotional state and tqist it for their own purposes.
posted by anonymous to Human Relations (32 answers total) 9 users marked this as a favorite
 
What is he doing with his time if he's not working? You can encourage him to work, but you might get farther encouraging him to do something else. Get to working through baby steps. If he really doesn't need to work, look at it as an opportunity to do something creative or volunteer his time. If for whatever reason working is too much for him right now, doing something constructive and ongoing that requires an investment of time and getting out of the house would be a way to work up to that.
posted by amethysts at 7:13 PM on January 23, 2010


You're not cold, but perhaps this fellow isn't the one for you. Let him go and find someone else for yourself, someone who doesn't come with the bag of emotional time bombs that this one is creating for you.

First, depression is not a free pass for anything, particularly not abusive behavior. I've had depression and I've lost a ton of friends because of my behavior while I was spiraling downward. Some of them, I needed to lose; some, I'm now reconnecting with, apologizing to and doing my best to be around when they contact me to go do stuff. But I wasn't ever abusive to any of them, thankfully. And if I had been, I would fully expect to never hear from them again. Don't give this guy a free pass just because he's taking Seroquel.

Second, depression might take a person out of work for a while, but part of the recovery process involves the person wanting to engage in life again. If he isn't to that point, then being with him might just make your life hell. Before I hit my stride in my recovery, my therapist told me to quit looking for a job; I did because looking and not finding was driving me insane. If this guy isn't even attempting to look... I can't imagine where he might be in his recovery, if he even is in recovery.

Remember that you are not his therapist, doctor, guardian angel. You do not have responsibility for this guy. Let him go and let him find his own path, without your help. Based on your own statements, doing anything else will only drive you to a point where you really are a cold bitch. (No offense meant).

Good luck!

(As a side note, and I'm not a medical doctor, but I haven't heard of Seroquel being prescribed for depression, no matter how severe the depression is.)
posted by LOLAttorney2009 at 7:13 PM on January 23, 2010 [2 favorites]


...how much does one hold an SO responsible for their own abusive behavior hen they've been diagnosed with depression?

Entirely. There is absolutely not excuse whatsoever for abusive behavior. And please keep in mind that you don't owe it to him to "fix" him.
posted by runningwithscissors at 7:24 PM on January 23, 2010 [2 favorites]


In my understanding, being told you can't work should apply for SSI isn't (or shouldn't be) so much like being told not to work because you need to stay off your injured foot or something. It's more "your issues are severe enough that you are quite possibly unable to hold down a job, so you should take advantage of SSI." Descriptive rather then prescriptive, as it were.

I wonder if something is getting lost in your interpretation or if groups/therapists are actually encouraging your boyfriend not to work. There are bad therapists outs there (and good ones.)
posted by needs more cowbell at 7:32 PM on January 23, 2010


Seconding LOLA: Remember that you are not his therapist, doctor, guardian angel. You do not have responsibility for this guy.

If you can be a part of his life-at-this-point, enjoy his company, do things together, fine. If not, part ways. But don't take him on as a project. Nothing good comes from that.

To reinforce: Remember that you are not his therapist, doctor, guardian angel. You do not have responsibility for this guy.
posted by exphysicist345 at 7:43 PM on January 23, 2010 [1 favorite]


As a side note, and I'm not a medical doctor, but I haven't heard of Seroquel being prescribed for depression, no matter how severe the depression is.

I was prescribed Seroquel for depression once (in combination with some SSRI's), although it did not help as much as other anti-psychotics have.
posted by XMLicious at 7:52 PM on January 23, 2010


I have been dealing with depression my whole life, and I never ever chose to go the route of shutting off and not bothering anymore.

Yea, and you never killed yourself either, so what's the deal with all those people who jump off a bridge? You sound like you think his depression/mind is the same as yours and he's just dealing with it differently (in your opinion, badly) but this is probably a mistaken assumption.
posted by jacalata at 7:58 PM on January 23, 2010 [4 favorites]


FWIW, Seroquel's not only for bipolar disorder; it's an antipsychotic also used as an add-on therapy for major depression (cite).

