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How to Help a Loved One: Depression, Alcoholism, Addiction ...

by Scott Haltzman, M.D.

help_couple_upset.jpg One of my favorite cartoons is something I found almost 20 years ago in a New Yorker magazine. In the first panel, a boy drowning in a lake yells, “Lassie! Get help!!” In the second panel, Lassie is lying on a psychiatrist’s couch, pouring out the contents of her heart.

When you suspect a friend or family member is having a hard time, you may also feel like shouting, “Get help!” But will that person be as obedient as Lassie? If he had broken a leg, he'd probably welcome your help. But for an emotional problem? There’s a good chance your suggestion will at best be brushed aside and at worst make your friend never want to talk to you again.

In fact, many people are so anxious about recommending emotional help for their friends and family members that they sometimes put it off until it’s too late. But your involvement can save a life! Here are some common problems and ways to deal with them.


GENERAL TIPS FOR WHAT TO SAY
When speaking to someone about depression, alcoholism, addiction or similar problems

Because your loved one may not see she has a problem, you might have to point it out. Gulp! Who wants to be the one to tell her best friend she may be mentally unstable? Like it or not, the responsibility to at least speak up may lie on your shoulders.

There are no hard and fast rules for helping a loved one. In the following sections, I'll talk about how to address specific kinds of mental health issues, but here are some general dos and don’ts.

DO point out your observations. (“I’ve noticed you’ve been acting differently lately.”)
DON’T
accuse or point fingers. (“You’re not the person I married anymore!”)

DO turn to other people in your life for support when you prepare to talk to your loved one.
DON’T
gather people for a Jerry Springer style intervention. It may further alienate your friend or family member. (See the box to the right for more on this.)

DO see the discussion as an opportunity to work together to help your friend.
DON’T
see the interaction as a confrontation.

DO let your friend know how important he is to you and how much his well-being means to you.
DON’T
give ultimatums, like, “If you don’t go for help, I’m out of here!” (If you do fear for your well-being because of your loved one’s behavior, you may have to leave. But simply threatening this action rarely makes people change.)


HOW TO HELP SOMEONE WITH DEPRESSION

Often, depression is associated with social withdrawal and negative thinking. When people are depressed, they can feel helpless and sometimes believe they’re to blame for their suffering.

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Avoid trying hard to brighten the mood by joking around. Also, tough love, such as, “Pull yourself up by the bootstraps,” doesn’t work so well.

Your best bet is to remind your friend you have faith in her and believe there is a brighter future. Because depression robs people of momentum, it may be up to you to schedule an appointment with a therapist. And that’s perfectly all right.


HOW TO HELP SOMEONE WITH PSYCHOSIS
(Sometimes associated with schizophrenia, bipolar disorder and depression)

Psychosis is a condition in which someone loses touch with reality. It’s generally associated with schizophrenia but often seen in bipolar disorder or depression. Sometimes a person’s beliefs can become so distorted that he believes he’s being poisoned or spied on. In these cases, it’s often fruitless to try to talk the person into seeing reality your way.

If your loved one is already on medications, see if he’s taking them as prescribed, and coordinate follow-up care with the psychiatrist. If he’s not already in treatment, forget negotiating. It’s time to call the doctor. Even if he says he’ll never forgive you for calling, it’s still important to get help. In time, you’ll be forgiven.


HOW TO HELP SOMEONE WITH SUBSTANCE ABUSE PROBLEMS
Including alcoholism, drug addiction, gambling addiction and pornography addiction

help_scared_teenager.jpgOne of the main features of substance abuse is the tendency to blame others for your problems or to deny that a problem exists.

It’s a waste of time to debate someone who doesn’t want to confront her problem. It’s better to present your evidence directly: “Kris, I think your drinking is getting in the way of work.” If your friend is open to talking, you can start a dialogue. If, instead, she defends or denies, reinforce that you’re available to talk later and walk away.

If the substance abuser’s activities are dangerous to you or others in your home, you may need to ask or force—by police if necessary—your family member to leave until she gets treatment. Remember that there are good treatment options for substance abuse problems, including Alcoholic Anonymous, Narcotics Anonymous and medications. There are also support organizations for you, such as Al-Anon and Alateen.


HOW TO HELP SOMEONE WHO HAS SELF-DESTRUCTIVE BEHAVIOR
Including smoking, overeating, neglecting hygiene and living in an abusive relationship

People don’t have to have an addiction to need psychological help. Those who smoke, overeat, or neglect their hygiene or safety have problems everyone else can see. And odds are, they know they have the problem. I ask all my patients who smoke whether they realize it’s dangerous, and so far every one has said yes. Obese people know they’re obese. Nail biters know they have no nails. Domestic-violence victims know they’re living in danger.

