How to deal with depression

By on May 31, 2009

Photo © Elena Derevstova



Since I moved to Tokyo, it seems that my wife does not get out of the house and have friends like she used to.  She is always tired and does not have energy to do activities with me on the weekend.  This is completely out of character and I am worried that she may be depressed.  I discussed this with her but she denies that there is anything wrong.  How can I convince her to get treatment?  John


This is a thorny problem for both the significant other as well as the therapist. First of all, once the therapist receives this kind of request, it is already clear that the ill person in question is not much interested in getting help. Persons with depression have too little energy to leave home and feel hopeless, and persons with anxiety often have even more anxiety at the thought of leaving home and meeting a therapist. Many persons with either problem often feel, “there is nothing wrong with me, I’m just in a little funk and this will pass.”


Sometimes if the significant other tells their ill partner that they will go to the therapist and will call them from the therapist’s office, the person in question may agree to speak on the phone with the therapist. Sometimes, it may be effective if the significant other calls the ill person from the therapist’s office even though they may have declined talking to the therapist before-hand. On occasion, a spouse who moves out of their home may effectively persuade the ill person that they need to get help, although this is a maneuver that requires consideration of the potential risks. 


At the end of the day, however, unless the ill person in question is an immediate danger to self or others, everyone is free to refuse treatment and this human right must be respected. If a person is only moderately ill, sometimes waiting until they get worse will result in their acceptance of therapy. 


One final twist: on rare occasions, the person who complains about their ill significant other may actually be the person who needs help, and the person they complain about may be just a projection of their own illness into a significant other as a defense mechanism to disavow themselves of their own illness.


Doug Berger, M.D., Ph.D.


Dr. Berger and his staff at the Meguro Counseling Center in the Shibuya-Ebisu area provide mental health care for individuals, couples, and families, in both English and Japanese.


The discussions herein are meant as general information and advice only. Each person needs to make their own personal life decisions and to contact a mental health professional for consultation if deemed appropriate.


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