Honestly, you guys don't sound like you're compatible in any serious ways. You're not going to convert him to your theories on mental health. You're not, as far as I can tell from your post, a mental health professional,-- and if you are, you're not proceeding in an ethical manner, making snap judgments based on someone's medication and lifestyle choices because you're romantically interested in them and want them to see things your way.

Leave the diagnoses to the pros, don't try to guess his condition based on his meds (they use Seroquel for a lot of conditions, not just bipolar), and let this guy handle his treatment in the way he feels is best for him. You would have to commit to not interfering with his treatment, as much as its politics or its outcomes gall you. I suspect you are not cut out for that kind of investment in someone you barely know.

Anecdotally, I have known people who are caring, wonderful, smart folks with a vast array of interests, who raise children and write professionally-- and cannot hold down a standard office job, because it exacerbates existing depression to the point where they can't function. They certainly do not lack purpose, nor work to do.
posted by fairytale of los angeles at 8:03 PM on January 23, 2010 [6 favorites]


He is an adult. It's unfortunate he has his problems. But...

You cannot fix him/change him. He has to fix himself or change on his own. (Louder- YOU CANNOT CHANGE YOUR PARTNER. EVER. WYSIWYG)

He has to take charge of his life and make it what he wants it to be. No one else can do that for him.

As the others have said, yes, he is responsible for his abusive behavior. Step back from the situation, and pretend that a close friend asked you "how much does one hold an SO responsible for their own abusive behavior hen they've been diagnosed with depression? Is that a free pass?" Does it sound ludicrous when you step away from it?

If I were you, I would break up with him and find someone who can manage being an adult. Unless you want to play pack mule for the rest of your life, carrying his baggage around...
posted by bolognius maximus at 8:05 PM on January 23, 2010 [2 favorites]


Seriously, depression doesn't = abusive. Abusive is a whole different thing to depression. And shutting down is a really really common attribute of depression. I know it's one of mine. Someone telling me 'oh you just need to get a job and a purpose in life' is drastically unhelpful. Suicide attempt level unhelpful in one case. By assuming that he's got the energy and mental stability to go and work as well as deal with the depression, you're telling him his depression isn't that bad. It's bootstraps by another name.

Yes in my case a job and a routine was vital to recovering. It didn't mean I wasn't depressed when I was working, I just didn't have the sharp spikes I did when I was unemployed/studying, which meant I could concentrate on the slow slow slow process of getting better. That's not the case for a lot of people - the job slows that already slow process to a point they're going backwards. Particularly those of us who shut down when depressed - I worked in an environment where I could be silent for the better part of the day, most employers aren't too fond of that. You're not only assuming your boyfriend can work, you're assuming you know better than his health providers. That's really dangerous territory.
posted by geek anachronism at 8:16 PM on January 23, 2010 [6 favorites]


Most people with depression aren't abusive. You should not accept abuse, and depression isn't a free pass.

But depression isn't, for many people, just not having goals. Depression isn't about a simple choice. He's not in "therapy", he's in actual therapy. And maybe they are wrong, but it's not particularly easy to get disability for depression, so they are more likely to be right than someone who just met him and wants what worked for him to work for her.

He's not allowing a government worker to tell him he cannot work. They can't force him not to apply for jobs in any case. He's deciding, with the help of his medical professionals, what things will and won't help him.

You should absolutely break up with him, because you don't seem to accept his illness and the idea that the government should give a small stipend to people who are unable to work for reasons the government thinks valid. You will find someone with the same work ethic as you have, and I sincerely hope that your depression doesn't recur.
posted by jeather at 8:44 PM on January 23, 2010 [1 favorite]


But depression isn't, for many people, just not having goals. Depression isn't about a simple choice.

Seriously - this. The first thing you can do to help your SO is to try and understand a bit more about depression. For one, it's not at all true that depression comes from a lack of goals. EVEN IF there were some kind of actual correlation between these two things, it would most likely be the other way around, i.e. the depression is making working, goal setting, etc. impossible. Not to get all Hume on you or whatever, but depression doesn't mean anything but depression - and there are as many different types of depression as there are people. Abuse, lack of goals to work towards, and the like are most certainly not implicit in the condition itself.

