Depressed Helper

Dear Grace,

You are wonderful. I wish more people were like you; doing everything in your power to help your friend. This is why I chose your question to answer, although I normally like a lot more information to work with, and also an email address so I can send my reply directly.

First, about your friend (though this applies to you too): You say she is currently undergoing therapy and is on medication, but it doesn't seem to be working. I suspect that your friendship is of more value to her than what the "experts" are offering.

One of my rules is: "If something works, do more of it. If it doesn't work, try something else." There are many approaches to therapy. If what she is getting is no good, she should go elsewhere. I suggest she look for a psychologist who uses Cognitive-Behavioral Therapy. In particular, seek someone who is competent at using the technique developed by Aaron Beck.

Beck has written many easily readable, non-technical self-help books for people suffering from problems like depression and anxiety. Find them, read them, and act on them - both of you. You would also get a lot out of reading my book: "Anger and Anxiety: Be in charge of your emotions and control phobias". If you check out my web site, I have posted a great deal of helpful information.

The final point for your friend is that she has the power to turn her life around, you don't. No one but her can do it. I was also severely depressed when I was your age, but got myself out of it. If you did, she can too.

Now, about you as a helper: This is a heavy load for you, because you are approaching it from the wrong angle. She will drag you down if you are a "fellow traveler" or if you are a friend. You can help if you stay apart from her emotions, that is, you need to be a problem solver. The dilemma is, 'how can I help her to see this differently'? By concentrating on your problem of how to help her, you will not endanger yourself.

When she is distressed and needs to unload on you, the best thing you can do is 'reflective listening': let her talk, and indicate in little ways that you have heard the message beneath her words. You might repeat back what you think she meant, and ask if that's correct.

However, when she is down, she will only see the bad. She will ignore, misinterpret, or rapidly forget good things. As helper, it is your job to find the good, and when you repeat back what she said, to include these exceptions into her current negative world view.

You know her. When she says something that is a distortion, overgeneralization, or inaccuracy, you need to challenge this with specific instances from her life. Or demand that she find such examples.

At my web site, read the pages on "Narrative Therapy" and "Cognitive Therapy". These, and chapter 7 of my book will help you and your friend. Have a good life!

Bob