[boomer]

I am trying to help my best friend, in receiving help for major depression. She's tried 2 different Psychiatrists now and 2 different meds...neither the meds nor doctors seem to have helped anything. I truly feel she needs some daily couseling and support, to establish a kind of "baseline" for her treatment...the problem is that she travels a lot for business and can't even get to her current doc but maybe once every couple of weeks - and then it's only a 30 minute session !

I really feel if she were able to check in to a facility for a couple weeks or more, she might then have an opportunity to actually start receiving the treatment she needs. She seems semi-willing to do it, but I'm needing more info.

Does anyone know where I can find out about such facilities in certain states ? I know she would prefer more of a "private" setting, versus staying in an actual hospital. I also think group therapy would be an important part of it. Any suggestions/ideas would be greatly appreciated. Thanks.

[SeptemberMorn]

Boomer, your friend's psychiatrist would be more able to answer the question of in-patient care in your area. I was in a county facility and I know they don't like to admit you unless you are suicidal or have suicidal ideation. Don't know what it's like for a "private" place.

If she has tried only two meds, really...that's just getting started. I completely agree with SM, unless she is suicidal, an in-patient stay is just not the place for her. A two week stay would be of little benefit in stablizing her on a medication, since it can take 6-8 weeks for a medication to become fully effective. Is your friend seeing a therapist in addition to a psychiatrist? Most people see the psychiatrist (pdoc) for meds, and a therapist (T) for the talk therapy.

You are a good friend to be so concerned.

Emmy

"If you want others to be happy, practice compassion. If you want to be happy, practice compassion." -- The Dalai Lama

[dexter]

I agree with the other suggestions here. I believe that therapy is an important part of treatment. The meds do not "cheer you up" they simply correct a chemical imbalance that makes the depression impossible to lift. Once the chemical imbalance is corrected, therapy becomes more effective.

Also note as others have said that it can take several weeks for the medications to take effect, and it is only after that period that it can be properly decided as to whether that medication is helping or another one should be tried.

Therapy during all of this will help her develop the coping skills she needs to fight the depression and will help get out of the depression as the medicines begin to take effect.

I would focus on trying to convince her to take the time necessary to receive therapy, and let the therapist help her decide how much treatment is needed. Group therapy or private therapy, how often, etc. There are programs that offer intense therapy every day. If she is in bad shape, but not necessarily in danger of hurting herself, this may be a good option.

Good luck and keep posting here for more info and support!

-- The world is what we make of it --
-- Dave
-- <A target="_blank" HREF=http://www.idexter.com>http://www.idexter.com</A>

[mj14]

boomer, I went to a day treatment program for a couple of weeks, and found it very helpful. It was about five hours a day, where we attended various therapy sessions. For people who are not in immediate danger, the people at the center I go to recommend it over full in-patient treatment. Especially if your friend's work is contributing to her depression, it may be a good way to get her into some intensive therapy, as well as regular monitoring by a doctor. Her psychiatrist should be able to let her know what day treatment programs are available.

But even if she can't do that, there should be group therapy available to her, and she could certainly see a therapist more regularly than she is seeing the psychiatrist.

Good luck.

mj

[(JD)]

Hmmm If she won't take time out for decent therapy as out patient, she probably won't have any lasting effects from in patient.

In patient is for stablization, and formatting of a plan for out patient therapy. It is reliant upon the patient complying with agreed-to arrangments.

So I agree with the others, she has to decide she worth it, and take the time now out of her too-busy schedule for on-going serious help. IMHO

<font color=green>...I can misspeak like the best of us</font color=green>

[boomer]

I hadn't actually thought about day-treatment facilities...that may be a better idea. It would still allow her to receive the benefit of daily therapy/discussion - without feeling she's been "institutionalized" (a normal feeling, I imagine).

Just for the record, the 2 meds and therapists she has tried have both been over about a one year period. My reason for wanting her to go to an 'all day' treatment schedule is not to get her stabilized on medications, but rather get her stabilized on therapy itself. In addition, she needs to be able to talk candidly and openly with others who are experiencing the same pain.

Since I've never dealt with serious depression, I truly can't understand what she's feeling...all I can do is be a sounding board for her and provide reassurance that she CAN and WILL get better.

Just a side note here: What is your opinion of a 30-minute therapy session ? To me, it just doesn't seem like that's enough time to even BEGIN developing a relationship with a therapist...especially when it's only once a week at best. In reality, it's more like 20-25 minutes of actual "discussion".

[dexter]

I also think that a day program can give better "results" than a short therapy session. Even if the session is an hour that is still pretty limited.

I was in an "intensive outpatient program" which is just a little less than a day program. Where a day program is maybe 6 hours a day my IOP was 3 hours a day, 5 days a week. Even that made a huge difference. That may also be a good choice for someone who wants to remain working part time during the treatment period.

With my therapist now I always feel like I would like more time when the sessions end. In the IOP, even though there were 5-10 people in the group, so technically less time per person for speaking, I always felt very satisfied at the end. Two excellent therapists ran the group, part of the session was for therapy and part was for education, but they were very flexible about that depending on how the course of the day went. The "group dynamic" helped a real lot for me.

I am glad that you realize that it takes time to establish a "relationship" and trust with a therapist. Sometimes a therapist may not "click" with a patient and a change is needed. It is important to realize that so that someone doesn't try therapy, say "that did no good" and give up. I believe the same can be said of day programs or IOP. The IOP that i was in was very helpful. When my insurance stopped paying for it, my therapist was able to get me approved in a different IOP program. This one was much more structured... 45 minutes for each "segment" and then it went to the next part, even if there was a "flow" going during that session and not everyone had a chance to speak. In this second program also the day and IOP programs were combined. I simply left after my 3 hours but I felt like I was not getting full benefit, for example maybe an educational segment scheduled in the afternoon for after I left.

This second group was very effective for some of the people there, so I'm not saying it was bad, but, like therapists it may also require somewhat of a personality match.

>> Since I've never dealt with serious depression, I truly can't understand what she's feeling...all I can do is be a sounding board for her and provide reassurance that she CAN and WILL get better.

Support and friendship is very much needed by people suffering from depression. So being there for her, taking an interest in her illness and her treatment, and encouraging her to find treatment that will help her really is a huge positive thing you are doing for her. Not everyone suffering bipolar or depression has someone like that in their lives. Learning about the disease, for example seeking out this website and posting here, is also a great thing to do. It shows her that you care enough to take an interest and also helps you be more confident in how to help.

I wrote a paper on depression that may help with some more information. It is available at http://www.idexter.com