Whether you want to stay with him or not I guess just depends on whether you're happy being with him - just remember that a person can be depressed, but depression is not what he is. You are not dating depression.

Not to be that guy, but I sometimes feel that AskMeFi is so quick to suggest break-up, I wonder what kind of utopian, issue-free love lives they must have. It sounds to me like you want to stay with him. It sounds like you like him. You might find it worth it to give the guy a chance.
posted by Lutoslawski at 9:04 PM on January 23, 2010 [9 favorites]


Maybe I'm just very cynical, but I assume your source of information that his doctor said he shouldn't work is him, and not the doctor directly? Because that seems like it would be a good lie to tell someone if he wanted that person to feel sorry for him and take care of him when he just didn't feel like working.

How much do you know about this person, his past, long-term friends and family? If not much, he could be a serial user/scam artist.
posted by Jacqueline at 9:10 PM on January 23, 2010


My theory on "maybe this won't work" in this case stems from the basic incompatibility of someone who doesn't want their tax dollars going to the social safety net dating someone who may well require the social safety net to get them sorted out, long-term or short-term. It seems like a recipe for resentment and contempt, which is no fun for anyone involved, unless the OP is ready to do some very painful discussion of her position with her SO and then let him make his own decisions.

One divorce, three real bad breakups, and a psych history. Better to do these things while the interpersonal investment is less, than to come back in three years looking for advice when the resentment's too great and property, kids, or marriage is involved.
posted by fairytale of los angeles at 9:31 PM on January 23, 2010 [2 favorites]


how much does one hold an SO responsible for their own abusive behavior hen they've been diagnosed with depression? Is that a free pass?

There is no such thing as a free pass for being abusive.

I've always been led to think that one of the key causes of depression is lack of a purpose in life, or put another way, lack of goals that one should work toward.

This is kind of a majorly flawed perception. For whatever reason I have roughly half a dozen people in my immediate circle who are so depressed as to require medication for it, and I myself suffer from it sometimes though I haven't yet needed medication, so trust me when I tell you: depressed people often have goals, TONS of goals. Depressed people without goals exist, I just don't have happen to know any. When you're depressed and you have goals, one of the things you get depressed about is how you're not making any progress toward those goals. Goals can be a major source of depression; if someone is holding themselves to an overly high standard, or else a standard that's important to society but not something they want, oh boy, are you ever depressed.

Later on you mention all the things this guy is good at, which obviously implies to me that he has goals and interests and various skills he develops to keep him from getting bored, so I don't think that's his problem. Your perception of the situation seems to be that "goals" means "making a career out of something" or making money of it. Please do not try to force that idea on him, because it's likely to make him more depressed. Even when I'm not at all depressed and having a good several months, when someone tries to pressure me into "doing something" with either singing or writing (my two particular talents), or else try to pressure me into some career path where I would be "making something" of myself, my mood tanks. People mean well but they don't realize this is condescending and just serves to make the person feel inferior and unaccepted, not to mention it's seemingly very difficult for work-oriented people to understand that other people do not want their job to be their life. It's fortunate for you that having so many jobs keeps you from being bored or getting depressed, but please realize that sort of thing would seriously make some people kill themselves, no hyperbole whatsoever.

So it seems counterintuitive to me that the "therapy" that this guy goes to would tell him that he "can't" work. At all. If I didn't work, I'd be depressed too.

Sometimes people get such severe depression they have to be hospitalized, or they cannot function whatsoever at work, or they've reached such a low point that they cannot -- for the sake of their own life -- afford to focus on anything else but trying out different ways to deal with their depression. Several of the things you say in your question make it sound like work is the be-all, end-all for you and there's nothing wrong with that, but for some people it really does come down to either taking a break from work, or killing themselves because everything is too much to handle. It is a full time job to deal with depression that bad, even if you don't recognize it as one.

You say that if you didn't work you'd be "depressed" too, but let me gently suggest that you really, really do not understand what severe depression is like. If you weren't working you would probably get stir crazy or somewhat morose, but those are not the same thing are being depressed in a clinical, needs-medication and cannot deal with anything else sense. You say that you've dealt with depression too, and the fact that you haven't needed to stop working or anything shows that there's a better approach, but your logic here is flawed: there other, more sympathetic, explanation is that since he hasn't gotten over it so easily, he's obviously much, much more depressed than you've ever been.

