Question:
It feels like this is catching. What can I do to ease my partner into trying something to help. I know they are capable of the activity of reframing their thoughts but when and how to approach leave me shaking. Family history of bi-polar. I see anxiety, depression and occasional self medicating. SSRI do not help. I see the patterns even before they do. We are now into a lot of doom and gloom and I have no choice, overwhelm etc. It does cycle with PMS being the time I wish I could go into hiding, not from meaness but from the personal self talk that is mean to her.
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- Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
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Answer:
It can be difficult to talk to someone you love about seeing a psychiatrist about taking medication and going to therapy for depression. At first, some people do become offended because they do not want to admit something is wrong. They may feel stigmatized by admitting they have a mental problem. If your partner has a family history of Bipolar disorder she may be especially sensitive about having a problem because of things she remembers happening in her family.
At the very same time denying that a problem exists can be dangerous. Your partner may have a bipolar illness or she may be experiencing a major depression. In either diagnosis there is always the danger of suicide and there is always the fact of emotional suffering.
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I would recommend a soft and gentle approach in which you let her know that you can see how unhappy she is and that you are worried about her well being. It could help if you let her know that it would help you if she saw a psychiatrist in order that you would not worry about her as much as you do. If she refuses then drop the topic and bring it up again in a few days. It is when you see her in pain that you will have the best opportunity of making a real impression on her. There is never an easy way to do this but it is important that you manage to get through to her about the seriousness of the situation.
Yes, cognitive behavioral psychotherapy is very helpful for people with depression and bipolar disorder. However, depending on the seriousness of the case, it is often necessary for treatment to begin with medication. I
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f your partner has a bipolar disorder then SSRI medication would not be indicated because it worsens the symptoms. Instead, she would need to use mood stabilizer medications to control the bipolar symptoms. She really needs a psychiatrist to see her and make these decisions.
In addition to encouraging her to get help I want to suggest that you get help for yourself. It is painful and anxiety provoking to live with a depressed or bipolar person. Psychotherapy would help you understand what is happening to her and you might learn some ways of getting her to seek help.
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