So if all these folks know that there’s a problem, why don’t they just stop? Because they can’t. Call it addiction, call it self-punishment, call it bad habits, call it lack of self-esteem. The problem is, you don’t know what to call it because it’s a professional’s job to figure it out. And that’s where your friend or family member should be looking for answers. (By “professional,” I mean nutritionist, doctor, therapist or physical trainer.)

Because your friend can recognize the problem, approach him in a collaborative way, by saying, “I know you’ve been having a hard time managing your ______. Is there any way I can help you get it under control?”

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If behavioral changes are necessary, consider the fact that, in a supportive effort, you might also have to start an exercise regime or quit smoking. Pitch in and make solving the problem teamwork.


Part of caring about loved ones is knowing when they’re having trouble, and part of being an important component in their lives is sometimes stepping forward and help them see when they need help. If you act lovingly and respectfully, you can make your relationship grow even stronger.


Board-certified psychiatrist
SCOTT HALTZMAN, M.D., wrote The Secrets of Happily Married Women and The Secrets of Happily Married Men. He's also medical director of NRI Community Services , a behavioral-health organization in Woonsocket, R.I.

Last updated and/or approved: April 2010. Original article appeared in July/August 2008 former print magazine. This article is not meant as individual advice. Please see our disclaimer.

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Comments (7)add comment
0
Finding ways to convince
written by Drug Rehab Anaheim CA , February 07, 2014

Helpful post!As I read it, some good ideas comes in my mind.

I have a friend who's an addict on some sort of drugs like heroin, weed and meth and an alcoholic too. Actually I want to help him, but I really don't know what to do. And as I read this article, I found some ideas on how I can help my friend. Yes I understand that they are always denying it, I always talk and ask my friend but he always says that he is not an addict. I think that asking is not a good way for me to convince my friend, maybe trying to talk to him sincerely and make him feel that I'm and his family always care and there for him is a good option to convince a friend to undergo on a rehab center and be cured and sober. Yes I'm thinking that a rehab is the way now to help my friend. I have one here at my name, I found it through my searching but I'm not yet knowledgeable about it. Hopefully I will get some suggestions here if I'm in the right way.

Thanks.

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Sister of an alcohol addict
written by EV , February 12, 2013

I feel helpless too see that my brother is letting himself die. He doen's seek help and when he does, he relapses every single time. This has been going on for years and to top it of he doen't eat well and is depressed. I feel hopeless. Any advice wold help.
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The physical effects of alcohol and addictiion.
written by Bill Keating , September 10, 2012

I'm an alcoholic who's co addicted to internet pornography. I can't begin to describe how unhappy I am. The problem with rehabs in general is that while they make a good effort, addiction has a physical component that alters brain chemistry. This explains why addicts have such a high relapse rate - they crave the dopamine released in their brains. This craving means they are willing to take chances that risk health (including liver damage, heart damage and death). I don't think anyone wants to drink themselves to death but they just can't help it. Even cold turkey alcohol detox is dangerous sometimes causing delirium tremors, seizures and death. Who wants that risk unless there's a powerful draw to the substance. A well know British pop-star, Amy Winehouse died when she tried to detox cold turkey. Every few months I relapse and commence a drinking binge for a few days to a weak where I drink whole bottles of whiskey. Pulling out is hard, my potassium level drop o the point where it's difficult climbing downstairs,, and I feel horrible for about a week, sometimes two.
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cafe owner
written by coffeeguy , April 29, 2011

The trouble with most of these problems is that the victims they'll usually lash out at those closest to them making it very difficult to have advice accepted, not to mention acted upon! It very often is a lose lose situation.
I know, I was once an alcoholic suffering from severe depression

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Meditation as a great option
written by Michael , February 25, 2011

My work in Meditation has brought me to interview Dr. Zindel Segal who is the research head of a study that found that Meditation treats depression relapse better than anti-depressant drugs.

I would highly recommend in addition to the options listed above to provide the option of Mindfulness Therapy - there is no religious association to it, you simply learn to view your thoughts in a state of no-judgment to them releasing you from the debilitating effects of Rumination.

Wishing all of you goodluck in your mental health endeavours.

All the best,
Michael

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More to treatment than the 12 steps
written by Charles Somer , November 15, 2010

I wholeheartedly agree that somebody with substance/alcohol abuse problems cannot be coerced into treatment. However, there are many non-12 step treatment options such as Rational Recovery, Women for Sobriety, Orthomolecular Alcoholism Treatment and so on.

AA has only a three year success rate of 5%!! In other words, only 5% of alcohol dependents who attend an AA meeting are sober 3 years later. Is this an effective method? I don't think so, you wouldn't accept figures like these in any other field of medicine without at least looking for alternatives.

It seems many in the medical profession have given up and just accept the shortcomings of the 12 step method.

It is time to wake up.

Thanks

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written by Ana Almanza , May 03, 2010

My boyfriend stresses me out like Major Crazyness.I dont know if thats why i have depression.
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