They say that it's OK to be dependent on the government when you are a 36-year-old male, no physical problems, has a great many marketable skills.

Please tell me you don't phrase things like this in front of him; having to hear it makes things SO much worse. I have seen my depressed friends date people like you over and over, who keep telling them things like, "Well I get depressed sometimes too but I just do XYZ and I never needed help for it! But seriously I'm sympathetic, really I am!" or "You shouldn't do ABC for your depression, that doesn't make sense to me, it's lazy/counterproductive, I don't care what your doctors say!" You will make him miserable. Miserable.

This is what depressed people need: for their loved ones to be supportive of the treatment they pursue, for their loved ones not to assume that what makes sense for them makes sense for everyone else, and for their loved ones not to hassle and cajole and make tons of well-meaning suggestions. You need to have humility about the limits of what you can know about how he feels. You need to have humility about your lack of knowledge about how to handle the clinically depressed. You need to recognize that the last thing anyone, especially a depressed person, wants is to be "fixed" by their partner. When he is in a depressed mood, the surest way to drive him further inward and away from you is to say the sorts of things you said in this post. Instead, hug him if he wants to be hugged, leave him alone if he wants to be left alone, reassure him that you have faith in him and care about him. Ask him how his treatments are going. If he says they're helping, say good, you're happy for him! If he says they're not working, ask what's not working, and ask if his doctor mentioned any other options. Let him express his ideas, opinions, hopes, and apprehensions about those other options. Do not start suggesting your own ideas, or if you think they other options his doctor suggested are dumb. Just say something like, "Well that's too bad, but the other options sound promising; maybe those will be helpful."

Most importantly, you need to respect his judgement and autonomy as a legitimate human being. He's an adult and he can make decisions. He does not need you judging his decisions or suggesting that other decisions would work better. He should not have to feel like you do not approve of his decisions. That kind of thing can make anyone depressed; one of the things you feel keenly when depressed is that nothing you do is good enough for the rest of the world. When you question what his doctors tell him to do, you are treating him like someone subordinate to you even though that's not your intention. Speaking from experience, it is amazing how far someone can come if you simply pull back from trying to fix them and instead express confidence in their ability to find what works for them. He doesn't need another mother, he needs to feel like other people believe in him; it's very hard to believe in yourself when the people you love act like you're a fuck-up with poor judgment, especially if you tack on the idea that other people think you're mooching off the government and squandering your talents, etc.

If you can't do that, you need to break up with him before you make his depression worse, because I've seen that happen way too many times, too. Being in a relationship where their partner doesn't understand or really respect their depression as a serious issue that can't be easily dispensed with is way worse for a person's mental well-being than being single.
posted by Nattie at 10:18 PM on January 23, 2010 [31 favorites]


Are they doing right by him?
This isn't the issue. Your boyfriend is an adult and should be able to decide for himself if he wants to go the route of meds and disability or not.

Is he doing right by allowing them to keep him from a meaningful life?
This is your real question. And not only do you think your boyfriend is in the wrong, but you're already envisioning how he's going to cheat you out of your hard-earned money. Red flag!

I hear two things mixed up in this question: genuine concern and resentment. You've only been seeing him for a few months; you don't say how long he's been dealing with depression in this way. If you're really into him, why not give it some more time, without trying to run his life? But if this continues to be such an issue for you, it would seem better to leave the man alone.

As for abusive behavior: no, depression does not make it ok.
posted by Paris Elk at 10:19 PM on January 23, 2010 [5 favorites]


They say that it's OK to be dependent on the government when you are a 36-year-old male, no physical problems, has a great many marketable skills. I say, get a part-time no-commitment job doing something that he loves to do

I assume you're in the US. Did it ever occur to you that he may actually be "dependent" on the health insurance he gets from being on benefits--which would evaporate if he earns too much money? What's REALLY depressing is the long odds of him getting adequate treatment (or any) with a preexisting condition plus the lack of mental health care parity in private insurance plans....if he were to return to work. Try bootstrapping that one.
posted by availablelight at 12:53 AM on January 24, 2010 [4 favorites]


Couple of thoughts:

Maybe the reason he seems OK and stable enough that he should be able to work is because he is not working. The stress of trying to work could be what puts him over the edge.

Also... depression for many people is not a stable illness with a smooth course. Sometimes you are better, sometimes you are worse, even with appropriate treatment. Just because he seems well enough to work right now does not mean he'll still be that way in a week, or a month, or a year from now. So say he goes and gets himself a job. He could jeopardize his eligibility for SSI, and then a few months down the road he has a relapse and can't work any more (or loses his job due to absenteeism or lack of performance caused by his illness.) From what I understand, SSI is a bitch to get approved. Losing eligibility is not something to play around with unless and until he is certain he can support himself long-term without it.

Also regarding the difficulty of getting SSI approved: this could be part of the reason his doctor is so adamant in stating that he cannot work at all. If SSI can make a case that he could work even some stinking little minimum wage job somewhere, they'd be delighted to cut him off whether his doctor considers him fully recovered or not.

If you want to help him feel better you could encourage him to pursue his hobbies and interests for his own enjoyment when he feels up to it, without making him feel guilty for being "on the dole." But if you really can't get past the unfairness that some lucky people get to sit at home nursing a blue mood while you are out busting your ass to support them with your tax dollars, then I don't see this working out long term.
posted by Serene Empress Dork at 2:25 AM on January 24, 2010 [4 favorites]


I'm a 38 y/o male, and I am starting to wonder if I am suffering from depression. I have an appointment with my GP booked in for very soon, and I'll see where it goes from there.

But I will say, I think working, holding down a career, won't necessarily help. I have a very good, profitable career, which I generally enjoy, and have worked hard to get to the point I am at. I have professional goals, which I achieve, and celebrate... but, it is not enough to quell the undefinable sadness.

But there is one thing I am quite sure of. Things would be a lot better if I had a loving, supportive partner who didn't question me, and just supported me and showed me that they love me as I try to work through whatever it is I have to work through, and was there to listen to me when I needed someone to talk to.

If you're willing to do that, do it. If not you may be causing more harm than good, in which case you should leave the guy be.
posted by Diag at 4:03 AM on January 24, 2010 [5 favorites]


You're only three months in and it doesn't sound like you're at a spot in your own life where you can afford to have someone leaning on you, at least not to the extent that he's looking for someone to lean on. Consider cutting your losses.
posted by thecolor12 at 8:30 AM on January 24, 2010


I don't think you're cold or unsympathetic. I just think that, among other things, you're VERY misinformed about depression:

1. Chronic depression is generally considered to be a brain chemistry or neural pathway problem. It's got nothing to do with having goals (though the ability to form goals and work towards them can be seriously compromised in a depressed person.)

2. Seroquel is, as others have already pointed out, also prescribed for serious unipolar depression.

3. Depression does not lead to abusive behavior, though it can certainly be very difficult to live with a depressed person.

It's really difficult to know whether your understanding of what your boyfriend's group therapy people are telling him is REALLY what they're telling him. We're getting it through two filters here: First, the filter of what your boyfriend tells you -- and that's going to be skewed by his own illness. Second, there's the filter of your own clear bias against the idea of depression being a genuinely disabling condition. What's the actual truth of the situation? There's no way for any of us reading this to know.

it's wonderful that you've managed so well despite your own depression problems. You're making a huge mistake, though, to extrapolate that because YOU have done so well and found such fulfillment in working, that your boyfriend should also do as well.

You've only known him for 3 months, yes? Give it three YEARS and you might...MIGHT...be in a better position to judge what he's capable of. I don't mean to be harsh. I really believe, though, that you're unqualified to attempt to "fix" this guy.
posted by rhartong at 8:36 AM on January 24, 2010 [2 favorites]


1) No. In my mind, there is no excuse or anything for abusive behavior. (Been there, done that, still have a scar on my hand from it.)

2) I share your hesitancy in terms of understanding what you hear from him that his therapy is telling him. That may be what they're actually saying (although I kinda doubt it) or it may be him hearing what he wants to hear.

I will say that my own experience with a certain fuckface is coloring my answer here. I got involved with a dude who had a lot of the similar qualities that you're mentioning here, just a bit younger. Personally, I couldn't deal with it. Everything seemed fine and dandy at some points and then we'd have these massive blowouts over simple things. Therefore, I know that I'm not willing to put up with that sort of stuff (aside from other issues, but that's a big part of me not dating.)

I'd say that it doesn't seem like you two are a good fit for a romantic relationship. Friendships never hurt and it might actually help him, depending on his personal flavor for depression. But I'd say that it's important for you to know your own limits as far as what you will and will not do. Will you loan him money? How much? Will you drive him places? What about job interviews or whatever?

I also don't see pragmatism as being cold, but that's just me. See caveat about previous relationship above.
posted by sperose at 8:48 AM on January 24, 2010


Look, I'd say this to anyone posting a question like this, regardless of whether the sticking point in the relationship was depression or something else. If you are at the beginning of a relationship and thinking "this guy would be fantastic IF ONLY..." this is not a relationship that's ever going to work for you. The things that bug you now will become more annoying over time, you will always be treating him like someone he isn't, and you will eventually give up in frustration. He is the way he is, and if you have fundamental problems with it, he is not the guy for you.
posted by MsMolly at 9:36 AM on January 24, 2010


Well, if the doctors are saying he can't work, then it's reasonable to think they're right. They could be wrong, but even if he just doesn't like work is it really fair to make him work just because you feel it's more appropriate? I can understand if you want to build a life with this guy that you'd rather have two incomes, but it just doesn't seem like it's in the cards.
posted by delmoi at 10:09 AM on January 24, 2010


Hey there, I AM a mental health professional (clinical psychology Ph.D. candidate) and I find it unlikely that not working ever is the correct solution to severe depression.

Yes, seroquel is prescribed to individuals without psychotic disorders, but also, it's often MISPRESCRIBED to people without psychotic disorders. I recently came upon a guy with severe anxiety whose brother is bipolar, so his irresponsible psychiatrist threw seroquel AND depakote at him. The guy was a zombie, and without justification. Psychiatrists should not be regarded as incapable of very poor reasoning.

Who is 'they,' incidentally? Has he been seeing only one psychiatrist who told him he can't possibly work? It's not uncommon for people to be advised to work part time, or to leave particularly stressful work environments, but as a general rule, it is VERY GOOD for people to be working. Yes, Freud is a bit passe, these days, but his notion that to be healthy a person need be able to love and work? That's ultimately remained with us as truth.

Look, three months in, don't stress him out with this yet, but if you're looking for an opinion on whether this is standard? Not from the information I have.

And stop jumping down her throat that she doesn't understand depression and needs to leave it to the professionals - there's no one solution to these things, and mental health professionals are often enough, unfortunately, hacks. Especially if there is reason to believe he would WANT to work, would derive satisfying activation from it, and is actively being discouraged by some guy, that would be tragic.
posted by namesarehard at 10:46 AM on January 24, 2010 [2 favorites]


Which, of course, does not preclude that three months in, you don't have the full story/are not giving us the full story.
posted by namesarehard at 10:50 AM on January 24, 2010


Depression is a physical illness. The sufferer does have some ability to self-treat with attitude, exercise, behaviors. This is true of many illnesses, i.e., diabetes, some forms of heart disease, etc. So blame and shame need not necessarily accrue.

Being on disability means that he's been judged too ill to work. It's icky that some people abuse this, but it's not easy to get, so he's probably significantly ill.

One of the signs of depression is irritability, but that's not the same as abuse.

Loving someone with a disability, whether it's depression, bi-polar disease, Multiple Sclerosis, hearing impairment, etc., makes like more complicated and probably more difficult. Don't borrow trouble by anticipating that he will behave in certain ways. Accept him as he is. You can't treat him. You can help him in whatever treatment program he's in. Many depressed people benefit from exercise and sunshine, regular hours, and creative expression, so planning outdoor and/or active fun, not staying up crazy late, and doing creative stuff, however you perceive that, may help. There have been many threads about staying emotionally healthy, so encouraging those behaviors is some help. But you are not his therapist or health care provider, and should not try to be.

He sounds worth staying with, but only you can make that decision.
posted by theora55 at 12:08 PM on January 24, 2010


namesarehard said everything I wanted to say but I'll add a little more.

1. Doctors fail, they especially fail when being fed bullshit by pharmaceutical companies
2. Seroquel, necessary or not, tends to make people unable to do much of anything--imagine waking up after sleeping for 14 hours and feeling like you've been run over by a truck
3. It is difficult to get social security disability and they often do punish you for working
4. Working at a decent job is generally good for depressed people, provides socialization, a place to be, less time to ruminate, etc.
5. Numbers 1 through 4 are not things you can change
6. You are awesome. That doesn't mean he's not awesome because he's different from you
7. If you're worried about him being abusive, be vigilant for small abusive behaviors and get out the second you see them
8. If you're worried about money, don't give him any
9. Life is short, please spend it kissing, laughing, and loving with awesome people
posted by kathrineg at 1:06 PM on January 24, 2010 [1 favorite]


P.s. To accept something is not the same as judging it good.
posted by kathrineg at 1:16 PM on January 24, 2010 [1 favorite]


I find it unlikely that not working ever is the correct solution to severe depression. ~ namesarehard

No, but certainly not working now or in the foreseeable future* while you deal with the depression is more than understandable, and probably necessary. Depending on the severity of the depression, of course.

*(which could translate to "ever" when you're dealing with black and white thinking, a type of cognitive distortion that in my experience was extremely common during my depression and very hard to break out of)

I'm on Abilify for my depression, which is also an atypical anti-psychotic and could be prescribed for bipolar disorder. It's for my depression; my psychiatrist has confirmed multiple times that I am not bipolar. (I'm also taking Adderall, which is a stimulant and could easily trigger a manic state, IF I were bipolar, so I'm very careful about my diagnosis.) In addition to my experience, it's not uncommon to be taking an anti-psychotic along with anti-depressants. ("Some 10% of visits involving antidepressants in the earlier period also included an antipsychotic prescription, which increased to 16% in 2005 to 2006.")

In addition, OP, when you say I never ever chose to go the route of shutting off and not bothering anymore, I'd like to gently tell you that sometimes that choice is not available. When the depression gets bad enough, the reality of the choice gets taken over by the new "reality" of feeling like shit, wanting to kill yourself, and frantically searching for a solution to the pain.

IANAD, IANA Mental Health Professional; I am just someone who's had to deal with severe depression for over a decade.
posted by saveyoursanity at 3:18 PM on January 24, 2010 [2 favorites]


This is me. I'm 33, currently on CPP disability and burning through years of careful investments and savings. Despite family help, I'm going to lose my home. I won't be eligible for ODSP income support and their drug plan until I'm essentially broke.

Guess what? This isn't fun. This isn't a choice I ever would have made for myself, and I'm pretty well gutted at any suggestion that I'm just being dependent on the government. It took months while I deteriorated further before even CPP got approved, trying new medications each with new side effects, waking up in the morning with gutwrenching, selfhating anger at my own weakness.

I'm pretty damn wonderful, kind, considerate, and caring. I'm smart! I have no physical problems, a great many marketable skills -- and right now I absolutely require medication, therapy, and cannot work. I've made it out of my house twice this month and I'm determined to make it out at least once more.

If your boyfriend has clinical depression, is taking medication and undergoing therapy, he is absolutely working on his problems. Believe me, neither he nor his doctors want him to be "drugged up", "disallowed from his job", or "kept from a meaningful life".

Despite your absolutely erroneous presumption that a person with mental illness will become abusive, I kind of want to kick you through the internet.
posted by soft and hardcore taters at 3:36 PM on January 24, 2010 [7 favorites]


Something just occurred to me, I don't know why I didn't think of it before: in my case none of the people who know me, even a couple of therapists and a psychiatrist, realized that I was severely depressed. Even the few people I explicitly told I was depressed evidently thought I just had some mild dysthemia.

My symptoms tend to manifest more when I'm alone and my affect is such that some people actually thought that I'm a happy and cheerful person. So my thought is that possibly his entire mood and everything he's dealing with is not apparent to you from the way he acts.
posted by XMLicious at 7:32 PM on January 25, 2010


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